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3826 MAIN ST./RTE 6A(BARN.) - Health
3 82' 6;1VIain Street, f +,r r Barnstable "g A h5 -'018 r .j I i ill w .TOWN OF BARNSTABLE SEWAGE# *•�, �— VILLAGE, ASSESSOR'S MAP&PARCEL ®/ INSTALLER'S-NAME&PHONENOt�Ccct {-�cr' �) `77 4VW SEPTIC TANK CAPACITY J��`7-Z ej .Ip. 40105efl- LEACHING FACILITY:(type)SSQ0 d� W SKCLQ-(size) 1�ZC 3�5. NO.OF BEDROOMS OWNER. PERMIT DATE: COMPLIANCE DATE: / d� 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 / f site.or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within ' ryry+ 300 feet of leaching facility) /Oa J3u AtF'eet FURNISHED BY r Of rtS 9m F JIG 19E G 6 .� lCVl O , `Y C ;. N; y 1✓//� 4 // No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 9pplitation for Disposal 6pstr t Construction Permit Application for a Permit to Construct( ) Repai ( ) Upgrade( ) Abandon( ) -IRComplete System ❑Individual Components Location Address or Lot No.25 X� a M0,hi Sf_ is Name,�A,,�d,�dress,and Tao. IAC Assessor's Map/Parcel �' ®/ff �C' ' '��'`S14. 7 J'O a O Installer's Name,Address,and Tel.No. 50F177 U U 1040 Designer's Name,Address,and Tel.No. 3000 Type of Building:Dwelling No.of Bedrooms A I Lot Size I i 1q r X09 sq.ft. Garbage Grinder( ) Other Type of Building ra'Uz. 1 No.of Persons Showers( ) Cafeteria( ) Other Fixtures t Design Flow(min.required) 41 JO gpd Design flow provided gpd Plan Date d Number of sheets `�Q'u Revision Date Title ,P Size of Septic Tank /-00 Type of S.A.S.4ACCL `a) 1- A 0 Description of Soil 4 Sl f 4 c l�a t •- d� ) �,�C'000— Nature of Repairs or Alterations(Answer when applicable) o$ ttj d C .0')j 4:; e-"4 fir r ,, hoer, T, ,� Lc hr-di&-T 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 Health. Pi ed Date Application Approved by Date Application Disapproved y Date for the following reasons Permit No. Date Issued ------------------- ------------- - - - No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:' �)3PIJBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes t 4plitation for 33isposal 6pstern Construction 3permit Application for a Permit to Construct( ) Repai ( ) Upgrade( ) Abandon( ) _Complete System ❑Individual Components Location Address or Lot No.,3 3' PAC%Y1 5 . Ir! er's Name,Address,and Tel.No. Ise D'ul�c .f��7� Assessor's Map/Parcel ? 10le VSG^ ' 416 Installer's Name,Address,and Tel.No.SD'e 77 C1 UI Va Designer's Name,Address,and Tel.No. SZO,15 6J,7.35U00 er k :a Yarrnoufi, 5 5 D i7a St awc Type of Building: Dwelling No.of Bedrooms A L Lot Size 1 L I's sq.ft. Garbage Grinder( ) Other Type of Building his,u/G Ti'a No.of.Persons > ; Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 4P 6 gpd Design flow provided '>'/ (J gpd Plan Date G Number of sheets r--Ov I- Revision Date Title IN Size of Septic Tank Type of S.A.S. C Description of Soil '1 9 1. f� Nature of Repairs or Alterations(Answer when applicable) Ch , r,.., s <4 I Cl _Cs..��a.),A I—� �e &,J d• hear, 7 -hoc rG5)�•<�C hC4452C:3 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 Environrtrental Code and not to place the system in operation until a Certificate of A Compliance has been issued by this Board of Health. - Sig ed j Date U� Application Approved by / Date Application Disapproved y Date for the following reasons i Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repai ( ) Upgraded( ) y Abandoned( )by • at ~�J A,4 a has been coWcted' c �7zv wii 4he provisions ofTitle?5 and the for Disposal System Construction Permit N Iristaller AC� �/ �' ' Imo_ �'}'. Designer " i ,y riL� , #bedrooms G Lf Approved desigp ow �I ? gpd �. The issuance of this pe it shall not be construed as a guarantee that the system will ffuncfion designe . Date Inspector �v -----—----------------------,----------------------------------------------------------- - - - No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS imisposal p8 em Construction permit Permission is hereby granted to Construct( ) Repair' ) Upgrade( ) Abandon( ) System located at LQ ��`} G�0'/jhL•o✓ ( and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructio mu t co .leted within three years of the date of this permit. Date Approved by ks � J h " A i Town of Barnstable Regulatory Services Richard V. Scali,Director '"" '"B' Public Health Division p 1639. ,0� Thomas McKean,Director } 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Date: l3 2 z o o Sewage Permit# c? L� Assessor's Map/Parcel v?C- 50 Installer&Designer Certification Form Designer: Installer: Address: ���o'X 1 '1 Z ` 9 Address: \PSG 136x 726 (On Jana C�CJ ��� "C7i� was issued a permit to install a (date) (installer) septic system at 30Z6 fA Ni t J ' 4-6-A) �'i" based on a design drawn by (a ess) ram-r-v 4 0 a-r-/ dated j O/z 9/ 19 (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certiA, 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. I certify that the system referenced above was constructed in compliance with the terms of the UA approval letters(if applicable). , �� s��� A�,`I0 taper's Signature) �'t" TY,�R 10, o ' 'n p esi r s S 1G a ANi�a4�1P. _r (D gn gnature .