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HomeMy WebLinkAbout0042 WILLIAMS PATH - Health 42 Williams Path West Barnstable ` A= 111-040 I o ° UPC 12034 V Ng.2,153LON co HASTINGS,UN user ic, c -- •- e vi �4,vs loays f.: I VW; >tA�Yy1!► 7-p ov f gt--•. �s�/��A/1/ •t y a - . t '? _ ry�� ' 1_1��r•+ix�4l�+r'� 9pL�siv� Pb�ca- ,�v v �• �Y`�'<_•r �a � .. t i 9 r e , �. `R . •' ` _ - .r - . Iwo t .max; '. �krA�' .''�Jc � Y�4T4 �,Y,e� • -:+ "5,. i i R k �.t\� ; �,, F '} art- r� zy� �����# t• � T + ��„ \ ••t' rl✓'r �•` 4 r • tw, S. ! ' Z < is +;Y r i•- - � •y a ''^. •n T a k,�,s+s,�'r, t �r "~� .i r 1 C ..� r.:.. ' .� Lt n Ft�t r, r r L" r�.'c •. ••si'.�:. i,i �, „ .;�. _ s •t - '. F, •s •. Oki '� \ M1f-� .a .�! • ♦�; •r v •.� E ;sue. �. t + - � •� .k is g'" . .'.!t 5 t} ' s..+r.`{ ''nk 1Sa { J • • ` r `_• ♦ fit` „1 c r yt s Unv it 10 ' �t kr`�,} � f,/� ,- - d � .'qj ♦ r,5 .{ , i K w' > }� _ -?. ' t f \*� `� - ^ ':♦ .< ",� ° p,ls. 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'r .'.i ; s:..r . ?' +- t ;,' P '•t R F tT';,, Y ♦s' 4 r �'t;t-, - .{' , 4 °_ y*'.. ` •"'21.r'• Fyt ' fS _._ VIA f 1 ` 'f yY, r•• • • iv f f. f ,y Dolores and Alexander Schermer 42 Williams Path W Barnstable Title V bedroom count 8.20.17 AFFIDAVIT OF DOLORES AND ALEXANDER SCHERMER IN RESOLVING THE BEDROOM COUNT ISSUE FOR THE PUBLIC HEALTH DIVISION OF THE TOWN OF BARNSTABLE MA August 20, 2017 To: Thomas McKean RS, CHO Public Health Division Town of Barnstable 200 Main St Hyannis MA 02601 RE: Bedroom count in our residence at: 42 Williams Path W Barnstable MA 02668 Dear Mr. McKean, It is our understanding that, in order to proceed with proposed alterations in our primary residence,we must resolve the Public Health Division issue with the bedroom count. Specifically,you have focused on an upstairs room and claimed it to be a bedroom by Title V criteria as per 310 CMR 15.002. First, let us state unequivocally that the room in question is not a bedroom.We have a 3 bedroom home and that room is not one of the bedrooms. Perhaps you have not viewed all the documents, and more important,could not be aware of the occupancy in our home until reading this affidavit. Below are important details about the residence. Occupancy We, Dolores and Alexander Schermer, are the only two occupants of the residence since 2013 and sleep in the master bedroom on the main level. The only previous occupant/owners since 1983 were the Malchman family consisting of 4 people: Nelson and Suzanne (a married couple),their daughter Cindy and son David. We purchased this residence as a 3 bedroom home from Cindy and David,which included, as they stated,a "bonus" room (the room in question). It was repeatedly made clear to us that this is not a bedroom. Existing Documentation The Town already has in its files, in different departments, relevant documents labelling our residence numerous times as containing 3 bedrooms. These include: • Documents from the Public Health Division for the residence from 1983 through 2014 demonstrating that the septic system (septic tank,SAS/leach field) is in compliance with the Town codes for a 3 bedroom home.These include Title V documents as recent as 2013 and replacement of the septic tank in 2014. Multiple documents list the bedroom count. • Documents from the Building Department that include a recent architectural plan,approved work permits and proposed alterations. Page 1 of 3 i Dolores and Alexander Schermer 42 Williams Path W Barnstable Title V bedroom count 8.20.17 • As Built cards. • Documents from the Assessor's Division. Backgrounds I, Dolores Schermer, age 68, am a consultant in the senior care field with extensive experience in federal and state regulations. I,Alexander Schermer, age 68,am a biologist with extensive experience developing and adhering to federal,state and international regulatory guidelines. As a biologist I also have a greater understanding of the SAS. The proposed alterations will have absolutely no negative effect on the SAS. Since we have moved into the home in 2013 we have taken numerous measures to improve the SAS and maintain the ecosystem. These include, among other improvements, replacing the more than 30 year old septic tank with a new larger tank, installing 3 double flush low water use toilets, adding landfill,grass and plants to contain erosion and upgrading the whole house water filtration system to help eliminate the addition of toxic metals into the SAS and local environment. Regulations 310 CMR 15.002 Title V Definition of a bedroom: Most important,the definition of a bedroom according to the Public Health Division's method of determining bedroom count for Title V purposes clearly states that a bedroom is"intended primarily for sleeping." The room in question does not meet this most basic criterion of a bedroom according to Title V. Never in the history of this 3 bedroom residence was this room in question intended primarily for sleeping.The room is anything but a bedroom. 780 CMR 9304.2 New Building Systems. "Any new building system or portion thereof shall conform to 780 CMR for new construction to the fullest extent practicable. However, individual components of an existing building system may be repaired or replaced without requiring the system to comply fully with the code for new construction unless specifically required by 780 CMR93.00." US Code Title 18 Part 1 Chapter 13 Section 242 Massachusetts General Law Part 1 Title 2 Chapter 12 Sections 11 H and I We enjoy the legal right to maintain our residence as a 3 bedroom home. We also enjoy the legal right to choose if and when we will modify the bedroom status possibly through a more permanent Deed Restriction or by increasing the size of the SAS. Not Reasonable or Practicable The proposed alterations will have absolutely no negative effect on the SAS. For us to legally restrict our ability to modify our property(Deed Restriction), increase the SAS or modify home structure (move walls)to change the bedroom count at highly increased expense and delay is not reasonable or practicable. Also,the options provided by the Town for resolving the bedroom count issue do not pertain to our home because it is a 3 bedroom home by the definition in Title V regulations. No Vicarious Liability Future owners would have access to approved Title V documentation required of a seller. It would be totally unreasonable for us to be responsible for the actions of future owner/occupants with respect to anything, including their sleeping arrangements or possible abuse of the Title V regulations. We have absolutely no vicarious liability in that respect. Such a mandate would be illogical and clearly demonstrate an unjust ruling. Page 2 of 3 i 4 Dolores and Alexander Schermer 42 Williams Path W Barnstable Title V bedroom count 8.20.17 Gist of the Law A determination by the Public Health Division that the room in question is a 4th bedroom would be counterintuitive to the gist,of the Title V regulation which is to be protective of human health and the environment. Unnecessary Hardship and Expenses We are senior citizens, both with serious health issues. I,Alexander, have stage 4 cancer for which there is no cure. In addition, I have a potentially life threatening condition,adrenal insufficiency, affected by psychological or physical stress. We are in the midst of alterations which clearly presents a disruption in our lives. The information in Town regulations,definitions and documents for the residence should alone suffice in aiding the Public Health Division staff in passing judgement. The options provided by the Town for bedroom count resolution are not reasonable or practicable and will add an unnecessary hardship to our lives and add unnecessary expenses. We want, at this time,to maintain our legal right to increase the SAS and bedroom count in the future if we so desire. Summary The Public Health Division of the Town of Barnstable has preliminarily determined that we have a 4 bedroom residence and is requiring us to resolve the issue through one of several offered options. We totally disagree with the preliminary determination and provide supporting evidence that clearly demonstrates that the room in question is not a bedroom. The room does not meet the most basic criterion