HomeMy WebLinkAbout1391 HYANNIS-BARNSTABLE ROAD - Health 1391 Hyannis-Barnstable Road
Barnstable
_ _ A= 797 008
TOWN OF BARNSTABLE
LOCATION 13 9 9 I'd SEWAGE # �CC 7—
VILLAGE ASSESSOR'S MAP & LOT , 7
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1 I�- ��-e r Con.-SO-0 A ly S J' 3(® �
� INSTALLER'S NAME&PHONE N0. /� 3�
SEPTIC TANK CAPACITY C 500
LEACHING FACILITY: (type)5 ` Out 'C (size) I. IX` 3F X f t
NO.OF BEDROOMS
BUILDER OR OWNER Sv S"r'1 A`7 cll
PERMIT DATE: S/N'/`2 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
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No. +� 1 } {'/V 0 v v Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
01pplication for i�tJ aY �p$tPm� Con.5tructi®n permit
a
Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. `1n�t',� � %wner's Name,Address,and Tel.No. S�45-,YL 0hS"!d
,"p
Assessor's Map/parcel 61 fh ),8 P
Installer's Name,Address,and Tel.No. 3& &o`3 7 Designer's Name,Address and Tel.No. Do,-^ cc,
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Desig�o min.required) gpd Design flow provided gpd
11
Plan atG Q Number of sheets f _ Revision Date S/)/G:
Title T—
Size of Septic Tank Type of S.A.S. �( � �� , h f F 'h�y� G✓✓a. 14 f"
Description of Soil S e s�I � 40 Sr� arras c-h.n
Nature of Repairs or Alterations(Answer when applicable) S- e Vie ,L e T h A-A O�W► C y�
p Cj).^L /Z.I�cis^^•
D�I-,,v4 OcV [.; gccG — 2-e,,&CA
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 EnviVwiipental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this B and of Healt
a
Signed Date S—// —u
Application Approved by �1 - Date
i
Application Disapproved by: Date
for the following reasons
Permit No. ®� _' t' Date Issued
OD
No. t Fee
+I THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBIC HEALTH DIVISION - TOWNOF BARNSTABLE,;MASSACHUSETTS Yes
y b .
I ZIpplication for" io at �pgtem ton.5truction Permit _
Application for a Permit to Construct( ,) Repair O Upgrade O Abandon( )1 ❑ Complete System Individual Components.
Location Address or Lot No. �� 1 + 9 h °s 34m f J� u ' Si13 G� Owner's Name,Address,and Tel.No. � S�►
Assessor's Map/Parcel.. �� S3� //%' S�G
CO
rim
Installer's Name,Address,and Tel.No. 3 6,0-&a 3 7 Designer's Name,Address and Tel.No.
LLA,n
Type of Building:
Dwelling No.of Bedrooms a` Lot Size sq.ft. . Garbage Grinder-( )
Other Type of Building —No.of Persons Showers( ) Cafeteria( )
Other Fixtures
DesigValfie'
G min.i_required) gpd Design flow provided gpd
Plan I Number of sheets Revision Date
Title \ r -
'� Size of Septic.Tank Type of S.A.S. U. n[I le, tvy f w L1 rS�
Description of Soil Jan
y
Nature of Repairs or Alterations(Answer when applicable) S PP S��)•., JJ �Si`fh 'r°'1 ��Wh Cc„� r 1z, ..�-�
VC,7'.,V4 Oct- t" 2L cc /9-4,r
; 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 Certificate of *-• °�'
Compliance has been issued by this Board of Healt
l
Signed _ Date
SAPPIcation Approved by Date +
° Application Disapproved by: Date
for the following reasons
i
i
't Permit No. 1 d o"7 l Date Issued. -P 7
THE COMMONWEALTH OF MASSACHUSETTS 4
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired,( ✓) Upgraded ( )
Abandoned b
at has been constructed i'n'accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 4. dated
Installer 1911 iS Q row r s (7C n S0,' Designer (fin Co„6{
u r
#bedrooms d Approved de nflow ,�/ gpd
The issuance of this p ermit shall not a construed as a guarantee that the system 01fuon as desi ned }
Date Inspectorld
v(/ V ifV r �! j
----- ----�-- -.