� -� (Affix Desig 6r-,%' ,,Starr a e) PLEASE RETURN TO ARNSTABLE PUBLIC HEALTH DIVISION CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION ' THANK YOU. gAoffice formsldesignercertification form.doc Town of Barnstable Barnstable UCily Inspectional Services Department �; 1n BARNb"fABL� Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#70.15 1730 0001 4988 1562 August 13, 2019 KUMIN, MAX H 3826 MAIN ST CUMMAQUID, MA 02637 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 3826 Main Street/Route 6A, Barnstable, MA was inspected on 04/08/2019 by Darrell Stone, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following- • Leaching facility with standing liquid level at or above the invert pipe (per Town Code 360-20 h). You are ordered to repair or replace the septic system within two (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\3826 Main Street Route 6A Barnstable.doc Town of Barnstable BARNSrAULF, p MASS.9 ,.� Inspectional Services Department TED MA'S� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) 0 6aching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts 1 Title 5 official Inspection For Subsurface Sewage Disposal System Form- Not for Voluntary,Assessments A 3826 RTE 6A Property Address 5e Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. City/Town State . Zip Code Date of Inspection I"-t Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information, ��� on the computer, use only the tab Darrell Stone key to move your Name of Inspector , y cursor-do return not use the ret Cape Cod Septic Inspection Company Name key. p y - P.O. Box 1466 rae Company Address Harwich MA 02645 City/Town State Zip Code nnca 508-240-2500 S14995 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 16 340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑ Passes t 2. ❑ Conditionally Passes 3. i❑ Needs u er Evaluation 1W • the Local Ap uthority , 4. ® Fa 4711-2019 . Inspecto s Signature Date The system inspector shall submit a copy,of this inspection report to the Approving Authority(Board ` of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of , f 10,000 gpd or greater,'the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to.the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments e% 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System,Passes:`. ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/2612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts h 1. Title 5 Official inspection For' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 3826 RTE 6A Property Address Estate of Max Kumin n Owner Owner's Name information is Barnstable required for every MA 02630 4-872019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (Cont.) , 2) System Conditionally Passes (cont.): El Pump Chamber pumps/alarms not operational_ System will pass with Board of Health approval if pumps/alarms are repaired.. ❑ Observation,of sewage backup or break out or high static water level in the'distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ' ❑ Y ❑ N. 0 ND (Explain below): 0 obstruction is removed ❑ Y- ❑ N -❑.'ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑-N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ ,Y ❑ N ❑ ND (Explain below).- 0 obstruction is removed ❑"Y ❑ N ❑ ND (Explain below): r 3) Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if, the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR . 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts ! Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) F ❑ 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 b. System will fail unless the Board of Health (and Public water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No z ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18. Commonwealth of Massachusetts �b F Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No , ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less < than '/day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ' ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. , ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. , ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable.water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ® ❑ . The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No . ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well f5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts M Title 5 official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section C.4 shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of El ® 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: ❑ ® Existinginformation. For example, a Ian at the Board of Health. p p Z El Determined in the field an if of the failure criteria related to Part C is at issue ( Y approximation of distance is unacceptable) [310 CMR 15.302(5)] t5inso.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments %f 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): N/A Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):' 330 Description: 3 bedroom residential dwelling , Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 2017 Date t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form c a I, _ , Subsurface Sewage Disposal System Form Not for Voluntary Assessments . � 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): — ---- Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Unknown Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts 1 �M1 _ Title 5 Official Inspection Form I a Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 3826 RTE 6A V Property Address Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system. ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract, ❑ Tight tank. Attach a copy of the DEP approval. ❑ r Other(describe): Approximate age of all components, date installed (if known)and source of information: 1983 Per BoH Were sewage odors detected when arriving at the site?- ❑ Yes ® -No 5. Building Sewer(locate on site plan): Depth below grade: 29 +/- 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.): Apparent good condition t5insp.doc•rev.7/26/201 a Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts �n Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments' ;1 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 23"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallon H-20 Sludge depth: 10" ,,Distance from top of sludge to bottom of outlet tee or baffle 22" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grade to inlet cover 6" Normal liquid level No sign of leakage Concrete outlet tee OK Recommended next maintenance pumping within 1 year Recommended maintenance pumping every 2-3 years t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts �m ,lp Title 5 Official Inspection Form If Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name isrequired for every Barnstable MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts go Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is required for every Barnstable MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No .9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): r5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts �s I? Title 5 Official Inspection 'Form 11 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 3826 RTE 6A u Property Address Estate of Max Kumin Owner Owner's Name information fo is every Barnstable required for eve _ MA 02630 4-8-2019 page. ut—Wrown State Zip Code Date of Inspection Do System Information (cont,) 10. Pump Chamber(locate on site plan): Pumps in-working order. ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: y ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: . ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 Commonwealth of Massachusetts 1p Title 5 Official Inspection Form le Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is re uired for every Barnstable MA 02630 4-8-2019 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 2, (48') chambers with stone Grade to chamber 55" Bottom 72" Ponding 8" Heavy black staining over the top of chamber This system has been in hydraulic failure 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer 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.): t5inso.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 ' Commonwealth of Massachusetts l Title 5 Official inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments ff 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is Barnstable required for every MA 02630 4-8-2019 page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) , 13. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): I I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts �w Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntar y Assessments 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is Barnstable required for every MA 02630 4-8-2019 page. Cltyrrown State Zip Code Date of Inspection D. System Information (coot.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately } 1 1 t 1 iZCAiZ O I F�17_111 2v- f� { jE3 4 f t5insp.doc-rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts 1= Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 3826 RTE 6A F Property Address Estate of Max Kumin Owner Owner's Name information is Barnstable required for every MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: . 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: Due to the failure of the system ground water separation was not determined Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts ,� Title 5 Official inspection Form 11 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 3826 RTE 6A Property Address Estate of Max Kumin Owner Owner's Name information is Barnstable required for every MA 02630 4-8-2019 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank— Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 0 LOCATION SEWAG-E- PER 11g� NO VILLAGE i I N S T A I L ER'S NAME & ADDR SS n /YI. or t'.,v S SQ ,o hL4- ; R OR OWNER 3� DATE PERMIT ISSUED _�/3C 3 DAT E COAPLIANCE ISSUED ✓31 V. o ® ,� No ............... _ ; . .............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .......::..............:...................O F...........................--...................---......._...-:.........-.--:........... Appli.rFatiun for MipatiFal Worka Tunitrnr#ion ami# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at �.1.. 11 .................. .. -�11'�?_.. ._.... �►1. .lid? ! -- ... Location-Address or Lot No. .-. ................ /. �...... ..:. ....... ........ .......................................... .... Owner Address a ...... ..... ....... .. .f Installer — Address d Type'kof Building Size Lot............................Sq. feet awellg— ( ) in No. of Bedrooms__________________________________..........Expansion Attic Garbage Grinder ( ) p, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a d Other fixtures .............-.....................................................................---------------._...........----•-•-•=-•-•-•......_................ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid Liquid capacity./l�Q.gallons Length................ Width................ Diameter.--..--......... Depth................ Disposal Trench—No..................... Width.................... Total Length................... Total leaching area....................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..........................................................•---------...... Date......................................... aTest Pit No. 1................minutes per inch .,Depth of Test Pit..................... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit------..........w... Depth to ground water........................ �i -• w -......_.:. ----•......................................•.---- ODescription of Soil---------------------------------------------------•-•-....-t--••-•-----....--------------------------•---------...---------------•----............................•--- U ..----------•.............•-----•---------•-•----------•-------•----------------...............-----=-----------•-------------------•--------- -----------------------.......:,,........................ W � ---------------------------- - UNature,of Repairs or Alterations—Answer when applicable.... ------10 �_...: ..........��. .!.�.... e , ................. Q 1 h `� Agreement: `. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance-with the provisions of'iT::L 5 of the State Sanitary C — The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be4 issue4 by e boar f liea th. Signed --r 1.... .. Dat ApplicationApproved By........................................... ..................................................... Date Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------•---........... ------•-•----------------•--------------........•----------.......•-----...•-•-..._............_._.........•----------_...•-----------•--------------•------•••-------•-----------... ..............-- Date PermitNo......................................................... Issued....................................................... Date No.2.... .. Fmi..........�............. r THE COMMONWEALTH OF MASSACHUSETTS . BOARD OF HEALTH .........I..............I.....O F........----..........................._................................................. ApplirFation for Disposal Works Tontitrurtion rrntijt Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: `� .__... 11 _ '� ,.� .d!l? r .Z.r .................... Location-Address or Lot No. j Owner !" Address a ..........................�-v'��i° _`•Q--•• .•.-^-'�.i:...... [.,...... �:: ..._.f s__1....-----... '..e' F.' -....................................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling`—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder. ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria PaOther fixtures -----• -•--_---_-------------•.................................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacityla24?.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-__---_-_____-_-_--__. (i Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ GG --------------------------------•-•-------------•--..__..............................---•---•--••---......................................................... Descriptionof Soil ---------•----------------------------•-------------- ------------•-••------•---•-----•-•-....---•---------------------------------_.. x UNature of pairs or Alterations Answer when applicable....� ___-Z©1a...rj.i4` � �e:.•... � Agreement: f The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT12 5 of the State Sanitary C —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issue by e boar f hea th. Signed r ------•-----..................�...... r-= ,� . ... Daft' ApplicationApproved By•••••-•----------•...................... ------------------------------•---------------- ............... ------------ Date Application Disapproved for the following reasons-----------------•-----------•-••---------------------------•-•-•---------------•------------.................. ...................................-..................................................................................................................................................................... Date PermitNo.......................................................- Issued....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... T.5rdif irate of Tnntpliatta TH TQ CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( � b ��, r .............................--•------------------------------------------•••••-- y...... , C-` Installer has been installed in accordance with the provisions of ITL",,., 5 of The'State Sanitary C/I�RANTEE g p, e5� in the application for Disposal Works Construction.Permit No.......... .....