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HomeMy WebLinkAbout1850 MAIN ST./RTE 6A(W.BARN.) - Health 850 IMain Street West Barnstable / A= 217-010 TOWN OF BARNSTABLE ✓ LOCATION ZE-52 SEWAGE # -Z000—3-510 VILLAGE U1. [��/'i1S�'fi��G ASSESSOR'S MAP & LOT /7-0/0 I INSTALLER'S NAME&PHONE NO. J-09—y20-9?738 VAs 4 fJ-t'Ys91A.-eS SEPTIC TANK CAPACITY 15100 Z29� LEACHING FACILITY: (type) /1rr 3� HC 440rS (size) 6, X IV NO. OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: //-3 —0 T COMPLIANCE DATE: 9—zS-6 9 Separation Distance Between the: 6- 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 %n4iezLzz, Gr two?/ TOY phCr;o'I Po�^l 3a a a No. Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS es ftpliration for Bisposal *pstrm Coustrurtion Vermit Application for a Permit to Construct(�' Repair(4)--15grade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No./8,f0 dl *i;l 92- Owner'sNWme,Address,and Tel.No. bwsoo Assessor's Map/Parcel Q/ -om Installer's Name,AA�ddress,and Tel.No. S'®g- Q&'d -77S'-Z Designef's Name,Address,and Tel.No.Sag-y7`7-,S-.3/3 ✓s5�eP6 /�� ,(fl4�"rOS FsM9r�/�cr/h�' cvo�t ks T t. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) x&:Erf�/SG© OV/ ,s-^ /2oivs of Y>x05 rc ,_(o He U`;Z_f 60 1, er A-,' 4ow Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of ealth. Sign d Date Application Approved by Date LL Application Disapproved by Date for the following reasons Permit No. '� -- � Date Issued i No. ,. Fee THEXOMMONWEALTH OF MASSAChUSETTS Entered in,computer: PUBLIC HEALTH DI S N TOWN OF AARNSTABLE, MASSACHUSETTS es ftphtation (or ;Disposal ipstrm Construction Permit Application for a Permit to Construct(4.' Repair(G)�pgrade( ) Abandon( ) ❑Complete System ❑Individual Components ,11 SrRr Location Address or Lot No./&fO ^#1 (i 14 Owner's,Nqrr►e,Address,and Tel.No. C�/i=f 7'/3f9rh3 rRd/� i I/ir'y�ni� �vhH,S'av! Assessor's Map/Parcel V/ _Old %/3 L 1,� gpl ir. t Installer's Name,Address,and Tel.No. 7,- I SO - 773 2 Designer's Name,Address,and Tel.No. ,S-ae-4/7-1-S`313 Jos.eP� Oe jyarro.s r'Hpo_--cf-,ryy wa./Q k5 Ir, _/1 / El /Zi/ /2 cv, vaSs rl Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd _�r Plan Date Number of sheets Revision Date Title ,_ Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) /.Sl,D 0w1 r"r,41 d I-211 f- leaW-5 a LE 5^ 1412...5 9 r,' -76 H U4;7 f f Date last inspected: Agreement: k The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Wealth. Sign d Date 'l Application Approved by Date i 1 1,,3 o Application Disapproved by Date for the following reasons Permit No. '3 Date Issued I THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(v) Repaired( L+ 'Upgraded( ) Abandoned( )by ,)-[ 94,,-as / at / 8 SD !y gi;-' ST 16 6# U1..9,1P-4'S has been constructed in accordance with the provisions/of Title 5 and the for Disposal System Construction Permit No. _350 dated O /3 Q Installer,1oS-G/OH 12Z 914, YdaS Designer 330 #bedrooms �� Approved design flo r�r gpd The issuance of thig permit srhall not be construed as a guarantee that the system willlunstilon as designed. Date ` u " Inspector --------------------- -- ------------------------------- - - =- �- ----------=----------------=-----Fee----------------= C 3 -- No.Q � ` /Q0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS disposal &pstrm Construction permit .a Permission is hereby granted to Construct( 4--). Repair( L)' Upgrade( ) Abandon( ) ,4 System located at AT G a. 9,4rWsr11.6/�- and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions, Provided:Construction must be completed within three years of the date of this Cb . Date 11 13 Approved %TOWNOFSBAiRNSTAiBLE . LOCA.MON VIL:Ll ,drP yv oyr�t Sr 41 ASSESSOWS MAP&Lp'1' MSTR LPIIt'S NAME A PROM.NO E1 G TANK CAPACITyf U3ACMG PACII,I l (iype) /c 3 i�U OP'i3laDR0OMS .:�.... t�BRNdITI�IeITE COi 'i[ ANCE 1RA'x'�E r' �Separatian�9��naa Betweefa kb�oi A2�ximumAci}usf d Cn�u�idwatet Tabletb tha grntamdLeading facility Pe1ya44 wpt6r Suppv v/OH`twd Leaahing PAcittty . arty�v$qs exist a eitcs ac within o bot of tassfuas fw lu ty) eai i cyf Wetlan 80d Leacbiog i ciiity.