stated in the definition of a bedroom in the Title V regulations that the Public Health Division uses in making its determination. Calling the room in question a bedroom is counterintuitive to the gist of the Title V regulation. Regulations are mandated to be practicable and reasonable. The Public Health Division has preliminarily mandated that we follow regulations that are impracticable, unreasonable, or a deprivation of our rights. Requiring us to adjust the bedroom count would be an injustice. Mandating that we have vicarious liability for future owners would be illogical and unreasonable. It would be so unjust that we would file a claim according to federal and state laws with reference to deprivation of our rights. Please take the above into account in determining your judgement and kindly reconsider. Regards, 65wm Dolores Schermer, M.S. ��� Alexander Schermer, Ph.D, b l� Correspondance to: alexschermer@gmail.com I Page 3 of 3 ALL PURPOSE ACKNOWLEDGEMENT State of Massachusetts Count;�03 before me,Noreen M.Manzo,Notary Public, Personally appeared J L6 exy44voL/ Ic eemej,' personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name(s) are bscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/hed sae uthorized capacit ies and that by his/her their signature(s)on the instrument the person(s),or the entity upon behalf of which the person(s)acted,executed the instrument. WITNESS my hand and official seal. Noreen M.Manzo,Notary Public My Commission expires: NOREENM. MANZO WTAV ` 40"F T'RoFmiusEtrs �c«ren :.< uv�vmzz Description of Attached Document: Title or Type of Document: Document Date: l® Number of Pages: 3 Signers Other Than Named Above, L ON OF B-M�NSTABLE tv V l('q r� /� W LOCATIO 4 } SEWAGE# a010_ q �n ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO.C 11 l"S �3l`d` 7,erS Ccn$J-- SolL 3GA�3 3 SEPTIC TANK CAPACITY _ 160 0 gyl ST V d- LEACHING FACILITY:(type) —.50$ 0#09G� '(size) A NO.OF BEDROOMS .. $tal✓6 A4 N� � . OWNER AIV ov -4t I� t/ ti; PERMIT DATE: 9/7/1 p COMPLIANCE DATE: S a O Separation Distance Between the: 1 . Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ;Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet . Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) } Feet FURNISHED BY uatd) C .. � � 3� _ t Zr • Ci � . 7 t Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for 0ioo9al 46p5tem Construction Permit Ap licati _fj a Permit t Construct( ) Repair' Upgrade( ) Abandon( ) ❑ Complete stem ❑Com S p y Individual Components IT ALocation Address or Lot No. ) 9 Owner's Name,Address,and Tel.No. 4b$ ��� `6u,. dP Assessor's Map/Parcel ' I C) Installer's Name,Address,and Tel.No. /.y Designer's Name,lAddress and Tel.No. an d>=-T &eZ c coy,�., 'i 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) r7 a gpd Design flow provided gpd Plan Date I I 'o�J G� Number of sheets I Revision Date Title Size of Septic Tank Type of S.A.S. 3 k Description of Soil Sew !R Nature of Repairs or Alterations(Answer when applicable) �sze,�Z jL ,o-'s� 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 EnvirontrigiiIal Code and not to plac he system in operation until a Certificate of Compliance has been issued by this Board of Health. Date Signed Sig ' �Application Approved by Date _q I f Application Disapproved by: Date for the following reasons 4 ' — ——— ., Date Issued - •�� w•••J ,I "y No' Fee VV y f THE COMMONWEALTH OF: MASSACHUSETTS Entered in computer: Yes a } PUBLIC`HEALTH DIVISION -TOWN ORBARNSTABLE, MASSACHUSETTS Application for'Th9pont 4pgtem Cow9truction Permit AP licatiL�f a Perinit to'Construct( ) Repairj* Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components R - !/1 Location Address or Lot No ) q` 9 4 L Owner's Name,Address,and Tel.No. s�& 3s3d Assessor's Map/Parcel ' ` I o i,•,0 14- Installer's Name,Address,and Tel.No. ) �-1 N Designer's Name,Address and Tel.No. I� 11i5 l�rol�rf r'ci`�} 1 // n h r r k/ 1 / L lei Fit'CO 5��1} t! V �c», ,N`�S L 14� Type of Building: Dwelling : No.of Bedrooms -3 i Lot Size sq. ft. Garbage Grinder -Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) f gpd Design flow provided gpd Plan Date IdS i C,� Number of sheets Revision Date Title Size of Septic Tank !!) Type of S.A.S. 0-- /1,,., ti-1�, /•�; Description of Soil _Sr•r S c, L c,I Nature of Repairs or Alterations(Answer when applicable) V("y S11h,/41IF V ;4 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 nol to plac the system in operation until a Certificate of Compliance has been issued by this Board of Health. 1j 1 Signed „ `� — Date ?jC7 10 Application Approved by fj S I Date 8 - fy i v - Application Disapproved by: Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ' Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) k, Abandoned( )by j at Lj�L- Lt.11 11, 'N. g / Uy-t(n SJ'g(i I has been constructed in accordance �61f with the provisions of Title 5 and the for Disposal System Construction Permit No. 9010` 3'-j 2_ dated Installer i S �, 1-0 0,0 (f CC:t s Designer r gG/C a �f/I I/' ,r'n �,f r IC' #bedrooms Approved design flow gpd The issuance of this p rmit all not be construed as a guarantee that the system will uncti as designed. (� Date a �� Inspector _._ ---------- -- -- ---- ---�r--__ --_------_ ------�----.— No. d'Ul y Fee THE.COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS M gpo!ml *pgtem Congtruction Permif Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) System located at 14c�, ty, li 1,of 1h 1 P-777-) , 6 y/,1 $ f ti/�/y and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. a, Provided: Construction must be completed within three years of the date of this-.mot Date Approved by TOWN OF BARNSTABLE LOCATION Z• WI I tt__ SEWAGE#, 2014 — 21 01 VILLt�GE " (/l�, A!7 ASSESSOR'S MAP&PARCEL 1(1 e} INSTALLER'S NAME&PHONE NO. JZoQ i" t S Imp r SaP Z b'Z cgd17 SEPTIC TANK CAPACITY I 6 A LEACHING FACILITY: e (typ )`lk/j[°e - SRO G A(. 4;(size) 1 U >��'l�Z r NO. OF BEDROOMS OWNER p�0 af'-C$ CG PERMIT DATE: 1 1 -1 I 1 4 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility to•Lf e Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) t SCE Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) _ 1 JJA Feet FURNISHED BY �i(CQ M�F iA Cif `v r � 1 1 1 • [I t ®v GPI L c S-Te,M/� I� p No. ol 4`� Fee j5d THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 60/00" Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for MisposaY 6pstrm Construction Vrrmit Application for a Permit to Construct( ) Repair(/upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot N . L k1/1/rty+.S P Owner's Name,Address,and Tel.No. Assessor's Map/Parcel rr<4h1� d1WDolo< SCh.e ue_ Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. "lip Type of Building: Sig 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) k1gpd 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 w en applicable) ' 9 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 pl a system in operation until a Certificate of Compliance has been issued by this Board of Health.. Signs Date Application Approved by Date s T r Application Disapproved by Date for the following reasons Permit No. C90 Date Issued Y " r l _� AIA No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes. Z tplifation for Disposal �6pstrm Construction hermit Application for a Permit to!Construct( )�t,Repair(/UUpgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot �'`S Pam'? Owner's Name,Address,and Tel.No. Assessor's Map/Parcel fn„`�) jc����h le" Assessor's 0��` �5 5e h y�i ,Z Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ��-e �-- .SDI- y� - e0rocec s/ . S� �c Type of Building: Nk J 6) X— "t 3 Dwelling No.of Bedrooms f�/ 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 a, 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 1 e system in operation until a Certificate of Compliance has been issued by this Board of Health.:-' Si ne Date Application Approved by Date f�' Application Disapproved by Date for the following reasons Permit No. Date Issued - f --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Pisposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by , at has been constructed in accordance th with provisionsO I t e of Title 5 and the for Disposal System Construction Permit No.a �L fated� Installer Designer #bedrooms Approved