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HomeMy WebLinkAbout0159 DUNN'S POND ROAD - Healthr Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 159 Dunn's Pond Road, Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon, Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27 2009 required for State Zip Code Date of Inspection every page. City/Town Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name 189 Cammett Road Company Address Marstons Mills MA 02648 City/Town State Zip Code 508-428-1779 SI 12855 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 �l February 27, 2009 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. 09-32 Wells Fargo.cloc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 r Commonwealth of Massachusetts _ W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 159 Dunn's Pond Road, Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon, Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27 2009 required for — State Zip Code Date of Inspection every page. City/Town 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 exist. An in 310 CMR 15.303 or in 310 CMR 15.304 e y failure criteria not evaluated are indicated below. Comments: Tank was pumped after inspection pump and leaching system are functioning properly. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If not determined," please explain. ❑ The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑. 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 ❑ obstruction is removed 09-32 Wells Fargo.doc•08I06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form lo Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 159 Dunn's Pond Road, Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27, 2009 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 09-32 Wells Fargo.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 f Commonwealth of Massachusetts T Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 159 Dunn's Pond Road Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon, Remax Real Estate Owner Owner's Name information is required for 681 Falmouth Road, Mashpee MA 02649 February 27, 2009 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 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 El ® 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 ❑ ® 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. 09-32 Wells,Fargo.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 159 Dunn's Pond Road Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27, 2009 required for State Zip Code Date of Inspection every page. City/Town B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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 CM 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 09-32 Wells Fargo.doe•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 159 Dunn's Pond Road Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27 2009 required for every 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)) 09-32 Wells Fargo.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 159 Dunn's Pond Road Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27, 2009 required for every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No 263,250 gal. _ Water meter readings, if available (last 2 years usage (gpd)): 360 gpd. Sump pump? ❑ Yes ® No Unknown Last date of occupancy: 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: Last date of occupancy/use: Date Other(describe): 09-32 Wells Fargo.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 159 Dunn's Pond Road Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27, 2009 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: None 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) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: Compliance date: 11/3/06 Were sewage odors detected when arriving at the site? ❑ Yes ® No 09.32 Wells Fargo.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 159 Dunn's Pond Road, Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon, Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27 2009 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Building Sewer(locate on site plan): 2' Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): 1' Depth below grade: 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 ---- --------------- -------------------------------------- 10 5' long x 5 8'wide- 1500 gal. Dimensions: 20" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 12" 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 Measured How were dimensions determined? Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 9 of 15 09-32 Wells Fargo.doc•08/06 Commonwealth of Massachusetts w Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 159 Dunn's Pond Road Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27, 2009 required for State Zip Code Date of Inspection every page. Cityrrown 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.): Observed excessive solids and grease in tank, tank must be pumped. Liquid was found flowing over inlet tee due to a clog in tee Tees are intact and tank is structurally sound. - Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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): 09-32 Wells Fargo.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 159 Dunn's Pond Road, Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon, Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mash pee MA 02649 February 27, 2009 required for p ry every page. CityTrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) 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 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.): No solids or high stains present, liquid level was found at bottom of outlet pipes. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No Alarms in working order: ® Yes ❑ No 09-32 Wells Fargo.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 f Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments I 159 Dunn's Pond Road Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mashpee MA 02649 February 27, 2009 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump and alarm functioning properly, floats are properly positioned. No solids carryover from tank observed. t Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® 6 Infiltrators. leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Interior of infiltrators were video inspected with no signs of surcharge found. Stone in bottom of SAS was found clean with no evidence of solids carryover. 09-32 Wells Fargo.doc•00/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 159 Dunn's Pond Road, Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon, Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mash pee MA 02649 February required for P 27, 2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 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 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.): 09-32 Wells Fargo.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 159 Dunn's Pond Road, Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon, Remax Real Estate Owner Owner's Name ----- -------- - —- --- — -- information is required for 681 Falmouth Road, MashP ee MA 02649 February 27, 2009 _ -_____.-. every page. City/TownState Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Dunn's Pond Road Water Service 7771 34 ,'/ , / i / /lr / r r , ! , \ \ \ \ \ \ \ \ 41 \ \ \ \ \ 54 28 3 14 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 159 Dunn's Pond Road, Hyannis MA 02601 Property Address Wells Fargo C/O Tom Dillon Remax Real Estate Owner Owner's Name information is 681 Falmouth Road, Mash pee MA 02649 Februa 27, 2009 required for P ry every 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 ground water: 5 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Pump system engineered to be 5' from high groundwater. I 09-32 Wells Fargo.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 No. INID r iQM0NYEA`LTH_6F Fee MA,SSArHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABL-E} MASSACHUSETTS 01ppYication for Migpozaf *pgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. 1)14 Owner's Name,Address and Tel.No. Assessor's Map/�arce 1 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 122 Cenq J �, C n 19Pn Type of Building: Dwelling No.of Bedrooms 14 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date L, 1/,-9 l C,6 Number of sheets 1 Revision Date G-/ap-/C-;'6 2 Title Size of Septic Tank l�'O Ps Type of S.A.S. Description of Soil �ee S�✓� l_ Nature of Repairs or Alterations(Answer when applicable) sue' �/!