No. 2007 " 'qL/ - Fee._.. _.
�/ THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVI•�SION-BARNSTABLE, MASSACHUSETTS
Iigpont *pgtem Con5tructi6h Permit
Permission is IiereBy granted to Construct ( ) Repair ( ) aUpgrade 4( ) Abandon
System'located atAj'S— 139I'llV1i-f /Z64C,/, /�S�nS �L3J`f, •/Y►�
t \ 1
and as described in'the.above A° lication for Tits osal S. stem Construction Permit:The a licant reco' .. z7 szh'is er du
�P - ,R, Y PP n'
to comply with Title S.,and the following local provtsiorrs�.o special"conditions.
Y
Provided: Construction must be confp"leted within three years of the date of this permit. .
Date S 1- 07 '. / Approved by 4
Jun 21 07 07.25s Etiis Brothais' 508�62.6266 p.3
'TOWIL Of Bamstablic
Th F.Geer,DhVdOr
etc Red&DMdDlm
t Oros:.50S-362-4644
man��Q`cirtltfle�ian'�.
per• Sewage PeraAft ._ a1Pwareet 3 9
Dedpw
Agana- mod'3h iow-�Ae-"
on /ti/o 61 a c-pz4'w" a�rt to imstan a
AW
mstau®r) Aa
septic 9 ,t..: baud an a dcd=drawn by
address) .
dated ,
I septic wo m ro above was uigWOd m6bslar�tl�► �W
the deli , Wbi r mmvr secb ai rein the
&M-butan box WW" =I& tank. SU*Mt (if Mond) Ms kopftdXd and the Sofia
were fotmd ,
1 certify dw the sepde sysdn reed above was iaMaBcd With comes (i.e.
smam am 10,Iumeeal boa athe SAS w mw veil rdocatiaa
OMRXmcnt
of*e septic syMm)burl in aceoffd==wzth Stasc&Loaal RtSahfi=& P
certified as-buf7t by des*=M ftftw. SU#Out Of ivq was mmRwcftd aDd the Soria
were fou'n'd: tctDry.
S ARNE • .
OJALA H
4 No.26348
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-ELLIS 810TNE4tS COAS
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608-362-IA237
ODDER AAO S 0 S9+1 A Stc
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LOCATYOR 131t 1�•��n�rS' .n�,r�s +�i .ah &�;?' td j 3 .
SE�IA6E PERaIT; 0 DATE 5��1 1 $ "' ZQ
• COMPLIANCE ISSUED DATE ul
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FINAL INSPECTION By:. tiw*i ' I-
US
DATE 6. --t4 o'? -' +o
MEH W OR REPAIR
4. MATER 'PUBLIC14 OR BELLE T
SEPTIC ,TANK CAPACITY 1000 t60 000 = t
OR EXISTING
,
LEACHING FACILITY TYPE
m` SIZE IN
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COMMONWEALTH OF MASSACHUSETTS
ID EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
d DEPARTMENT OF ENVIRONMENTAL PROTECTION+
5�•� David B.Mason,R.S,Certified Title V Inspector,508-833-2177
TITLE 5 a
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION -`
a „ A^ . rest ab.(,
Property Address: 1391 M Hyannis>lmml,Barnstable,MA
Owner's:Raisldo
Owner's Address:33 Union Street,Yarmouthport,MA
Date of Inspection: September 8,2006
Name of Inspector: (please print)David B.Mason
Company Name:_N.A. ..
Mailing Address:4 Glacier Path
East Sandwich,MA 02537
Telephone Number: 508-833-2177
CERTIFICATION STATEMENT
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 15340 of Title 5(310 CMR 15.000). The system:
_X Passes
Conditionally Passes
Needs Further Evaluation by the'Local Approving Authority
Fails `
Inspector's Signatu Date: duo
The system inspector shall submit a copy of this inspection report to the Approving Au ority 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: System as inspected is operational. Increase in occupancy may result in failure. The
information as identified represents only the condition of the system on September 8,2006 at 5:00 PM.