(ti' y WetLgds exist i � ivitlalj��UQ factaf teac�ting laeytity} . �`. } nlstiod.by < � f'z C, .�. " f O � 6 F Zqr3 - sS' %-3 67 Y ti f Town of Barnstable Regulatory Services Sl, Thomas F. Geller,Director • Public Health Division KAM ' ¢ Thomas McKean Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: G ==FF 6 Sewage Permit# d DO Assessor's Map/Parcel Installer&Designer Certification Form ��i-e,✓ c-. t-e.e S Designer: k c • Installer: Address: YZ W. Crel4 s-C�-tl cA 0_rJ\ Address: On J o• SV C, was issued a permit to install a (date) (installer) a �a ^- -01k 64-� W , � based on a design drawn by septic system at 1�5 (address) M C—&N t-�e� f dated (designer) _ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory.��� �;j, SeP-tL -fG,,.k +,if^k d q 6 0 -- �,% to 16,-A 2, 4vajale,, reg1r-kSk'.rA etsJeae l ha4-4x fo`rcke,c.>' I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation.of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required) was inspected and the soils were found satisfactory. V�N OFl�jtss�y 9 /Y-O?t -i i PETER T. (Installer's Signature) o WENTEE U CIVIL -0 9 No.35109 0 (Designer's Signature) (Affix Deg e) PLEASE.RETURN TO BARNSTABLE PUBLIC HEALTH DIVISI N. CERTIFICATE OF C MPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM.AND AS- BUILT C`'RD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gloffice fonrAdesignercertificarion fonn.doc WF-3% b�9,L N I Wate e< , �r• Pond ,got/��y EX/S7iMfiG CESSPOOL o t" t g8' PERMISSION SHALL BE OBTAINED a dge. -2/�!. FROM ABU77ER TO PUMP, FILL S WITH SAND AND ABANDONED OR LOCUS 09 0k 5 Z a DISCONNECT AND ABANDON .g ag b e R /Edq i } F 04te o x 96°3 `' 2 g2 rn 61 0 j (/ r Benchmark Set TOP CONC. BOUND e°�+a,, oo �`, �s EL.=100.43 (Assumed) i. ff 95 ��ceydh��FAff LOCUNOToSSMAP CALE r QSTING CONTOUR / PROPOSED og XISTING SPOT GRADE SEPTIC TANVERHEAD WIRES ROPOSED WATER LINE GARAGE 'C.2. . ,16 's OTTAI3LE WELL 0. 6 \03c 01 F TEST PR LEGM \p`S�,`� aq 1`4. �•�. EX. SAS C° S e +103• �`��`c^�'� °D N VENT �Cl \° �' ( x Opo.\0\ f �05 \ o (y V 4 a, EXIST. WELL y2' HOSn({G850) .(to be o I abandoned) �0 03 TOF. 1 74.+ ��oPa�F�CB dn �p PEC� o °p ,'as = 3 'av lay, \06•, EX. S P71C TANK bo q 4. c' p Ep 7a� • oo ,o,yo o z. �` p2 HODS V g663 i W p0 qp m EX. SAS q 1? . o EX. WELL cw 'n 100 r P SED 1... f Co M WELL J 98 split roll fence i 2q N o �C - EXIST o q� 012 BAR , .SEP77C TANK t •� � . qy3 � 9g2\ I. f qb HOUSE 1I1866 ,1 Co •�qb g2 � Pb m b4 m rn q 9 3 0 32,022tS F. 603 Map 217 +q Q s'ewo Parcel '010 q1by� - a q1 0" 1 02 EX WELL 20 90. q G a 35• w catchbas'HOUSE a �1 11837 PROPOSED SEPTIC SYSTEM UPGRADE PLAN EX. SAS 1850 MAIN STREET RTE 6A , WEST BARNSTABLE, MA Prepared for. Virginia Johnson, 113 Linden Street, Hyannis; AAA 02601 OWNER OF R—ECORp Engineering byY SCALE DRAWN JOEL NO. LEEMAN, LILLIAN V., ESTATE 0 C/o JOHNSON, MRGINIA Engineering Works,Inc. 1'_�' P T M 194-09 113 LINDEN STREET 12 WmA Crossfleld Road„Farestdole, AEA 02644 DATE CHECKED SHEET NO, HYANNIS, MA. 02601 (506) 477-5313 9/25/09 1. P.T.M. 1 of 2 f o2/-7-010 Commonwealth of Massachusetts 3 Title 5 Official Inspection Form ICI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St7 Property Address ^; Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 0 page. City/Town State Zip Code Date of Inspection rO Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. Inspector Information 51:w- (s Soo f Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000);1 have personally inspected the sewage disposal system at theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails ' I 5-3-19 'Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts - Title 5 Official Inspection Form Ylrl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St 1._VI Property Address Craig Everhart Owner Owner's Name information i e W. Barnstable MA 02668 5-3-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: System is in good working order with no sign of failure. 