Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0005 PIONEER PATH - Health
5 Pioneer Path W. Barnstable A = 128 017005 o �iti o e o o a a UPC 12034 No.2• C� � _ ° r e d a . i e e I ° e '" i R9n° � r'�r, a � #� is baa..+•a^"' ,r .. ^ M3�rs+a._�.-. a ea,�*w.a�7' _' ,. «and ux �` -�`*,�`I w � aq�a'{�, a�� -r p3 "' e + a•', q �.e �s y 4;� r"r,.'•Ck� yak' N Y "� t ^fJ7-,,' °'`!r ,r:, .��'!C�}�t',f+by.Jr �bait ?•,�Ea,_x � .''� '�„T `''a ?f'"�>�'te TC4�.is"t'-;r",+f r r.' ' -� °Fk J: . 7•.N' 'i y� i r'�ie^ T.i, �a 4 "�• � r' �-.tF'C it� '1'• � Tt��{n G"i t - a }'j rAt..�, �, •. ) z ` w( v �°"a, 'iF '�-: Lrcc a. +`` tJ r• _ a, r M: s yr ,�, �;`�'a � '+ � i j •...aa<G �tt"rrt �{#� �1 .rt�$kS''���v,"� s'a�v,�_y j 3�i • .� a_" • a., r - 'a. >r k 4 h. )'t/" �r.a 4 .H;.- �i =3:^v l.� ���N�r��,��� �a��,,��'t ''i.�.."`�� y pr 'T a,: • a � .�«rr�w re ; a-4 n ,.+�z'4"rt'�re•s'�yr�r•.'b,�f'�w°`��',` ���,r�ky>2}C , 4 _ w` " " `7" �,• r b i 1 F ''t• �� r � , a {� �'r'�+t" ;'fir �r � � �,' a +�� a a � - �.r ��q T s r�r+.?•rs'�Y,�)"a,'��+ �, •`•+�� ^t s��ra.G{ � r ... t x .,�tr+r+T :,•y .n r t a y :,t�. 'w.JrT � �`+-' F��(" 1.7 m t f ri I��` /,},f• E r •rt +r �ft�A ry Eiy s�`,ag'yr , i � S w''7 R., 1 t' ^i a a t�/ �l✓, �, t ��^r� C •( '4 �,tf',�."r�'�yM. • t ' fyzR `{' !✓ :' r ref..\. f r `a a • .,,� i•{y.y'f`��.,hr ';` i £ 6r,; Pf r _ ie, 41 "� *' + t t r •Ld t ,`f4 .ss•+ilp _ *: rViSa..- r.^Err i 1 ,y, i •'L4 -'•r ai fi s 4 tf •.., ', n av'rt. t�7t {,yi°'. r '.°x„�x 1 t� : s ... w t'i•.Y4 a ` r * ,t i k. t�.F. < ':Cs E r� ._ a 3. is r�rn���i rrP�ar",t'r � r" � 'r"'�' t a a-•,'` �: t � T '`F' ^z' r r i,n a �. T s �?u� `4a� �4' '� t1'7ka "'t �'i."�'{ , s; ..C-+ a-1�+�_„• t vj d ix y s«- a"T..t,n• *n Fa ia.� 4„°` t,"kiru ', '*., ,'- _. v,, T'WI 4 .,7 a,n _ - .` „t � � ,) t 9y w � ,,� ; •r^ .;.., .'r ; r i 4{.,4h. f r r Jt'� � a��r-�i}f'°� �1p` L'� � t r' y'�y � rj• V! .. � ,._r �.t Cif .,� ? wf,i r _.r s��.% a r�,E,.�,x' '^'�., ��, y ,.._*,� '< � � P' S ) 1 E r r F,:.• r� 4[ t 5 a 1 t� -. M � ,. .aF•,... } r air br+> •�' ,T 'rd a R�r• F L ,.7 l ±t tY{.-c � � j-. �i+ii«•r , tt��t r:.� 3 >'ar "'� _.^"„r. ,3: t,•r ti,rr. .. r' ,.,F�' t r ErYv. T .• i c r �Sr.'4 l,,Cy,"'v_Gl s}tf,.1r- may #- "% t`� (L .i F >- �•:. r '•� - ytF v^ �r vs"?0"�'tiJ'.As, ,7'`�- t"4F�'d ry�`�•.. {p ,,,,,;, r '!s '/� �; ,. M 11 `�`.ia.- w s S R, � `{' '�.`.'z" k'�ii: Y' ♦n', '�� ,, •ir r .f a^ <f y.: a` "� "✓Lrf �? i '�:� * '"`'� -l' %r t,: 4 'i) t *ax t.ra'w•a��:ur�aE�...�. r r� t 'E ' ♦-€ -. r ,{ .S'rt x- „�1 Y' f', i. _{.♦+F"r r�'�,.� J"�bS ..a�`e r� ad`-�}r1'�"j`a }3• '_a K ) ::>l 5'.. w a t ! t.Y,q r• t: n'1a ± /•Cat; u 'a --x.•,.F t rt _ ' `i i 2 i�s«. �. t -i°aa.1tyr i'.� s a s t'ki•""�* ,.''t'' �•.4 ft °L` �s +��2 •r$� '[�* � 4�.� IRK-, k�' - it;' •�� t•it J''- � rgr ��fr. rt�t�'gYYiy �� "t r'�-.. TM'S,£ {+. <i•t•r�'as✓ � 4 �F•+E�� < J>;, t�.:�ty � f �,i K$,�:a'`S r• b t f �1+ L i a f is Z 1 F w •. B r-0.. - •: V 'N 3-rtia N '.�4y,-Sr"k S"`} x � • "•�„� ',A '� y "`Y.�y r a� •r ',y�'L� *t z, •�'� �i. .i, tom,',�r��4�S„^ty.t'P`.rtk'F't`•u'�•4i 4 �'�r"^ � , 6- v i .. � •j+..Y•r . 4: T {,'i t � ,tl 1' +^• 4 - t 5 r. � .0 y? a` i t 3..:� fa`r;���aaSk �- i t}r ; r. +r s,.t'a �+ : w � eE tr.v '+���. rR34;a,, .''t .•er".>i` rT� y, ���'rt 'p'�il-. rw'` �"�t"a"' � },�!r Tr y v t:ir- a +"S4''',� i , •t t"a yD ,t a -xJ 9 i E, t. - 1 iC M.. Y 'C •5 f .E,. `r it�, .'- l',' .t•. i i.s; a c,r:`�ee '^t rt' ,'t"�'.,,�. #r =.-av""osf '.�3 4r ".F %4 l '+? ♦ '! eta a "YE r{. ;ti •• L Yys �d, tryaa 'C +ti-lT= .:wi,{}, 'rtF r .",.,� i?' f5`r Y.rr+!<y .• F a .n. ' sCoi°� a:k-,r `'^�y rqj 'iL.. y is •;0 1r ' t`•, x wAt yx rµfr syq # T M _ y - �"'�. } �•S" .0 ! .: r i` y .Jt R Y:a rt t 3 .•t �+E. y Y R t a.t it r' •v'rn �'r + "a`'a t ,,y i" .4,. Wr S t` %.+r ; „}r 11 '+43 * 3� t�� -.ry R CA°E$'. •f .3;A •a � .'t . �%r r.1 t,..a*'`4 tam'�wr,R ,ar-a S? ��w`t�a�.�r,.�'•`f' x r.`:'t ,.�t � �, tx ., � 4`', fr' •S `"'�nh""�```,A s f.Iaf d�a`Mi#��,�.,:-,li '> t :i '1 'E`-`•�* :"f w .k aY S r: ..,P. ''?1r'tY.:: 'ar•",j..,S a ..� ,ys. r i"^ CC sr;,�.: h•' ' �^'`' f.YY�-h :. a` '�".f yam:. 0 I ,T�_*:>^�;•,.° 4a..s t��n �.�`v Y :�^�.r,1'+�� y!%- .-.,`� qn '� ,,, rak a ;,rs$� ^r.•r*{`�; �al'aa.a'¢'.j'e'"kd �b `t'.i.ki a��.,F�y';. .� . L r � � � �i,�.+'ja i, ,� < ��, '• 'ryi a°T�! _4 "`*o ;4''*' w_+' .. s � ��1• tid'�?"C, tr� � f��•'4°s**" ��...i n ,4� ti +` � ; Y " �'#'%'r,a,.T ,�•a'.`,�^ a"�t: wrt ra:a ,'akra�a ,� r ; "+� `* �. � ,� t1^Tr.�s�r�'r'°'�ra•�r +^ ems, r,.:a..r 4 µr: �11 y, pi �. t t r'Y { ♦ '' t`•' -^,.Y r-i sr' fir, 4." �* _ n a• 3 it - 4 yµa T. 'S4�k1"i•*$� w kri' .�:i •�c }{;f`.' .: nv' t Ef r* r y i'T f __" -y.. c e ro a'rty'r�S'J�i'4 �. 1 N,tt�a tC,?'k.,tsa, a" >.,06 i;s }t •a!:,,{.,4 �a Eb.,• 4 r �' r .K ,t.;" •4.,.`'t � # J„i�tieF`'�"'� � �,rM1a t � r �.. z, �tI s s, * yS d�. n,5+ •'} a �,b �>da• i ,ti M.�t„�� S x , :¢ cf -• a.f .xjr�+C r- ? ..,,. `;y.;� r.,,;, a' rt a S`,r'- 4* .' Via;;. r a a s f 'Y- C i' �.trr F r t E- «E `•7t S'k�^ ".!�`x a:. ? n .`rl �v •r��-Y.,..Cpw��.rr•x �#';.�ti ( r .: a "iF1 X !n".v i [ ��, � .' a `�x t:. � M� x h. r '`6 * c +�:.i r}' pryw- «r 1 � ♦ ' ���y}'W. !�i•a .•iN 'J, 2 ( r :ti T. ry+f .i�' Nar' �.�. A"[.• $�..�" �i ��,H f f � "+. .A r. 'tsn6.f F.rk^.rii` '1,n C4 4 `�t:� '�2��(�r L� :�^.. ., _ ,. rv•� •- Sr .<'.��'r°N •`: "r�'��1s�Mi�,.*.:.� iF, it,i^+r¢ t;'x'+r" a s : 'r y 'Mkr..� x� 'L.�'Y�,a r;,r +"�a`.er'k y�l,&-4.t`�E+S�a�4a�•i:Sr" - i '� x - � F'�7 n+t}i��'r'';P�,� K,^k ><� *g., * a i i CSLr'}.mot �, i „e i `�`rrs S""� .ice •. '�w r:� F• � .,f�. rra r r{J't� �`'a. -�' .¢ # £.. � ..t i„`'i 4�i+ ,$i,e t,c`"'Suy¢ j+'� .t a " a.:r �., ^ t. ��.fg �.+� '{-�'��''-��n��.'+j.��i yr� ,�� rE�Ti 0.1 �� :." )4 - ;Crs) ,`�ar�ors�.:�4"+�S+rY•9'W .c". ;_ ".'a. e d •a �, ;'• a kr"4 r r �r'PE i> s t ' a ti 4 t v ) <} ♦( `#. •. aT t•tk*r'�1'4' n-•` +r�L 'a: t t • _ ,'a_�, i r:k k ,.t:xttµs c "�.C'i *t <, ss 'L� 3` ', h`F# "F►a°t+�+ •r'f. F�. Y� r'C "✓a ^ r 4 cn z .} "•s t.k a'h,'n& ia`•r 'r9�. 'c s:,. �, �'3" • ar 3 t. $'s itt„deEy:+`r�ri }y ' eer1: 4 `• � n e ! F t.+t• 'x' ?y a dF r r ww+r 5 r t;$t o � 1 rr* i•�.@ * }'� ,k ti .na r.�S 4t�• +�� •x ,,�� it d'"r+i• t�. #i ,! ,J» r y r �•a' �.'� 4. �- a� �.,' +1 r a e� •5+�}�w ''�t `z '`"�:"y. r+'!.+• i' _r * ,�,� �.•' rk a� �'C_ �t t ' '� 3 •..r � }iw may. �tk �,'.�+.a� a �a, s »•r : { k��, ••�, i .y h" ys� E .. i .,. '-x. r c�'Lt:, �} `tsff •+�t� .+�k, rT�'ti�aF-. + ;.� =y� r � K.a. J' x L �. �, r' .^.n` '� t «, je*,•• r t.h '� i�fi ,r a t Y. St.; .+. n. t+' a ,cR r ��,w ,t �..^. a '�'}ta ri i• irx .. i:,i rrfi`; .;'#ds-•'Tn.tKf'�'e•-'°.�'.,f'r?.,, 1�ti?d.:. p' - .1 : r ,,E t t '.,fsys ,v*. a,«, ,q\ £ w•y r+ y d'+�'' a fi. v-, + t j : !+a`•� :'< z"a it' '"^i..: r ^, 6.'w:i.A•a r,: a �-s a }T` "•,i krz + .r^+ ,: S �, {� ,at F ),.( rf � y ?...t:r 1 '.c � as s"-,� ;'d.-�,� '*D'�'Y"h ra ; ba.' }r^{*r''yx�.ti+-S"a�•.Ygs{}`^�`r i M {; s`.'C' + ..g •. - -7 - E 's .. f `� t. g t*,T✓+`+.t a'r tr '.t`:Ty.x r•Y. • R 3 t'o.E • '`` e�' r '* _ ':t'�'g� '.• e as ' >�`$ . t ,•'", >_ r "�a eft � �1 f. Town of Barnstable All .°FHE,r � Regulatory Services i Thomas F.Geiler,Director + BARNS'I'ABEE, s �a Public Health Division rFo ;�a Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form r Date: 10 Designer: '/ WIT,7 'rl ��"� Installer: Address: . �O '`1���' 'l Address: b 7 '�� o was issued a permi+to install a (date) (inst/a�ll�er) septic system at S �� MP, based on a design drawn by /�, �n (address) 1 )NY I D "/ ►Y I dated (designer) ' 1-certify that the septic system referenced above was installed substantially according to "'Isle design, which may include minor approved-changes such as lateral relocation of the Astribution box and/or septic tank. t. . I certify that the septic system referenced above was installed v�nth''malor.changes q e, greater thsn'10' lateral reloeation of the SAS or any vertical arelooat►on of any component of the septic:_system)but in accordance with State&L6cal Regdiations. Plan revision or certified as-bM b.y designer to follow. ' ID may. taller's Mature) ; B• n `WASON R, � 0 1066 •� @15T�P SgN1T-A. (l) er s Signature) (AfhX e er's Statrip Here) PLEASE RETURN TO BARNP,T"I;E PUBLIC..HEALTH.DIVISIO C R C TIFi TE ®F. CONII' CE WILL NOT ZEJSSUED:Y BOTH-'THIS 1FGRM BUILT CAS ARE RECEIVED KV THE BAI2 S`TA$LE PUBLIC AT,LTUR THANK YOU. , rrn Q:Hea1th/Septic/Designer Certifica"lon'Fo ia8 Dig_ao6 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments fy.� qM 5 Pioneer Path Property Address °., P� Andora Hamilton Owner Owner's Name information is West Barnstable Ma 02668 5-23-17 required for every page. City/Town State Zip Code Date of Inspection ;b? Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms o� b on the computer, use only the tab 1. Inspector: key to move your cursor-do not Matthew Gilfoy use the return Name of Inspector key. B&B Excavation Company Name 374 Route 130 Company Address Sandwich Ma 02563 City/Town State Zip Code (508)477-0653 S113640 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 5-23-17 _ I 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments <c 5 Pioneer Path 4M Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System was in working order at time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °w 5 Pioneer Path M Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ® Y ❑ N ❑ ND (Explain below): The system required pumping more than 4 times a year due to broken or obstructedpipe(s). The ❑ Y q P P 9 Y system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 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: 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 '/day flow t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 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 El ❑ 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 Pioneer Path M Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 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): 330gpd t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. CitylTown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 4 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): See below Detail: "WELL WATER" Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: NA Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design-low (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: - t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner-date of last pump unknown 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: New SAS added to existing tank in 2008 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 4 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: Well >100'from leaching feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 3' feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: - years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallons Sludge depth: 6 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 30" Scum thickness 3 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? 