✓�C w�° % s� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmentalre and not to place the system' :nratuionuftil.lCeNfi- cate of Compliance has been issued by this Board of Health. Signed S' Application Approved by Date Application Disapproved f he following reasons Permit No. _200�, Date Issued V • tl�V ' 5' tc `" 1� �l•t r��� lj7l p c No. ,jl ✓ ✓ f Fee / THE'COMMONWEALTH OF MASSACHUSETTS Entered in computer: a, . .. ... �. „„ -- _ ..._. ,Yes PUBLIC HE'ALT_H:DI_VISION - TOWN OF BARNVSTAult,, MASSAC,HUSETTS `1[pplication for Oi5po5ar *pgtem Cow5truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. I S g 014 nh S �e N !1 Owner's Name,Address and Tel.No. Assessor's Map/ tpcl, Installer's Name,,Address,and Tel.No. r Designer's Name,Address and Tel.No. Type of Building: y 7 Dwelling No.of Bedrooms L4Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1 U 't �' - 4 4G gallons per day. Ca ulated daily flow gallons. Plan Date Number of sheets Revision Date G 9 C/G� «� Title Size of Septic Tank /S U o Type of S.A.S. SP� S�, I c Description of Soil; L rC}' 0 1 , Nature of Repairs or Alterations(Answer when applicable) S � `� �/� C 1,'O 5,i Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system ih operation until a Certifi- cate of Compliance has been issued by this Board of Health. Signed /r^1� �'"� , G , F^r� ,r. Date Application Approved by +� SIN= 144<Z>/'? Date Application Disapproved for the following reasons Permit No. .2 W(0 Date Issued A-11>10 )U THE COMMONWEALTH OF MASSACHUSETTS / BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired(,r Upgraded( ) Abandoned( )by t= !rS �3��i ro;j crnyJ, cc at S /)C4 n h S /'0-0a /7 c l, ; �S�'n 51A,I / e tc75/? 'f has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No . 006 ir` dated { Installer 1-//t S Designer The issuance of this permit shall not be construed as a guarantee that the,ystem w,�illt unction as designed. Date >/ C -��'%� Inspector - - No. ��-----------4--` -----------------Fee THE COMMONWEALTH OF MASSACHUSETTS h. .r PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS 4- Y . Mizpoof 1ptem Cott.5tructionerntit ' Permission is hereby rant d to Construct( )Rypair( ) grade( )Abandon( ) System located at S /)W.171) ,e st l/� Y�lr�7 r/1 /7q%y r/n and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following.local provisions or special conditions. ,i Provided: Construction-must be completed within three years of the date of this permit. f' Date:_. f d�! �r� Approved by 1 f �c)✓+/ C �`t to✓1 T ir^- ( ` cc, _7 o t,l i . (,tl l H : 4 Town of Barnstable THE r�ti o Regulatory Services saxNSrnsze Thomas F. Geiler, Director 1639. � ]Public Health Division lED MA'S A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 April 6, 2006 Ms. Deborah Hirschon 31 Burlington Street Providence, RI 02906 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located 159 Dunn's Pond Road,Hyannis,MA,was last inspected on March 3rd, 2006 by, Robert J. Bortolotti, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system has "Fails"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Inlet cover under porch. Tank appears to be leaking at seam. You have 2 years from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. BARNSTABLE HEALTH DEPARTMENT Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health a- COMMONWEALTH OF MASSACHUS Q W EXECUTIVE OFFICE OF ENVIRONMENTAL A-F! S d DEPARTMENT OF ENVIRONMENTAL PROTECTION G,N Ski"` ago ^ o�� Loy 9, TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM . PART A CERTIFICATION Property Address: / 7 Sk t1 r1� r+ R ©`729 ,r l 0-2 6 o/ Owner's Name: iro / /r Owner's Addres3 r .hovi ehro r �a9O � � � Date of Inspection: Name of Inspector:_(Pplease print) M11 Ir— /"o l �/ Company Name: Mailing Address:- o Yvx 1o2 Telephone Number(o-vz 2 41Z CERTIFICATION STATEMENT x' I certify that I have personally inspected the sewage disposal system at this address and that the information reported= below is true,accurate and complete:as of the time of the inspection.The inspection was perforrriec 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 systeia: r :ft Passes CD r— CD M. Conditionally Passes s-�ur her Evaluation by the Local Approving Authority Fails Inspector's Signature: _. : _. - Date: — C The system inspector shall sub 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. Notes and Comments g q F ****This report only describes conditions at the time of inspection and under the conditions of use at that u time.This inspection does not address how the system will perform in the future under the same or different conditions of use. ., Title.5 Inspection Form` 6/1r5/2000., page 1 . Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: S 9dQ� [� q ✓T Owner: /' 1 ✓S O Date of Inspection: — — O1 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: /VSy 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: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health, will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound, exhibits substantial.infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup of break out or high static water level.in t-he'd-istribution 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): i broken pipes)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: -Titlo C Tnenprtinn T=nrm 41rsi�nnn 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) / Property Address: / s- 9 d/ Qc� ✓► 6 �� Owner: t "5 ,, Date of Inspection: C./�Further Evaluation is Required by the Board of Health: Fu / � Conditions exist which require fiuther 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 CTMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: — Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. 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 conform bacteria and volatile-organic compounds indicates that the well-is free from pollution from that facility 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: TiFIo G I, 6/1 si1nnn 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) SProperty Address: / N vt ea �H► Oa o� Owner: I r s o Date of Inspection: 3 — D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: ' Yes No _/B kup 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 ed SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or spool _ jLiquid depth in cesspool is less than 6"below invert or available volume is less than'/z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped ✓✓✓ any portion of the SAS, cesspool or privy is below high ground water elevation. _ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface 1,,-�ater supply. ,Any portion of a cesspool or privy is within a Zone 1 of a public well. �/ A +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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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] (Yes/No)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• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Xs� n he system is within 400 feet of a surface drinking water supply he system is within 200 feet of a tributary to a surface drinking water supply he system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped one 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. Titles G Tn cnonhinn Rnrm F./1 G/7n(ln 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: /✓ So tins h pd- 6 p/ Owner: f fC Date of Inspection: Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes Now ✓ 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? r/ 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) r/ Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? v Were all system components, excluding the SAS,located on site? cove✓ ct viclo,r �_ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition �JO✓c t, of the baffles or tees, material of construction,dimensions, depth of liquid,depth of sludge and depth of scum? v — 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:. Yes o _ xtsting 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(3)(b)] f Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: A'(" �vv� / � 0 D� o� Owner 1 V- 40 � Date of Inspection: FLOW CON)DITIONS RESIDENTIAL (/� /— Number of bedrooms(design): oZ Number of bedrooms(actual): 9— y�Ll DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): a b C' Number of current residents: (2 Does residence have a garbage grinder(yes or no):/� O L-1 Is laundry on a separate sewage system(yes or no);///,�'I [if yes separate inspection required] Laundry system inspected yes or no):/W Seasonal use: (yes or no): eS Water meter readings, if availa a(last 2 years usage(gpd)): Sump pump(yes or no): /v aJG Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): end Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: /T Was system pumped as part of the inspe on(yes or no): If yes, volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYP 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) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all co n ts,date installed(if own and source of information: Were sewage odors detected when arriving at the site(yes or no):" Titlo G 1--ti— 9— 4/1 G/IN)j1 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) n Property