****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.
Page 2 of 11 '
OFFICIAL INSPECTION FORM-`NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued) 7 .
Property Address: 1391 Old Hyannis Road ;
Owner:Raiskio
Date of Inspection: September 8,2006
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes: .
_X_ I have not found any information which indicates that any the failure criteria described in 310 CMR'l 5.303 '
or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below.
Comments: _ 4
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. r
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally
unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the-'".
existing tank is replaced with a complying septic tank as approved by the Board of Health. - .
xA metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance r
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 orY
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
distribution box is leveled-or`replaced (THIS IS REQUIRED TO BE
COMPLETED)
ND explain: • " ,,
r ,
The system required pumping more than 4 times a year due to b_Token or obstructedpipe(s).The system will , -
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed w
ND explain:
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
t -
Page 3 of 11 t .
PART A t
CERTIFICATION (continued)
Property Address: 1391 Old Hyannis Road 4'
Owner:Raisido E .
Date of Inspection: September 8,2006 Y
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. ,
_ 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 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:
i
N OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
Page 4 of 11 ,
F Y PART A
CERTIFICATION (continued)
Property Address: 1391 Old Hyannis Road ;
Owner:Raisldo
Date of Inspection: September 8,2006 g
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
_ _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool _
_X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than %2 day flow
_X_ Required pumping more than 4 times in the last year NOT due to clogged'or obstructed pipe(s).
Number of times pumped.
— X_ Any portion of the SAS,cesspool or privy is below high ground water elevation.
X Any portion of cesspool or privy is within 100 feet of a surface water supply or.tributary to a surface
water supply. -
X Any portion of a cesspool or privy is within a Zone 1 of a public well. +
_X Any portion of a cesspool or privy is within 50 feet of a private water supply well.
_X 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.]
NO (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) t
yes no ,
the system is within 400 feet of a surface drinking water supply_,
— _ the system is within 200 feet of a tributary to a surface drinking water supply•'
= — the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped
Zone II of a public water supply well
If you have answered"yes"to any question in Section B 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.
r • z.
Page 5 of 11 Y'
OFFICIAL INSPECTION FORM—NOT FORVOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B ,
CHECKLIST
Property Address: 1391 Old Hyannis Road
Owner:Raiskio E'
Date of Inspection: September 8,2006 �.
Check if the following have been done.You must indicate"yes"or"no'as to each of the following:
Yes No ry
_X_ — Pumping information was provided by the owner,occupant,or Board of Health
X Were any of the system components pumped out in the previous two weeks?
X Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
_X — Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X — Was the facility or dwelling inspected for signs of sewage backup? '
X Was the site inspected for signs of break outx?
X — Were all system components,excluding the SAS,located on site. '
_X_ _ 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? ,
_X— _ 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 ofthe Soil Absorption System(SAS)-on the site has been determined based on:
Yes no
X— — Existing information.For example,a plan at the Board of Health.
_X_ _ 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)]
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS.
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
Page 6 of I 1 _s
a PART C
SYSTEM INFORMATION '
Property Address: 1391 Old Hyannis Road'
Owner:Raisldo ,
Date of Inspection: September 8,2006
FLOW CONDITIONS '
RESIDENTIAL
Number of bedrooms(design):4(per assessors records)Number of bedrooms(actual):4 septic design
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): (440 gpd capacity)
Number of current residents:_0
Does residence have a garbage grinder(yes or no):NO (Not Allowed)
Is laundry on a separate sewage system(yes or no)-NO [if yes separate inspection required]Per owner
Laundry system inspected(yes or no):NA
Seasonal use: (yes or no):NO
Water meter readings,if available(last 2 years usage(gpd)): 2005:4000ga1. 2004;3000 gal.