de§RNflow gpd The issuance of this permit shall of gn 6 a guarantee that the system�u ctio" dDate Inspector 1/ 6� , X' --------------------------------------------------------------------------------------------------------------------------------------- No. v L( 0-1 Fee 1 sy THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal *pstrm Construction permit Permission is hereby granted to Co Ma ct Repai ) Upgrade ) Abandon( ) System located at y '-- { G �,k IrN S Lt e 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 in st be completed within three years of the date of this permit Date Approved by (`/) r i OCEANSIDE SEPTIC P.O. Box 201 Brewster, MA 02631 Phone: (508) 896-1513 & ENGINEERING, INC 618 Route 28 W. Yarmouth, MA 02,673 Phone: (508) 827-7151 August 1, 2014 Tom McKean Board Of Health Department 200 Main Street Hyannis, MA 02601 Re: Septic Tank Installation 42 Williams Path Barnstable,MA Map 111 parcel 40 Dear Mr. McKeon, We recently completed the final inspection for the newly installed 1,500 gallon Septic Tank at 42 Williams path in Barnstable, MA. The septic tank installed at the above referenced property has been constructed in substantial compliance with 310 CMR 15.000, all local requirements of the Barnstable Board of Health. Sincerely, P Linda J. Pinto Project manager LJP/1 t Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiams Path,West Barnstable M- 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 January 31, 2013 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information [� on the computer, (a use only the tab 1. Inspector: ^ /, key to move your cursor-do not Troy Williams --J use the return key. Name of Inspector Troy Williams Septic Inspections Company Name 19 Hummel Drive Company Address South Dennis MA 02660 City/Town State Zip Code (508) 385- 1300 S1682 Telephone Number License Number B. Certification -, ... I fl 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 V040 of; Title 5(310 CMR 15.000).The system: F3 ® Passes ❑ Conditionally Passes ❑ Fails j u CD rn ❑ Needs Further Evaluation by the Local Approving Authority S January 31, 2013 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 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. L& Z-) 1 . I � t5ins-11/10 Title 5 Official Inspection o .Subsurface Sewage Disposal System-Page 1 of 17 r o T Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments �M 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is )��required for every 968 Main Street Route 6A Dennis MA 02638 January 31, 2013 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System meets minimum standards set by Massachusetts DEP at the time of inspection only.This inspection is not a guarantee or warranty on the future working conditions of leaching, pipes, components or the future structural integrity of said components and only represents conditions found at the time of inspection only. 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 r 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. C r, 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): N/A t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 January 31, 2013 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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): N/A ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): N/A C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638- January 31, 2013 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well*". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for 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: N/A D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool .❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 official Inspection (corm o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is g68 Main Street Route 6A , Dennis MA 02638 January 31, 2013 ( required for every ) 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 flow 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 design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is AR i 968 Man Street(Route 6 Dennis 02638 January required for every ( )� MA 31 2013 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form x Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 January 31, 2013 page. City/Town State Zip Code Date of Inspection D. System Information Description: 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d private well 9 ( Y 9 (gP ))� Detail: well 150' from leaching. Sump pump? ❑ Yes ® No Last date of occupancy: vacant 2 years Date Commercial/Industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): N/A Cations per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A 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: N/A t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is g68 Main Street(Route 6A Dennis MA 02638 January 31, 2013 required for every ) ry page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: N/A Date Other(describe below): General Information Pumping Records: Source of information: No pumping info was available. , Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ` ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-11/10 Title 5 Ofridal Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 42 Wiliiams Path, West Barnstable M- 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 January 31, 2013 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Tank was installed on 4/1/83 per compliance. D-box and leaching were installed to existing tank on 8/24110 per compliance. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 18"+ Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: N/A feet Comments (on condition of joints, venting, evidence of leakage, etc.): Flushed lines and found clear at the time of inspection. Septic Tank(locate on site plan): 1' Depth below grade: feet Material of construction: ® concrete ❑ metal El fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 5'X9'X6' 1000 gallon 4" Sludge depth: t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is 6At R t St i 968 Man StreetDennisJanua required for every ( �� D MA 02638 ry 31, 2013 page. Cityfrown 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 2' 8" Scum thickness none 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 14" How were dimensions determined? probe/measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pvc inlet and outlet tees were found present and in working order. No evidence of leakage or damage was found. Tank was not in need of pumping at this time. Grease Trap (locate on site plan): Depth below grade: N/A feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): N/A Dimensions: N/A Scum thickness N/A Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of last pumping: N/A Date t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P -40 Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 January 31, 2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): N/A Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): N/A Dimensions: N/A Capacity: N/A p ry' gallons Design Flow: N/A 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.): N/A *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111' P -40 Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 January 31, 2013 page. Cityfrown 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 level 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 was found level and in working order with equal distribution to outlet lines through speed levelers. No evidence of solid carry-over or backup in the past were found at the time of inspection. 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.): N/A Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 January 31, 2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3 -500 gallonwith 2' of stone ❑ leaching galleries number: 10'X30'X 2' ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Chambers were found dry &clean with no visible staining. Checked stone and found dry and clean. No evidence of hydraulic failure or problems in the past were found at the time of inspection. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan).- Number and configuration N/A Depth—top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is 968 Main Street Route 6A Dennis MA 02638 January 31 2013 required for every ( )� rY , page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A Privy (locate on site plan): Materials of construction: N/A Dimensions N/A Depth of solids N/A Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 r Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is Dennis R 968 Main Street(Route 6A , MA 02638 January 31, 2013 required for every � � ry 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 A = 3 3.1 3 Owl 1/ 11 0 FG o t5ins-1 Ill 0 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is 6At R t St Ma in Street(Route , DennisMA 02638 January required for every 968 M ) 31 2013 a e. City/Town State Zip Code Date of Inspection p P 9 D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 20'0'+ 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. 11/7/08, 10/28/82 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: SDW252 Zone B 47.3' 2.2'adjustment You must describe how you established the high ground water elevation: Test holes recorded on plan showed no water found at 16.0'& 11.1'. Hand augered 4.4' below bottom of leaching with no water found at a depth of 10.0'. Groundwater adjustment at the time of inspection was 2.2'. Bottom of leaching at 5.6'was found dry & not to be located in the high groundwater elevation at the time of inspection. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 42 Wiliiams Path,West Barnstable M - 111 P-40 Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 January 31, 2013 page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 f p.1 vz/VD/LVIV to jo rnA Jvu VVVVVG[. v-ter.vim.. r. —•••• •a• Town of Barnstable Regulatory Services Thomas F.Geiier,DlrectOr L = public 11adit Wvisial e s TMmas McKean,Directer 200 Main Stint, Hyannis,MA 02601 Office: 508-8624644 Fax: 50 -790.6304 Date: - Sewage Permit#aQ IQ" W JAsscsuf's Map/Pared l to ftRer& er C9[fiScstian Form Installer: E: I I t S Q jV fl-`o r3 Cek j'L Designer: crate � t f� Address: )o al cep Pow Ala _ 3 Ftid�r 14_ _ l�0'rr►a v J"h 406 TJ.er' was issued a permit to install a i On :nstatler) ( am) S�4� gn � septic s,�at �1f, l;Ste'} �17j q/F+ based on a desi drawn (address) st -- XI ceni,Fy that th4 septic system referenced above was installedsubstsntinHy according to ,the desi wb#b may include minor approved changes such as lateral relocation of the 1 t� t was ins and the soils d�saibuaon bole antf/or tic t$nk. Stri if roqu�rod) Pad were found satisfactory. I certify that the septic system referenced above was installed with ma or changes (i.e. greater than l 0' laterat relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Re revision or certified as-built by designer to follow. Stripout(if rega' the soils were found satisfactory, o� y� U DUMAS (insta er s Signature PF �o Q�gTE.� t Sq�I1�A��p`ta (designer's Signature) (Affix Designer's p ere) FLEAS :RETURN TO BARl11STAS E PUBLIC HEALTH DIVIS><t'M CERTIFICATE OF C M:NIL NOT BE ISSUED BATS T� I+dRM ANA AS B[lII EIVED ARE REC BY THE B STABLE PUBLIC IEiEALTH DIVISION. T +►NK,YOU_ ' q;loirtca r Weagno�nfi�ativn fam,aae �,: 1 ��'4. s� ' !�, 4+4^ � � G+Y r� l`+' ,,., �#�' ,' b?,"..•. Fyr.' �;� ks. Ati if. 'I:t•l ,, �� ,�". /�• .. , �`. " " '� ., -rya J Ui Vil "",�",'.,s''"''4=e:�a'SaF;. ,r -:� +� �•. «c"" /� v_:r ;, > :.«.� ,�' � „` a ,.�"+4 r:�y,ds� �Y -_ ` �+�i+d� F.tii:• � Yq.. 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" r yCiV / t h Vv �`� '. „,, .,� `'sy„�•wv;,'♦ v ^..,,r1 ",� ,.,.Ci �vy a + eo'.�.�m �.'"�d '� i ,rr`"'�-rr. 771 'T`- 0 .�/lw erg:: -._._ ' �,�••�'-' ! +"s� 't'..t3 ■r.,-3�+dM� s' l%'�+R +. i'.M ��., .. a a. ,�rMe'�n.aas. v'..,'� �4_ Y6 tiY.x �'J �a 3 .. r� �dtt-i a..?t• !.�?t',rt`. - ,a.`�. ; .4*- 40 rya , ,. yi '•A`.�- -� ,�,,,`'� ...,�': '��'r'�z� : +,�'. _ � <� .y N .�� -�Z �� '14'.. r �,,�,�,,�. su -�cµh ~az�;� y .. r. �.e'^' '. ,ass Y�F .rC'tYi. �,�ro" � 'S++ �'tiF .,��. � :. i:��S r�•^^.� i'�:i.-.X'�cu y,:Y �i .frr'�`--+'^�u�:,'.�}� '�M �,"y�„�;c,�,'9F`S,a��„'!..•. ��. �.y.....� ._i``. `��LL' ^r ."kil"na+.t��r,.� r-a'.,'�", Y� y,'.^c �,�� l �' n� � u'' .,` � .:`;.'�st.F,+��= ,.y„e�.��-„�. �_- ` !+►y .t ,`'•�«c 4'.; „h.A-+� '-i";"'I�,.. ,�.a,.�..f. .`�.:. -?4.tiy,� ,,.:' Y..s� �� �S_ e _ - '�"�,��»a �k>t �--ter � � �^-'t:' r. ; �>r.sGy: •� �:-� �xG,��" 1i v�+•h+:.. 'eta., _,:y;::r.�'' �'� � t • L _ ��� .��;.\'ys�� 4 %+�•_ i/av' .,* �r .� d .�., r ,ia• - •'�.,ey�` rr'$i- y,.:'T. r + •gym „ v, ;w.pr ,L . 0 Df fNE tp� Town of Barnstable Barnstable kzgnd Regulatory Services Department ns-kneneaCy STAIRM 03¢. Public Health Division � 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 70062150000210418054 4/14/2009 Cindy Vanwagenen 968 Main Street Dennis, MA 02638 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 42 Williams Path West Barnstable,MA was last inspected on October 21, 2008, Troy Williams, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. • Liquid depth in cesspool is less than 6"below invert or available volume is less than %2 day flow. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health A. All" Commonwealth of Massachusetts 0%A Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments t-- M 42 Wiliiams Path, West Barnstable Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 October 21, 2008 page. City/Town! State Zip Code Date of Inspection i Inspection results must be submitted on this form. Inspection forms may not be alteredin any way. Important:When , filling out forms A. General.lnformation on the computer, use only the tab 1. Inspector: O p key to move your cursor-do not TroyWilliams use the return Name of Inspector key. Troy Williams Septic Inspections It�l Company Name 19 Hummel Drive Company Address South Dennis MA 02660 City/Town State Zip Code (508) 385-1300 S1682 Teleihone Number License Number i I B. Ce'rtification certify that I have personally inspected the sewage disposal system at this add resL and thA the information reported below is true, accurate and complete as of the time of the inspection. Tie Inspection" was performed based on my training and experience in the proper function and maintenance of onrsite f sewage,disposal systems. I am a DEP approved system inspector pursuant toSection!�5 340 of Title 5 (310 CMR 15.000). The,system: , ❑ Passes ❑ Conditionally Passes ® 19i s zz. , ❑ Needs Further Evaluation by the Local Approving Authority ? ` q CD October 21, 2008 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 is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the reportt 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. k 42 Williams Path,West Barnstable•03/08 Title 5 Official Inspection Form:Subsurface Sewege Disposal System,•Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable Property Address Cindy V.anwagenen Owner Owners Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 October 21, 2008 page. CityrFown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D.or E/always complete all,of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: N/A B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass: Answer yes, no or not determined (Y, N, ND) in the ❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20..years old` or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health, *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: N/A Obsery i f w � ❑ at on o sewage backup or break out or high static water level In the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken,pipe(s)are replaced ❑ obstruction is removed 42 Williams Path,West Ba m table-0 3/OH Title 5 Official Inspegion Form:Su49rfaa3 Sewage Disposal$yetem,Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposmal System Form -Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Ma Street(Route ), en Main Rte 6A Dennis MA . 02638 October 21, 2008 _ page. CityfFown State Zip Code Date.of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: N/A ❑ 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 ❑ obstruction is removed ND Explain: N/A C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that.protects the public health, safety and environment: The system has a septic tank and soil absorption system (SAS)'and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. t ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 42 Williams Path,West Barnstable•03/38 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface.Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable Property Address Cindy Vanwa enen Owner Owner's Name information is 968 Main Street Route 6A Dennis MA 02638 October 21, 2008 required for every � ), page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: N/A This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: N/A D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than /z day flow El 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. 42 Williams Path,West Barnstable•03/03 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 4 of 15 . k i Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage,Disposal System Form -Not for Voluntary Assessments M 42 Wiliiams Path, West Barnstable Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 October 21 2008 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) D) Sys ttem Failure Criteria Applicable to All Systems (cont.): i Yes No I❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. I❑ ® 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 j 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.) i ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. !Z r, The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve_ a facility with a design flow of 10,000 gpd.to 15,000 gpd. 1 For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No El ® the system is within 400 feet of a surface drinking water supply i E ® the system is.within 200 feet of a tributary to a surface drinking water supply 0 ® the system is located in a nitrogen sensitive area (Interim Wellhead Protection, Area IWPA)or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 42 Williams Path,West Barnstable•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 16 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiamc- Path, West Barnstable Property Addrass Cindy Vanwagenen Owner Owner's Name information is 968 Main Street Route 6A Dennis MA 02638 required for eve � )� _ October 21, 2008 9 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans.of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition.of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan'at the Board of Health. ® El 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)] 42 Williams Path,West Barnstable•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 42 Wiliiams Path, West Barnstable Property.Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 October 21, 2008 page. Citylrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 gpd Number of current residents: 0 Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage(gpd)). Private well 150' 9 ( Y 9 Sump pump? ❑ Yes ® 'No Last date of occupancy: Occupied Date Commercial/Industrial Flow Conditions: - Type of Establishment: N/A Design flow(based on 310 CMR 15.203). N/A _ Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.); NIA Grease trap present? ❑ Yes M No Industrial waste holding tank present? ❑ Yes ® No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ® No Water meter readings, if available: NIA Last date of occupancy/use: N/A Date Other(describe): N/A _ 42 Williams Path,West Barnstable•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System+Page 7 of 15 �4 a� . Commonwealth of Massachusetts - D. . .U Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable Property Address Cindy Vanwagenen Owner Owner's Name information is t Route required for every 968 Main Street 6A�� Dennis MA -02638 October 21, 2008 � page. City/town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: No pumping info was available. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: NIA gallons How was quantity pumped determined? N/A Reason for pumping: N/A Type of System: ® Septic tank,.distribution box, soil absorption system El Single cesspool El Overflow cesspool El 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 Tank, d-box& leaching were installed on 4/1/83 per compliance. Were sewage odors detected when arriving at the site? ❑ Yes ® No 42 Williams Path,West Barnstable•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-.Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Williams Path, West Barnstable Property Address Cindy Vanwagenen . Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis, MA 02638 October 21, 2008 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): . Distance from private water supply well or suction line. N/A feet Comments (on condition of joints, venting, evidence of leakage, etc.): Flushed lines and found clear at the time of inspection. Septic Tank (locate on site plan): 1'to 4' Inlet cover Depth below grade: feet Material of construction: ® concrete ❑ metal El fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: N/A, years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No --------------------------------------------------------------------------------------------------------------------------- Dimensions: 5'X 9'X 6' 1000 gallon Sludge depth: 4 Distance from top of sludge to bottom of outlet tee or baffle 2' 8' _-- 6„ Scum thickness — Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 8 How were dimensions determined? Probe/Measured 42 Williams Path,West Barnstable•031.08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y 42 Wiliiams Path, West Barnstable Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 October 21, 2008 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pvc inlet tee and concrete outlet tee were present. No evidence of leakage or damage was found. Tank was in need of pumping at this time_Tank was heavily root bound and roots should be removed. Grease Trap (locate on site plan): Depth below grade: N/A feet Material of construction` ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): N/A N/A Dimensions: Scum thickness N/A Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of last pumping; N/A - 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.): - N/A Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): N/A 42 Williams Path,West Bamstable•03i00 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable _ Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street Route 6A), Dennis MA _02638 October 21, 2008 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) Dimensions: _N/A Capacity: N/A gallons Design Flow: N/Agallons per day Alarm present: ❑ Yes ❑ No Alarm level: N/A Alarm in working order: ❑ Yes ❑ No Date of last pumping: N/A Date Comments (condition of alarm and float switches, etc.): N/A "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Level with 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 was found level and in working order Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 42 Williams Path,Wes(Barnstable-03/08 _ Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 42 Wiliiams Path, West Barnstable Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A) Dennis MA 02638 October 21 2008 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc,): N/A Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: N/A Type: ® leaching pits number: 1-6'x6'pit w/1'stone ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology.- Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Soil was rocky with some clay.Leach pit was dry due to vacancy with visible staining above inlet invert. This is evidence of hydraulic failure of leaching when home was occupied in the past. 42 Williams Patti,West Barnstable•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable Property Address Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 October 21, 2008 _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A Depth—top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A . f Indication of groundwater inflow ❑ Yes ® No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A Privy (locate on site plan): Materials of construction: N/A Dimensions N/A Depth of solids N/A Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A 42 Williams Path,west Barnstable•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 42 Wiliiams Path, West Barnstable Property Address Cindy Vanwagenen Owner Owner's Name information is �required for every 968 Main Street Route 6A , Dennis MA 02638 October21, 2008 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. I,jL�i _ I A 3t -� s3.5 r ti 3r� 1 O a• .O l m j J ►3.6 �(,.rJ� . ►'tip ti: Y,,,✓�.. N'L�wi�- 42 Williams Path,West Barnstable-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,.' 