Address: 7 (, ., 1,;,7 n'—j "C z oac of Owner: I,- Date of Inspection: — q—0 .6 BtiILDING SEWER(locate on site plan) Depth below grade: Materials of construction: ,, -cast iron _0 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_(locate on site plan) ?n:Depth below grade: �Material of constructi _c�/oncrete_metal_fiberglass polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: S X Sludge depth: a 7/-- Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 0 Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to botto of outlet tee or baffle. L� � How were dimensions determined: /o .2 'QGi e v Comments(on pumping recommendations,inlet and outlet fee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): J n IffQ✓ �0✓c 4 I � ✓I � B A✓1 7Z7 t t n c? S ^eS�6rn GREASE TRAP-: Zoc on site plan) Depth below grade:_ 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): T:ffo : Incnarr nn Rnrm 4/1 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) rQ / Property Address: / S(A vlvtf 449 N! poi 6 Owner: e - ' Date of Inspection: O-,h 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if— present must be o ened locate on site plan) P )( P ) Depth of liquid level above outlet invert: �0/✓`7 G�- Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage i or out of box, etc. : / - �b� ,,-, PUMP CHAMBER: (locate on site plan) ) Pumps in working order(yes or no): Alarms in working order(yes-or no): Comments note condition of u ---- tc( pump chamber,condition of pumps and-appurtenances, etc.): d T7rlo inenort nn Rnrm �ii;i�nnn 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 159 ilf 01/_1,07 4" 1�2ci, 657d 6 o I Owner: I V, C. Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits, number:_ leaching chambers,number: leaching galleries,number: ding trenches,number,length: leaching fields,number, dimensions: overflow cesspool, number: innovative/alternative system Type/name of technology: Comments�jnote condition of soil, signs of hydraulic failure,level/of ponding,damp soil,condition of vegetation, etc.):��O� e. Gi'v►. c' �©i / � (2G Gi � �/ O O G Lt CESSPOOLS: w (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 or no): 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.): Titlo C i Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:J 9 S4 t4gf /�B w� �.L Owner: 1✓'S Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benc rks. Locate all wells within 100 feet. Locate where public water supply enters the building. gu- - - a g ' 3 I Zr _ 3 fil:; vi Jot S Talc G fncncr10 Page 11 of 11 ' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C J Q SYSTEM INFORMATION(continued) Property Address: / / 1�14 kl J_ ��c-/ /�d G vt rat t � �oL 6-0/ Owner /�!►^ ,�, e- Date of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water N feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: iQ Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You t describe h w you tablished the high ground water elevation: // // / / (/l G O,� 7�t9 07 n L.O C 7�d C—ro K n G'Irc 14;II(✓02 Za e Town of Barnstable Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Sumner Kaufman,MSPH Paul Canniff,D.M.D. Ms. Tanya Johansen, R.S. July 14, 2006 26 Compass Lane Dennis, MA 02638 Dear Ms. Johansen, You are granted variances, on behalf of your client, Deborah Hirshon, to construct a replacement onsite sewage disposal system at 159 Dunn's Pond Road, Hyannis, Massachusetts. The following variances are granted: 310 CMR 15.211: The soil absorption system will be located seven (7) feet away from the southeast property line, in lieu of the minimum ten (10) feet separation distance required. 310 CMR 15.211: The soil absorption system will be located one (1) foot away from the southwest property line, in lieu of the minimum ten (10) feet separation distance required. 310 CMR 15.255(5): To remove only one foot of impervious materials at the southwest corner of the SAS, in lieu of the minimum five (5)feet lateral removal of impervious soils required. Section 360-18 (A): The soil absorption system will be placed in an area where there is not at least four feet of naturally occurring pervious soil below the entire leaching facility. These variances are granted with the following conditions: (1) An additional test hole shall be excavated for soil evaluation at or before the time of installation adjacent to the proposed SAS location. L) Q:WP/JohansenDunnsPond2006 .4 r (2) 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. 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 1 11 recorded deed restriction shall be submitted to the Health 'Agent prior t p o obtaining a disposal works construction permit. (4) The septic system shall be installed in substantial conformance with the revised plans dated June 8, 2006. (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 dated June 8, 2006. These variances are granted because the proposed plan appears to meet the maximum feasible compliance standards contained within the State Environmental Code, Title 5. Sin rely yours, a n iIIer, .D. Chair an Q:WP/JohansenDunnsPond2006 -Mcov 03 oB 09: 14a Tadco Consultants Town of Barnstable Regulatory Services _ Thomas F.Geller,Director Public Red&Division Thomas McKean;Mroctor 200 Maas Sh*e4 Hyannis,MA 02601 OTt=.5094162-4644 Fay 598490-6304 IasmIIer d -Ihtffier C.erd6caden Form Date: i r�f�. SawapPerm1W A00 ro 3 S is?Aa*Parcd 220 4_4 Designer: 0.e�Y _G4 ���� R:b r3 Cc�s3 , CG Installer. t� Address L" Address. 4N 3 ii ftM rrtr S? /&evt/ �ireft�S R—� oZG3S ,rW`o'�{ V �'.art on Sf 1t 510 0 I:_I 1 tS COTIV fS Gs sued apexmit to install a (dam) (installer) septic system at RJ is!3.SS nr� � ?'gtj based on a design drawn by addmsd) ".ft4 dated 02 d gne I certify that the septic s3 s m referenced above was installed substantially according to d w design,which may ml"Mak nectar approved changes soli as lateral relocation of the distribution boot andlor septic tak St qmd (if required) was inspected and the soils were found satisfactory. I certify that the septic ssyyss rs fe remcod above was installed witb major changes (i.e. g+eater then IV hueral rele a:of they SAS or any vertical relocaiem of eeay component of the septic systenc)but is acconda nce with S�dt Loco]Regulations. Plan revision or certified.as-built by designa to follow Su"ut(if r was inspected and the soils were found satisfactory. (humors ems J"`�`�"".. �!:,`• +"""""^ti•',,'. YA DAIGN 's ) (AME t p ST • FC I�tJII, ARE CIIV BY THANKYOU. Doc e 1 s 04, w 641 08-14-2006 3 e 12 BARNSTABLE LAND COURT REGISTRY DEED RESTRICTION August 1,2006 RE: 159 Dunn's Pond Road,Hyannis,MA Map 270 Block 004 Lot 004 Book&Page or Cert.#- ((�'O, As required by the Town of Barnstable Board of Health,as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, Title 5, I Deborah Hirschon hereby acknowledge that the approval by the Town of Barnstable Board of Health for the installation of the new septic system requires that a deed restriction be placed on record with the Barnstable County Registry of Deeds,in accordance with the State Environmental Code, Title 5,that the septic system installed on my/our property,as shown on the Town of Barnstable Assessors Map 270/4-4, RESTRICTS THE DWELLING TO A FOUR(4)BEDROOM RESIDENCE. Witness our hands and seals this day of _ 2006. Then personally appeared the above named a and acknowledged the foregoing instrument to'be their free act and deed,before me. No Pu 1 M IeYtart' y commission expires � No. Fee ti "THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZIppfication for Mis�pooal *pgtem Con5truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot No. Owner's Nam Add ss Te No. Assessor's Map/Parctht "3 SiT Installer's Name,Address,and Tel.No. 3 Cog-3 Designer's Name,Address and Tel.NK a 3 (z'/kr n �� Ca /it "_ Cow- L ,t 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 gallons per day. Calculated daily flow gallons. Plan Date LI Gg�($�'' Number of sheets /. Revision Date ` Title Size of Septic Tank ZSo� Type of S.A.S. 6 Description of Soil Nature of Repairs or Alterations(Answer when applicable) &-t S-epA-r Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is ate y this Board of ea Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued b� 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 ��l 1 S 63� / Coh So-- at ha!54 h,T �3��r�S'd�i� Chas been constructed in accordance with the provisions of T_itle,5"and the for Dispodl System Construction Permit No. dated Installer r!CAS' ►f c(/�',fT co__o si, Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi0pont *pgtem (Construction Permit Permission is hereby granted to onstruct( )Repair( )-Upgra e( Abandon( ) System located at S9 C/ ,I A ,� ,(��� � � �>�y�n n and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date:_ Approved by e No. Fee "r I�THE CO ET MMONWEALTH OF MASSACHUSTS "Entered in computer: N' +rs .., * Yes `PUBLIC HEALTH DIVISION - TOWN OF BAR NSTABIEr-MASSAGHUSETTS `ZIppficotion for Mi.5poga16pgtem Conotruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. b I Sq i� 40/-4aJ-G�Sy /� .. Asse sor's Map/Parce; 1� -n Installer's Name,Address,and Tel.No. 3 Ga ;3 7 Designer's Name,Address and Tel. '0. i j T 6 C,2 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 gallons per day. Calculated daily flow gallons. Plan Date E4 /!y` & Number of sheets / Revision Date Title Size of Septic Tank Is Type of S.A.S. G N/J v Description of Soil:5fe 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 disposaliystem in accordance with the provisions of Title 5 of the Environmental Code and not to place the system,in operation until a Certifi- cate of Compliance has been issue 1by this Board of Idea1'th. _ .. Signed Application Approved by t Date Application Disapproved for the following reasons Permit No. Date Issued ,.. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (tompliAnce THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded Abandoned( )by 1311,S at 1 �7 OL"11-1 S �cn / ��� i�fgc�r� S ��glnSd�r� Chas been constructed in accordance with the pWvisions pf Title 5 and the for Disposal System Construction Permit No. dated Installer r/1`s ( °f (-Ctt 7�j . Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector _.- --- ———— ,.--------------------------- -�-= No. Fee } , THE COMMONWEALTH OF MASSACHUSETTS y PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ligoar 6pelem Construction Permit Permission is hereby granted to,-onstruct( )Repair( )Upgrade( )Abandon( ) l System located at 1'.S`J V(4 11 f! ,Oend /2 c,1,,E E%`1 r and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date:_.. Approved by *,OAT% SOY 6A �'���'.� .__ � ������Rv •tip :.Y• '�..ti �(�ri '���,�+: \ �' � _ - ='r UIOI�ILDLOo.:LL/a-lu61'A ,mom OR, f LZ tu j' Y � rYy Y � '�.ka � �• PKa T(U+ (sl �oe s P'Q��csA S p 'lam tY i���i c T rtA w y� e a r4yT+ '�`. `I�"" r, �Ayy�y�r rf! ti i�M1 Ah���F�5�i4}My..,.�.,.1 {f��:�� �• ,�it #'{y,.i,�_!.!�*��E�w/!f;,�-v' `'y fj r t r y.� '��l�t y '` �}"«�,g,�,, IF, L `�Y,hu{ a p����t ' 45��j �� � Q , � t ' • n Fj_�+. «r�'(�'d,�►�r .�1•F a �� f r'S'"t��n i�� � ♦ s ''� .p' :u u�� � � \ 'Ltl+.,s ��� 6�r�, a! f .� 5`�k. i�� y��r„7. +,M �`� � �• �a;1?4'i�;'L 5•'.55��+! "4,5 f A�'�.� k �•r r�� 1'lr• ,� !t � f��� ' - M•.t�� •.{A t1�bk•1 it ,TR i lr'`r '�. �j��ft �"` .• �A , ,�.is a 1 r' , �`. � � 1,+ '� e," k�t'1t�1'" 51 *1 1 e§F.� 1r,.,�"1.a�� i�F'A' �� -� a. � -''�..\ � �rl�.�.,•.�..tr pry .Y 7 ��� �1 .01 ;•f. r 5F�1+`..,11„� �«`..,' i\ 5��� `x:+ ,r•. 5 �•� #.it ri 41 go p� "Opts "LR � .r il,= wq y.;,p I a •`!!` :s'�7i�j lcT1 '� i :lif�i�-� ' y[p. � � ,« j. ",�, � �/ _ v � f f. a+ ••ram'.('�� f 7 f r W's * r}` (}(. IV �� �,?, {.. yr. .� .r i�•�•. 01 t ��Q� C �� � 0 , a�� �$ � °� 0 � � �aa� �-ham.`� "✓eC' .} - :'r'! \ 1 ��AA �TL_� may✓ Z ' � 1 \\ jI 1 �Qu�9� �� �� Cam, � � � �€ 2 R", No......................... Fps..-. ..._............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ------....OF......-.........../2JVST�3 Appliration for Dispersal Morks Tnnstrnrtiun Prrmi# Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal qSystem at: �" .... 11�!�5..._. cnr�4�?..1�1�� t7` �a!s .1_¢_ .. -•--..-`�--1.............................................. ocat n-Address or Lot N0 . f tYTlf� l rS r..f ���... Q r_ ' .,c� �� _ i� = % j�:..... Sri a Owner Address W _ Installer Address Type of Building Size Lot...��.&__���:___Sq. feet Dwelling—No. of Bedrooms.......... ______________________________Expansion Attic (1-� Garbage Grinder (We) Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------- ------ - W Design Flow.............................................gallons per person per day. Total daily flow-._-._._____ _®....................gallons. W Septic Tank—Liquid capacity_/-�Pt9_gallons Length....... ._._.. Width....A........ Diameter---------------- Depth............... �'x Disposal Trench—No.........Z......... Width.....Z ........ Total Length..... :`f_____ Total leaching area.... �4-__sq. ft. Seepage Pit No------_------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (✓) Dosing tank ( ) __ - �, ®- �_ `~ Percolation Test Results Performed by...... �' �L n�4...... _:� 1 1!ssDate._-_. ._�.....................:..... ,aa Test Pit No. 1....� P.minutes per inch Depth of Test Pit......... 4_____. Depth to ground water._._7'`- ......... Test Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ .........--................................................ O Description of Soil-.,..-- � �r-•---L O! .......................... -��`.._.-��! �c L.------._.............-.__...... ................................................. -------- V Nature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ -----=----------------------•---•--...-..--•---------------•-------------------•---••---•----•-•----------=----------------------------------------------••---------------------------=-•---.........__. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iIT .; p 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 �h� . Signed--- .........:. =7`� Date Application Approved By..— 9 ..... . '� w --•---7.1 -- ----------- Date Application Disapproved for the following reasons:--------- .....................--------------------------------------------------........a....................... ...........................••-----•---------•---------------...------------------•-•-•----•••-----._...•----•------•----•----.--..---------...--•-------------------------------------------------_----- Date PermitNo......................................................... Issued.... 7 �- _-•....................... Date 4 No......... Fimic....1 ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................... .................OF.:.... 444 76)11,4..&..................................... • Appliration for Elhqpasal Works Tianstrurtion Upprutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: A ....... ............ ....... ...... ... . ............................................. .............. Rn. Avs L t' n-Address Lot No. TAO........................... ....................... & ZA�Kmq z: " *.... Owner Address' � .................................................................................................. ................................................................................................. 4 Installer Address Type of Building Size Lot---�'-&-20PAM..Sq. feet Dwelling—No. of Bedrooms.............:..............................Expansion Attic ( ) Garbage Grinder W4 Other—Type of*Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ...........................w........................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............- 9--Q...................gallons. 1:4 Septic Tank—Liquid capacity.IPA'O.gallons Length...... ...... Width.. 4........ Diameter" Depth................ Disposal Trench—No:......... ......... Width___ ._._.___A�........ Total .......... Total leaching area_.._ il:05��.sq. ft. Seepage Pit No--------------------- Diameter..................... Depth below inlet...................... Total leaching area,.................sq..ft. Z, Other.Distribution box Dosing tank Percolation Test Results Performed by..a ....... . 79........ �4 ............ ....... Test Pit No. 1....A. .minutes per inch Depth of Teft Pit.......... Depth t6 ound water.._.?2:4 gr 44 Test-Pit No. 2................minutes per inch- Deptly of,Test Pit.*................. Depth p to ground water.___.......:___....._... Rai ........................... . ............................................................................................. 0 Description of Sojl....... ........44 .................. - ------------ .................. ........ ------------ -------- ......4 .0.................. I........... v---­----------.............../... ... ............... --------------------------- ......................................................................... ----- 4% _Y$7....... ........... ................ 7 U Nature of Repairs or Alterations—Answer when applicable---- .................................................................. ...........................................................7.....................................................................................................I....................................... Agreement: The undersigned agrees to install the aforedescribed Individual,Sewage Disposal System in' accordance with the provisions of T IT LIZ• 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-pf health. Signed. ................. ..................... ................................ .. Date . .................... 7.*.......-71.......... Application Approved By= ....-, /440� Date Application Disapproved for the following reasons:...................... ............................................;.......................................... ..........................................................................................................................................................._