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.): Tank was in working order at time of inspection with liquid level equal to outlet invert. Tank is in need of pumping at this time and should be pumped every two years for maintenance. Grease Trap (locate on site plan): Depth below grade: NA feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments , M 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is West Barnstable Ma 02668 5-23-17 required for every 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.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: NA Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: — Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 11 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 in working order at time of inspection with no sign of past backup or carry over. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): NA * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Pioneer Path M Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ Reaching pits number: 0 leaching chambers number: (2) 500 gallons ❑ 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.): Leaching was in working order at time of inspection. No high staining, damp soils or lush vegetation were present. Chambers had 4" of standing water with no higher staining. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: NA Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is West Barnstable Ma 02668 5-23-17 required for every page. Citylfown 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 FRONT B A1.71' B1.44' A2.68' 132.61' GARAGE A3.666" B3.UY 1 A t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 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: No GW 153" 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. 9-26-08 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Plan on file with BOH. Before filing this Inspection Report, please see Report Completeness Checklist on next page. (Sins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 r Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Pioneer Path Property Address Andora Hamilton Owner Owner's Name information is required for every West Barnstable Ma 02668 5-23-17 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 , Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 I ',�� Commonwealth of Massachusetts.:': Title 5 . ffcial Ir ec 'on or Subsu.,rface Sev�age Disposal System Form Not for Voluntary Assessments - 5,Pioneer Path Property Address .Richard Mann , i , >: Owner Owner's Name mforrr aU on: is West Ba[nstable Ma 02668 3/5/201.. requir.`ed for every a C !Town%p State Zi Code Date of Ins ection,,ge h+, P P Inspection-results..... must be,submitted on'th�s form In"spection form"s may:not be`altered in�any- way::Ptease see completeness checkl�st,a#the end,of the f©rm Important When A�. General lnfo.rmation 511ing.;out.#orris ...._:. `- re computer, ; ` use only the tab 1 Inspector key to move your cursor do not use the return; Seam ICI.".�Orle5 key : Name of Inspector Capewrde Enterprlses `. ; Company Name 153 Commercial St Company Address Mashpee ' _ Ma 02649 CityRown, I. -"State Zip Code 508 477=8877 !' SI 4522; -: .. :Telephone Number 'Lcense�;Number°:' B. Ce�t�f�catron; cer#Ify that I hake personally inspected the ev✓age disposal=system at';thrs address and that the information repo"rtedgbefow is true, accurate and c"ornplete as of the time of the nspec pn.,The mspectron - was performed basetl on my,trainin 'antl eXpenence in the proper function and" �mainfenance of on site sewage:drsposa!systems I am a DEP approved system,�nspector pursuant to Seaton 15 340 of Title 0j 5(310 CMR 15 00 The system 0 ® Passes ❑ Conditionally Passes:. ❑` �tl ;: ❑ Needs Further Evaluation by=the Local Approving Authority ,��' ....13 i Inspector s Signature :. Date ate: The system inspector shall submit a copy of this inspection report to the.Approvirig Authonty.{ oard of Health orDEP) vrthin 30 daysof completingAhrs{inspection If:the system is a;shared:'systenaor has a design flow of 10,OOO.gpd br greater, theinspector,and the system owner sha11 submit the report to the appropriate regional offrce,of"the........... EP The original slioultl be'sent toahe system owner and copies sentto'the buyer, if,applrcab e�andthe appra�ing authority ts repor#only describes condtttons at the>ttme of tnspectton;and under the condittons of use at that ttme.Thi'is nspectton daes.�not address how the system uvtlh perform:an°the future under:.- the same..or d>Ifferentconditions"of use . t5ins,.-11L10 _; T tIe S Qtf cial'Inspecton.Forin Subsurface Sewage"Dispasel System Page 1 of 17., Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown 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: The dwelling located at 5 Pioneer Path West Barnstable is served by a Title V septic system consisting of a 1000 gallon septic tank, distribution box and 2 500 gallon leaching chambers. The system was found to be in proper working condition at the time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts H Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown 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): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and 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 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 5 Pioneer Path Property Address Richard Mann Owner Owners Name information is required for every West Barnstable Ma 02668 3/5/2013 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fall 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. ❑ 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 asses if the well water analysis, performed at DEP y p y , p a 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: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts H Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 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 16,000 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•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 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 El ® 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 om ® ❑ 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)] 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): pro gpd provided t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Pioneer Path Property Address Richard Mann Owner Owners Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present.> ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 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 Official 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 ,•''� 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: system repaired 10/14/2008 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints ok, no leakage, vented through roof Septic Tank (locate on site plan): Depth below grade: 2.5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallons Sludge depth: 611 t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown 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 3' Scum thickness 3" 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 10" How were dimensions determined? opened covers, took measurements Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank does not need to be cleaned now but should be done soon and again every 2 years for proper maintenance. Inlet and outlet tee intact and in good condition. Water level was good, tank was not leaking and was structurally sound. Inlet cover is to grade with a steel ring and cover. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 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.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0' Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box is in good condition, functioning as intended. 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.): 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 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ 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.): Leaching facility was found to have approx 3" of standing water with a stain line only a few inches higher. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 1 Commonwealth of Massachu efts; 4 Title 5fficial Insp.j ctn ornn Subsurface Sewage,Disposal System Form Not for Vgluntary,:;Assessments 5 Pioneer Path .. . Property:Adiiress. Richard Mann Owner — Owne�s Name Infomatlon Is > WeSt Bam$table Ma 0266$ 315t2013 !. requ+red far every , Page-; CityTT,* _: _;; _ Slate " Ztp Code Date of inspection D System:anfarmatlon (cons} Sketch Of Sewage Disposal System Provide-a,view of the sewage"disposal syst .....I. . ties to at least two permanent reference andrnarks or benchmarks Locate all wells within 100.feet.pLocate where pubhe water•suppiy'enters the building Check one of the boxes below ® hand ske#ch 3n the area below ❑ drawing-'attachied separately . . . � � f A ;; 3 o ; 3 © ❑ �_ ! , + a3 r � _ . A 2... 'ro$ .:p ....i_ oS . tSins .11/10 . Title 5'Offiaai lnspecUon Form;Subsurtace Sewage t3 sposal System Page 15 M 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown 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: 12+ feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 9/17/2008 (perc test)Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health --explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: design plan perc test dated 9/17/2008,indicates that no groundwater was encountered at 153" and system is designed to have 5'+ seperation between bottom of s.a.s. and adjusted high groundwater elevation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 5 Pioneer Path Property Address Richard Mann Owner Owner's Name information is required for every West Barnstable Ma 02668 3/5/2013 page. Cityrrown 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 I TOWN OF BARNSTABLE C LOCATION s,f� {�io�2{r P14?7 _ SEWAGE VILLAGE j3,grrSry��G ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. _ r SEPTIC TANK CAPA6ITY /ODO LEACHING FACILITY:(type) =moo Li�Isi e®" ' (size) NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland anc Leaching Facility(If any wetlands exist within 300 feet of leach' g facility) Feet FURNISHED BY - I I V U�' 63s 3 4 1� I TOWN OF BARNSTABLE �G LOCATION ��oil {�" {J�4TLi _ SEWAGE#�O p�- YO(o VILLAGE U.J, r3#r11STs1J1e ASSESSOR'S MAP&PARCEL / S--U/7 INSTALLERS NAME&PHONE NO. i c O r SEPTIC TANK CAPACITY /ODO / LEACHING FACILITY.(type) 2=SOo (f ,wAV,6et5' (size) NO.OF BEDROOMS OWNER I LJi rlr` PERMIT DATE: /O _ 7-O COMPLIANCE DATE: /O Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY /(f/ -0,00� c ... `',arq�e �.y.. . � , ., 0 a yl, ti �e �� s � �. �• A �i L' S • . o q. � ® ,(.