Sump pump(yes or no):No
t
Last date of occupancy. December 2005
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):_ 4
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: p
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information:
. x
Was system pumped as part of the inspection(yes or no): No
If yes,volume pumped:__gallons--How was quantity pumped determined?
Reason for pumping: System pumped moments after inspection due to the need for maintenance pumping.
TYPE OF SYSTEM
_ Septic tank,distribution box,soil absorption system
_Single cesspool
_X_Overflow cesspool
_Privy 3,
—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 r
Other(describe): Two cesspools;Main cesspool with overflow
Approximate age of all components,date installed(if known)and source of information: 1960's `
Were sewage odors detected when arriving at the site(yes or no):no,,,
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
Page 7 of 11 +.
a
e
PART C
SYSTEM INFORMATION(continued) .
Property Address: 1391 Old Hyannis Road ,
Owner:Raisldo
Date of Inspection: September 8,2006
BUILDING SEWER(locate on site plan) -
Depth below grade: Approximate;24 Inches
Materials of construction:_X_cast iron _40 PVC other(explain):
Distance from private water supply well or suction line:_NA
Comments(on condition of joints,venting,evidence of leakage,etc.): Appears in good condition. No evident
leakage. `
SEPTIC TANK:N.A.(locate on site plan)
Depth below grade: '
Material of construction:_concrete_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:
Sludge depth:
Distance from top of sludge to bottom'of outlet tee or baffle:
Scum thickness: 3 t
Distance from top of scum to top of outlet tee or baffle:
t1
Distance from bottom of scum to bottom ofout tee or baffle-
How How were dimensions determined:
Condition of tank(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid
levels as related to outlet invert,evidence of leakage,etc.)
GREASE TRAP:—N.A.
Depth below grade:
Material of construction: concrete metal fiberglass=polyethylene_other
(explain): — — _ •
Dimensions:
Scum thickness: f
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,'s"ctural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
r
Page 8 of 11 „
OFFICIAL INSPECTION FORM .—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1391 Old Hyannis Road
Owner:Raisldo
Date of Inspection: September 8,2006
TIGHT or HOLDING TANK:_N.A._(tank must be pumped at time of inspection)(locate on site plan) r
Depth below grade:
Material of construction: concrete metal fiberglass polyethylene other(explain):
Dimensions:
Capacity. . . gallons
Design Flow: gallons/day" t
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.): F
DISTRIBUTION BOX: (if present must be opened)(locate on site plan).
Depth of liquid level even with outlet invert:liquid level even with outlet pipe
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.): R
PUMP CHAMBER:,(locate on site plan).
r
Pumps sinwOrking order es or no ;
,
e
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,-etc.):
I
Page 9 of 11
OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued) 7 :
Property Address: 1391 Old Hyannis Road
Owner:
Date of Inspection:July 27,2005
SOIL ABSORPTION SYSTEM(SAS):—X (locate on site plan,excavation not required)
If SAS not located explain why:,, ,
Type
leaching pits,number
_leaching chambers,number:4 infiltrators ` U
_leaching galleries,number:
4
_leaching trenches,number,length:
_leaching fields,number,dimensions_ .
X overflow cesspool,number:_2_
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)There is no signs of hydraulic failure. The first cesspool is holding I foot of water the second cesspool has
received effluent flow but is dry.
CESSPOOLS: X (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:two in series '
c
Depth—top of liquid to inlet invert:5'
Depth of solids layer:4" -
Depth of scum layer: 2" .L
Dimensions of cesspool: 5'diameter, 6'deep '
Materials of construction: concrete block
Indication of groundwater inflow(yes or no):No
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
The first pit is holding 1 foot of effluent. The second is dry. 'Standard vegetation growth.
PRIVY: N.A._(locate on site plan)
Materials of construction:
Dimensions:
Depth of solids: P ,
Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
Page 10 of l l
F .
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 139101d Hyannis Road
Owner:Raisldo
Date of Inspection: September 8,2006
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference Jandmarks or
benchmarks.Locate all wells within 100 feet. Locate where public water supply enters the building.