7............................................ Date Permit No................................................... Issued.._.:_..::- . .................................... ...... Date THE COMMONWEALTH OF MASSACHUSETTS —0-00 BOARD OF HEALTH ........ ..............OF...1,5?9?N_S��Otnc...................................... .. ...... ...... ........... THIS IS TO CERTIFY, That the Individual Sewage Disposal,,,System constructed or Repaired b . ...........J:............................................... .....................I.....................................................7........y................... .......-1-:7.Instal{.. A. ............... 7 ........... at...............................................................t?�X......... 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......................................... .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A,GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......... ....................................... Inspector- ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .OF...... 4/ y ......................................... .............................................................................. No ........7..... FEE........��. vahg Tri. Atuton Famit f-4 Permission i hereby granted._ X.4 &? ........ .... oi�,_' , :7----------------------------------------------------------------------------------------;.................... to Const ct �to�&pair n, Se %j Dis al SWstem, &,iduah, iV Vs ................ ­_1...................... ...................................._ at No...................................................................................... Street as shown on the application for Disposal Works Construction Permit N ... ....... ...... Dat --- ........... .... ... ......... . . .. . . . . ..................... ----------- Boar o ealth' DATE------... ............................................. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS -� aY } F4, N 3S0/7 0°� 7e, J u C-X/ST/�✓Cr \\\ TES E I 3z' 15 �P�(H�FAt4p v G 4 ix ROBERT, �c. !� c P. ^. L U T 9/ i s BUNIKIS ,�.Flo.22162�® ti AL p . , D /I w /S V VV ;y �W vC' i LEGEND n EXBSTING . SPOT ELEVATION OxO CERTIFIED PLOT PLAN. EXISTING CONTOUR - - - ® G-07- cImAls p FINISHED-_ SPO-T, E_LE_V AT—LOPd FtNIsHE® CONTOUR o AFOROVED : BOARD OF HEALTH DATE AGENT SCALE / =��D DATE A 1'E-7z /V s L®REDGE,ENGINEERING CO. INC � 4�—._ � CLIENT -.. -- .. I CERTIFY THAT .THE PROPOSED EGISTERE �REGISTERED' JOB NO. -7 ?D�0 BUILDING SHOWN ON THIS PLAN CIVIL �=SURVEYORS CONFORMS TO THE ZONING LAWS. DR. BY /� i�}..- MASS. ENGIN_EERS� OF BARNST BLE , 33` NO MAIN ST 712 MAIN ST CH. BY -_� �'� ' 3 /? SO. YARMOUTH MASS. . HYANNIS MASS Z_ , SHEET__ OF __-___ DATE REG. LAND SURVEYOR 2® FT. AV IV. - : , .: Alea�'.� ; /.� '�'hD� .��®®C TAs�� 's s Al®J�'E IWC�A�S S8,VL its 4F.QA,0C, A 2-0 /V FT �-A YY 7 CONCRETE - M/!d!. P/TCAd G'A.S T /ROAR COVER S'fP�L.G EE' VS eo 1 R /A FL /0 0 , CO!/E/�5 'PER FT Usk/d��WAY 2X/tfrN. 4*oTA P-- � 4"ooue�LE -Z-R,0 0NA-rEo ®: • .• A I., .. PVC P/PE 4"CA ST'-I,i /RO,V P/PE l p Gi4'L. l•_ ..•� > . ..I MIN. P/7C14 SEAT/C ��/!>'� „ o.•,•.o ad°°°. �Tr —�oO: ep a° .b ®OX E/ems e �y. 6• CSEE L EACI-II NG FIELD f3 C T.4 BYL61 T/O/v) .SECT/OM Of' _ GRO(//VD JVA TER 7AOLE GE'ACf IM6 =/RL® o/M�Ns/oiY A 4 �T 3 FT. 6 FT. O,C. SCALD �,�•• = / '- O" FT Q/M.ENSI ON �F T. -2"LAYEA' 4 DOUBLE OF I 3 I P,E/�FORATED S®®L ���� S®d�. � �8•- 1S.• SO/L TEST #/ SOIL TES7.#2 1N�9SiJEDSTONg PVC PIPE Q,q'-g OF SO/L TEST 7 rI ELEV, q�.0 �-ELEV. _ RESULTS W17A/Z.SSED. BY /z //NCR 4, PEIRCOLAT/O/V RAT-- yb�2 MiN//A/Gp/ PER/FORATEO WOOD.STA/(E.S /VUMaHR OE EED/TOOM.S 2 G0.32s ESPl1C PIPE. yyA$NFD STONg SET .8 FT, GA)M6E D/5P415,41. 41,W/7P _ .�s�•✓c� ON CENTER ESTIMATED FLOW ZZ d GAL/DAY Gp ak• LEACHING AREA 3 SQ. F;r SCALe /�" I '-0 ❑ /v®GROU"D YVATE/R L-1VCOUiv7-�Re0 Q GRC3U/VO WA7,CR AT �L_EY -- 1 N VER:T ELEVATIONS - ���P�ZN D`Mgssq SOT 9 / �v/✓/�/S j�fJ�!> k?!�. ao D20BERT, c�� /M✓ERT AT BUILD/r!/G �b ��"T f1 t�£/�Iwn 5 /Z/'Z/14 A1/V-/ S P. INLET SEPTIC . TAIVI< `d.SS FT - j BUNIKIS OUTLET .5EPTIG TANK ''3 PT q No.221614; 6 /NLET DISTR/49U970/V BOX S./ FT E�®R�D���N�ONEE�'4NG �'®,dMC 5T�� e� S1C 702 MAIN .ST. 39 Mo. MA/M ST. �,•� `�OtdA1.��\ 0V 7L ET D1S'rM18 UT/OlV �X — F7 a HYfdMM/S,, /"nsI SS. SO. Y�9RMOUTP; /+9s0Ss. Ey0 ®r LEACHING . _D 74.®.FT Nov 03 06 08: 19a Ellis Bros Cont 508-362-6266 p. 2 Town Of Barnstable P..�' Regulatory Services Thomas F.Geiler,Director W na • aut, gar s, .,_, clwo) Public Health Division co i 9 Thomas McKean;Director 200 Main Street,Hyannis,MA 02601 o_ a T `f'fice:.50 �62-4644 Fax: 508-790-630A Ca Installer&Deslener Certification Form ' Fate: 4` A Lo 6, Sewage Permit# ';L 00 6 35&Assessor's MaplParcel Designer: jgmq a Installer: I. 11 i S A''ci T'tieA A. C.c;1 S3 C G Address: 1_G Cites 4L4 to,� Address: 3 I3h le r p f, S? tZ-o-7 V On SS 1 I S j 6 0 I,;,i l l s 6.ro 1t sS C009tsued a permit to install a (date) (installer) septic system a.t Q 'Uhns n'nf- R-ryc) based on a design drawn by (address "rA'1J dated 6�0 / (d s'gner V I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactoy. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance,with State&Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required) was inspected and the soils were found satisfactory. (Installer's Signature) T,4NY; U uriIGN A I.I' ,f...._ N logo L 13 C(.O (D i is Signature) (Affix Design PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION'. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTI1L BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 03-09-06.doc x Town of Barnstable Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Sumner Kaufman,MSPH Paul Canniff,D.M.D. July 14, 2006 Ms. Tanya Johansen, R.S. 26 Compass Lane Dennis, MA 02638 RER ,.\lariancesrte'c/�9 ©umoJ�oad� Hyann A$ 7dk Dear Ms. Johansen, You are granted variances, on behalf of your client, Deborah Hirshon, to construct a replacement onsite sewage disposal system at 159 Dunn's Pond Road, Hyannis, Massachusetts. The following variances are granted: 310 CMR 15.211: The soil absorption.system will be located seven (7) feet away from the southeast property line, in lieu of the minimum ten (10) feet separation distance required. 310 CMR 15.211: The soil absorption system will be located one (1) foot away from the southwest property line, in lieu of the minimum ten (10) feet separation distance required. 310 CMR 15:255(5): To remove only one foot of impervious materials at the southwest corner of the SAS, in lieu of the minimum five (5)feet lateral removal of impervious soils required. Section 360-18 (A): The soil absorption system will be placed in an area where there is not at least four feet of naturally occurring pervious soil below the entire leaching facility. These variances are granted with the following conditions: (1) An additional test hole shall be excavated for soil evaluation at or before the time of installation adjacent to the proposed SAS location. Q:WP/JohansenDunnsPond2006 (2) 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. The applicant shall record a properly worded deed restriction, signed by I�1f the owner of the property, at the Barnstable County Registry of Deeds �G restricting the property to four (4) bedrooms maximum. A copy of the ((( recorded deed restriction shall be submitted to the He alth Agent prior to obtaining a disposal works construction permit. (4) The septic system shall be installed in substantial conformance with the revised plans dated June 8, 2006. ,(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 dated June 8, 2006. These variances are granted because the proposed plan appears to meet the maximum feasible compliance standards contained within the State Environmental Code, Title 5. Sin rely yours, a n iller, D. Chair an Q :WP/JohansenDunnsPond2006 DATE: 0 ' >� (� � "C. BY_f/� . _ Town of Barnstable $®. DATE: Board of Health- 367 Main Street,Hyannis MA 02601 Office: 508462-4644 ` FAX 508-790-6304 SumnerKauSnan,M S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION Property Address: 1517 ilnri-s 4y,+4 mu, Assessor's Map and Parcel Number: Z7D� - Size of Lot: Wetlands Within 300 Ft. Yes Business Name: 74- 0,co oz* y 4znls No_ Subdivision Name: APPLICANT'S NAMEr �/�IVTY�} -�*4M,591U 1Z5, Phone '1-7+-S3 -24D,7_____ Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OW NAME CONTACT PERSON Name: 1e$012+4w t+i e&t4ol,J Name: S" A�. P$ZOV I DEN t ser Address: _3 1 &0-'U iJ fiTDj,1 ST oz k2(e Address: Q� Cv a$1 e z,t�l W k 38 Phone: 401 421 - (oZ7T+ Phone: 1' �_CE ROM REGULATION pa Reg.) REASON FOR VARIANCE(May attach if more space needed). NNlr1'[u►ro1 -1=x plst>w Si t63 t 17w0 C.ocr<t-,7oxl Z. N cn 04 to Pt(.L gggg&j JLJ+I' , --vp`)i D 5 A&I0 NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System Checklist(to be completed by office.rtaf -person receiving variance request application) q/ Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e g.septic system plans) Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense F v 4 (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same . owner/leasee only],outside dining variance renewals[same ownedleasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan O.Rask;R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.Fl. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. 4 S p6w-D N�. j ^ n �4 _. ...,....�-...,.y.....+•M^..... a.. ,_...,•+�r�-f *r^}�., ;� '_ _ �,�� ,. "f�'t'r"r^' Sf.y t4 Y, � ✓a � tt����`� ^F _w�e�r- ��� - a ' ' I r mow V --- --- ----- rlllrr I , rllrllrl IIII iI IIIIII--------------- rllllrll r r.-. I I f I r i r I r_.. t._-_ , .I_____ ________�___ __ .- ___ ____ ___ ____ 1 i r I I - I I I I r r��• I e< , I avanr I I I I I ; _ f�l ! - ! - - i I r , I r _I I r � r , I r I I , r ; 1 I r I I r I I -I - I r I r I r r - J - A - - Y I r i i I 1 , I , r I I i r r I r r r �; - - - , r - , I , I _1 r r r ... ,.. r r --------------- -------------- --- ____r_ _r____r_ _ - I , r I , I , I r � 1.___t._..-J-__. -___J____L____r_-__Jt-..__,____J____A_". I 1 I I 1 I 4 r IAm- ' r i____ __ ___ ____ ______ ___ ____ _ ... . ___.._ - ___T___-.r-___, i _.___._ r ____rr.__., _ .i.r._-_-r•-_- _-__.I1 r I I r I 1 r I , I 1 1 I , - -•- --- . . Y - r I 1 I I r r r r� ___ ___ __ I i �ry r I 1 r 1 i 4/ 1 I I I -I -1 R � I 1 , I r n I 1 1 1 . � i yf1(�j/ ; 1 I . I I . - , - - - - _ -P 1 r r r I r ___ __._I____ f_-_ r---Y___ ___ _ __ _____ __ ______ _____ _ __ _________ _ _ _ � r r r I I _ '._ _ _ � i �' a ;` ; ' _ _ _ -i I I t I I I , -r r I I r I I , I I I , I , , I I I r , I - ---L--- --_-A-.--l-_-J-___A__..l_ _J_ _Sn r , 1 c I , -,� I I ; , I r , r t _I___ I _- , __ ___1____L___ _.-t_ I 1 I 1 1 r . , I 1 f i � F H . n _-.,_________ ____y..__ . 1 I 1 I I I r 1 r r I r I e I I r I , r r I r 1 I I i 1 _._!._____________!____!.__.I._.------ --...1___.:.___.-___!.__._-..__!-_-_..__-- -_--!-._-_-_-,,.--„_.._.____....__„._.._._..._._---_---..--_----__..---. - Al --- - ----- -- - ---- -I_ 1 , r I r --------- 1 �--t-TJ-^--w t , t ' I I , I t ; I ' .....J_.._L_.._ .._d___„......6_...J_..,.wi_...r„_.._J I r I 1 a I I I I i r r ; J- L----` -'-_—' —_ _-—— _1 i _-- I.r-s '_ ' a r ; I I 1 r ---—------------ PI - — -- _ .................. 1..._•j_ -.L..._r..__J."__<4... ...d�i.. ' , 1 1 1 �'• i _. ...... r I 1 , r r , , I I _ , I 1 :.__-J--•_''—" L � 1 I , , , 1 + - r , ' - ; • ; ; .lit I � ----}----f--- --------- ----'--- - - - --- ----T ...... ; I r I " Y ........... ,.......... - - ... 1_ I I .._J �i-_.-J____L-__.L___J_-__1 I I 1 r ------------------- CTJ a. 1- , -Y , I f , r � , f I r , , , 1' I Y t r ye . r. A" 1 r i , ; 'elf 11J DATE: 0 s�l9► REC.. BY JIM- Town. of Barnstable : , Board of Health 367 Main Stiroet,Hymmis MA.02601 Ofca: 508462 4W Susan G.Rad,I S. FAX 108.790.6304 Sumner Kanfi m,M.S.P.R Ralph A.Murphy,M.D. YARMNO REQL,j=FORM y � � (�`(,�}'xll�(IS /!'! r -.� Assessor's Map ad Ptrcel Number: 270 J�=�, Size onct: 121 w-I t Weftds Within 300 Ft Yes Business Name: Tft co 0,61,5v-u 2"is No 1 S.uMvision Nam �.ICANP'$NAW:• �1, IWi} y�+�t Al X1 a S, Phone T7+-S3& —?-40: Did the owner of the property authorize you to represent him or heal Yes No Name: 12&00t J Name: � Address; 3! aylZL,tnl P2dvio�cs,Qr" Ada EDN ST`. 02 J22(e Address: Phone: Phone: V OGRE ON(Wr Rag) REASON FOR VARIANCE(May auaoh if more space needed). 1• MINIM" inD1sn-w St lo i t7W r- L 0&1q-n J1 J •• ...t A U 5 OU &WOM ►4rt1Cc� v t � 1 �' . NATURE OF WO t: House Addition C3 House Renovation C3 Rep*of Failed Septic Systemx (to he complstrd by opiCc sld�person>sagtvMg vasfarra regrrast opplicatlar} Four(4)copies of the completed variance request form {)ceps of eagineesed plan submitted(p g.septic system plans) Amw(4)copies of labeled dimensional floor place submitted(e.&house plans or restaurant kitchen plans) Signed 10W 310fng dW the psvperty owner authoriand you to represent hi a4m 1br this request Appf l understands drat the abutters must be notified by certified mail at feast ten days prior to meeting date at appflcartt's expmtde (for Tnie V and/or local sewage regulation varies only) .Full menu submitted(tbr grease trap variance requests only) Variance request sppflosdon to collcmd(no fee!br ff ftwd modification rermnis,geese trap varfeaae reaewais(same . r own0 ieadee only],outside dining variance renewals(game owtudlasee onlyh and variances to repair ftriled saww disposal systems tonly if Ito expansion is the buildhtg prtnposca . Variance request submitted at least 15 days picot m meeting date VARIANCE APPROVED Susan G.Rasic;RS.,Chairman NOT APPROVED Smw Kmdnw4 M.S.P.H. REASON FOR DLSAPPRAVAL Ralph A.Murphy,M.D. t f ABUTTER WORKSHEET Owner: Deborah&r Melvin Hirschon Address: 31 Burlington Street Providence,RI 02606 Map 270 Parcel 4-4 Applicant: Tanya Johansen R.S./TADCO Consultants Address: 26 Compass Lane Dennis,MA 02638 ABUTTERS Map/Parcel 270/004-003 Name Linda Zola Address 21 Van Buskirk Way Sandwich,MA 02536 Map/Parcel 270/004-001 Name Joann Roza Address 153 Dunn's Pond Rd. Hyannis,MA 02601 Map/Parcel 270/004-002 Name Lori Crawley Address 155 Dunn's Pond Rd. Hyannis,MA 02601 Map/Parcel 270/005-002 Name Carlos Santos Address 173 Dunn's Pond Rd. Hyannis,MA 02601 Map/Parcel 270/011 Name Josephine Doran Address 160 Dunn's Pond Rd. Hyannis,MA 02601 Map/Parcel Name John Vickery Address 89 Rosemary Ln. Centerville,MA 02632 Map/Parcel 249/94 Name Barnstable High School Address P.O. Box 955 Hyannis,MA 02601 MHY-.5-dU10b lb:4f thtUM- 1U:IDITU tsDbm,9 r.1 May 03 06 12:36p Tadao Consultants bUU3UbUUUj p.t T.I . Consulting TADCO Consultants 26 COMPASS LANE DENNIS,MA 02688 509-385-2425 ' DUMAS TAr11iA LC HANSEN May 3,2006 Deborah Hirschon 31 Burlington Street Providence,RI 02606 I hereby grant permission to allow Tanya Johansen R S. of TADCO Consultants to represent me at the Town of Barnstable Board of Health.Meeting in regards to the required Title 5 and Town of Barnstable variances for my property located at 1S9 Dunn's Pond Rd.Hyannis,MA. Deborah Mrschon Ownr 159 Dunn's Pond Rd.Hyannis,MA Ir TOWN%F BARNSTABLE LULATION ,OC9 eD0'nhS ?e914 1ZCQ SEWAGE# n Sum VILLAGE Wyc4orli'S ASSESSOR'S MAP MAP&PARCEL 1J R'S NAME&PHONE NO. `g r��-L SEPTIC TANK CAPACITY i!�'00 (1?0- . LEACHING FACILITY:(type) :T,-,V lirr'V rs (size) NO. OF BEDROOMS_ �I OWNER wilt tc- n PERMIT DATE: C E DATE::a SP. oq,Ic�7 O�'J 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 k Dunn's Pond Road ater ervice h \ h h h h \ \ \ h \ \ h 4 4 h 4 \ \ ♦ \ ♦ ♦ \ h 4 h 4 h h \ \ \ \ \ 4 ♦ h h \ 4 4 k \ 4 \ 4 \ 4 ♦ \ \ �' f • r 1 r / J r. F f / f • • • J • / f f ; r \ h h 4 h h h h \ \ \ \ k h h h h h \\ ♦ \ 4 4 4 4 \ \ 3^ . f f `t \ ♦ \ h k h 4 \ \ \ 4 h 4 4 \ 4 f f f f f ! f f f f f f 4 ♦ ♦ \ \ ♦ 4 4 ♦ \ 4 4 4 4 lrrffff , f F / r ! 1 54 4 ♦ \ 4 \ \ 4 4 h \ \ 4 \ 4 ' ' \ 4 h h \ • \ 4 h h 4 h 4 4 h 4 4 4 4 4 h 4 ♦ \ 4 \ 4 4 4 \ \ 4 4 4 - 28 30 14 15 nn TOWN O/F�BARNSTABLEC_ LOCATIONr k/ 14-J 9 '1 -SEWAGE #aOO� VILL-kGE_ a b� n I ASSESSOR'S MAP &LOTS IN"iTALLER'S NAME&PHONE NO. Cc,,7sd, 3 6 a -6a 352 SEPTIC TANK CAPACITY /S a d LEACHING FACILITY: (type) Z41 /T/P/-1%6/2 S (size) NO.OF BEDROOMS .BUILDER OR OWNER fill PERMITDATE: COMPLIANCE DATE: f le Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leachifig 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 __ 4 wo C/ O 0� Qo d ,A _ s w TOWN OF ARNSTABLE C—ATION D0 �f SEWAGE # E ASSESSOR'S MAP & LOTo�7�"�� NAME&PHONE NO. SEPTIC TANK CAPACITY \ LEACHING FAClL=: (type) l (size) NO. OF BEDROOMS BASF-.I -9 OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the�� Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Welland 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 � t Town of]Barnstable P# 4 Department of.Regulatory Services • ; � ' Public lEtealth Division Date A *AM ��s$ 200 Main Street,Hyannis MA 02601 /Eb MA't Date Scheduled InAe 'Time l Fee Pd. i LL ewa 1)rs Soil Suitability Assessment,for S ga osar Performed By: ? A ti ��'1 C1 Witnessed LOCATION & GENERAL INFORMATION Location Address S� ��5 �� Owner's Name I,e-scl iDj / I Address n _n r� Assessor's Map/Pacel: �GZ j Engineer's Name iT J� 5-0 4JcF. � NEW CONSTRUC�,'1'ION REPAIR Telephone# CW -7-7TL 63-3(.0 2 ®7 i i Land Use Slopes Surface Stones Distances from: Open Water Body ft Possible Wets Area ft Drinking Water Well ft Drainage Way ft. Property Line ft Other ft SKETCH:(street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) i / Jke M� I rt-ker 1 J1f t�r k O(a� , G+���I. �B� �+1e.rap l Cltvr,4 /t©ur /A 7 4a7 1 fJ�✓n ,/`Pvs�•.t�y ,J/'` f1/11JFDtl(�l . Parent material(geglogic) Depth to Bedrock �151-4 i Depth to Groundwater. Standing Water in Hole: I Weeping from Pit FAce i Estimated Seasonal Vigh Groundwater i DtTERMINATION FOR SEASONAL HIGH WAT +'R TABLE Method Used: - Depth Obperved standing in obs.hole: _In, Depth to Soil mottles ln. Depth tosweeping from side of obs.hole: in. aroundwnter AdJusttrlent ft- Index Well# Reading Date: Index Well level A41•faetor ,.,.