� (�J 5 No. , r ���" Fee E COMMONWEAL"TH`Of MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for Disposal 6pstem Construction i9Prmit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �jl/� Ow is Name,Address,and Tel.No. ® Assessor's Map/Parcel #/I`� 7 Aor J' aQ® pf 0/P., � ®l G Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ftk Ed Cbel euh Type of Building: Dwelling No.of Bedrooms 13 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 I Revision Date Title Size of Septic Tank / �� Type of S.A.S.12 A a,06 1941,41104MWO Description of Soil 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 jEnvinmental Code and not to place the system in operation until a Certificate of Compliance has been issued by Board Aigne 40 Date Application Approved by Date e� Application Disapproved by Date for the following reasons Permit No. Date Issued � ; No. c � � - Fee T �Va fTEE OMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftpfication for Misposaf 6pstent Construction 3permit i Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ stem Complete Sy stem y El Individual Components Location Address or Lot No. � Ow er's Name,Address,and Tel.No. Assessor'sMap/Parcel .i /, ' '` 7�fpS�' G � r� � J Installer's Name, aame,Address,and Tell.No. r Designer's Name,Address,and d Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) -� gpd Design flow provided gpd Plan Date:/ , �1j� Number of sheets I Revision Date Title ` Size of Septic Tank /� r /Jf ". T e of S.A.S. jl�fr Yp Al� Description of Soil !� d Nature of Repairs or Alterations(Answer when applicable)�guy/ilJ� V = 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 Envnmental Code and not to place the system in operation until a Certificate of Compliance has been issued 1h* Board of/] ealt.. fj,gned� _ C C /,� Date � 7�✓ • Application Approved by j Date ` Application Disapproved by V v z V J Date for the following reasons .+ r k. Permit No. Date Issued 4 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by at n D v r p a r• f a has been constructed i acco danc d1, with the provisions of Title 5 and the for Disposal System Construction Permit No. a e° ( / Installer Designer #bedrooms Approved design flow 3 gpd The issuance of this permit shall not be construed as a guarantee that the system wi fT as designed. Date l �r �/[u I1 Inspector �ij„/, -- -= - - - ------ --- --- -- --- ------------------------------------------- --=--.�_ . No. .Fee HE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS Misposaf Opstent Construction permit Permission is hereby granted to pa!/ ct • ) Rep 'r( Up trade ( ) bando ( ) System located at / /�j� _ 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:Construetio st be co- pleted within three years of the date of this permit. Date / Approved by / WELL VARIANCES GRANTED DURING YEAR 2002 • 1655 Main Street; Route 6A, - Variances granted 1/25/02, 107 feet to well, four (4) bedrooms approved 1595 Main Street, Route 6A—Variances granted to wells 120 onsrte and 140 to neighbor's well 7/17/02, , five (5)bedrooms approved • 40 Maggie Lane- Variance granted 120 feet to well 5/30/02, four(4)bedrooms approved. • 1025 Main Street West Barnstable-Variance granted to well 1/25/02, offices an workshop building, 418 gpd calculated flow r WELL VARIANCES GRANTED DURING YEAR 2002 • 1655 Main Street, Route 6A, -Variances granted 1/25/02, 107 feet to well, four (4) bedrooms approved • 1595 Main Street, Route 6A—Variances granted to wells 120 onsite and 140 to neighbor's well 7/17/02, , five (5)bedrooms approved • 40 Maggie Lane- Variance granted 120 feet to well 5/30/02, four(4)bedrooms approved. • 1025 Main Street West Barnstable- Variance granted to well 1/25/02, offices an workshop building, 41.8 gpd calculated flow f WELL VARIANCES GRANTED DURING YEAR 2002 • 1655 Main Street, Route 6A, -Variances granted 1/25/02, 107 feet to well, four (4) bedrooms approved • 1595 Main Street,Route 6A—Variances granted to wells 120 onsite and 140 to neighbor's well 7/17/02, , five (5)bedrooms approved • 40 Maggie Lane- Variance granted 120 feet to well 5/30/02, four(4)bedrooms approved. • 1025 Main Street West Barnstable-Variance granted to well 1/25/02, offices an workshop building, 418 gpd calculated flow Town of Barnstable �AIi1V5TAHLE. MAS& Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. January 25, 2002 Mr. Timothy Santos Holmes and McGrath, Inc. 200 Main Street, Suite 201 Falmouth MA 02540 RE: 1655 Main Street, Route 6A, West Barnstable Dear Mr. Santos, You are granted variances, on behalf of your client, Holly Rogers, to construct an onsite sewage.disposal system at 1655 Main Street, Route 6A, West Barnstable. The variances granted are as follows: 310 CMR 15.211: The soil absorption system will be located five (5) feet away from the property line, in lieu of the ten (10) feet minimum setback required. PART XIV SECT 2.00: The soil absorption system will be located 107 feet away from an onsite well, in lieu of the 150 feet minimum setback required. PART VIII SECT. 1.00:.The septic tank will be located only 48 feet away from the wetland, in lieu of the 100 feet minimum separation distance required. The variances are granted with the following conditions: (1) The septic system plans shall be revised to show the following (a) a locus map, (b) the notation should be revised to indicate that there are no other private wells located within 150 feet of the proposed soil absorption system, and (c) all of the variances shall be listed. A revised plan shall be submitted prior to obtaining a disposal works construction permit. Borselli. (2) The applicant shall submit a floor plan depicting the locations and dimensions of the rooms within the. building. Also, each room shall be labeled on the plan in regards to the proposed use. This plan shall be submitted prior to obtaining.a disposal works.construction permit. (3) No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (4) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining.a.disposal works.construction permit. (5) The septic system shall be installed in strict accordance with the revised plans. (6) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in. substantial compliance with the revised plans. These variances are granted. because physical constraints at the site severely restrict the location of a soil absorption system due to the fact that wetlands adjoin the property. It is the opinion of this Board that the proposed new septic system is designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sincerely yours, Csan G. Ral, R.S. Chairperson Borselli II ,� � � / � i j Town of Barnstable NAM Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. July 17, 2002 Mr. David Mason, R.S. DBC Environmental Designs East Sandwich, MA a Dear Mr. Mason You are granted conditional variances, on behalf of your client, Irina Weatherly, to construct an onsite sewage disposal system at 1595 Main Street, Route 6A, West Barnstable. The variances granted are as follows: PART XI I: The new onsite soil absorption system will be located 140 feet away , from the new onsite private well, in lieu of the 150 feet minimum separation distance required. PART XII: The abutter.'_s soil absorption system (located to the east of the subject property) will be located 120 feet away from the new onsite private well, in lieu of the 150 feet minimum separation distance required. The variances are granted with the following conditions: (1) The Registered Sanitarian shall provide revised plans to the Public Health Division showing relocation of the proposed soil absorption system ten feet further to the south, in order to provide the required minimum separation distance of 150 feet to the neighbor's well (located to the north- east. (2) No more than five (5) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. Mason (3)f The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to five (5) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (4) The applicant and/or owner shall not expand the office and retail uses at this site in the future without first obtaining written permission from the Board of Health. (5) The septic system shall be installed in strict accordance with the revised engineered plans. (6) The Registered Sanitarian shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board bf Health that the system was installed in substantial compliance with the revised plans. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to the proximity of private wells in the area. It is the opinion of this Board that the proposed new soil absorption system will be constructed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sin erely your , yne . Miller, M.D. Chair Mason Town of Barnstable NAM Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. May 30, 2002 Mr. Stephan Wallace P.O. Box 490 West Barnstable, MA e. RE: 40 Maggie Lane West Barnstable, A= 217-32 Dear Mr. Wallace, You are granted.a conditional variance to construct a soil absorption system at 40 Maggie Lane, West Barnstable. The variance granted is as follows: PART XIV SECT. 2.00: The soil absorption system will be located 120 feet away from the existing onsite well, in lieu of the 150 feet minimum separation distance required. This variance is granted with the following conditions: (1) The designing engineer shall revise the plans to show the following: (a) a 1,500 gallon septic tank and (b) the correct soils encountered during the soil evaluation (loamy sand) as described in the sieve analysis report. (2) No more than three (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (3) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. Wallace rr (4) The septic system shall be installed in strict accordance with the revised engineered plans. (5) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised plans. These variances are granted because physical constraints at the site severely restrict the location of a soil absorption system due to the location of the existing onsite well. The Board was informed that the property owner possesses insufficient funds to construct a new well at this time. It is the opinion of this Board_that the.__proposed soil absorption system is designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sincerely yours, Lt�, Pusan G. ask, R.S. Chairperson Wallace f Town of Barnstable b� Iwo 6�o NAM Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. June 25, 2002 Mr. Stephen A. Haas, P.E. Eagle Surveying Inc. 923 Route 6A Yarmouthport, MA 02675 RE: 1025 Main Street, West Barnstable, A = 178-24 Dear Mr. Haas, You are granted conditional variances on behalf of your client, Robert Olander, to construct an onsite sewage disposal system at 660 Main Street, West Barnstable. The variances granted are as follows: PART VIII, SECTION 1.00: The soil absorption system will be located ninety- three (93) feet away from wetlands, in lieu of the one-hundred (100) feet minimum separation distance required. PART XII, SECTION 3.00: The soil absorption system will be located one hundred and forty-five (145) feet away from the onsite private well, in lieu of the one hundred and fifty (150) feet minimum separation distance required. 