21
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Page 11 of 11
OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
a .
PART C
SYSTEM INFORMATION(continued) ,
Property Address: 1391 Old Hyannis Road
Owner:Raisldo
Date of Inspection: September 8,2006 a .
SITE EXAM
Slope
Surface water
Check cellar (crawl space) -
Shallow wells
Estimated depth to ground water_15_feet
Please indicate(check)all methods used to determine the high ground water elevation:''
X Obtained from system design plans on record-If checked,date of design plan reviewed:" ;
_X_Observed site(abutting property/observation hole within 150 feet of SAS)
X Checked with local Board of Health-explain:Recent Test Holes, Existing engineer records with BOH
X Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water'elevation:
Utilized existing site design information on file with the Board of Health. Additionally,existing site and abutting
site topography. ,
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SYSTEM PROFILE NOTES
TOP FNDN. AT EL. 100.7
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) 1. DATUM IS ASSUMED
ACCESS COVER (WATERTIGHT) TO PROVIDE INSPECTION PORT TO WITHIN 3" OF FINAL GRADE °od
100.0' MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE 2. .MUNICIPAL WATER IS AVAILABLE o
2X SLOPE REWIRED OVER S M
INSTALL INLET ,O of/roo
�*97.0'± " FOR FIRST 2EL /
TEE i ABOVt 3. MINIMUM PIPE PITCH TO BE 1 8 PER FOOT.
OUTLET INVERT �O�sh
(PROP.) PROPOSED 1-500 2" DOUBLE WA%E? PEASTONE 3 MAX. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO Aweop
GALLON SEPTIC 96.45' OR GEOTEX FABRIC H- 10
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96.7 TANK (H- 10 GAS 94.0
BAFFLE 9-3.8T X93.7 5. PIPE JOINTS TO BE MADE WATERTIGHT. �o� �oc� Ora
.' c 93.6T 4' AT SIDES
(� SLOPE) �6' CRUSHED STONE OR MECHANICAL 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH c�
80 0.67' 3' AT ENDS MASS. ENVIRONMENTAL CODE TITLE V.
COMPACTION.-(15.221 [2]) - $ o 93.0'
DEPTH OF FLOW = 4 ��
TEE-SIZES: 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO
BE USED FOR LOT LINE STAKING OR ANY OTHER -PURPOSE.
INLET DEPTH = 10" 3/4" TO 1 1/2" DOUBLE WASHED STONE
OUTLET DEPTH = 14" (19�R SLOPE) (1 x SLOPE) 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. �-�CUS
FOUNDATION 12' SEPTIC TANK 25' D' BOX 3' LEACHING 7.6' 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED
FACILITY_ WITHOUT INSPECTION BY BOARD OF -HEALTH AND PERMISSION SCALE: 1" = 2,000*
OBTAINED FROM BOARD OF HEALTH.
ALL SYSTEM COMPONENTS 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING ASSESSORS MAP 297 PARCEL 8
SHALL BE MARKED WITH
MAGNETIC TAPE OR DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION LOCUS IS IS WP OVERLAY DISTRICT
COMPARABLE MEANS FOR BOTTOM TH-2 EL. 85.4 OF -ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO
FUTURE LOCATION. COMMENCEMENT OF WORK.
LEGEND 11. EXISTING LEACHING FACILITY SHALL BE PUMPED AND
REMOVED OR PUMPED AND FILLED WITH CLEAN SAND.
100.0 PROPOSED SPOT ELEVATION 12. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE
REMOVED 5' BENEATH AND AROUND THE PROPOSED
+100.00 EXISTING SPOT ELEVATION LEACHING FACILITY.
100 PROPOSED --CONTOUR 13. INSTALLER TO VERIFY SOILS AT SITE OF LEACHING
100 EXISTING CONTOUR FACILITY PRIOR TO INSTALLATION OF ANY COMPONENT.
14. NEW SEWER LINE TO BE INSTALLED AT LOCATION AND
4 ELEVATION SHOWN. LICENSED PLUMBER TO VERIFY
FEASIBILITY PRIOR TO INSTALLATION OF ANY COMPONENT.