�.- Ad.araUtldWnter 1.t:Va~l•,,_ PERCOLATION TEST DAte,,_•.m• 7►'tme Observation Hole# Time at St" Depth of Perc Time at G" Start Pre-soak Time.CO) Time(9"•6") ---- End Pre-soak Rate Min./Inch Site Suitability Asse'asment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Hehlth Division Observation Hole Data To Be Completed on Back u must first notify the ------ ***If PercolaOon test is to be conducted within 100' of Wetland,yo 'DEEP OBSERVATION HOLE LOG Hole#.�_ Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) I-lottling (Structure,Stones,Boulders. i Consistency.% ravel DEEP OBSERVATION HOLE LOG. Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) _ (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel J PEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel 'DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Ora el Flood Insurance Rate Man: Above 500 year flood boundary No Yes Within 100 yen boundary No— Yes, Within 100 year flood boundary No____ Yes Depth of Natutally Occurrin Pervious Material Does at least fo feet of naturally occurring pervious material exist in all areas observed throughout the area proposed fbr the soil absorption system? If not,what-is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the soil evaluator examination appr0ed by the Depardnent of environmental Protection and that the above analysis was performed by tree consistent with the required training,expertise and experience described in 310 CMR 15.017.. Signature Date Q:1SEfTICVERCItORM.DOC 9 � p, ��� � H �?�,�e � �� V��I „� � i � l� '�i� �itiuiL�i � � i ''„; � „ day �V �,i i � i;uu j� �§�4s 4 � �}i iyr„ lu„ ill, p t �� �,' �� it Ss, f' Y�� : :?', i 2' � vv_A 1e��5 �.• 4 q.r'pa � ,Y� ,�,n -.rV^�,,!•, .' �• OF AN 8 # 'L e)Y 02J0ir �, 270003 - i I LO CAT ON E W A G E PERMIT NO. 'v y -` �I-.I LAG E 4 I N S T A LIER'SNAME i ADDRESS �.c.w�.. ►' Imo-t.a.�zn.., , e U I l D E R OR OWNER s DATE PERMIT ISSUED _.: -- 7 - ���-� DATE COMPLIANCE ISSUED �_�� <'7 0 6 8 P �.. �� • �, w . ... I 20 FT. MINIMUM FROM CELLAR 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE SOIL TEST ` CLEAN SAND 2' PRESSURE PIPE 4' SCHEDULE 40 PVC PIPE INSPECTICN PORT DATE OF SOIL TEST ELEV. 150 PSI MINIMUM MIN. PITCH 1 8 PER F�. SOIL TEST DONE BY _ ��t _ _ TOP OF FOUNDATION r T 2" LAYER OF +�N1$��, ELEV. - 100.0 10 FT MINIMUM 1/8' TO 2 1/ ' WITNESSED BY _�_�''���`__►'`_�'�'_� �g (ASSUMED) 4�'NCPEDCH 1/8' PER 4C PVC FITS MANHOLE " A ` fi WASHED STONE VENT `��i. ! COVER OBSERVATION HOLE 1 ELEV.=__ CONCRETE Z j PERCOLATION RATE < � MIN./INCH AT _� INCHES \k COVERS t 0161 DEPTH HORIZ TEXTURE COLOR I MOTT. OTHER 4" CAST IRON PIPE " \ C ` ,ti �/ 111Y M iJ (? 3� Ifs ---- (OR EQUAL) MINIMUM ° ° _ o� o ° A� �� Y , --{ ` �� 4 PITCH 1/4" PER FT. LEVEL F, o eS rrc ° = 4 /.1� �1�4` '` /, S BEL A18 0 FIL E 6" SUMP ELEV. _ `!�` 4r _ _ o o = ELEV. �� _• (� - ,2�_ FLOW LINE fJ - -- - TRIBUTIONv, ELEV., 1 IN _ -THIN L i u 3/8" DRILL - ''� ��) NIGH CAPAQ'TY/NFIZTRATJRS ININ STONE- GAS I� HOLE BOX ; .g� Z� g EJ qb.� WATER ENCOUNTERED AT ZL� ELEV. a IN AN / TRENcH FORMA 710N I ELEV. _ `___ BAFFLE m TO BE WATER TESTED WE-L ELEV. = 9s'7 V) (TO BE PLACED ON FIRM BASE) SOIL ABSORPTION ZONE �Q 3/4" TO 1 1/2"Y � INDEX DQUIID OUTLET CHECK WASHED STONE SYSTEM (SAS) ADJUST -DEPTH TEE 4 FEET 14 INCHES (TO BE PLACED ON FIRM BASE) VALVE 5 FEET 19 INCHES 1 500 GAL 6 FEET 24 INCHES SEPTIC TANK 0 0 GAL. 0.4 HP (MAX ) USGS PROBABLE WATER TABLE ELEV. 7 FEET 29 INCHES OBSERVED WATER TABLE ( 14 /' n/GO ELEV. _ 8 FEET 34 INCHES PUMP (OR EQUAL) DESIGNCALCULATION i - BOTTOM OF TEST HOLE ELEV. _ '__�_ NUMBER OF BEDROOMS CHAMBER N� PUMP CHAMBER CALC/U/ LATIONS: TOTALESTI ATED FLOW DISPOSAL T ELEV. AT INVERT INLET -�- ' , _ /1 _ ( 110 GAL/BR/DAY X SR.) GAL./DAY SEWAGE DISPOSAL SYSTEM PROFILE ELEV. AT ALARM ON REQUIRED FLOW PER CYE25 X GAL./CYCLE 1JCU. FT. REQUIRED SEPTIC TANK CAPACITY "�a� GAL. VOLUME PER CYCLE _ GAL/CYCLE /7.48 - _ CU. FT./CYCLE NOT TO SCALE ELEV. AT PUMP ON = •CU. FT. ACTUAL SIZE OF SEPTIC TANK GAL. ELEV. AT PUMP OFF VOLUME OF WATER IN PIPE 3.14 X 0.9Q6ts� X _ FT. _ SOIL CLASSIFICATION I BOTTOM OF INSIDE PUMP CHAMBER rr% TOTAL MINIMv VO ME PER CYCLE ���� CU. FT_. BOTTOM OF OUTSIDE PUMP CHAMBER r1 � DISCHARGE .� fr CU. FT 34.67 CU.FT./FT. _ FT. (1000 G.S.T.) , DESIGN PERCOLATION RATE <�`_ MIN./IN. SAGE CAPACITY fi✓r GAL./DAY /7.48 GAL./CU.FT./34.67 CU.FT./FT. _ !G_ FT. EFFLUENT LOADING RATE 74_ GAL./DAY/S.F. jREQUIRED Z� PROVIDED LEACHING AREA SQ. FT. LEACHING CAPACITY (AREA X RATE) 4 '7 GAL/DAY TTL4u- S Y� �'; � RESERVE LEACHING CAPACITY _h � GAL./DAY 5.7� /5. Cl /yl trrh � Zt t � +frn NOTES: '3f VA-f-Al"MIC6- '�...(,WM F.MUl !zpo fDf 5-e-TV,�011fiC 'T 1• ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 r AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL 7D 4zoe__lf_I Y tl"a- (SOVT"F-Ie�,.t 7 OF SEWAGE. j 96.2` 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF \\ FINISHED r t ' 2_f I �� � � " � ? F-�•�`•z `�' � 101 �� 1�rti'I 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF \ 95.s L _ �Deevr y �� /�� �c��-�. WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN'� G� C 10 FT, OF DRIVES OR PARKING AREAS H 20 LOADING SHALL BE 0� 9 USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. jl 10 ��� 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE �\ r MORTARED IN PLACE. 97.0 • 96. �. 1 r, 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED Q OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. t \ 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR . IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS N PRIOR TO COMMENCING WORK ON SITE. 7 CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY QD 95.9 97.0 VARIATION IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ` c' �` � ENGINEER IMMEDIATELY. _97.9 1 ^^"'"'."V IM4 v�4N� rz u461D S Inc( Ll 8. PARCEL IS IN FLOOD ZONE 6 { 98.0 � l 98.2 98.1 9. LOT IS SHOWN ON ASSESSORS MAP _�ZQ AS PARCEL � v ' rT +.'� 6.6 8.0 eHoo '►V 51 ►��:� f�$Lr1'T>ti.1�1r- I�C.tV�iwr lr pet cI*l44 r I 98.4 j 98.1 ���SH OF MASS4�, LOT 91 / 1�D# S° TANYA 12,961.9 f S.F. 99.� �.2�.U r t'rg�1o/� QF U r� 38 DAIGNEAULT -"i . w x 1 : �No. 1095° % APPROVED: BOARD OF HEALTH 99.0 • 98.8 � 11 }>,,t�' v rt�"-�+ 1� V 1 ' #• Fir aF �'` / 98.9 98. s V 98.8 98.9 / 1 •-97.7 i,( 99.0 DATE AGENT - i \ 98.6 � \99.f \ 98.7 PROPOSED SEPTIC DESIGN FOR 98.9 99.4 p e � 41 SC4 + Oti. 98.7 _ 1 \ 99.0 0 00 L OCUS PRDJ 15 9 D UNNS POND RD. 97•9 %3 0 s� / �° BARNS TABLE, MASS. 98 TADCO ENAIRONMENTAL CONSULTANTS p1NE ST• J� 26 COMPASS LANE, DENNIS, MA 02638 0 (508) 385-2425 LEGEND:EXISTING SPOT EXISTING CONTOUR --- 00-- - \R \� `G��L� DATE 19 (Q(1 I SCALE 1 " = 20' FINAL SPOT ELEVATION Va f FINAL CONTOUR ---[ / 99.8 ��C O GR RE'7ISED JOB N0. SOIL TEST LOCATION 00 j \ ov 19 UTILITY POLE cla.) TOWN WATER -W-�- W- GASCLINEASIN C G\O� � � ,� LOCATION MAP � � sED � , SHEET � OF � CESSPOOL , NOT FOR ZONING I PLANNING USE REv I CLEANOUT w_ C.O. i S6 ! P.40J 1 2677-00 I a'wg 2B71-SAS..0WS C 2GG6 TA,9CC 20 FT. MINIMUM FROM CELLAR 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE CLEAN SAND SOIL TEST A]DICEMATOP of FOUNDATION 2' PRESSURE PIPE 4' SCHEDULE 40 PVC PIPE INSPECTION PORT DATE OF SOIL TEST ELEV. _ ______ 150 PSI MINIMUM MIN. PITCH 1/8' PER FT. 2" LAYER OF SOIL TEST DONE BY _ - t,4Se'r�j _ ELEV. = 100.0 10 FT MINIMUM 1/8" TO 1/2" WITNESSED BY _ _RC`fV i_�" � Few- (ASSUMED) 4' SCHEDULE 40 PVC PIPE WASHED STONE MIN. PITCH 1/8' PER FT. MANHOLE �• �'' VENT COVER OBSERVATION HOLE 1 ELEV. „ CONCRETE z PERCOLATION RATE < 2 MIN./INCH AT _��____ INCHES �,J q� 61 DEPTH HORIZ TEXTURE COLOR MOTT. OTHER 4" CAST IRON PIPE tM �� ' �t �-yy-,- =r �-Vr� I�hlii ���� i()'115 TOTI��i_ (OR EQUAL) MINIMUM 2 0" o o ' Q-7 �� ` V - _-i_•✓ 1L11`'1 - j1M4 PITCH 1/4" PER FT. LEVEL oe3 ° I i - _1 I_�p �1}' 1 �^ Z i ^1�1U(N BEL A18 0 IL E 6" SUMP J�,ivJ _ ELEV, � ELEV. _ � - �.-:_- _ � - - + 1FOLOW LINE - TRIBUTION � � ,✓ ��'�.,.> --- -- - - - ELEV. _ �____ �/ -- MIN. 3/8" DRILL B '' IO 1' HIGH CAPA(YTY/Nf1Z IRA TORS M7H STONt ,' ,,t BAFFLE a HOLE BOX IN AN AWYII �-�� TRENCy FQ4MA7704' � W� t�v �b"� WATER ENCOUNTERED AT ELEV. ELEV. _ ____ TO BE WATER TESTED - L ELEV. _ 'S'7� N (TO BE PLACED ON FIRM BASE) SOIL ABSO PTI N `�' ZONE j� 3/4" TO 1 1/2" INDEX LZ _ LIQUID OUTLET L CHECK WASHED STONE SYSTEM SAS ADJUSTT= DEPTH (TO BE PLACED ON FIRM BASE) VALVE 4 FEET 14 INCHES 500 GAL FEET 19 INCHES 6 MYERS SRM 4 u,r 6 FEET 24 INCHESGA . USGS PROBABLE WATER TABLE ELEV. _ 7 FEET 29 INCHES SEPTIC TANK 11 0.4 HP (MAX.) OBSERVED WATER TABLE ( ,-t /i `0'/C)6) ELEV. _ T_ 8 FEET 34 INCHES (OR EOUAL) DESIGN CALCULATIONS - PUMP BOTTOM OF TEST HOLE ELEV. _ _ NUMBER OF BEDROOMS CHAMBER PUMP CHAMBER CALCULATIONS: TOTRAL ESTIMATED FLOWT t ' + � ELEV. AT INVERT INLET REQUIRED FLDW PER CY .25 X� = iv _ GAL./CYCLE ( 110 GAL/BR./DAY X W) _ GAL./DAY SEWAGE DISPOSAL SYSTEM PROFILE ELEV. AT ALARM ELEV AT PUMP ON VOLUME PER CYCLE Z&- GAL/CYCLE /7.48 ;AlJCU. FT. = CUCFTFT./CYCLE ACTUAREQUIRESIZE POF SEPTIC TANKTIC TANK GAL. SAL. NOT TO SCALE VOLUME OF WATER IN PIPE 2.14 X 0. 