42 Wiliiams Path, West Barnstable Property Address --- Cindy Vanwagenen Owner Owner's Name information is required for every 968 Main Street(Route 6A), Dennis MA 02638 October 21,2008 - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam; ® Check Slope ® 'Surface water ® Check cellar ❑ Shallow Wells Estimated depth to high ground water: 20'+ feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 10%28/82 _ - 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: SDW252 Zone B 47.5' 2.4'adj1ustment You must describe how you established the high ground water elevation: Soil was sandy. Test hole 4' below bottom of leaching showed no water found at16.0'. Groundwater adjustment in area at the time of inspection was 2.4'. Bottom of leaching at 12.0'was found not to be located in the high groundwater elevation at the time.of inspection. 42 Williams Path,West Barnstable 03/O8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 , Town 01 ISITY115Li1V1G r rr Department of Health,Safety,and Environmental Services O PubliclRealth Division Date � 367 Main Street,Hyannis MA 02601 4 sear�ar�ar�. - bs .� Time Fee Pd. r�l th Date Scheduled 8 Soil Suitability Assessment for Sewa a.Dis osal Q v Performed By, Witnessed By: J+� Rosa ,L�2 JW111iArnS p07W Ownet's-Name C IN Dy t, �1A6 AIZAl Location Address, VAN wcsr 3ARNS7V-e/r— Address 968 77ONS'f R4 41 Assessor's Map/Parcel: ��� D4 Engineer's:Name TH60DOQE _. NEW CONSTRUCTION REPAIR Telephone# Land Use R Ed iDFNT)A+ / Slopes(%) '"� 30 it Surface Stones yE'3 Distances from: Open Water Body ft Possible Wet Area—k4t—" Drinking Water Well �ft Drainage Way Iq ft Property Line -f ft Other jt/C,�/ f 34O ft SKETCH:'(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) /V I i j I Pv R C r = -- j U); u. 77 I r' Qy rn j j i s1' Depth to Bedrock -t• -3SD Parent material(geologic) OU7-W46H De p Depth to Groundwater: Standing Water in Hole: O Weeping.from Pit Face P _g — -._._.-._.._..__�. Estimated Seasonal High Groundwater vi MethodUsed::::::::::::.:::....................... Depth Observed standing in obs.hole: A in. Depth to soil mottles: in. Depth to weeping from side of obs..hole: in. Groundwater Adjustment_ ft• Index Well#__,.,...._ ,Reading Date: _ index Well level.-___ Adj.factor Adj.Grounawa erLevel � i Observation I # Time at 9" Hole Depth of Pe is Time at 6" Start Pre-soak Time® Time(9%6") End Pre-soak Rate Min./I C ch Site Suitability Assessment: Site Passed _ Site Failed: Additional T-esting;Needed(Y/I� Original: PIublic Health Division Observation Hole Data To Be Completed on Back-� Copy: Applicant i Depth from Soil Horizon ..!.L: Soil Texture :::,::::.::::.::;•:;•;:<:;:<•>:;.;�:;:<..>:•::.::.:;.:::;.::: ..::::...:::::..::::,::::::•::: Soil Color Soil ..... .... :....:.:::..:: Surface(in.) (USDA) Other (Mansell) Mottling (Structure,Stones,Boulderes:. Ll 3G 6o Cl ED S4AP /0 2G. 4- GD"- .. ....... Depth from Soil Honzon .... . :........ .. ....... .. ... ..... Soil Texture Soil Color Soil Surface Other (in.) (USDA) (Munsell) Mottling (Structure,Stones, eres. b �aom ,�i�KD ...fo 8" :Z� Mo -`4 137 Depth from Soil :::::::::::::::;:;;;;:;•;;::•;:•;;.::;::::»::>s :<>:; :::::::;:<;;.::<•;:::::::;:<::_>::::,>:;::<;«:::::::::>::>:z Horizon Soil Texture Soil Color :::::>:::> Surface(in.) Soil Other (USDA) (Munsell Mottling (Structure,"Stones,Boulderes. 't ° J i+'?2>asisit�>::as'`rii!i%ii;i'iilaf:.> ''i.;;' i ;'i �,':.�::> :i�:: �:::: '.;; .:i';: ::...:.'•:.,i:':.,�::': iiiits8:$i83.`•..:,;,i�•S:'<:i;•r;;rr::or;:<t::�:;; :::::::::.�::.�::.:............... pth from Soil:Honzon Surface(in.) Soil Other USDA ( ) (Munsell) Mottling (Structure,Stones,Boulderes. ° e e ; Flood InsurancRate Main• II , i/ Above500,yearflood;boundary No Yes Within 500 year boundary No, Yes _ Within 100.year flood boundary No_ .Yes Depth of Naturally Occurring pe iou MatPrlAt Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? - If not,what is the depth of naturally occurring pervious material? Certiticati�n — I certify that on' (9. �9 date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and.experience described in 310 CMR 15.017. Signature A.A �� Date /r lv o� � � r LOCATION 2 SEWAGE PERMIT NO. VILLAGE 11/ — o40 INSTALLER'S NAME i ADDRESS JOHN A. AALTO :BACKHOE SERVICE +r77- 150 iwalnutreet West Barnstable, Mass. 02668 3UILDER OR OWNER , DATE PERMIT ISSUED DATE COMPLIANCE ISSUED _ _ �p 1/ �� �- ', � I - _ `� _ /,r � ,� F i i , vt/z I l v 0�o No. Fxs...:l....o_............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH J.�i ✓, .................OF.............h`iC,�tJ .......................................................... Apli iratiun for Diu1tuua1 Workfi Tongtrn.rtiun ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: • i 1 l �.t ---•----------------------•---------_.... Location-Address or I of No. �? M.1Le.`..d..h4it ..... ........ Owner Address ..................................... .--•-----...-------•--..........-•••-•-----•----- Installer Address dType of Building Size Lot___;!4e4 7_____......Sq. feet U Dwelling—No. of Bedrooms........... ..............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ________ No. of persons,___________________________ Showers — Cafeteria Otherfixtures --------------------------------------••--....--------------------------------------......-----•-•----.............................................. Design Flow_,//C'__.x_5_.......................gallons per person per day. Total daily flow....... .. ........................gallons. WSeptic Tank—Liquid capacity/AW_---gallons Length................ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No_____________________ Width.................... Total Length............. Total leaching area....................sq. ft. r---- Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ('*") Dosing tank y------------ Percolation Test Results Performed b S' w ___.___. J{s"it`�'�.1 "___________________. Test Pit No. I.__..4.._.._.minutes per inch Depth of Test Pit______! ____.__ Depth to ground water________________________ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth�to ground water........................ -------------------------------------------------------- .................................................................. 0 Description of Soil---C %1t<�_..lh ...................- �� '�Z�g-----•----------------•---------------------------------..._.......•--- ---------------------------------------- --------------------------------------•-------------------------•---•-------------------------------•--------------------- U Nature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ --------------------------..................-................................................................................................................................................:_....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI'TLL S 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. Si ed.. (, ' z, ... .---- - - -------=-- Application Approved By--- ----- -----•-• •-•'•------ ----................ Date Application Disapprove or he following reasons--------------------------------------•---------------•-------: -•---------------•--••-•-----------------...__. -------------------------------------•----•--•--••-•-------------•-------....-----------•-•---•-----------•---•--------•--•---------•--•-•-•--------=-------•--------•-------•--•----------------......_ Date PermitNo...................---------------._.----------•--_.._.. Issued....................................................... Date e- 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF 7 HEALTH � � Appliratiun for UWpoiiFai Workii Towitrurtiun Vamit Application is hereby made for a Permit to Cohstruct ( ✓f) or Repair ( ) an Individual Sewage Disposal System at: ...... ......._._........•-•....... .. •---•-•.......-- ••-•••--•------••-.........-•••••. .......................................... Location-Address r Lot No. •-•-••�� ... �f.'1t.-Gfi.......0 ...... � f���r/ � ?�..?�1��_ �t�!`�iia!G!.a,...�lf.!�.__.... K-- C7!11 AA Owner Address a ---•---•---- •.....................