310 CMR 15.405 (1)(a): The leaching facility will be five (5) feet away from the property line, in lieu of the ten (10) feet minimum separation distance required. These variances are granted with the following conditions: (1) No person shall change the use within any of the units of this building without first obtaining written permission from the Board of Health. Haas (2) No person shall increase the design or flow nor the estimated wastewater discharge flow within any of the units in this building without first obtaining written permission from the Board of Health. (3) The septic system shall be installed in strict accordance with the engineered.plans dated May 16, 2002. (4) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the submitted plans dated May 16, 2002. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to the proximity of the onsite well, neighboring wells, and wetlands adjoining the property. It is the opinion of this Board that the proposed new soil absorption system is designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sin erely yo s ayn Miller, M.D. Chair an Haas Town of Barnstable Board of Health 200 Main Street, Hyannis MA 02601 Office:.508-862-4644 Susan G.Rask,R.S.. FAX:. . 508-790-6304 Sumner.Kaufman,MSPH Wayne.Miller,M.D. January 25, .2002. Mr. Peter McEntee,. P.E. 23 Deer Hollow Road Forestdale, MA 02644 RE: 296 Long. Pond.Road, Marstons Mills Dear Mr. McEntee,. You are ranted variances, on. behalf of our client Kenneth Ki nes to construct 9 a y p , an. onsite sewage.disposal.system.at 296 Long. Pond. Road, Marstons. Mills. The variances granted are as.follows: PART XIV, SECTION 2.00: The soil .absorption system will be located. 123 feet away .from. the. onsite well, in lieu of the, one. hundred and. fifty (150).feet minimum setback required. PART XIV, SECTION 2.00:. The. soil. absorption. system will be located 141 feet away from. the neighbors'. well,. in lieu of the. one hundred. and.fifty. (150)feet minimum setback required. The.variances. are granted.with the following conditions: (1) No more than. five (5). bedrooms maximum are authorized. at this. property. Dens, study rooms,, offices, finished attics, sleeping. lofts,, and similar-type rooms . are considered "bedrooms" according. to. the MA Department of Environmental Protection. (2) The applicant shall. record a properly worded. deed restriction, signed by the. owner of the property, at the Barnstable. County Registry of Deeds restricting. the property to. five (5) bedrooms maximum. A copy of the recorded deed restriction shall be submitted. to the Health Agent prior to obtaining. a disposal works.construction permit. McEntee2 f ' (3). The. septic system shall be installed in strict accordance with the engineered plans dated, December 29, 2001, signed January.7,. 2002 by the designing. engineer. (4) The designing. engineer shall. supervise the construction of the onsite. sewage disposal. system and. shall. certify in writing. to the. Board. of. Health that the system was installed. in. substantial. compliance with.the submitted plans dated. December 29,: 2001. and. signed. by the designing. engineer dated.January 7,.2002. These variances are., granted because physical constraints at the site severely restrict the. location of a. .soil absorption. system due to the fact that there are wetlands. adjacent to. this. property. The proposed new soil absorption. system is designed. to meet the. maximum feasible. compliance standards. contained. within. the State. Environmental Code, Title V.. Sincerely yours,. Susan G. Rask,. R.S.. Chairperson McEntee2 TME `"o The Town of Barnstable 1&3AA.IWNST.A4JMBaX. = Office of Town Manager 16gq. p1� 367 Main Street,Hyannis,MA 02601 Office: 508-790-6205 Warren I Rutherford Fax: 508-775-3344 Town Manager TO: Thomas McKean, Director Health Department FROM: Warren J. Rutherford Town Manager/ab SUBJECT: Shufelt Complaint DATE: October 23, 1992 In reference to additional information received from the Shufelts (see attached), please attempt to provide a further response to this particular matter at your earliest convenience. l Laura F. Shufelt 'Fric W. Shufelt 1696 Osterville-west Barnstable Rd. TOWN OF q& 4STARLE West Barnstable, MA 02668 TOWN.MARA%rfrfA,�OFFICE (508) 420-0579 October 16, 1992 '92 OCT 21 .R1 : , Mr.' Warren Rutherford Town Manager 367 Main Street Hyannis, MA 02601 Dear' Mr. Rutherford: I received your letter.and the copy of the correspondence from. .Mr.. McKean today i�- reaction'•is one of- anger and didbei ief: ro*?tra, to what Mr. McKean wrote, the septic system was installed June. 11 &`12, ' 1992, two and a half months after the expiration of the disposal works permit he refers .to. However, according to the Building Inspector's office, the work was completed using disposal works permit #90-118 which was applied for on 11/28/91, 'well after the.expiration of the variance. I would like to.have our concerns taken seriously, not brushed off as "not significant" as Mr ,McKean wrote. From my first call .to the Health Department, Ia have :been treated like 'aybothersome pest. „I - y Mr.. McKean justifies the decision to grant a variance by ,com'paring it to past decisions, but history has shown that past decisions have rot always been right or safe. ' His statement that the appeals period has, expired is amazing. How were we suppose to appeal 'a decision that was made behind our, backs, three years, before. cons truction►began? This y . is especially true since-in 1989 we were assured by the Health Department that we would be notified if a vat ':iyance was F" quested. c: 1., •_ r��. � Y ..# Yid � •7 t 'f _' ,f:. .. -. � This total disregard for' our rights as taxpaying property owners is the real issue. +''•'►; .x � t _ ,[ .,� ' f If, after our many conversations; Mr Dunning believes, my main ,8 • objection is the.size of. the garage; I can only say he should enroll in a course to improve listening skills. My complaint from day 1; June 15, 1992, has been the issuance of a variance that may affect the health of my family without our being notified. The copy of .the variance, after 3 months of requests, only added to my concerns. First, the issue of the expiration date. .r Page 2 That, to me, states that the owner has until -that date to get •a building permit. Maybe there is 'a loophole whereby if the owner applies for a disposal works permit he can extend the-variance 2 years, during which time he can sell the- lot and the new owner can reapply for a disposal works permit with a different design, arid-it will all be legal and, above board. Somehow, I doubt it. Second, the house size, or rattier number of roams, is restricted by the variance but, when asked' the •Health •Department'had not even- looked at the plans prior to signing off on the building permit. My concern. regarding the garage is not its size but rather 'the fact, ' that the area above it is finished and should -be included`in the room count.' I q��estion' whether that has been done. t r Third, the variance requires the owner to have the septic system - -pumped out every three years. ' Given the performance of the Health ' Department toIdate on this, I vuuld like sane-assurance that this will be monitored and enforced. Fourth, and last, as I discussed with you; -our septic system is ' seven years old and must be increased due to the saturation of'the leaching area. Fortunately, we have the space to add.ariother. However, ' should this occur- on the lot `in question, the only'place to add- another, is closer to our well. , We are- concerned that, if the Health Department, doesn't change its policy; another,,variance will be granted without our knowledge that further endangers our water quality and the health " of our children. We are not asking for the house to be torn down, ;although we do t believe it was built after the variance expired and should•, ,at the very ' least, be subject. to a new hearing. We are asking for some s',' le controls. and assurances•to make sure our watertremains safe. Thank you, Laura F. Shufelt Eric W. Shufelt FROM : SCOtt CHMP8ELL I-HA NU. : 5d'JIIWU uct. n1 enutj We.eern re OCT. 1.2003 12;:96FIi 6FRNETA3LE SOFRL OF HEA-TH t,o.012 P•.3/5 The Town of Barnstable Health Department Ga ( SOL' ' 367 Main Street, Hyannis, MA O'2601 Office SN.790-6265 Hone A. McKean FAX 508 775.3344 Dire-t, r of PAU Healtb TO Warren J. Rutherford, Town Manager 1 FROMr Thomas A. Kcxuanf Director of Public Soalth .Q./•ad' r-� DATE! October 26, 1992 GUBJDCTa Shufalt Letter Dated October 16, 1992 My memorandum dated September 29, 1292 briefly reepomds to Fir. and Kra. ehufelt•s concern regarding the date of installation of the septic system. Health Inapeetor Jerome Dunning stated the septic system aonatruction began within the two year time frattne, prior to March 21, 1992. The Certificate of Compliance was not issued until months later, after Juno 15, 1292 when we received the certification letter from the designing Sanitarian. I believe the aonfuaion here is the difference between the date of construction of the @optic system versus the date of completion of the septic system. The two year expiration deadline of the Disposal Works Construction permit only reform to the date the licensed installer begins construction of the on®it® somagqe disposal eyatem, not the date of cotnplstion of the onsite teewaga disposal system construction. Also, the Disposal Works Construction permit #90-119 coats issued on March 21, 1990, not on 11/28/91. The additional four concerns in the above referenced letter are addressed as followso 1) The first concern is the possibility of re-deaLlning house plans prior to construction. This is presently enforced by the Building Department. The Health Department has been involved in this proeesn. I would like to dinauusp this issue further with Fir. Joseph DaLuz, the Building Cammissianar and Mr, Robert Schernig, the Planning Director. The Realth Department and the Building Department work together along with tho Conservation Department# Planning Department, and -the Historic Department as one Division, entitled the planning and Peimitting Division. This Division meets on a regular bacia to dicause permitting issvea. 1 will ask Mr. Schernig, the Planning Director, to plaeo this itasue on the agenda of car next Division meeting. r FRUM : bLUtt LHMFUELL FHX NU. 5dV1108 Uct. 01 2008 b2:22 M Fl,s OCT. 1.2002 121371F11 ..AR`IST�#sLE DOFF m or HULTH Iio.312 P.a, 2) The second concern is th®re is a tiniahed "axe&" located above the garage. An the variance letter states, the dwelling cannot contain more than three (3) bedrooms. If the room above the to is enclosed, heated, and provides sufficient area to be utilized for sleeping pyrposes, that room shall be counted as a "bedroom". I again suggest that the Building Department personnel inspect the dwelling and the garage to ensure it conforms with the state said local Building Coders and the submitted plans. 