2) 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): J Y t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts a ;w Title 5 Official Inspection Form it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 p Y rY ys: 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA .02668 5-3-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y N El ND (Explain below): ❑ distribution box is leveled or replaced ❑Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced El ❑N ❑ ND (Explain below): ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. i a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts 1� Title 5 Official Inspection Form Y1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St .:.r• Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary(cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 9 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and.the presence of ammonia nitrogen and 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. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes'- No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev:7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts 1� 3 Title 5 official Inspection Form • it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis..[This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. E] ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems:To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 k� Commonwealth of Massachusetts Title 5 Official Inspection Form .w pi' Subsurface Sewage Disposal System Form Not for Voluntary Assessments " .. >" 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ Z. Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not ' available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 C ,` Commonwealth of Massachusetts 1u� Title 5 Official Inspection Form -i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? t ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 5-2019 Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 c �� Commonwealth of Massachusetts Title 5 Official Inspection Form h. I, *I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day•(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 ram'° Commonwealth of Massachusetts r� pl,, Title 5 Official Inspection Form ! i,�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19' page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 2009 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 30"feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Good condition. i t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts r� 3 Title 5 Official. Inspection Form %I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 24"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 Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 0 Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. t5insp.doc-rev.7/26/2018 Title 5 Official Inspedon Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts fi Title 5 Official Inspection Form �,rF Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank (tank must be pumped at time of 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 t5insp.doc-rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts Ir' Title 5 Official Inspection Form w:� �i-Ii Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1. >" 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ .No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box(if present must be' opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover;any evidence of leakage into or out of box, etc.): Good condition with water at working level and no sign of back-up from field. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 61 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St J Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 . page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 25 Arc 36's ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts jFEW= Title 5 official Inspection Form wa irk Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) = 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach field in good working order and empty at inspection with no sign of back-up into d-box or surrounding soils. 12. 