•-•--••-..........•-•----••-----------....•---•--••-•--•-•••--•-•-----•-•--- --•- , ........ Installer Address dType of Building Size Lot__+?94M...........Sq. feet V Dwelling-No. of,Bedrooms...._.....3..............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures -------------------------------- - w Design Flow.P!.©.k_.1....................•...gallons per person per day. Total daily flow....... .......................gallons. WSeptic Tank—Liquid*capacityA4 ...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. Other Distribution box (`�) Dosing tank. ( ) zu - 5a1� 1 .4.A%r'. Date�4°'.""...8,4 a Percolation Test Results Performed by...........:.. . .. ........_. _.. __..._......_._...._..__. Test Pit No. 1....A.......minutes per inch Depth of Test Pit------S�........ Depth to ground water________________________ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ....................................................... •...... .•-•--...........------•-•--•--...._---•••-- ODescription of Soil... Lf'! %._._!�? ......... a '..... .---------ma's---�=�---------------------------------------------•-•---•--........-•------- x c., •••------•--•----------••-•-----------••-------•-------------•-.................---......-----•-------•-------------•-------•-•----------•--...--------••-••-•---•••---...........---......•--•••-••---. w . -•---•-----------------------------•------------•--------•------------••-----------------•--•--------------------------------------•--•......••--••---••-•-----•------•------•--------•---•-•--•--•--- UNature of Repairs or Alterations—Answer when applicable.--------------------------------------_......................................................... -•----------------------------------------------•-----------------------------------••••----------------••------------------------------------------------------------------•-------•--..........------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 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. ...`. � F SignedG �'wro/3 :........ ate Application Approved By f% - .......-.•--------------------------------------------- = D ate Application Disapprove)if or,1 he following reasons:................................................................................................................ ....................•---•-•..........------•••-•••--•-••----•---...-•----••-----••--.........•---••------------•---•---•••----------------------••--•----•------•••-----------•--.------------------•-- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS p�L / BOARD OF HEALTH � / LG'l ...........OF........ W/C?S�T +f.,?.4 ................................... «I Tntifirttte of Toutph anrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (✓) or Repaired ( ) by..... 1.�,3 wm t..`. �a ..............•-•---------......----•---•••----•------•--•----------•-•--•----•-•�-•�.......-••---.........-•--••..._...._ .......... ............._.-•--•_..•••---••- Installer .. at. � �, ,lt �'� --i�,� .---•-_----1__P-•t'�S"------�------�.� `���� .................. has been installed in accordance with the provisions of TITLE E 5 ofihe tate Sanitary Code as desb . • the application for Disposal Works Construction Permit No... . .. ,--:... X... da.ted_..!f"*.'�_'_.... � .�.1......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST U ® AS A GUARANTEE THAT THE SYSTEM WI NOTION SATISFACTORY. Inspector...DATE....:.. -•-------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No..:. FEE........................ �i��ro�aal urk� �on��rtiun rrnti�.. ......... ................... Permission is hereby granted......_..._.✓ ......... _....... ! .���............................ ........ to Construct ) or Repair ( ) an Individual Sewage Disposal System_ at No.. ---•1�...........s i_�..1:9t t�...... !�� .....................................' ......--.....``-_''.....i ............... .. _........ .T�:/_ ................. Stree as shown on the application for Disposal Works Construction Permit tNoZ� � � r �, :°= <-''- Dated' '�`_^ --•-Aj................. Board of Health DATE........... -- FORM 1255 HOBBS & WARREW-INC., PUBLISHERS SN��T 2 OF 2 /g . r c�' O N � J rn B .- 0—Az Ago P,r e_9�/_ �`- --ems Q �9 —9i:2 -Top OF CIS !+77 \ .< v of ��� wVA OF 414 w- FNCHAFit7 •rs a� y ALAN Z 97�5 � I ' •,`� A O G F3AXTE R 'N C4 rah \ i' ZONES 8ASIAJ . 251 'S T y Wt I ' �1►J Gur= FAMtt_Y - � BEORooM uo GAczeAGE Ga�No�a. vA1LY FL"bW 110 x 3 = 330G.Pp SE.PTVC, TAwK =' 330xl5t>V• ',495G.P. R v51=- ►000 GA%-. 015Po5AL PIT ystc 1000 l5 1 DG.VdALL AeGa. 1,o s.� RAJ off $b►GIL I-�E - i I�jo $.F K �•7r a 3?5 G.PD. . . gOT TOM AREA r �� �F'- ?r• � I �I LL I We, P�►T•a 50 s.F x I- G A. 50 G.P o••" "TOTAL" DE.51GN * -42-9 GPM -TOTAL DA 1 t-Y FLC>V4 = II PER.CovAT10N RATES t''1N 2MIN otzLf-=55S • I ai � D.�{N ti, f �PLZN OF •; � a ALANW. m� � 13A TER JONES No.21048 F No. 251 0 I +�u�ST'R�� � CI • Q d -r1=s-r P-I42a •8 NDLc. ID-2911-ts'L . .,�04 Imo' ' eM loon tNV. i + 014T. boy. GAL. B(r� 5v�ap1I04 SCPr�G Z�L (Opo tNV; 'G TANK �! LAAGN INV. INV M 19•I�i - SUTF- 1-4 +(tSoy 2.1 Tv EL S2 -r-� I WASNGD 6T�N6 MSA6• Z9 GE ZIT IFIGD PL-oT P1-AN P yO F I L6 1.o G A-T►o IJ I I(o p10 SCALE SCALE ,IL �'p DATE II-It--f32 Ib II IJo WATEQ— REF P—EN GE 1 GEcz?1r— 'THAT THE 00Ic O6Is 5Noww I �' H6.REON �•OMPI..`(5,.1�lITN�'TNE 'S I c�uN E ��� � I � A►J D S b'c tc6►GK �,�.Q v►2 fCMIcN'f� F I N E y� L� i .'TOWN OF Z3A2IJSYAT3•LG AND 1S (J� � L� t_O�GATED WITH 6 G oD LAN PL. �� I t'(o is DAT E tl-IZ-$Z. �" BAxTEv-e NYE INC• LEG I S'T i_K6►V o S u ftv E Z. �I A , �I ?LI15 PI.QtJ Ili NaT' gt�S�D pid IJ 03T�ciZVILI$• • �'sS• Iu5.1-2,uMENV Su2vC--Y 4-TNE 0r-V.6ET5 6u0u1,� � � � ', ►JOT fsR= V (.DTCd DC ---V4AI►�C Lmil.. tN�'� !PPLIGPAN"r V�/IL.L-. 5VC717T BARNSTABLE, CONSTRUCTION NOTES - MA 1.)ALL WORK SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE, TITLE 5(31 O CMR 15.000):STANDARD REQUIREMENTS FOR THE SITING, CONSTRUCTION,INSPECTION,UPGRADE,AND EXPANSION OF ON-SITE SEWAGE TREATMENT AND DISPOSAL SYSTEMS AND FOR THE TRANSPORT W AND DISPOSAL OF 5EPTAGE,AND THE LOCAL BOARD OF HEALTH REGULATIONS. _ Q LOCV5 2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE 15 POTENTIAL FOR VEHICLES OR HEAVY EQUIPMENT TO PA55 OVER IT SHALL BE DESIGNED TO WITHSTAND AN 1-1-20 LOADING. IF UNDER AN 5 �• g0) �°i IMPERVIOUS SURFACE,SYSTEM SHALL BE VENTED TO THE ATMOSPHERE. ' 3 ,9 ,ti, O Proposed 3.)TO MINIMIZE UNEVEN SETTLING,SEPTIC TANKS SHALL BE INSTALLED O "� ��`,; Septic Tank ON A STABLE MECHANICALLY-COMPACTED BASE ON 51X INCHES OF CRUSHED STONE. -3Hlgh St 4.)COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK,THE e e \_ "g P rL m - DI5TRIBUTION BOX,AND THE SOIL AB50RPTION SYSTEM SHALL BE RAISED °� °� do \ K\ �� \ < TO WITHIN G'OF FINAL GRADE. LEACHING FIELDS,TRENCHES,AND OTHER �� - .Ex(strng`� `Exi�tan9 BENCHMARK SOIL ABSORPTION SYSTEMS WITHOUT ACCESS MANHOLES SHALL HAVE I I -`D`-Box �.� �x ` `SAS �• �� p. \ N To Corner Concrete i ` erg, ♦ ` / �, AT LEAST ONE(I)INSPECTION PORT CONSISTING OF PERFORATED 4"PVC I P •\ ee �` / �\ O / m I EL=99.5(Aseumed PIPE PLACED VERTICALLY TO THE BOTTOM OF THE SOIL ABSORPTION L--_--- _—� SYSTEM WITH A CAP,TIED WITH MAGNETIC MARKING TAPE,ACCE551BLE _ ;..'�'+ \t%'��e` `� O OVA \ •Ob a TO WITHIN 3"OF FINAL GRADE. j; ��` 5.)PIPING SHALL CONSIST OF 4"SCHEDULE 40 PVC OR EQUIVALENT. j .1� -'`V\ " l� `. KEY MAr SITE LOCUS PIPE SHALL BE LAID ON A MINIMUM CONTINUOUS GRADE OF NOT LESS \• ' THAN 2➢o FROM THE BUILDING TO THE SEPTIC TANK,AND NOT LESS THAN NOT TO SCALE NOT TO SCALE 196 OTHERWISE. \ G.)GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL \\\�\ j,)1i5tin `Se is Tank CONCRETE STRUCTURES IN ORDER TO PROVIDE A WATERTIGHT SEAL. \\.. \ 9 pt _ \\' c/o to be Abandoned 1.)Assessor's Map I I I Parcel 40 7.)IN ACCORDANCE WITH 3 10 CMR 15.221,ALL SYSTEM COMPONENTS _ '`� \�\ (see Note#15iy ` 2.)Deed Book 27179 Page 175 SHALL BE MARKED WITH MAGNETIC MARKING TAPE. _ p �. N. - 3.)Plan Book 291 Page 44 -�\o 4.)This property is not in a Zone 11 of a Public 8.) THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE SYSTEM AS - o �S -\� ��\�\ Water Supply DESIGNED UNLESS CONSTRUCTED AS SHOWN ON PLAN. ANY CHANGES '60 `�\ -- 5.)Flood Zone:C SHALL BE APPROVED IN WRITING BY THE DESIGNER. - T9� -_\\\�\ - - �•, 9.)THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION q �\ _ BY AN AGENT OF THE BOARD OF HEALTH AND THE DESIGNER. THE _ �%` \\\ �•\- DESIGNER SHALL CERTIFY IN WRITING THAT THE SEWAGE DISPOSAL ��%�n SYSTEM WAS INSTALLED IN ACCORDANCE WITH THE TERMS OF THE PERMIT AND THE APPROVED PLANS. 