3) The variance requires the owner to pu&V the septic system every three years, This Vill be eaforoed by the Health Department. On or prior to June 19, 1995, the owner is r®quixad to c rrtify to the Hoard of Health that the system was pumped. If the a®rtitication is not received, the Board of Health may require the Health Department to write an order letter to the owner of the dwelling. 41 The concern i6 that another variance will bs granted without Mr. and Mrs. 8hafelt' s knowledge should the septic system at Lot 21 Pioneer Path become saturated. Please be advised that another variance will not be neeeasary. According to the letter from the Board of Health dated September 18, 1989, the Board also grantad a variance to install the reserve area 123 feet from the abutters well at Lot 7. In conclusion, Blsase be advised anyone can request a hearing before the Board of Health. If Kr. and lira. Shufelt would like to request a hearing, please write a letter briefly explaining the concerns to: Town of Barnstable Board of Health, P.O. Box 334, gyannis NA 02601. Thank you. r P THE, The Town of Barnstable Health Department { 'A"STAU & 367 Main Street, Hyannis, MA 02601 039 A Op t67 q. \ �0 Yis a' Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health TO: Warren J. Rutherford, Town Manager FROM: Thomas A. McKean, Director of Public Health �0, nz DATE: October 26, 1992 SUBJECT: Shufelt Letter Dated October 16, 1992 My memorandum dated September 29, 1992 briefly responds to Mr. and Mrs. Shufelt's concern regarding the date of installation of the septic system. Health Inspector Jerome Dunning stated the septic system construction began within the two year time frame, prior to March 21, 1992. The Certificate of Compliance was not issued until months later, after June 15, 1992 when we received the certification letter from the 9 desi nin Sanitarian. designing I believe the confusion here is the difference between the date of construction of the septic system versus the date of completion of the septic system. The two year expiration deadline of the Disposal Works Construction permit only refers to the date the licensed installer begins construction of the onsite sewage disposal system, not the date of completion of the onsite sewage disposal system construction. Also, the Disposal Works Construction permit #90-118 was issued on March 21, 1990, not on 11/28/91. The additional four concerns in the above referenced letter are addressed as follows: 1) The first concern is the possibility of re-designing house plans prior to construction. This is presently enforced by the Building Department. The Health Department has been involved in this process. I would like to discuss this issue further with Mr. Joseph DaLuz, the Building Commissioner and Mr. Robert Schernig, the Planning Director. The Health Department and the Building Department work together along with the Conservation Department, Planning Department, and the Historic Department as one Division, entitled the Planning and Permitting Division. This Division meets on a regular basis to discuss permitting issues. I will ask Mr. Schernig, the Planning Director, to place this issue on the agenda of our next Division meeting. f ' e � 2) The second concern is there is a finished "area" located above the garage. As the variance letter states, the dwelling cannot contain more than three (3) bedrooms. If the room above the garage is enclosed, heated, and provides sufficient area to be utilized for sleeping purposes, that room shall be counted as a "bedroom" . I again suggest that the Building Department personnel inspect the dwelling and the garage to ensure it conforms with the State and local Building Codes and the submitted plans. 3) The variance requires the owner to pump the septic system every three years. This will be enforced by the Health Department. On or prior to June 15, 1995, the owner is required to certify to' the Board of Health that the system was pumped. If the certification is not received, the Board of Health may require the Health Department to write an order letter to the owner of the dwelling. 4 ) The concern is that another variance will be granted without Mr. and Mrs. Shufelt's knowledge should the septic system at Lot 2I Pioneer Path become saturated. Please be advised that anot er variance will not be necessary. ing o t e letter oard of Health ated September 18, 1989, the Board also granted a variance to install the reserve area 125 feet from the abutters well at Lot 7. In conclusion, please be advised anyone can request a hearing before the Board of Health. If Mr. and Mrs. Shufelt would like to request a hearing, please write a letter briefly explaining the concerns to: Town of Barnstable Board of Health,, P.O. Box 534, Hyannis MA 02601. Thank you. CUi K- kQUID SURVEY, INC. BOX 51 Cummaquid, MA. 020"31 Edward E. Kelley , President June 15, 1992 Town of Barnstable Board of Health 367 Main Street Hyannis, Ma. 02601 Refs Lot # 21 Pioneer Path West Barnstable, Ma. The Leach Pit was installed in accordance with the Variance granted by the Board of Health on September .18, 1989. The Pit was installed in June of 1992. 0,\,70 Of 1,14p EDWAR Gr' Cjsr E R.MALL y KE:L! EY �' Fo Reg, � Land d urvey r Re a i ` L L0")� SgNrtaa�a� ` `ofTXETO`, The Town of Barnstable Health Department 367 Main Street, Hyannis, MA 02601 Op t67q. `� Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health TO: Warren Rutherford, Town Manager FROM: Thomas McKean, Director of Public HealthcQ, OAOL DATE: September 29, 1992 SUBJECT: SHUFELT COMPLAINT, WEST BARNSTABLE-SEPTIC VARIANCE I am in receipt of the electronic mail correspondence dated September 28, 1992. I believe Mrs. Shufelt is misinformed, the permit was not issued after the variance expired. The disposal works construction permit for Lot 21 Pioneer Path, West Barnstable was issued on 3/21/90, more than four months before the variance expired. The permit was valid for two years and the septic installation began within that two year time frame. A copy of the permit is attached. Also, this variance was granted from a local Board of Health Regulation which prohibits the installation of a leaching facility within 150 feet of a private well. The State Sanitary Code, Title V, also regulates the set-back distance and prohibits the installation of a leaching facility within 100 feet of a private well. The applicant in this case met the State Sanitary Code but not the local Health Regulation; he/she requested a variance to install the leaching facility 133 from his/her neighbor's well. I do not believe a 17 foot variance is significant. The Board has granted variances with only a 102 feet separation distance in the past. I believe the appeal period has lapsed and it is now too late to appeal the Board of Health decision. An appeal could have been filed within thirty (30) days of the Board of Health variance hearing, which was held September 16, 1989. In regards to the groundwater direction flow question, a hydrologist or some similar professional would have install at least three (3) monitoring wells and study the water depths in the monitoring wells on the site for several days in order to figure out which direction the groundwater flows. G Mr. Dunning stated he spoke with Mrs. Shufelt several .times. He believes she is unhappy about the large garage constructed on this site. The owner apparently collects classic cars and stores them in this large garage. In regards to your question concerning an occupancy permit, the Building Department has control over such permits. However, in the Health Department's view, there would be no basis to deny the occupancy permit due to the fact that the applicant appears to have followed the proper Board of Health and Health Department procedures. However, the occupancy permit could be denied for other issues which may apply, such as building code violations. If the real issue is that Mrs. Shufelt is upset about the size of the garage, I suggest that the Building Department personnel should check to see if the garage conforms with the Building Permit issued and to see if the garage conforms with the State and local Building Code regulations. y a, TOWN OF BARNSTABLE LOCATION �/t?` � N SEWAGE # .� MAP & LOT VILLAGE �� � ASSESSORS INSTA LLER'S NAME & PHONE .NO. l�G��!-�/'1� C�✓'"`�T� � SEPTIC TANK CAPACITY (size) LEACHING FACILITY:(type) r �" NO. OF BEDROOMS _,_ _ RIVATE WELL R PUBLIC WATER, BUILDER OR�LtYt' D DATE PERMIT ISSUED: • DATE COMPLIANCE ISSUED: No VARIANCE GRANTED: es a - O cv�rcg. AS-i N �roUK wN OF BARNSTABLE LOCATI SEWAGE # � i VILLAGE / ��v� �? ASSESSOR'S MAP & LOT,��617=ate INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY lft6 LEACHING FACILITY:(type) /� �/ (size)_ NO. OF BEDRO-OM'S RIVATE WELL R PUBLIC WATER BUILDER 016S +'��E& 1,1,4oAJ5 DATE PERMIT ISSUED: I I DATE COMPLIANCE ISSUED: VARIANCE GRANTED: es No � 1 ��a u��� �`�� E'� 6�, O ��r c� ��,�,� C�r��- ����� VR7e No.. •-_...... FEic _.... THE COMMONWEALTH OF MASSACHUSETTS M IV 12 BOARD OF HEALTH �W'N.........OF........ / - Ls�s 'C ................ ................ .AppfiratUvn for UWpuuai Varks Tonaft aiun f.ermit Application is hereby made for a Permit to Construct (✓r or Repair ( ) an Individual Sewage Disposal System at: Location:-Address or•Lot No. .._4 41 �� •-----------------•--.........--•-•• ----......S.v7 ....,}� '� ® Z.l........................-•---- •- - - own Address W a ....... Installer Address d ��,��Type of Building Size Lot.. 7.,..3� .....Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) Other—Type of BuildingNo. of persons............................ Showers Cafeteria WOther fixtures -----------------------------------------•----------•• ••-•-••-•-.....••-----•-••-----.......-•----•-•------....-------------------•............................................ Design Flow.-_--.--.---•-- ...................gallons per person per day. Total dailyflow...............330.._ ............gallons.W ��WSePtic Tank—Liqaid caPacitY.�°bogallons Length.._q•G...... Width....� _ Diameter________________ Depth.s `8`'.. x Disposal Trench—No..................... Width................... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No.......Z.......... Diameter......e� Depth below inlet...-g!.:E.... Total leaching area.q�Z..4�..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed b ...... !'!o�r ! . . .. .. Date..�!�r.... Test Pit No. 1...4minutes per inch Depth of Test Pit...l� .7_.. ------ Depth to ground water..... .......... Test Pit No. 2----G 7--..minutes per inch Depth of Test Pit..L ...... Depth to ground water........................ a ...............................................!...B----.