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 n Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 s Commonwealth of Massachusetts ,w Title 5 Official Inspection Form bl Subsurface Sewage Disposal System Form -Not for Voluntary Assessments /ol 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.WM2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form w_, "i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately XL___ lr ........... .� ..� I r `. 4 t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 r Commonwealth of Massachusetts fi Title 5 Official Inspection Form N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts ,. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1850 Main St Property Address Craig Everhart Owner Owner's Name information is required for every W. Barnstable MA 02668 5-3-19 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System.drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Town of.Barnstable r# Department-of Regulatory Services s Public Health Division Date, �1 I s619. 200 Main Street,Hyannis MA 02601 Date Scheduled - � � Time / Fee Pd. Q 0 0 �. Soil Suitability Assessment for Sewage Puposal Performed BY: '1 �Cy� e 1 Witnessed By. r,J LOCATION& GENERAL INFORMATION s Location Address ��Q i � S t Owner's Name i—i I I'C,V. L .--i" ," a e • 1 k1 to S c t Address to3 L Nlx M. Sa- Assessor's Map/Parcel: 217 (7 l Q . Engineer's Name n�� f NEW CONSTRUC nON REPAIR Telephone# � --73.7 4-7(D.�r Land Use k� S ,Q.vt 4 ( Slopes(%) � t� .Surface Stones a ,_ / Distances from: Open Water Body f i / ft Possible Wet Area Drinking Water Well�--ft Drainage Way 2!f� ft Property Line ft .Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holds&perc tests,locate wetlands fn proximity to holes) ZE � 1 Parent material(geologic) Depth to Bedrock > r r !� Depth to Groundwater. Standing Water in Hole: � �ai�a y. Weeping from Pit Face Estimated Seasonal High Groundwater -G tc © C>rt DETERMINATION FOR;SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: In. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. index Well,# - Reading Date: Index Well lever-„ Ad),factor. ._ Adj.Groundwater Level e PERCOLATION TEST Date Thne..��. Observation — Hole# Time at 9" y� Depth of Pere ` �08 L Time at 6" 2-` Start Pre-soak Time® �_ Time(9"-611) End Pre-soak Rate MinJlneh Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC • j l DEEP.OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture.- Soil Color Soil Other Surface(in.) (USDA) (Munselq. Mottling (Structure,Stones;.Boulders.. Consistency, vl 2 �� �� ►�� g6 CL SL S11�- co �5r 'DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders._ _ Consistency, 4 r L 1c r257e L La Ya,51 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. �. Consistency. Gravel)- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,`Stot►e0 Boulders. isten Flood:Insurance Rate Man: Above 500 year flood boundary Na= Yes Within,500year`boundary No2(1- Yes,.;; Within 100 year flood boundary No Yes Death of Naturally Occurring Pervious Material Does at least four feet.of naturally occurring pervious material exist in all areas.observed throughout,the area proposed for the soil absorption system? �1 If not,what is the depth of naturally occurring pervious material? Certification i� . (date)I have passed the soil evaluator examination approved by the I certify that on _ Department of Environmental Protection and that the.above analysis was performed by me consistent with . the'requred ` g;expertise and experience described in 310 CIvIR 15:0`17. _. Date Signature Qi\SEP79C�PERCFORM:DOC dC r Massachusetts Department of Conservation and Recreation M—s—h—errs Office of Water Resources Well Completion Report 17-NOV-09 11:08:18 WELL LOCATION 267200 GPS North: 410 41.805' GPS West: -700 20.745' Address: 1850, Route 6A W �a - 1 Property Owner/Client: c/o Clifford Well Drilling Subdivision Name: Ica Mailing Address: P.O. Box 430 City/Town:Barnstable City/Town, State:South Yarmouth MA Assessors Map: Assessors Lot #: Permit Number:W2009-026 Board of Health permit obtained: Y Date Issued: 10/25/2009 Work Performed Proposed use Drilling Method Overburden Drilling Method Bedrock New Well Domestic Auger CASING From (ft) To (ft) Type Thickness Diameter 1.00 -69.00 PVC Schedule 40 4.00 LU CN —I — SCREEN F ) To (ft) Type Slot Size Diameter -64 00 -72.00 Stainless Steel Well .012 4.00 m co Point Z ' Lrl WELL SEAL / FILTER PACK / ABANDONMENT MATERIAL p � From (f )-� To (ft) Material Description- - • Purpose- WELL TEST DATA (ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) Date Method Yield Time Pumped Pumping Level Time to Recover Recovery (GPM) (hrs & min) (Ft. BGS) (Hrs & Min) (Ft. BGS) 10/28/2009 Constant Rate Pump 20.0000 1:30 16.0000 0:01 12 STATIC WATER LEVEL (ALL WELLS) PERMANENT PUMP (IF AVAILABLE) Date Depth Below Ground Pump description: Measured Surface (ft) Type: Intake Depth: 10/28/2009 12 Nominal Pump Capacity: Horsepower: WELL DRILLER'S STATEMENT ADDITIONAL WELL INFORMATION Driller: Thomas E Desmond III Developed: Yes Fracture Enhancement:No Supervisor: Thomas Desmond III Rig #: 100 Disinfected: Yes Well Seal Type:None Firm: Desmond Well Drilling Inc. Total Well Depth: 72.000 Depth to Bedrock: Registration #: 764 Date Complete:10/28/2009 Comments: _ OVERBURDEN From To Description Color Comment Water Loss/Add Drill Drill (ft) (ft) Zone of Fluid Stem Drop Rate .00 20.00 Cobbles Brown Yes N/A ` 20.00 60.00 Silty Clay Brown Yes N/A 60.00 72.00 Fine to Coarse Sand Brown Yes N/A BEDROCK From To Code Comment Water Drill Extra Drill Rust Loss/ # of (ft) (ft) Zone Stem Large Rate Stain Add of Frac • Dron per ft 1/1 is No.-------------------- Fee-------------------- BOARD OF HEALTH TOWN OF BARNSTABLE ZippIicat ion,for Well Construct ion Permit Application is hereby ma for a it to C nstruct (�- , Alter ( ), or Repair ( )an individual Well at: �j Qt --1--°--`S� -------f'` -S -- --"`'' ems --- — — ---- ———--- ---- �. Location — Address Assessors Map a d Parcel C Owner Address 7 Installer — Driller Address Type of Building Dwelling------- ''---f------------------------------- Other - Type of Building ------ No. of Persons-------------------------__—_________ . Type of Well— `�—--- - ---— -- Capacity-- . � ------------------------- Purpose of 1!Uel1 ����- �e_� -- --------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Prot ction Regulation — The undersigned further agrees not to place the well in operation until Ce i ' ate . ce has been issued by the Board of Health. Signed - - - ----- — -/®- --(>--�(-'— �� date Application Approved By --- ---------------------------- -----_-- ---- ------------ date Application Disapproved for the following reasons:-----------------------------------—--------------------------—----- ___________ -- —-----------_--- — ----- - -----------------------— - -- — - -------- Q f a 6 01 - d ;L pp date PermitNo. --�—/--- ---- ---- ---------------------- Issued------------------------------------------- — --------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS✓IS�O CERTIFY, That the Irldividual Well Constructed (Z- Altered ( ), or Repaired ( ) ----------------------------------------------------------------------------------------- -- ------ ---- ----------- Installer -------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection �t — 0�� Regulation as described in the application for Well Construction Permit No. -------------------------Dated------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- --- — - —-------------------------- — -- Inspector-------------------------------------------------------------------------- , No.-------------------- Fee--------------------- BOARD OF HEALTH TOWN OF BARNSTABLE ApplicationArVell Co0tructionpermit Application is hereby mad fora a it to Construct ( GJ, Alter ( ), or Repair ( )an individual Well at: i —— S --- - c I • � .:__- Location — Address -- — � —ssessors Mapan Parcel ( 1 s t Owner Address Installer — Driller Address Type of Building Dwelling ------------------------------- � --E- I Other - Type of Building--------------------------- No. of Persons------------------------- i Type of Well----C41-L-�f---- - -------- Capacity--- - r� -- ----— Purpose of Well -�G ' ��' --- — ------- -- I Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the in operation until,a-Cer if' ate .o nce has been issued by the Board of Health. � Signed ------ - --- --1------ `S ° ' - � Application