69 X �_ FT. _ - ELEV. AT PUMP OFF , ' SOIL CLASSIFICATION I_ BOTTOM OF INSIDE PUMP CHAMBER s'� TOTAL MINI MU VO ME PER CYCLE CU. FT, DESIGN PERCOLATION RATE < 5_ MIN./IN. BOTTOM OF OUTSIDE PUMP CHAMBER DISCHARGE CU. FT. / 34.67 CU.FT./FT. _ � FT. (1000 G.S.T.) ;7 EFFLUENT LOADING RATE L74_ GAL./DAY/S.F. STQ) �4GE CAPACITY._ GAL./DAY /7.48 GAL./CU.FT./34.67 CU.FT./FT. _ ;1 /©_ FT. LEACHING AREA '_ SQ. FT. REQUIRED PROVIDED LEACHING CAPACITY (AREA X RATE) 4 '? GAL/DAY T v � RESERVE LEACHING CAPACITY �� 1�" GAL./DAY I - 5.7 /S C1) /Hl lMh LfYY! •SEx''M,4Cr, otsnq a.1 cez '- ! NOTES: I vA-f_1 il4o%1 c_c- fy-o l eenLvkjze,0 10, scT-{I&j(*t -Frzc.*yj 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO O.E.P, TITLE 5 AND THE TOWN RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL L( I Y L!�-��' �O�It?-� T OF SEWAGE. 96.2� j-� r-+ 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE. 95.6 �` r � � t/9{1�[> � V I tG "1� 1 Q �1C -�""�I 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF 14 � r+110?���( ��� /�0� „S-r Wil}iSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN k t '- ( J 10 FT. OF DRIVES OR PARKING AREAS H-20 LOADING SHALL BE USED UNDER OR WITHIN 10 FT OF DRIVES OR PARKING AREAS. 4. ANY MASONRY UNITS USED TC BRING COVERS T' TRADE SHA,, 8F 97.0 96. ) ( iC ;v DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED �� IVJ OP ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH `� I ! DETERMINATION FROM APPROPRIATE AUTHORITY. / 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR 96 C\ K 'gJ IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. IS:Zs�['' / c TL► 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS 'S C.S, �dr`�J` �V1j � I SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY ( " 9 5.9 �� , 97.0 \ VARIATION IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN \ _ 97.9 L�vG++.7 t Aj e7 4/ ��A'� t1G,,is t" R ,LA eai� :+ Z�� �.,.. ENGINEER IMMEDIATELY. E 7 - _fig ) _ 8. PARCEL IS IN FLOOD ZONE 98.E 98 g81 \ �{ � / t.-- 01.1 v t >-T�f i� e*Ot Di= SPI•�,^.� /�-��b 9. LOT IS SHOWN ON ASSESSORS MAP _�ZQ AS PARCEL 6.6 8.0 SH. p �r yea k. 1 r 98.4 j 98.1 LOT 91 �w.�^^��- s 04OF 72967.9 f S.F. 99.4 -Dial GAF RiM Q`/ oe�+4 4 / 22" J ` TANYA ti 96,7 ��� , \ ,. (x o DAIGNFJULT99.0 APPROVED: BOARD OF HEALTH 98.9 98.8 /� F.�� �"L.A,3� . +"t t�, . � 98.9, \ 08 8� , DATE AGENT --87 7 99 4 / 98.6 99.1 95.7 _ PROPOSED SEPTIC DESIGN I \ /bwAJ OF fielf)cLe V ! l FOR ` .+ � �98.9 99.4 � � {� 1 iZ�cAA o • 98.7 PO iG^-1 r � 1►- r •,, .. \ 99.0 ' k1 `` )f'VG �7� r rI�J�'►r1 ftL 1 .(,ptu���' ROB LOCUS PROJ 159 DUNNS POND RD. 97.9 �' �� 3 \0 �° BARNS TABLE, MASS. 99.3 �\ �. , .� OCtGt ' na�V1EX,., y�� �Q H Y.q /VN/S 98 tea. \� ! ��� TADCO ENVIRONMENTAL CONSULTANTS prNE ST OJT Q 26 COMPASS LANE, 385E 2425 MA 02638 LEGEND: i', ' 0 �?�a Rz EX',STiNG SPOT ELEVATION *0.0SCALE " ' ' / EXISTING CONTOUR ----00---- , / \�t�` CiJ1� l9 �D 1 = 20 FINAL SPOT ELEVATION IOU, ve l �v ev RP` I FINAL CONTOUR - ��'� �p 99.8 ��r SOIL TEST LOCATION -fT00.1 01- REVISED 0(% 4-03 r,0. JOB N0. 40 UTILITY POLE TOWN WATERCAT GASCLINEASIN c G C- ---- ` LOCATION M A P REVISED SHEET 1 OF 1 CESSPOOL p CLEANOUT --�� C.O. C: I SB I PROJ 1 2977-00 1 dwg 12677-SAS.DW(:i cC 2006- TADCC 20 FT. MINIMUM FROM CELLAR ^ T SOIL TEST 4 , mmc 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE CLEAN SAND 1 Vp 2' PRESSURE PIPE 4" SCHEDULE 40 PVC PIPE INSPECTION PORT ,A E OF SOIL TEST r _ `_ TOP OF FOUNDATION ���. S� - -- 100 0 10 FT. MINIMUM ELEV. - 150 PSI MINIMUM MIN. PITCH 1/8' PER FT. \ 2' BLAYEERI��» SOIL TEST DONE BY __ ELEV. _ _-_-- -, / " WITNESSED BY _�_ r v� - � (ASSUMED) 4 SCHEDULE 40 PVC PIPE , WASHED STONE VENT Q T•O g MIN. PITCH 1/8' PER FT. COVER LE " A _ � OBSERVATION HOLE 1 ELEV.=_ - / CONCRETE / z J ��� PERCOLATION RATE ___<__2 __ M!N./INCH AT _�� 1NCES : DEPTH HORIZ TEXTURE I COLOR MOTT. OTHER 4" CAST IRON PIPE ppI' Y (OR EQUAL) MINIMUM 2.0» o 0 0 = - - 0 o Hv P t � 1 Y PITCH 1/4" PER FT. I LEVEL o I� I �`` -7/to -7)VIA1E" -iyBEL A18 0 IL R E 6" SUMP T.63 0 = o o . ELEV �(�M 2 5 FLOW' LINE + �;�. ELEV. = j V� Pv E✓ ELEV. _ ------ �M N. 1 fR I BU TI ON 4a , �)t / 3/B" DRILL - rb H/6w CAPAGYTY 1NF21RATORS lYlTH STONE I q �l GAS a HOLE BOX �b}>'fl'�.�3' ? - `J 'fib' WATER ENCOUNTERED AT ZU__ ELEV. = 9 •�_ ELEV. _ _ _J BAFFLE TO BE WATER TESTED �N AN TRENCH FORMAT10h' `L tii� ` ELEV. _ D (TO BE PLACED ON FIRM BASE) SOIL ABSO PTl N L� ZONE.? ----- 3/4" TO 1 1/2" INDEX Z LIQUID OUTLET �0 WASHED STONE SYSTEM SAS ADJUST i.°T CHECK 4 FEET 14 INCHES DEPTH TEE (TO BE PLACED ON FIRM BASE) VALVE 5 FEET 19 INCHES 1 500 GAL. MYERS SRM 4 - - 6 FEET 24 INCHES S�PTiC TANK 7 FEET 24 INCHES GA 0.4 S (MAX.) USGS PROBABLE WATER TABLE ELEV. _ 8 FEET 34 INCHES PUMP (OR EQUAL) OBSERVED WATER TABLE ( rt /' r/(r>) ELEV. DESIGN CALCULATIONS CHAMBER BOTTOM OF TEST HOLE ELEV. _ �__ __ NUMBER OF BEDROOMS PUMP CHAMBER CALCULATIONS. GARBAGE DISPOSAL UN�T ELEV. AT INVERT INLET // TOTAL ESTIMATED FLOW SEWAGE DISPOSAL SYSTEM PROFILE ELEV. AT ALARM I N _ REQUIRED FLOW PER CYC E .25 X�� _ __ GAL/CYCLE 7 ( 110 GAL/9R./DAY X BFQ � GAL./DAY S `' VOLUME PER CYCLE �&_ GAL/CYCLE /7.48 G/��./CU. FT. _ CU. FT./CYCLE REQUIRED SEPTIC TANK CAPACITY �D� GAL. NOT TO SCALE ELEV. AT PUMP ON =�.= ACTUAL SIZE OF SEPTIC TANK _ GAL. ELEV. AT PUMP OFF VOLUME OF WATER IN PIPE 3.14 X 0.996/9 X ��- FT. _ � CU. FT. r) TOTAL MIN!MU VO UME PER CYCLE :�4r CU. FT_. J SOIL CLASSIFICATION I BOTTOM OF INSIDE PUMP CHAMBER �_ � , DESIGN PERCOLATION RATE <_s5- MIN./IN. BOTTOM OF OUTSIDE PUMP CHAMBER _ DISCHARGE I = CU. FT, / 34.67 CU.FT./FT. _ C FT. (CU.F G.S.T.) 7 EFFLUENT LOADING RATE 74_ GAL./DAY/S.F. SjQ$�AGE CAPACITY �,�- _ GAL./DAY /7.48 GAL./CU.FT./34.67 CU.FT./FT. _ •y_0_ FT. LEACHING AREA �'_ SQ. FT. REQUIRED ._L.� PROVIDED - 44�,"7 � /, LEACHING CAPACITY (AREA X RATE) __' CAL/DAY , \ Tn r 440A, 'f RESERVE LEACHING CAPACITY ",-_� GAL./DAY j 5.7 - /S, 2I I Cl) lH I ll I/'1'1 L*n 45Tv,4cx_ 0 R T7 xi ce, NOTES: I� Q`�•�'1") f 4 3' v� [.J�0.1�f { (,YY'� e Vl Izec 10, -r"1 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 rr 7 AND THE TOAN RULLS AND REGULATIONS FOR THE SUBSURFACE DISPOSAL r. ,�L� 's, �rJ• 7D �v 7'' / ; (SQur�; � OF SEWAGE. 96.2\ i- ` r � �� 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF FIN\ SHED GRADE. 95.6 dk\ L ' ,2 ' , �i� / �I � I � � �# � !p' � ram' o 3. ALL I COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF \ j \, Q0 ew '�-� �( / c-j.. WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 0K �,, �+ *l (� l�+ ( ��� �'� V�,/ 10 FT. OF DRIVES OR PARKING AREAS H-20 LOADING SHALL BE USED UNDER OR WITHIN 10 FT OF DRIVES OR PARKING AREAS. 4. ANY MASONRY UNITS USED TO BRING COVERS TC GRADE SHA.-i. BE T MORTARED IN PLACE. 97.0 96 ; 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED i OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. n , h 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR �96.� IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. 1�, ^ �-�,��{ /� �• % � /r�sj /q� C•��j��'y���P'•111. � I� �k : / � 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS / l / LJ G•»'� 141/` w SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY 5.9 / � 97.0 VARIATION IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN _ / / 97.9 �lI'�'16rfti-G7L1 l� �• S/ �� ENGINEER IMMEDIATELY. - / !��� w S. PARCEL IS IN FLOOD ZONE - C 98.2 {i.i.Jv "cv� w �5, VT�+vf ,r clob e 0}~ Isiq � 04-01.1 L 9. LOT IS SHOWN ON ASSESSORS MAP _�7Q AS PARCEL 6.6 98.1 .� �•&,8.0 B,H'. p � q +,.,may LOT 91 / �tr+� �c'�A�iYA^S��\ � 72,967.9 f S.F. 99.� f �� r� C,g- ol�l OF' �'` AiGNEr" T 96.7 ��� �a� , Y 99.0 / LX i f+ Y: a No 1G95 APPROVED: BOARD OF HEALTH 9888 / 98.9 98.8 / �r1�w` 98.9 --97.7 99.0 `� DATE AGENT 98.6 99.1 -98.7 PROPOSED SEPTIC DESIGN 1 /OWN OF, ofv-AJ'5D161 c FOR 98.9 99 4 �C,esyl _ef1C „ �$ 98.7 l 99.0 R00 LOCUS 1 3 v4.4io x�ec Rim 1 oftutt .� PRO-1 159 DIJNNS POND RD. 97 9 �° BARNS TABLE, MASS. 99.3U�G�I, �tj1� NN�I S 98 11 T7 a � �`� 1 TADCO ENVIRONMENTAL CONSULTANTS Pi NE ST. J� Q I 26 COMPASS LANE, DENNIS, MA 02638 (508) 385-2425 LEGEND: � � / •� Ro. EXISTING SPOT ELEVATION xO.0 EXISTING CONTOUR ----00---- '' �� 1G J1��E DATE f Iq i�� I SCALE 1 " = 20' FINAL SPOT ELEVATION � vd FINAL CONTOUR -{ � y �99.8 SOIL TEST LOCATION -'`(00. Gj` �\ OL� REVISED r (o A63 L' JOB NO. -40 19 UTILITY POLE `-Q.) �tl J`ram TOWN WATER -W - W_ CATCH BASIN GAS LINE 0 G ` LOCATION MAP REvISEC SHEET 1 OF CESSPOOL CLEANOUT � C.O. --- - - �- __ __ i S8 I PROJ 12977-00 1 dwg 1167 SAS.DWv G 1006 790,7