-'------ - ............................ ........--------------..o..--�----- ---------- O Description of Soil.....®f- �! ...................................... .......... B _... ........_. U .....•-••.........� �_•-•-•• Mt�-ca..._�S',�.� DESIGNING..ENC�J1�l FF.':a .:T. W.E.L bl z -- INSTALLATION AND CERTIFY.t1�1_I�lRlT91�1 r...............................••-- `f'F1E" Y Tl:M WAS INSTALLED INS•- U Nature of Repairs or Alterations—Answer whe TRIQT.................................... �� ►��]i;E'TO PLl3iV. 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 ' ue y th b d heal Signed...... -----... ...... ---••----•............ .. .......... ... Application Approved 'By-•--=- _15 ... .......... .. ------..... ..--••-------------- .............................eO .......... Date Application Disapproved for the following reasons:.............................. ............................................................................ ------•-•........................................................•------....--•-------............-•-•--........-•--------•-------------.......-•---•----------------------.........•-••••••--•-----•---- / > ate Permit No. --�'�-----------" G ------------..... Issued....ty.:�1_..-4:; .--- Date ..... l No Y/f '. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH - --.........t>!�/1/.------...OF........ /3%G USTr�'G .................................. ApplirFa#ion for Disposal Marks Tonstrudion 1hruti# Application is hereby made for a Permit to Construct (,,� or Repair ( ) an Individual Sewage Disposal System at /! •i! r' f�MI'� VI// T, �/,?�v s GaT �' / ................__ _...............-• ---- ...._.__...__..._....... ------•---......-------- ................. -- ....._....--............--•..........------ Location-Address or Lot No. S•.---.. .----..SG?�.�� VX 7l�U!i Ti-1 - ......_.... .......................................•---•--................................. Owner Address W Installer Address Type of Building Size -•--._Sq. feet V Dwelling—No. of Bedrooms................................ .Expansion Attic ( ) Garbage Grinder ( ) P4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q•1 Other fixtures ------------------------•--------------....--••---•---.------........-------------------------•---•---•--------.....•-----•........._..__.....-------- W Design Flow...............��-•_�...................gallons per person per day. Total daily flow............. 0__. ------ ......gallons. _ th ���WSePtic Tank—Liquid caPac>ty__/ao_a_gallons Length____ G_..____ Diameter----------•-.... DeP =• - x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area...--^........a•.sq. ft. Seepage Pit No-------/........... Diameter._...Z4....... Depth below inlet..:.-'?.......... Total leaching area.:x Z..�2_sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by......G:. .^./�.j.. L � ....�_C.`/ Date..'-f:.... y - ------- ,`�a Test Pit No. I...4... .._.minutes per inch Depth of Test Pit.... ......... Depth to ground water...............•........ f=, Test Pit No. 2.._!.__`^....minutes per inch Depth of Test Pit__ __.. Depth to ground water.......".............. .............•---------------------•----••-------..................-•••••--••••-•---.............--•......................................................... 0 Description of Soil.....0 _/L'i ' G_G- /; .��;" laio:...� -- - 1v3..So� ----•........ 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 TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................... .........................._.... Application Approved By........e�-!�,..' !. ............................................... Date Application Disapproved for the following reasons:----•-------------••----..•.............................................................................. ..............•-----•-----.......-------•--•-•--•-•-••-•-............---------.............--•-----•-•--•....................-----•-------•-•---•-•-•---------------------•••.......-----------•••-•-•--- ate .1.._f.._. ................... Issued-_..r .. .....................Permit No..... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................... .... OF..................... ................................................................. (9rdifirab of (1 ampliana THIS IS.TO CERTIFY,_That the Individual Sewage Disposal System constructed (t,,<or Repaired ( ) Install at....... -- ' ``!..... ' " ., ."............;......... �-�--..........:... =-- ............................................. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.._ __---___ 1 ....... dated....__ --x. /.. ,�---.._.-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......................... ....................................................... Inspector------------.... .--a ................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH y-vw A E— s? ..........................................OF........:.......................................................................... ............ ... FEE .*r-�" . Disposal orko Tonstrur#ivit Frrutit Permission is hereby granted_.. 5; " ' _� _.__: ` ........................................._.... to Construct (&,I or Repair ( ) an Individual Sevv ge Diis�possal,, em at No.. r '.'"71. . ,gyp!'a.'.._ '.- •�"�r'= - - ............................................................. Street ^^` as shown on the application for Disposal Works Construction Permit No/ �"l Dated..... ....�..�� ............................•--.........-----•---------•-----...........---•-••...---••--••••••--•....._ Board of Health DATE........................... ..................................................... FORM 1255 A. M. SULKIN. INC.. BOSTON ~ RARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT LABORATORY REPORT r VOLATILE ORGANIC CHEMICAL ANALYTICAL RESULTS Client: GARY A ELLIS Collection Date: 03/12/90 Mailing Address : 20 CAPT SIMMONS Date of Analysis : 03/13/90 S YARMOUTH MA 02664 Type of Supply: WELL Well Depth (FT) : Not Given Telephone: 362-9802 Sample Location:LOT 15 PIONEER PATH LAT. (DDMMSS) : Not Given W BARN LONG. (DDMMSS) : Not Given Collector: GEORGE HEUFELDER Map/Parcel : 28-017-001 Affiliation: ' BCHED Analytical Method: 502 .1=1 , 502 . 2=2 , 503.1=3 , 504=4 , 524 . 1=5 , 524 . 2=6 , 502 . 1/503 -------------------------------- ------------------------------------ Contaminants Anal . Result MCL Detection Meth. ug/1 ug/l Limits (ug/1) ------------------------------- ------------------------------------ Chloroform 7 0 . 5 0 . 5 Only those compounds listed above were detected. Attached is a list of chemicals which the method is capable of detecting. r NOTE: Contaminant levels equal to or exceeding the Detection Limits are reported. Contaminant levels below the indicated Detection Limits are reported as -ND- MCL means Maximum Contaminant Level for EPA-regulated compounds . (ug/l = micrograms per liter = Parts Per Billion) The Environmental Protection Agency has set Maximum Contaminant Levels (MCL) for the following compounds . This sample compares as follows : COMPOUND MCL (in PPB) Benzene 5. 0 * level not exceeded * Carbon Tetrachloride 5 . 0 * level not exceeded * 1 , 2-Dichloroethane 5.0 * level not exceeded * 1 , 1-Dichloroethene 7 . 0 * level not exceeded 1 , 4-Dichlorobenzene 75 * level not exceeded 1 , 1 , 1-Trichloroethane 200 * level not exceeded Trichloroethene 5. 0 * level not exceeded Vinyl Chloride 2 . 0 * level not exceeded Comments or additional compounds found: + Bernard E. Bartels , n.D. L oratory Director a,°� BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT SUPERIOR COURT HOUSE r BARNSTABLE, MASSACHUSETTS 02630 U s. t?j aa� TABLE 1. Compounds Detectable by EPA Method 502.1* PHONE: 362-2511 EXT. 330 LAB 337 COMPOUND D.L. COMPOUND D.L. CLINIC 340 Benzene 0.5 1 ,1-Dichlor.oethane 0:5 Carbontetrachloride 0.5 1 ,1-Dichloropropene 0.5 1 ,1-Dichloroethylene 0.5 1 ,3-Dichloropropene 0.5 1 ,2-Dichloroethane 0.5 1 ,2-Dichloropropane 0.5 para Dichlorobenzene 0.5 1 ,3-Dichloropropane 0.5 Trichloroethylene 0.5 2,2-Dichloropropane. 0.5 1 ,1 ,1-Trichloroethane 0.5 Ethylbenzene 0.5 Vinyl Chloride 0.5 Styrene 0.5 Bromobenzene 0.5 1 ,1 ,2-Trichloroethane 0.5 Bromodichloromethane 0.5 1 ,1 ,1 ,2-Tetrachloroethane 0.5 Bromoform 0.5 1 ,1 ,2,2-Tetrachloroethane 0.5 Bromomethane 0.5 Tetrachloroethylene 0.5 Chlorobenzene 0.5 1 ,2 ,3-Trichloropropane 0.5 a Chlorodibromomethane 0.5 Toluene 0.5 Chloroethane 0.5 para Xylene 0.5 Chloroform 0.5 ortho Xylene 0.5 Chloromethane 0.5 meta Xylene 0.5 ortho Chlorotoluene 0.5 Bromochloromethane 0.5 para Chlorotoluene 0.5 . Dichlorodifluoromethane 0.5 Dibr.omomethane 0.5 Fluorotrichloromethane 0.5 meta Dichlorobenzene 0.5 Hexachlorobutadiene 0.5 ortho Dichlorobenzene 0.5 Isopropylbenzene 0.5 trans-1 ,2 Dichloroethylene 0.5 n-Propylbenzene 0.5 cis-1 ,2 Dichloroethylene 0.5 Sec-butylbenzene 0.5 Dichloromethane 0.5 Tert-butylbenzene 0.5 D.L. is Detection Limit in micrograms per liter or parts per billion (ppb) . This table lists our normal limits of detection. If we report a smaller amount, ,then our detection limit was lower for that analysis. *A photoionization detector is used in series with the electroconductivity detector, thus allowing for the analysis of most. of the compounds listed in . . EPA Method 503.1 as well . TABLE 2. Compounds which have Maximum Contaminant Levels (MCLs) set by the Environmental Protection Agency. COMPOUND MCL (in ppb) Benzene 5.0 Carbontetrachloride 5.0 1 ,2-Dichloroethane 5.0 1 ,1-Dichloroethylene 7.0 para Dichlorobenzene 75 1,1 ,1-Trichloroethane 200 Trichloroethylene 5.0 Vinyl Chloride 2.0 Total Trihalomethanes 100 Chloroform, Bromodichloromethane, Chlorodibromomethane, and Bromoform comprise the total .trihalomethanes. S P ti, i Log NL�mber: Bottle # XVI E Date: Nov 13 , 1989 of s^�M BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT SUPERIOR COURT HOUSE BARNSTABLE, MASSACHUSETTS 02630 Ass DRINKING WATER LABORATORY ANALYSIS PHONE:362-2511 Ext. 337 Client: Gary A. Ellis Collector: Gary El l i s Mailing' Address: 20 Cagti Simmons Affiliation: owner South Yarmouth ; MA 02661ime & Date of -` 02664 Collection: 11/2/89 9: 00 a .m. Telephone: 362-8582 Type of Supply: well Sample Location: Lot #18 Pioneer Path Well Depth: 801 _West Barnstable . MA Date of Analysis: 11/9/89 2 : 20 P .M . PARAMETER� SAMPLE RESULT RECOMMENDED LIMITS Total Coliform Bacteria/100 ml O 0 pH 5 . 8 Conductivity (micromhos/cm) 135 500.0 Iron m) , 1 0.3 Nitrate-Nitro en m 10.0 Sodium m 20.0 I. X Water sample meets the recommended limits for drinking of all above tested parameters. II. Based only on results of the parameters tested for this sample, the water is -suitable for drinking but may present the problems checked below: A. .