Approved By--- ___— _—___-------------------------- --------- --------- ----------- I date Application Disapproved for the following reasons:-----------------------------------------J--------------------_-___-_-______________ 4k ------------------------------------ ------ __ 6 01 date I dr 1 1p PermitNo. ---�----------------------------------- Issued---------------------------------------------'------------------ � date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS CERTIFY, That the In ividual Well Constructed (Altered ( ), or Repaired ( ) L ¢------ — — ------------------- --------------------—------------------------------------- — —----------- ---- --------- Installer -------- at --o6e--------- ----------------------------------------------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection j Regulation as described in the application for Well Construction Permit No. --------------------------Dated------------------------ r I THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL j SYSTEM WILL FUNCTION SATISFACTORY. DATE- --- - - - -- - - ---- - -- 4 Inspector-------------------------------------------- - ------------ BOARD OF HEALTH �I TOWN OF BARNSTABLE lVelf Con0ruct ion Permit W a od j - G�� qS No. ---------------- . Fee----- Permission is hereby granted-; ---- �_�_1�%-_--_------_-__ to Construct ( Alter ( )�or Repair ( ) an Individual Well at: No. - ---------- - -"��-' ==—-�� �-� - - - - ------------------------------------------------------------ street as shown on the application for a Well Construction Permit a I_d C7 No. - O4 — - - Dated--- -G -w d� --�- -�� --- — ' - ----- --------- ------- - � Board of Health DATE -- ----------- -- I 4 Pond vlo �t EXIS77NG CESSPOOL g t ga' PERMISSION SHALL BE OBTAINED e / FROM ABUTTER TO PUMP, FILL WITH SAND AND ABANDONED OR LOCUS .-'fig o 2 9Q DISCONNECT AND ABANDON „ R e e 0 4te 6 i3 moo. q ° qti Benchmark Set &6 o a.' TOP CONC. BOUND -'a fls EL.=100.43 (Assumed) g0" �o '1 9a LOCUS MAP O .,Og. CB/dh EF�'R NOT TO SCALE ♦ ...-101— EXISTING CONTOUR 1o0.9e EX1SnNG SPOT GRADE PROPOSED p�•- � j' —BHW—OVERHEAD WIRES SEPTIC YANK ♦O♦ �- p�0$ s \ —w PROPOSED WATER LINE 1 POTTABLE WELL i 'GARAGE\,� .i/_•... ... I2 ,021�6�,o a>6s., ® TEST PIT -" ro ..04Q —1 F•-�O i fi :♦03 0 -2 ?7p2 a LEGEND EX. SASg ♦03 �O' ,j, ��.. VENT ea0e bp0 10�$�A 76 O� q� Inf- ♦o�' EVSA G e EXIST. WELL �pbL''. ".T USE °c o (to be J/o Cbondoned) i%j c, I N$dbh 03 �, G '1 0o /0R 1pb 1pb, EX. S PTIC TANK b C4 2� 0iUX '`- 0� Oa AQ - e -Iota " - ♦O�y0 `j A3 A� GARAGE, HODS `I 91 l `o' y183 b3#W �o o 4- EX. SAS 0b 9� IS 0 EX WELL N if, n P WELL o o° zsplit ra0 fence to =' EXIST. 0� $ �622 SEPTIC;TANK SAR'' 4, P866 t : c �j b m � 3 3 0 32,0221S.F. boa a• Map 217 +9 s,eWa Parcel 010 �bh� by Q2 (.I EX WELL 01 T8g O 9 �1 fib. N 41 •20• b� Mg1jI S 9e ` w catchbosrp3 � HOUSE �a ,41&37 ` Dr �'ss* 6A) PROPOSED SEPTIC SYSTEM UPGRADE PLAN M Ew EELiNqL 1850 MAIN STREET RTE 6A . WEST BARNSTABLE, MA EX. SAS ENT No. 35109 Prepared for. Virginia Johnson, 113 Linden Street, Hyannis, MA 02601 �0 OWNER OF RECORD Engineering by: SCN.E DRAWN JOB.N0. ��` LEEMAN, LILLIAN V.. ESTATE 0 t"=30' P.T.M. 194-09 �„ ♦ c/o JOHNSON, 14RGINIA Engineering Works,Inc. U 113 LINDEN STREET 12 West Crossfield Road, Forestdate. MA 02644 OATE CHECKED SHEET N0. 6C( HYANNIS, MA 02601 (508) 477-53t3 9/25/09 1 P.T.M. 1 Of 2 f 3YOjoOD TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS .. 0-8 r C7� ASSESSORS MAP No. `.J PARCEL NO. ( I've �JA ,(z 1- 3 JADDRESS. Route 6 and Route 132 VILLAGE' BarnS IT - P NAME' Gulf SerFrice._.Dtation (Saeed Chaudhry-Manager) .(617). 362-3207 or 362-8922 Massachusetts Department of Public Works _ CONTACT PERSON Me Ananian PHONE NUMBER (617) 973-7905 LOCATION OF TANKS: CAPACITY: TYPE OF FUEL. AGE: TYPE: LEAK OR CHEMICAL: DETECTION 8,000 gal Gasoline U SYSTEM: - -- K Steel � e 000 nal Gasoline 7=s Steel A 3/ 5,000 gal Gasoline 7yrs Steel k QQn gal rra.sol inn 7yrc S'{;P-.P,1 ✓#6 3 10,000 gal Diesel UK Steel #7 ?,2J 500 gal Used Oil UK Steel (Not Used) #8 11000 gal Heating Friel UK Steel DATE OF PURCHASE OF. EACH: 1. 2. 3. 4. 