INSTALL 45't 40 MIL LINER AS
SHOWN PER PLAN R BENCH MARK - TOP OF
TOP ELEV. 94.0' SYSTEM DESIGL.
BOTTOM ELEV. 90.0' CONC. BOUND EL. = 93.7 __
TEST 1 HOLE LOGS GARBAGE DISPOSER IS NOT ALLOWED
88.90' DESIGN FLOW: 2 BEDROOMS 110 GPD) = 220 GPD
ENGINEER: DAVID FLAHERTY, R.S. 9 USE A 330 GPD DESIGN FLOW
DON DESMARAIS, R.S.; DONNA MIORANDI, R.S. 5' REMOVAL of UNSUITABLE SOIL 93 SEPTIC TANK: 330 GPD ( 2 ) = 660
WITNESS: REQUIRED AROUND PERIMETER OF
DATE: OCTOBER 4, 2006, MAY 4, 2007 (TH-3) LEACHING FACILITY, DOWN TO a 19 1-0 19A 1500 GALLON SEPTIC TANK
SUITABLE SOIL LAYER. REPLACE 95 s LEACHING:
PERC. RATE _ < 2 MIN/INCH WITH CLEAN MEDIUM SAND.
9'�" LOT AREA &
'• 11,543 SF � 2(38.0 + 10.83) (.74) (.58) = 41.9
SIDES:
CLASS I SOILS P# 11475 `� P P`l� 38.0 x 10.83 .74 = 3 4
BOTTOM: ( ) 0 .5
=.`~ -3 9
ELEV. ELEV. ELEV. o,`O z M
�' 98.5' 97.4' " 97.6' �� TOTAL: » 468 S.F. 346.4 GPD
0 0 p USE 8 QUICK 4 INFILTRATORS WITH 4 STONE AT
� SIDES AND 3' AT ENDS
FILL FILL FILL �0 9(9 O
10" 97.7' 12" 96.4 33" 94.8' 0 9
A A d 98 BH
LS LS S , 1e2- DECK - W S° 3 a TITLE 5 SITE PLAN
" 10YR 5/2 10YR 5/2 10YR 5/2 99 EXISTING c of
14 97.3 16" 96.1' 39" / 94.3'
B B i00 Q TOP OF FNDN 9L 3
B = ELEV 100•7- � 1391 HYANNIS-BARNSTABLE RD.
LS LS LS 2
39" 10YR 5/6 95.2' 10YR 5/6 " 10YR 5/6 i0i rn 3 .� BARNSTABLE, MA
41 94.0 44 93.9 � -� � PREPARED FOR
C C C �O� � 3
PERC +� SUSAN ANGUS
to
FMS FMS FMS ,moo TH-1 DATE: OCTOBER 6, 2006
41 TM-2 REVISED DATE: APRIL 19, 2007 (ADDN, MOVE ST)
REVISED DATE: MAY 7, 2007 (TH-3)
2.5Y 6.4 2.5Y 6/4 2.5Y 6/4 •iHoFn�4s ��,•c�oF"',�Ss
S� 2� gcti off 508-362-4541
126" 88.0' 144" 85.4' 123" 87.3' 1 t-O3' o� DANIELA. ° pANIEL fax 508 362-9880
NO GROUNDWATER ENCOUNTERED -x x x � x x x x x- � a�� o�LA
IL
6502 o No.
Scate:1
down cape en gin eerin g, inc.
= 20 °�F`�G/sr�� � t es °
s�8/0 At G sultvE� C/VIL ENGINEERS
MA 0 10 20 30 40 50 FEET
LAND SURVEYORS
DCE #06-235
APPROVED DATE BOARD OF HEALTH DATE DANIEL A. OJALA, P.E., P.L.S. 939 Main Street - YARMOUTHPORT, MASS.
06-235 ANGUS.DWG (DDF)