-Water: sample has higher "than average levels of Nitrate. future monitoring is recommended (2-3 times per year) to establish any upward trends. B. The low pH of the water may shorten the useful life of the house's plumbing. C. Water may present aesthetic problems (taste, odor, staining) due to D. Water sample has high levels of sodium. Persons on low sodium diets should consult their doctor. III. Due to one or more of the reasons checked below, this water sample is unfit for human consumption: A. High Bacteria B. High Nitrates REMARKS: FF19!86le Evanly lquofth and EnvironmentaT- Depar'ment shall not endorse any statements, interprc;ations or conclusions made by anyone else concerning these results wi- hout written consent. CC: Barnstable Board of .Health 1/7185 Laboratory Director APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS LOCATION Lam Z i �joAl&�� NO. ? 6 VILLAGE BLYl2/VS�o z DATE APPLICANT Z/SSc,G1 S FEE _ ADDRESS TELEPHONE N0. (Non-refilndable ENGINEER TELEPHONE NO. 3eZ-ZZee DATE SCHEDULED (Applicant' s signature) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . O . O'. 00 O O . . . . . . . . ASSESSOR'S MAP & LOT NO: /- /08 /7 SOIL LOG SUB-DIVISION NAME Z4,yJ Cet„e_T 371S z DATE / G u' /jam `�' TIME /o :oo ,A717 EXPANSION AREA: YES L,- OO ENGINEER TOWN WATER PRIVATE WELL BOARD OF HEALTH l�L� �`LGGG EXCAVATOR SKETCH: (Street name, etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes ) NOTES : Z 1717 m c O, 7 4 •�� yV � • 9�6V CIS z 9 of off. :y 2 Q3t• -jN P,� p. / 'fig• n r . I 3i .oj• 0 � . . `cL 3�• 3`F` w PERCOLATION RATE : /c,��- r2- r TEST HOLE NO: a ELEVATION: TEST HOLE NO: ELEVATION: wooD1-Of.A"7 ,� uJaaQ,/ad)r"rl 3 3 ik1 -' sv/ u yg 4 5 . 5 6 6 9 9 10 10 12 12 13 13 14 14 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE : LEACHING FIELD LEACHING PITS t/ LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS : NOTE: ENGINEERING PLANS MUST SHOW NUMBER .ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P , E , AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Gravel) if DEEP OBSERVATION HOLE1O.G _ Hole# Depth from Soil Horizon Soil Texture Soil Color �' Soil Other Surface(in.) (USDA) (Munsell) ' Mottling " (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C _siste c a Gravel) s S + DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) __ _ _ _(USDA)- (Munsell) Mottling (Structure,Stories',Boulders. - onsi to Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No Yes ' Within 100 year flood boundary Nq!Z Yes— Depth of Naturally Occurring Pervious Material t Does at least four feet of naturally occurring perv'o atonal exist in all areas observed throughout the area proposed for the soil absorption system? , If not,what is the depth f naturally occurring per ious material" ! f{' Certifiication q I certify that on b 1 (date)I have passed the soil evaluator examination approved by the Department of Environ ental Protection and that the above analysis was perfor ed by me consistent with . the required ' ing,exper' e experi nce described in 310 CMR 15.017 Signature Date L ��� • QASEpTIC1PERCFORM.DOC oF� Town of Barnstable P# Department of Regulatory Services BAMMBL& Public Health Division Date s� ��FD Nilg� 200 Main Street,Hyannis MA 0260TAUT ! J _ t Date Scheduled ; � O`I �1, 07- Time Fee Pd. Soil Suitability Assessment for Sewage D's osal Performed By: �l►�� a/�y 4�"'`"U y� Wi_tnessed By-�V !Y LOCATION& GENERAL INFORMATION Location Address �5 Owner's Name Assessor's Map/Parcel: oV© Af17,00 Engineer's Name''Y [D NEW CONSTRU ON REPAIR Telephone# Land Use L�""L" "1� Slopes Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well l off-/ft Drainage Way ft Property Line +tc) ft Other ft SKETCH:( locate wetlands in proximity to holes) `A1 1 r_ CD Parent material(geologic) Depth to Bedrock ` O V4 � I Depth to Groundwater. Standing Water in Hole: 2 Weeping from Pit Face Estimated Seasonal High Groundwater rJ 0 ' DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in, Depth to soil mottles: in, Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft. Index Well# Reading Date: index Well level Adl,factor___. _ Adj.Groundwater level,, PERCOLATION TEST Datt; , Tlma.� Observation l Hole# Time at 9" ' Depth of Perc v D Time at 6" Start Pre-soak Time @ r Time(9"-6") End Pre-soak 1 52_ Rate MinJlnch � Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division 1 Observation Hole Data To Be Completed on Back===-------- ***If percolation test is to`be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. Q:\SEPTIC\PERCFORM-DOC 4 / I OW" v )v Li Wets- —6,e47V OF cA71r-4 r OrrA-li A �7 'y 71 ^ ' bacc 15-7 well(- kV •� r�l� �i's�i•`.a � .fit \�INLLAT ION ANDj -t,i ITiNG 1 o THE STEM WAS �B�L' STRICT G�qcN D `[ LOCATION SEWAGE PERMIT NO. YIILAG It U/ 005 7 I N S T A LLER'S NAME i ADDRESS BUILDER OR OWNER `_ U6/' .� DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 1.2 1 ! r r� bui T c TPK)tC' Li it 11 �� 'D 13"x � � C, , 0 �t a p►? ��' No. �1--1 ---- Fee-- - ----- BOARD OF HEALTH TOWN OF BARNSTABLE 0(pplication-*rVelr Con0ruct ion A3ertnit Ap licati n ifi hereby ma Arermit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: --� - zodie r---- ---------- ----- --------------------------------------------------------------- Lo ation — Address Assessors Map and Parcel -Q o� � -------D - - ----- --- - ------------------ - -- ---- t-Owner Address `` -------�±/�-z ------------------------ ----------------------------------------------------------------------------------------------- yl Installer — Driller Address Type of Building Dwelling-------------------------------------------------------------- Other - Type of Building----------------------------------- No. of Persons------------------------------------------------ -- -Type of Well--------------------- ---------- Ca---------------------------- pacity_--------------------------------------------- Purpose of Well--------------------------------------------= - ------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. Signed ----------------------------- date Application Approved By-- -- ----------- - --- r- - '-ct�,/ -- —--—— date Application Disapproved for the following reasons:------------------------------------------------------ ----------------------------- --- ------------------ -------- -- - - - - date Permit No. -- -------- Issued------------------------------------------------------------------- �' - -r- - ----- date BOARD OF HEALTH TOWN OF BARNSTABLE (tertificate ON (Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired(�° by----------- —�"r-�-- -- -------------------------------------------------------------------------------------------------- Installer Ad at-------- - =Q --- `r'-- ---- -- - ---�'�"`'-" - - - -- - has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -) Dated---------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. i DATE- --- —-— -- ------ --- -- Inspector------------------------------------------— - - ------------ �,',.y(. a.»�,1.' C�-,r..�ikyt.ir+b �' ..('*�,r�`?�{t�'�►l:^i,.`l:r,sl•+.(X'6"i�['<-rF�r�.rty("....r,..rT..�a�,,,i4-4,•w�1F►St�!t{Y,.��', �,T"d`.�yv�:�y^'�,�'�,.iya.�y "�;:..:.�.a+ - s �., �I No. 3--���---J--- Fee--- BOARD OF. HEALTH TOWN OF BARNSTABLE Application-forvell, cootruct ion permit Application iB hereby mad or a permit to Construct (_ ), Alter ( ) or Repair ( )an individual Well at: er - - - - -- - - -- - ------ --- - -- -- - ------------- Location —Address Assessors Map and Parcel - � @ -- --� Owner — —Address — �? ��--��----------------------------- ----- --------------------------------- --------- ------------------------------ / Installer — Driller Address TYPe'of Building s '. Dwelling-------- ------ -- ---- - -- -- --- -------------- •------ No. of Persons------------------- �. .Other - Type of Building---s------------------- -------------------- T e'of Well- -------=- -- - -- -- ------ Purpose ---— ---YP - ------------ Capacity----------------- --- -------of Well-------------------------------------------------------------- Agreements The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the.well in operation until a Certificate .of Compliance has been issued by the Board of Health. Signed ---- —` -` � -- - -- ----------- date I ! Application Approved By — —— —— date I� Application Disapproved for the following reasons:---------------=—-------------------------------------------------------____ ------------ -- -—------ -- - --- - - =----- - - -- — --- —--- I date Permit No. ------ Issued------------------------- - -- - ----------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certif irate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ' bY-----------L-------- - - - -- Installer at - - - ------------------ ------------------------ has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection j Regulation as described in the application for Well Construction Permit,No.V)Yq-- -s`•'•--P-Dated----------=-------------- I THE ISSUANCE:OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- --- ---— — —- --- Inspector- ---------------------------------- ------- ------------ 1 • i fBOARD OF HEALTH TOWN OF BARNSTABLE Vell Con5tructiori3permit No. r 3 Fee-- ------ Permission is hereby granted- -----__________-----—_------ -------- to Construct ( ), Alter ( ), or Repair an Individfueall Well at: ---------- - ---------------------------------- Street as shown on the application for a ell Construction Permit ------ -------- ----- ------- —--- - No. Dated--- - - �- ---------------------- ------------ ------------------------- ------ '} C� oard of Health DATE--— ��-=c-�-�- -�- EL ,/-70P OF FOUNDATION )v CONCRETE COVER , CONCRETE COVERS Sob •, ° 4„CAST ON 12��MAX. r 12r MAX. ' OR SCHEDULE 40 4"SCHEDULE 40 PVC.(ONLY) P.V.C. PIPE PIPE- MIN. LEACH PITCH 1/4"PER. PITCH 1/4'PER.FT PIT PRECAST L�f /�G LEACHING Wt'LL o� INVER • Q�; PIT OR ` o EL../.�. .- INVER INVERT SEPTIC TANK - /o,p�$5- DIST. /03 w EQUIV. cL..... .. . . . BOX EL.....6$. r>= , ,.o INVERT EL. /000 .. .. GAL. INVERT 3S�a $: :�. 3/4"TOIV2� o; EL......'... .. - /a98 INVERT ww / EL...... /o3.Zo48 ki--: V WASHED w 99, STONE h �� • 23 - 6'DIA. „'.', , �—/¢' DIA.-•--►1 trn/cow/TE.2Lrn tole PROR LE OF GROUND WATER TABLE r ( \ 1 SEWAGE DISPOSAL SYSTEM I -6,� N 9Rsi.v a/o3.oa G�7 NO SCALE �/G 'to V I ' SOIL LOG — WITNESSED BY : \y %-� � DATE f1r>6. 8 047 TIME. /a.:.00 qH •�[a C • BOARD OF HEALTH TEST HOLE �/ TEST HOLE "2 �`3 t5' 3 ELEV. . .�.�� Lo . . ELEV. .!`7 ENGINEER.70 toy v 7N u 8 DESIGN DATA � �� �. _.-' � �G ` 8 ez /os/ / EZ./oC.2o ` i- 70 WoopLoilry w000Co.g-rt NUMBER OF BEDROOMS 3 _ /eL'_ - s a TOTAL ESTIMATED FLOW . GALLONS/DAY - ---�'� \ ` D� J BOTTOM LEACHING AREA SO.FT. /PIT /G P,D.Af c-wsnivG 'moo SIDE LEACHING AREA . . ./. SO. PIT�� spa 1 \ 1 � s GARBAGE DISPOSAL .lYgY4. . (5O % AREA INCREASE) \ � Z� s TOTAL LEACHING AREA . . . . 7 So SQ.FT `iS.7o PERCOLATION RATE /fit 7?