5. DATE GF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS 'See Attached PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. .7 rV1Ce St-3 ti C`T7 r.. ;toutL 1#2 L_ GAT C `Bari s ble, MA 02630 I• ' T Operatgr: >,• ,i y MobashA-r Zafar (61.7) 31,62-3207 Day/Night Telephone � Owner: Massachusetts Department of Public 'Works w (617) 9,73-7910 Day Telephone (617) �,,73-3100 Night Telepho ; S ARrA.3., � .. �•:..•.:::•.�...•..•..:•..::....•..},.._•_may.........•• •6-MCsr woww RCl'TE C ' :u =s. L t :as 1XV no CAST "a"-* Tank Capaoities and ContRQts: M14 of w. t ROYTC3 s tax • ` 1. 8,OQO gal-.* Gasoline ' Mumma food Fat l scALC„w.Surr• ( 1 > 2. 5,000 gal. Gasoline Coated 3-5-81 3. S,OOO gal. Gasoline 3-4-81 4. S,OOO gal. Gasoline 2-26-81 , o 5 5000 gal Gasoline `J � 3 J P . ne �� 3-8-81 _ 6.10.000 gal. Diesel 7. 500 gal. Used Oil R� • 8 - ,boo GAS • C4x�ecu.►�� ©��a���.e anc�T� ury, April 29, 1988 RE: 1988, BARNSTABLE Board of Health Underground Fuel and Chemical Storage Systems Mr. Thomas A. McKean, Acting Director Town of Barnstable Board of Health 367 Main Street Hyannis, Massachusetts 02601 Dear Mr. McKean: Enclosed, kindly find completed Underground Fuel and Chemical Storage Systems report for the State-owned Gasoline Station located at Route 6 and Route 132 in Barnstable as requested in your letter of February 1988. This Station is leased to Energy Distributors, Inc. , P.O. Box 2747 , Danbury, Connecticut 06813 . Please be advised that the requirements for the issuance of a Permit from the Fire Department have been submitted and a copy will be forwarded to you as soon as it is received by us from the Fire Chief . Kindly advise Mr. Saeed Chaudhry, the Manager of the Station in order that he may pick up the applicable brass valve tags. . Sincerely, a J A. Fanale, Director ght of Way Bureau Enclosure/Certified Mail Return-=Receipt MA/yb m WF-4 WF-3°j�oi1�o��°L e N f waterA�t Pond �o�e� �sa I EXISTING CESSPOOL o ak PERMISSION SHALL BE OBTAINED a d ke 2/�. J I FROM ABUTTER TO PUMP, FILL e/ `1 / /\ WITH SAND AND ABANDONED OR LOCUS 0 2/ ' \9 DISCONNECT AND ABANDON Ro ae I ut e .6 ,q Benchmark Set e°k� TOP CONC. BOUND o"°Oa \06' EL.=100.43 (Assumed) PR POSED I �O SE TIC TANS / ��� /� LOCUS MAP 00 / �° cB./dh �FF� NOT TO SCALE —101--EXISTING CONTOUR / x 1oo.98 EXISTING SPOT GRADE ---GHW--OVERHEAD WIRES —W—PROPOSED WATER LINE GARAGE — 102— 116� 0. O POTTABLE WELL O• TEST PIT o'` \o� n� p`� 110-- o°\ LEGEND EX. SAS N VENT ' o x 100 `� HOUSE(#1850) �e EXIST. WELL .yob' T.O.F.=108.74f 0 (to be abandoned) C dh� 03 / 1610a o 1 O' + gN � ti0�• 0 EX. S P TI C TANK o t i HODS 0,°�1� 1 GARAGE �#183 �� \ 1 +w > �o 'I o, EX. SA S EX. WELL N P SED I.� w WELL o i — 98— °1 ? split rail fence �� kP � �_ EXIST. o • ���� ��22 \ 4-- `o. BAR SEPTIC ANK A HOUR, + + , #1866 0 co 032 a Q �� �� 3 0 32,022±S.F. ��03 Map 217 + S%d��ak Parcel 010 1 c0l� �0 88 2D, EX. WELL M00 �O9e _ N 41 Al 34 3 N S � of ,00Ve • �� 41L --� � 1'3 23 ���� 01� gent si e J� catchbasi�n� HOUSE fj'q� °��• #1837 44ss / PROPOSED SEPTIC SYSTEM UPGRADE PLAN EX. SAS PETER T. 1850 MAIN STREET RTE 6A , WEST BARNSTABLE, MA J McENTEE o CIVIL "' Prepared for: Virginia Johnson, 113 Linden Street, Hyannis, MA 02601 No. 35109 OWNER OF RECORD Engineering by: SCALE DRAWN JOB. NO. ' RfG SA �� LEEMAN, LILLIAN V., ESTATE OF Engineering Works, Inc. 1"=30, P.T.M. 194-09 9 G� c/o JOHNSON, VIRGINIA 9 9 113 LINDEN STREET 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. HYANNIS, MA 02601 (508) 477-5313 9/25/09 P.T.M. 1 Of 2 t.A. ! t c 71 NOTE: BREAKOUT,TO PREVENT F NISH GRADE S ALLLNOT BE PROPOSED :99 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET INSTALL WATERTIGHT RISER & INSTALL INSPECTION PORT OVER END UNIT AND SET TO 6" OF FINISH GRADE. COVER SET TO 6" OF GRADE ` T.O.F. PROVIDE ACCESS TO GRADE OVER OUTLET COVER CHARCOAL EXISTING F.G. EL.=102.Ot F.G. EL: 102.2t F.G. EL: 103.3(MAX.) VENT +� MAINTAIN 2% GRADE MIN. OVER S.A.S. INSPECTION L = 72' L = 3' L = 9'(MAX.) PORT ® S=2% (MIN.) ® S=1% (MIN.) ® S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC s" 1o"I s 10.38" TO 14" INVERT INV.=100.00 48' LIQUID INV.=98.87 r- LEVEL ADD INV.