48 HOURS ADVANCE NOTICE 15 - REQUE5TED. 10.)LOCATION OF UTILITIES 15 APPROXIMATE AND CONTRACTOR SHALL 24'D/4ME/2RLONCRE(EGOVER5 BE RESPONSIBLE FOR DETERMINING THE LOCATION OF ALL UNDERGROUND \ - -- _= <a d TOP OF FOUNDATION AND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF ANY WORK.THIS \,•\ - __= •a ��P �� EL=99.5+- RA4969 rOE IM/W 6*���&" INCLUDES,BUT 15 NOT LIMITED TO,REQUESTS TO DIGSAFE,ANY PRIVATE - , UTILITY COMPANIES,AND THE LOCAL WATER DEPARTMENT. 1 1.)CONTRACTOR SHALL VERIFY THAT ALL WASTELINE5 ARE CONNECTED \� G ZZ=93.Gyrmn)-95.2(ma) EC-dd.Bt EL=B6:Ot BY WATER TESTING WITHIN THE DWELLING PRIOR TO INSTALLATION OF ANY SEPTIC COMPONENTS. �\ LOT I I O h- Proposed 12.)CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO < Area=44,152 S.F. PVC Tee INSTALLATION OF ANY SEPTIC SYSTEM COMPONENTS. �' �\ - 92.2_t 13.)INSTRUMENT SURVEY CONDUCTED FOR PROPOSED WORK ONLY. O SITE PLAN SHALL NOT BE USED FOR STAKING,OR ANY OTHER PURPOSES. �, qj 00 '. , � �:� q • 86.3+ i� 14.)THIS PLAN DOES NOT CERTIFY,GUARANTEE OR WARRANTY COMPLIANCE WITH DEEDED OR ZONING BYLAWS,SPECIFICALLY,BUT NOT 9 ��' 917.75 BS.Ot -'- B4•gtt N- LIMITED TO,SIDELINE SETBACKS AND BUILDING HEIGHT RESTRICTIONS. •'� . �,yaoZN OF OWNER 15 RESPONSIBLE FOR OBTAINING SUCH A DETERMINATION FROM , \ 4 G�DJe\� �� qCy G.45 I THE APPROPRIATE AUTHORITY. \� G '� �� LINDA J. Gv, 27'--} PINTO I5.)EXISTING SEPTIC TANK TO BE LOCATED,PUMPED DRY,FILLED WITH \ �` °: - - ' CLEAN SAND AND ABANDONED IN PLACE. AREA TO BE COMPACTED TO •\ \� I ,LI- L PROP05M/500 GALLON Existing fxisdng MINIMIZE SETTLING. � �x •,, O.L _. o No '6 SEPTIC TANK D-BOX LEACH CHAMBERS �, Exietmj Ss�ONAL EaG FLOW PROFILE LEGEND �. i well NOT TO SCALE EXISTING SPOT GRADE 24x5 PROPOSED SPOT GRADE ` 26 20 SITE PLAN - - - EXISTING CONTOUR —24— PROPOSED CONTOUR \�\�. Pre ared for: V —W— WATER SERVICE LINE 5 G SCALE: 1'=30' I' —o— OVERHEAD UTILITY LINES `1 Dolores Schermer—L'— UNDERGROUND UTILITY LINES S—G— GAS SERVICE LINE 42 Willlam5 Path, Barnstable, MA 02GG8 O � Y�� EDGE OF CLEARING ; l_L FENCE / TEST HOLE LOCATION O 30 GO 90 SEPTIC TANK Proposed Sewage Disposal System oe DISTRIBUTION BOX 42 Williams Path' Barnstable, MA 02G68 _;�x sA5 SOIL ABSORPTION SYSTEM SCALE 1 "=30' "dF�� UNG D)6P�KU do CLAN OUT C:\Oceanside\05-William5\05-William5-5eptic Tank Plan.dwg Date:04/04/14 5-I-. As Shown I By: UP Check: MLA I Project No. 0514037 P.O.Box201, Brewster,AM 02631 Phone:(508)896-1513 i e'S .-aF:"-..., y .-n.. 3N'n•u- r:-:,e-°' „€.rr :f'-k..'_^""�`.r..�-s»e. Tm.k` •—'h mF '.,_"'---Tma.e-A!p, -�- , '. —aa� Z. e.-,..-.s...r.. s 9,...a.. a,.-.> `3c';«: .,�:.-� .s z.::: ,...t ..,,.,,-.. .: ._ �'�:- r .Y s K BENCHMARK FT MINIMUM M R R RA 20 U FROM CELLAR O C SPACE , F EL CRAWL C ` bESI GN CALCULATIONS . :TOP of FouNDA71oN ; 10 FT. 'MINIMUM :FR M SLAB_. 3 - u o , D000 : , ,�, _1 1 d FT.. MINIMUM NUMBER OE BEDROOMS ._....._. >=�EV. . ., , NOESIG N ------ CLEAN :SAND i .AUNT _� (ASSUME -: GARBAGE, DISPOSAL L !, ._ � _ ___ S E ) E CONCRETE NO k COVERS M OW ` T ATED FL TOTAL � 1 N O L S ,. » LOAM AND SEED.. SCHEDULE,4 PV P 40 C.PIPE 330 _. BR. _ GAL.. DAY y 110 GAI. 8R. AY X �,� / _. MIN.`PITCH 1 8 R FT. GAL. , _ PER 2 LAYER OF n � ' REQUIRED SEPTIC TANK CAPACITY Qr 1 $ 70 1 2 ��� : ; f / , -AC AL Si2E 4F SEPTIC TANK __. GA L. .. _ TU A A I » II`` W SHED:STONE , 4 CAST IRON 6-- VEN T L CLASSIFICATION PI N REQUIRED I _ NOT 0 ED 2 ORE UAL M NI+ UM .: 5 IN IN. ( EQUAL) --DESIGN PERCOLATION `RATE ,_.__._ M � �DE5 G E _ / » . 4 PITCH 1 PER T. ,74 Y F T a O GAL, DA S. o � _ NT LOADING RATE _____EFFLUENT � � �. 460 FT. LEACHING AREA �..___. SO x -------- FLOW LINE (10X30)+(40X2X2) , LEACHING CAPACITY !AREA XRATE _ GAL, DAY ELEV.- LEv . ._ - �1a _ ❑ O ❑ ❑ oMIN. o c 460X0.74 : ELEV. 8as � r� ❑ 0 :.LEVEL e o , t O 4 4 MP , > GA . DAY -, s u RESERVE LEACHING CAPACITY �Q l V, � GAS 83.4 S ,� o 0 f ELE ELEV _ ---- ELEV. r____ , BAFFLE o: _ o r DISTRIBUTION ELEV. 00b0 ❑ 00 ❑ ❑ o ❑ . 0 0 0 �,:,, �,, o 0 o V ar LtQUID OUTLET : $3.0 ELE _ DEPTH , EEP N I A BOX' -83. TO BE LACED 0 F RM 8 SE O BE WATER ;4 FEET 14 INCHES T TE TESTED 500 `GALLON DRYWE`LLS Wlf 570 E J 5 FEET 1 J INCHES � �--� 00 IE MORE THAN ONE OUTLET < � 1 0 GALLON _ 6 FEET 24 INCHES NIA _ 1 X3(f X2 ) tNCN FORMA77CN TO BE .PLACED ON FIRM BASE /N AN 0' TR WELL - � �� _7 _FEET 29 INCHES „ ( ) D T „ V ZONE � , _N 8-FEET '34 INCHES SEPTIC G .T I'< , 4 TO 1 AN �STI�G 3/ 1 /2 CLEAN INDEX I �>� � SOIL .ABSORPTION • . DOUBLE WASHED STONE - ` ADJUST 1 FREE :OF FINES & .SILT EM SYST SAS r 7 E A USES PROBABLE WATER TABLE ELEV. I T ...SEWAGE DISPOSAL SYSTEM PROFILE V. OBSERVED WATER TABLE ( / / )_ELE NOT To SCALE H V. BOTTOM OF-TEST HOLE 'ELEV. OIL TEST S . r _ _ DATE SOIL TEST 1 17 2008 SOIL . TEST DONE BY DC x NAM.� WITNESSED ES�ED B Y __D� 0 + NOTES. I _._ 90 A CONFORM TO TITLE 5 �+ lT�> OBSERVATION VA'TI ON 'HOLE � E�EV, ._. .. ._,_ 1. ALL WORKMANSHIP AND MATERIALS SHALL o D.E.P.D ([ P s < 2 66 AND THE TOVM :RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL PERCOLATION�'T{ON. RATE MIN. INCH' AT INGHES .✓ --._, _.,_. � \ \ E COL. . . __�__ _ OF SEWAGE. » - M .< T ,THIN 6 OF 2 ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT O VYI --_. DEPTH HORIZ TEXTURE COLOR MOTT. QTHER RE \ , -._. 8 .. .._ FINISHED GRADE. ,q J E A 10YR3 4 —._. 0 16 A P LOAMY SAhD M' E CAPABLE OF _- 3. ALL COMPONENTS OF THE SANITARY. SYSTEM SHALL'BE C L �- '} RDQTs 84 _ f( .., � .� / IN UNLESS THEY ARE UNDER OR WITHIN J 16 36 B LOAMY SAND 10YR5 6 WITHSTANDING H 10 LOADING E 20% COBBLES _ .- O T i"'- R PARKING AREAS. H 20 LOADING ::SHALL BE \- ',-SAND ..,, 36 60. Cl MtDIU�� SAND 0 1 I _ _ I - • R `PA KfNG AREAS. USED UNDER OR WITHIN 10 ET. OF DR VES 0 ;R A 2.5Y7 6 60 126 C2 MED. � JRSE—SAND GRADE SHALL, BE � .. OTT 9.5 4. ANY MASONRY USED. TO BRING COVERS TO_G D 1 . _ f _Q 1N_-.PLACE',, , o1�o o L -.. �I�.fiN .TZ7�f3' N A A T COMPLIANCE J Dl<. a ti'X'S �1=E M DE S t� C � CE ,!htTH DEEDED 1 4 � ORZONING, REGULATIONS. `OWNER APPLICANT IS '7O OBTAIN `SUCH >� 0 WN � L S \ \ _ x s 126 _ .n'' .. _ NO WATER E�CUUN �ERED - AT ,---��- �LEV. _,_..,,_.---.,..,, DETERMINATION FROM APPROPRIATE AUTHORITY. 6. UTILITIES SHOWN ARE AP PROXIMATE ONLY, EXCAVATION CONT RACTOR . . 9 IS TO CALL "DIG—SAFE"<AT: 1 888 344 Z2 3 T A 7 H _ 863 A LEAST 2 OURS V. \ OBSERVATION NOSE 2 .�.�_ - .- ^ \ OBSE PRIOR TO COMMENCING WORK ON SITE. (96 \\ a T VERIFY , C 5 INCHES 7. CONTRACTORS 0 VE Y GRADES AND ELEVATIONS AS . WELL. AS \ PERCOLATION RATE .�__ MIN. {NCH AT I.•._...._�..,_.�_ , 1 'CONDITIONS PRIOR' TO COMMENCING WORK ON SITE. ANY g SITET N 1 o I 1 / \ b ,MO TT. OTHER COLOR M T H R � DEPTH HORIZ T(�XTkJRE VARIATION tS :fiO BE BROUGHT TO THE ATTENTION 0. THE DE IGN o J _ ,. ENGINEER 1MMEDlATELYi. . 4 .- D 8 A` P LOAMY SAND 1OYR3 - � � .� \ � r / ROOTS + o — c E � I � _ � `\ 8., 'PARCEL IS FLOOD -BONE ti M 10YR5 6 c � \ 8 4 B , LflA Y _SAND , 2 f 20� COBBLES � T SHOWN A � _ _.___._ , :. _ _ 9 LO IS S 0 ,ON ASSESSORS MAP �'�_ AS .PARCEL.. q. ;, -.Y Y7 6 , E . 24 137 C1 MED.' COURSE SAND 2.5 - � ✓r r,�t � o � r� c g r o � \ T 74,6 o ^ i 3 _ 7 _ APPROVED: BOARD OF HEALTH . G � -N0 WATER ENCOUI�T�RED AT ._,:_..r__�. E V b 40 0 DATE AGENT b O _ bJ 0 O _ WEST BARASTABLL' SASS. �. PROPOSED SEPTIC . DESIGN + g `L E _ c 0 g rk I 4 CIA + 4 ��-�, � : AN A EVEN �. .. b s _. .\ 3 6 ? , { �H0 I: ti o O I?. � , 2 ' WILLIAMS PATH ; b fiA �► ouMas _ BARNSTABLE MASS. J 1 No 6 PATH _ + WlLLJA P WEST BARi'J T N S ABLE . � p p Tyco ENv�ox�E�TAL :CONSULTANTS . r J Hr C 0 6 M• � o � S : � COMPASS LAN_ DENNIS NfA' .02638 .r o O F T d' ' 508 385 2425 —.. \ D. . � 7 i..BGEN BA TH EXISTING SPOT ELEVATION 90.0 A TE_».��. .. .. SCALE. EXISTING CONTOUR 00 Q 20 0 -c2' P ELEVATION , FINAL SPOT ELE ATIO Q h FI A CONTOUR - N L, TP O O SOIL TES LO CATION REV1 BALL ED J06:N0. y. ... ./ UTILITY POLE �` < . 41 .ram. W 7owN WATER w w 0 � :CATCH BASIN O �0 REVISED , . 1 OSHEET CESS SECOND FLOOR c ANOUT COGAS LINE ° OGATION , F 1 C. 1.58 I P O 4.69D2 OtJ 1 at 1 68D? fsas.:awG �0 2008 :TAD , d, pp i I