/Aw ?Wa. IAIN/INCH O `o -10 //P LEACHING AREA PER PERCOLATION RATE NO-WATER ENCOUNTERED try 9 NUMBER OF LEACHING PITS . ONE P/T W/771 • ,,�,Qa T Of STdn/4- S/D�3 `ENGINEER (=.i<1S SU�ERVISI APPROVED . . . . . . . . . . BOARD OF HEALTH . . . . . . . . . . . . . . . . . CE- .Ti=v DESIGNI �i WRITING DATE . . . . . . . . . INST/kTON AND R _ s STRICT IVI THE Sys E WAS iN AGENT OR INSPECTOR _ a � olk WEST LQivsT�l3 o S ,o � . PETITIONER �- r-- -� • � � . i t I t i L.. - 4 ' - _- - _- i EL. /o.So �OP OF FOUNDATION CONCRETE COVER )v CONCRETE COVERS 06 •0,0 4 CAST IRON 12"MAX. r '. 12•MAX. ' S, OR SCHEDULE 40 4"SCHEDULE 40 PV.C.(ONLY) _ P.V.C. PIPE PIPE- MIN. LEACH ° PITCH 1/4"PER. PITCH I/4"PER.FT PIT L`�t�/ c, PRECAST wCyc, LEACHING o' INVER� e PIT OR `•0 EL../.�. .�'� INVO T INVERT SEPTIC TANK �o9S&s DIST. /03 w ; EQUIV. e INVERT EL. BOX EL... 6S. ' ��F= /oSoZ /000 - ., GAL. INVERT ;�; 3/4"TOIVZ Ad ' \` o' EL......c... .. INVERT `t e tL EL./o3, o o V: WASHED z � h a w STONE h �� TO /23�--�--6'DIA. o• � . . �'/¢' DIA.----� dntcour♦/TE2E7� tom PROR LE OF GROUND WATER TABLE I p SEWAGE DISPOSAL SYSTEM �� _G� P .Cq� 9sts�v s/03.o G ► Ez n NO SCALE 7-? $ � sz' SOIL LOG _ 'WITNESSED BY : � \S, !.�30` ",��DATE tt%�6. 8, �y.89 TIME. /D:oO AH J Zy L7UIV�l//�G BOARD 0 F HEALTH TEST HOLE TEST HOLE "2 4e 3 hWi9?�D E- K �., is' 04,4 o /07 70 �N�r ENGINEER to'1 t ELEV. . . . . . . . . . . ELEV. .. . . .'. . . . . \ 0 t 3t• t / r�iv�c �Pi / G DESIGN DATA : - EZ. /os/ EZ.ioC.Zo \ ;,� ;�fo err woopGoHrj woaOCosjrf i 3 - ILSI -f wivao t IV NU 1,3ER OF BEDROOMS /eG'1 \ 49' 3vg-Sac. ,�„ •S'�✓3-•���' 3. 7T.0. 3. B./oZ.Go ez_/o3,� TOTAL ESTIMATED FLOW . . .0. GALLONS/DAY BOTTOM LEACHING AREA /. . SO.FT. /PIT/G f?D_ �--. 46X/sT7n/6 � %s.3. 38¢.8 SIDE LEACHING AREA . :�, . .,./. SQ.FT./ ?IT/G• � s GARBAGE DISPOSAL .NgY6. . (5O % AREA INCREASE) TOTAL LEACHING AREA . . . . 7 8o SQ.FT �ow�Cns PERCOLATION RATE S. a. MIN/INCH �o /ee, 'ep� e 01 no, Ez.91.,c0 /¢¢. Ez. 95.7o p �e�� �- !vo LEACHING AREA PER PERCOLATION RATE . 6S. 7SQ.FT./G.Ol>. NO-WATER ENCOUNTERED NUMBER OF LEACHING PITS . 55? !T. e17_� k//?t/ APPROVED . . . . . . BOARD OF HEALTH • • STDNGr D/✓�}L� S/ 3 •O SiSI NING ENGINEER '���� SU'ER`JISI: DATE . . . . . . . . . c M WAS , BALL DIN STRICT IN LLATI - • - - � THE STEM AGENT OR INSPECTOR ACC®R CE7PI AN. r - t LoT z - -Lc, 3 rS, r?isT/.v 0 _57- PETITIONER GA2 �. �ZG/S ✓ - �w —r•I s - r .A + i I All, • i / i • I , ! i i _ Y - ! i �t i Ij i I - I ! P-PPROV EO BY 9CAlE1 --•� DRAWN BI .l�I\ DATE: /`Gl ^� REVISED }-- //•• DRAWING NUMBER {1�'� I•� +�i .rJ.. ��i'.+�1..I>',.1+1'� n�\C..:Y'fl-=!J l-�f`!' L t� ------ -- --_5_7 ' I I / _ 1 i Ll _I 1 11 Al f l � 1 i IIII � I I KALE: �f-l{)-G11 APPROVED BY: DRAWN BY �_ _.._.__._ .. DATE: ��It f .fr+f 1 :r REVSED 51_C'•. )C\ R.(1C1ir. A-, i�CiVS�� DRAWING NUMBER r i 1i11!i2:�Llu;�-E:•!GL� I '��l (1 \ 10' f ice^_.!,___. I•-' ,ti i � c3 j I •- _ j ry l-.�LJt - � I,�,-.)51r.k1.�i� � I �_- ! �_C J�• �f).ib( �h., f( 7� ��/�) �1 i i \ i i ��I :>:frtlzrcP�I vr•r�,,:,.— i `1 ....... I _ I j Am rl ! JI E ! ! •�J �I -� { i { I ``�! � E:nr.j.Oyu^J ! � , i i ,-'.a�d•:�>�°�r,.l�;�,flJ:.l: `r (°L1_llc �,t lP�i )rb_ '.l hJ�_ SGALE.,�/�� :i,-S� PPROVED BY. DATE: DRAWN BY REVISED Rql- DRAWING NUMBER ?(\`�1—(\f 1 � ; I _!a1.7"1 Ir -7r— ! I _7.Q___ it I 1 1 I � % i � 1�1 j ' 1 i3v 1/EN r/1 E S •� Lob , I 1 f -' fir; I r 4 1 I S —'--- // i5 io 7 T'• F'i11�- � � I ! f i pZuausc'� '.�cac�p7!u^>>•``-v=. �tl:>>�.a ICI.�. lt.. ,t;. __ . MI Ua'SCALE: �- 11 APPROVED BY: • ORA—BY DATE:, i'n- }" REV15F.D ORAW ING NUMBER .^, ♦4l 1>l Kli' ��/:/iJ)iJ�- -fi}i^J>J�9�Z .1, . w ------------ -, --— -- _ .— i-----.-_-`�--._-._._._._.----_-,j✓H ' l _ I I f � `• �. -j�.1 •life L ,11 l A'I iJ 1,l cj r. i ,I I / I, 1 ( � ___� ! _ — /y � �. i �t 1 'Ft �J�l L� fl.11 CTF't'. „rr'• / nise%n - 1 I i : c-h,l�t F)ET i i%++•,l�:r�f�, �,c .�fi(?;lilil x l �L. rTLb � 1 / I !— ; � j 7 /� f� 1 _ ► _ ` { k - SCALE:,1•t 4- 1 `I+, APPROVED BY: DRAWN BY �,• ., DATE: ICI N,-( �1 REVI5E0 l ORAWIND NUMBER i°''��',{.t�,i <<. •.tu:o1;•1C;�,,tc_ :;off.F'lir;-'u`i"d .�1 —.-_ _•-_---_•_•_.-. f.-.-__,_._"---_-r-:-�- —�:l—r -___ -.--" -�—_—_ - -_- . _ -_-- ___.__.--,_ ---•,-_•---- - --"- - ----"_•_---` --.-.." ... - . ..� - . - ` - - - . . , , , , - . � - . )t .., . .- . � .. � . . :� - -----. _'. . I . . :. ... .. . . is f . ' . . . . :: - o. � ' . _ -' -- . • . . i - PLa: Gc'oo is - . '` _ :. _ . . r u: - .. �. it - - v - f b . --. - I 1—.•:--- : , . .' •' --- - . � :�" . f — , - - -7.- — - -.. , -- 1 , . - . - . ��g. .. . .. .. : - . - 4 �"- I. . j' . i M. - . . " . . . _ . , . - .- M. ::�:� , i -F 12�:::L ,.- • < - -.,. _. . . "_ f -*W L .. E�sR t . . �.: ' M. . - is z. .-...:: . . :. :.. �. - . - ,> :. : . , :. : .. :::: - _ M. :''. . w>:: • .. , .: : . . , . _ . - . . - - .. . . . �.. . : :... is `.:. #3 — t' *,: :.. . „.:. r . c :. . zjr '_ 1' _ . - .. - i :- . .is A�� t'� - ,. 1 -. _ :'1 -.. -,.. • M.I. .. t,. .. - , . ..4. �{ - is '_ '. :...: - .: d+- .. - _ , .. .. ... - a .. ... _ _. ... , - ..-. f , ti. +j : : )i t. ..:. - _ .i' ��c .. . . _ .. - . . -,:. v: = ^+lei-' r. _ .. _ y, . . ... _ .. .. .. .. - _ ii - 1 t fhI �'�-. mmm M. F "i, .. . - :..- . .. :� :' :F (<1 � .: i ''- :`F ._ ...., . .-- - :.._ ., _ .. _ :s. !d• Y': F: t :3 ice' .. ... .. - .. . .. .. -.... .. .. .. ..._.. .. - _ M. r -::. 1. _-i,i 'fb::r •-.:. ::111 f ,. rf , v �: :r ' i �r. 4' . ':' 1... {x. I� +:` s' 4 .t: : . .• • i.- 4.1 s y, ,,. _ t 4.. 5 1! jfy - }' ` , _. t a .. - _ ,.t - - - . '` 1 t iR' '. - F Y���f , .. ... - i. .. _ - _, ... i •V' t 3' :t. i _ 'i- v.Y-. t, ♦-.^ ..,. t s. �.1' F Y _ > a '.': t- - :: :... w :: - i !' P� i :;R . . r. 3 f r 5'. :: C':'.' ;.pv .. : ... .. ,- .- _ - i -- �' .�. I. .-.. .. _ .. - _ . , , _ - M. -. 1. M. _ — - . :'Y t', . .E".- . .. ., -. t 5 1.. �.isM. S T' l J::+ y, •f. + .. >•;„ �'- _� �, r' .. . { }: �` ,MIc i' _f �" ., _ -' . -.i .. .-- . .. ,., , . c ::< <t_ - - :.,....:: ': t " . �' T r� .. _ . .. .._-:- . .-. _ _ _ _ - M. i::. .. Me - .. _ - _ - .: ..'v. mp .. _ n - - .. .. _ _ . _ a - >.. a" .- - - _ - 1 „ _ - - - T ... 'r ' •ter - . . ..- .. _. - - ,,,p,,y. - ''1 . . r ...-M. .:, :: mmmmmmm mm I i x ` Ai'FYi�YEG$V wuwrrsx: ,::. - . " :::=y o11t[ . - - ..- :. _ . - - .. _ _ _ - it - - - - .. . _ - - .f.. - - .. MI `. - - - - . . '.. , . : .. _ , .f. .- .. . - - _ - - .. .. \ : ... - - .. __._.-_.-._, ---_ -z..,_ _ - - `\ 1 I� al i _ cn$waswrac �1 °I — 47 (1 Stlll•K.LESKICR:uIlM@EY.._ In _ IDI �-- tc O�i 1 J�1M.ASJJSELL._._. �lFd7 FL.1SNLLSCr.":. t— pq — 1 _ I IP _ �" .20a2•t INCVL. O VI MJJWON W 74'-O,• .'3•♦' 4'. - :'1+1. I 1S.-1O" '1,-10' - I IY`H. 2#:fie 4K5(A.. t pi cAn�'ctq,. • I : i-4^� a.i-4" _ D-4' (0.2• _ S�C'. a..`.. a 10'-6.. �.. ('.O'- 4'.a• $'-O � IA ' - —_— —. WRL Ze ft-- ' EIRST.CLDOR hC.nN S 5T8".F1;Id1:5R�ZROtJC � !I � 'y II` I It Ul .0 ry; 1 ns ewa¢'.SULerc LEI.. �ti C; )tit\VIµO,24.Z.4 CZDAR \V?7E£ZAIa1.E .. I: FKICK$TEP_z_._:y._._ .. I� LL10, 7Is SCAtL wVVNOVED BY: ORwYM BY: A. . OwTE: � � RENSED ' Dwwwlrm rwwe[w I l FA 0 ' L/8 � L 0 T 17 o � /� y �6 0 0 /' o SEpT1 �, o 04 DIST. 5 4 T� g, ANK , � ACI4 PIT o --- ' 0 Box z5 -�� r / �' ►� LOCUS 4. 0 PLAN OF LAND o L0CA TED IN 4. 0 0 4. o BARNSTABLE JIA. O well o PREPARED FOR ...., 34. 0.,,...,,..., HA NS SZIMME TA T o 50. 0 ' SHO WING PROPOSED I NEW L0CA TION �0 OF D WELLING s � � NO V. 14 1991 UTILITY POLE #4-35 LOT PLAN REF 3715 7E FL O OD ZONE C RES. ZONE "RF" GRAPHIC SCALE 20 0 10 20 40 80 ( IN FEET ) 00 1 inch = 20 ft. \ �� yn` rr . NOTE' SEE ALSO SITE PLAN r r r ���� PAUL��� YAI�KEE SURVEY CONS U L TA-A TS ! y °s 3 PREPARED BY ED KE'LLEY 143 ROUTE 149 _ o. BOX 265 5, MERYTHEW �z FOR GAR Y A. ELLIS. MARSTONS MILLS, 02648 `crsltR�° j. J50082 K. JH ...,.-„_„ ASSESSORS MAP :- - ��`Z�s _ _-_ - - -_- _ TEST HOLE LOGS NOTES: 1 PARCEL - --/_7 _05-_ _ FLOOD ZONE: SOIL EVALUATOR: �• ��✓��� 0 - - W 1 TNESS : 'X` A M IvalAt4 C) 1) The installation shall comply with Title V and Town of Barnstable Board of REFERENCE: C'E /7 F 1 F1J> ��„{�'/ � � j�i!� ;, DATE: i V.l-t-loo �r Health Regulations. PERCOLATION RATE: G Z M l I 2) The installer shall verify the location of utilities, sewer inverts and septic „ components prior to installation and setting base elevations. TH- 1 ! TH-2 3) All gravity septic piping to be 4 inch Sch 40 PVC at 1/8" per foot. The first two feet out of the d-box to the leaching shall be level. 4) This plan is not to be utilized for property line determination nor any other purpose other than the proposed system installation. 31p,N b� 5 W . � 1 � 5) All septic components must meet Title V specifications. bh4 '' 3q 6) Parking shall not be constructed over H10 septic components. LOCATION MAP �` 1 '� ( i I p� � 7) The property is bounded by property corners and property lines. \ a( l 2,`�• °`� / [� 8) The property owner shall review design considerations to approve of total design flow and number ofbedrooms g to be considered for design. Receipt � �tt,q f 6►W410 of payment for the plan and installation based on the plan shall be deemed approval of the design flow by the owner. 9) The existing leaching or cesspools shall be pumped and filled with material Al per Title V abandonment procedures. Those within the proposed SAS shall �130 }l Ifs ► be removed along with contaminated soil and replaced with clean sand per "o 2�t 4o ► tt 140 4"0. WWML Title V specs. 10)System components to be 10 feet from water line. Sewer lines crossing the water line shall be sleeved with 4 inch SCH 40 PVC with ends grouted if ��-A `�' SEPT IC SYSTEM DESIGN applicable. The proposed SAS is being installed below the water service V line. The line is to be sleeved as aforementioned and maintained in place. /v / \ \ �� i �b8 ,3 �✓ 11) If a garbage grinder exists it is to be removed and is the responsibility of the 41 FLOW EST 1 MATE� � 1 \ � / � owner to ensure such. 12 J^ '7- 12)The installer is to take caution in excavation around the gas line. �� 3 BEDROOMS AT 1 I0 GAL/DAY/BEDROOM GAL/DAY 13)The installer shall verify the location, quantity and elevation of the sewer a lines exiting the dwelling prior to the installation. 3�70 OAL/DAY x 2 DAYS GAL USE )C:)0p .GALLON SEPT I C TANK S}'S� �-t 1�Ip tarsi �___--_-----_. Ll� I SOIL ABSORPTION SYSTEM Nil- N1 ��r°� SIDE AREA• . C� w l t �, z / / �/ ELF BOTTOM AREA: Z '� 13 O.�'T 7- QO\JqXL law T_L C1 SYSTEM SECT I ON V�-(, "fU 'jlam° 1`2 v` Q)Iku(�LIola ' �. IUwGN�( ,t�, .�.� lt,t "[Y - c. tt -Th dry ----- 0� 4cp or- rVO4D p704_ P, 154`5 5 j` o �C0q rl`�' aos° �- - . N if ki11� 6n cl�-nt,.1 am' (� VjeAA'0W L cv�►-t. oo� a G� t� I i !� �� --- -_ J �7Uyi� )y �./ �wwc o ICiL7-�2. 21 1 Z � ' �^y 00 GAL '^�:� � -----� � ��-► 122 AO SEPTIC TANK Ile `` ----- - —t—�— 2- Y. ►zj - I It -TEST HOL.C- e/. I >z SITE AND SEWAGE PLAN �� �''" LOCATION : �)DW 19 1 H IC PREPARED FOR -nEprV o Ar ��►�t, % S0 SCALE: 50 DAV I D B . MA S 0 N RCS DATE: _ ----� DBC ENV I RONMEN� AL DESIGNS �� - EAST SANDWICH . MA W DATE HEALTH AGENT W ( 508 ) 833- 2177 Z - - - - _ - - ------ -- - -- -- - - -