=99.72 (5 ROWS OF 5 UNITS AT 5.0'/UNIT) + 1.2' (1 COUPLER) = 26.2' Gas BAFFLE PROPOSED INV.=99.55 PLACE COUPLER AT END OF EACH ROW FOR VENT MANIFOLD INV.=99.75 � (5 OUTLETS) SOIL ABSORPTION SYSTEM (PROFILErn ) ' PROPOSED SEPTIC TANK FRALO ST1500 GALLON PLASTIC TANK BE SUBSTITUTED FOR CONCRETE TANK TIE IN TO EXISTING 4" C.I. PIPEI ESTABLISH VEGETATIVE COVER 2' FROM HOUSE, INV.=104.7 BACKFILL WITH CLEAN NATIVE OR PERC SAND TO TOP OF CHAMBERS NOTES: BREAKOUT=TOP =' TOP ELEV.=99.33 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=98.87 INVERTS, PRIOR TO INSTALLATION. " 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.=98.00 GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED 2.83' STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 4' MIN. SEPARATION TO "C2" HORIZON EFFECTIVE WIDTH=14.1' 3) •INSTALL INLET & OUTLET TEES AS REQUIRED. EXISTING SUITABLE 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE "C2" HORIZON, EL=91.7 = MATERIAL AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. USE 5 ROWS OF 5-ADS Arc 36HC UNITS + 1 COUPLER PER ROW WITH NO SEPARATION BETWEEN EACH ROW & NO STONE s TYPICAL SECTION SEPTIC SYSTEM PROFILE } N.T.S. SOIL LOG DATE: SEPTEMBER 23, 2009 (REF#12,709 SOIL EVALUATOR: PETER McENTEE PE, SE .(SE#1542) WITNESS: DAVID STANTON R.S. HEALTH AGENT ELEV. TP- 1 DEPTH EL- '- TP-`2 DEPTH ' 102.0 A O 102.7 A 0 SANDY LOAM SANDY LOAM 101.3 10YR 4/2 8' 101.9 10YR 4/2 10' GENERAL NOTES: _ B B SANDY LOAM SANDY LOAM 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 10YR 5/8 10YR 5/8 BOARD OF HEALTH AND THE DESIGN ENGINEER. 99.2 34" 99.7 36" , C1 C1 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE SANDY LOAM SANDY LOAM LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: 10YR 5/4 60" 10YR 5/4 60" -310 CMR 15.405(1)(b): PERC PERC 1) A 1' variance to the 3' maximum cover requirement, for 4' of COBBLES 1 72" COBBLES 1 72" max. cover. S.A.S. shall be H-20 and vented. & BOULDERS & BOULDERS 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 91.0 132" 91.7 C2 132" TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE C2 DESIGN ENGINEER. SANDY LOAM/ SANDY LOAM/ SILT LOAM SILT LOAM 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 87 0 10YR 5/3 180" 87 7 10YR 5/3 180" FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. PERC RATE 20 MIN/IN. ("Cl" HORIZON) 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. NO GROUNDWATER ENCOUNTERED 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF A� THE CONTRACTOR .OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY PRIVATE WELL. 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. EXISTING WELL AT LOCUS WILL BE ABANDONED AND REPLACED. DESIGN CRITERIA 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE NUMBER OF BEDROOMS: 3 BEDROOMS DIRECTED BY THE APPROVING AUTHORITIES. SOIL TEXTURAL CLASS: CLASS II 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING DESIGN PERCOLATION RATE: 20 MIN/IN CONSTRUCTION. DAILY FLOW: 330 G.P.D. 11, WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS DESIGN FLOW: 330 G.P.D. r `` IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND", REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). GARBAGE GRINDER: NO 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE' PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. FRALO ST1500 GALLON PLASTIC TANK MAY BE SUBSTITUTED FOR CONCRETE 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. LEACHING AREA REQUIRED: (330) = 622.6 S.F. USE 5 ROWS OF 5-ADS Arc536HC UNITS + 1 COUPLER PER PROPOSED SEPTIC SYSTEM UPGRADE PLAN ROW WITH NO SEPARATION BETWEEN EACH ROW & NO STONE 1850 MAIN STREET RTE 6A , WEST BARNSTABLE, MA BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF UNIT) Prepared for: Virginia Johnson, 113 Linden Street, Hyannis, MA 02601 (Arc36HC Units) 25 UNITS x 5.0 LF x 4.80 SF/LF = 600.0 SF (COUPLERS) 5 COUPLERS x 1.2' x 4.80 SF/LF = 28.8 SF Engineering by: SCALE DJOB. TOTAL AREA = 628.8 SF Engineering Works, Inc. NTS P.T.M.. .M 194-09 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. DESIGN FLOW PROVIDED: 0.53(628.8 S.F.) = 333.3 G.P.D. (508) 477-5313 9/25/09 P.T.M. 2 Of 2