�'_.....r.......... dated__.. .__._................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A G THAT THE ................•----••••......•-• ,1-- " !--' DATE.................................................. ---.... Inspector...... -••••••. ....................................... Lz-�� -��--- SYSTEM WILL FUNCTION SATISFAC ORY. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............OF............................•,....._............................................... N . FEE/ `' o...._-•••-••............. .. i fro o rki Tonstrudion Vamit `• - --� `- J, Permission is hereby granted..... ...:: - --•---------•-••--- ---------- to Constrruct.�, or Reba' '( dual-Sev��age Disposal �3yst Street as shown on the application for Disposal Forks Construction Permit ......... _......_.:. Date _. .._ ...............................••----• •-•-------•--- .............................................. Board of ealth DATE..............................................................----•--------•---- I FORM 1255 HOSES & WARREN, INC., PUBLISHERS AsBuilt - Page 1 of 1 L0CA.TION Q GSM . GE- PEIlM1 -M'0. 38a 6 + ` Qo , VILLAGE -- � INSTAL tER'S NAME & ADDR SS J'. R OR OWNER DATE PERMIIT ISSUED sg) DATE COMPLIANCE ISSUED �3� http://issgl2/intranet/propdata/prebuilt.aspx?mappar=335018&seq=1 7/25/2019 Town of Barnstable Barnstable kxftA Inspectional Services Department WC8 Cft x MRNSMABLE. 9Q M" 9'. Public Health Division vp �g Q 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4988 1562 August 13, 2019 __ . . KUMIN, MAX IH -3826 MAIN ST CUMMAQUID, MA 02637 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 3826 Main Street/Route 6A, Barnstable, MA was inspected on 04/08/2019 by Darrell Stone, certified Title V Septic Inspector for the State 'of Massachusetts. 'The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching facility with standing liquid level at or above the invert pipe (per Town Code 360720 h). You are ordered to repair or replace the septic system within two (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\3826 Main Street Route 6A Barnstable.doc COMPLETE • •MPLETE THIS:SECTION ON DELIVERY, ■ Complete items 1,2,and 3. A. Signature - j ■ Print your�name and address on the reverse X ❑Agent i I so that we can return the card to you. O Addressee I ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) Q Date of Delivery I or on the front if space permits. I J I i _o_r�-rielivPnr address different from item 1? 0 Yes \ f . . - delivery address below: ❑ No 7-1 KUMIN, MAX H 13826 MAIN ST I I CUMMAQUID, MA 02637 I II II I�III�I I'II III I III II II IIII II II I�I�I I I II II III O ❑Priority Mail Expre ss® Adult Signature ❑Registered Mai " u k I)❑ Sig rceevery ❑Registered Mail Restricted 9590 9402 5225 9122 7023 11 ertified Mail® D live ry ertified Mail Restricted Delivery Return Receipt for I \ ❑Collect on Delivery Merchandise _2. Art icle_Number_(?ransfpr_frnm_c...,.r o i.r,en n r u t^n Delivery Restricted Delivery ❑Signature ConfirmationTM 7 015 1730 0001 4988 156 2 ail ❑Signature Confirmation ad Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053` Domestic Return Receipt l �.c t f of7,7 IKME Town of Barnstable Public Health Division I U.S.POSTAGE»�TNEv eowEs BARNS ABLE. 01- ,� G^7 200 Main Street i . " 'FOMrt" Hyannis,MA 02601 i .L O ,+ 0ZIP 2 4ry601 $ 006.80 �7015 1730 0001 4988 1562 00003.36455AUG. 13. 2019 + 1 � f Q�f Y KUMIN, MAX H 3826 MAIN S T NIXIE. aIS FE'1 RETURN TO SENDER 9 NOT DELIVERABLE AS ADDRESSED i UNABLE TO FO,RWAR.D { 1,►1.8F .1=a11.liit+ s.i .a.i 1 i]� eala it a o�4s�al�' 6isj �d v126t3:t.>4302 s� iE i AsBuilt Page 1 of 1 L 0 C A,T ION �� (, G qM�c� Q UR At� -`N-D VILLAGE INSTAL ER'S NAME & AD DR SS nn /� l� o �hL7Lf.z, R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 2 � � 0 r,. '1 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=335018&seq=1 8/20/2019 N ' _ z LOCUS DATA z LOCUS CURRENT OWNER ESTATE OF v_ MAX KUMIN 10 %/ N v PLAN REFERENCE 371-50 S e; s 0. 6A DEED REFERENCE 8548-133 ZONING DISTRICT RF-1 / RF-2 FLOOD ZONE SEPTIC IN ZONE X `��• 'g�• i \ R LOCUS MAP #25001 C0588 J 59,� NOT TO SCALE: JULY 16, 201419-0130 ASSESSORS MAP 335 �� 1 d` • ` ryN PARCEL 018 wcoi LOT 119,150f S.F. OVERLAY DISTRICT NOT A ZONE II - o f \ 2.73t AlCRES \_�.� �`� �von �� of N LOT AREA 119,150f S.F. �, \ \�` �` -A�o;, �, \� o . I SITE 8c SEWAGE BARN REPAIR PLAN \ \ un Mil IN S T — R T. 6A N WE LING SEE SHEET 2 BARNSTABLE, MASS ,, , DATE: OCTOBER 29 2019 VOF b / Cp OWNER/APPLICANT: EDWARD y acp. EST. OF MAX KUMIN -4 STONE 4 No.28980 ; o� �� i 11 I ; , y SUSAN K. HARRIS �, '� \� ii; '� ;;Y 152 BALTIC STREET BROOKLYN, NY 11201 z ; � � cv !;/�� SKH5©KU . EDU � �; \ ; i SHEET 1 OF 4 1� it PREPARED BY: EAS SURVEY, INC. ; l co' 11 P . O. BOX 1 729 '�`�`�" 0 50 75 100 l SANDWICH , MA 02563 CELL (508) 527-3600 N 4.7•07130" W 172'" ` GRAPHIC SCALE: EAS.SURVEY@YAHOO.COM 1 INCH = 50 FEET w N F#1 \\ \ \ - o o s01. / \\ \ \\ \ \ Og. \ BENCHMARK \ / N \ GALV. NAIL SET I LOT ELEVATION 18.13 / 2 \ \ 119,150f S.F. WF# 2.73t ACRES \ \ \ EXISTING BARN / T-FND.=28.6 SLAB=19.8 ' .; f\ _ � V0 0. \ PROPOSED / PCLY LINER 15.5' / O/ r SI TE 8c SEWAGE 1 \ / \ / \'-:JJ•. O '� 1 I /O� BENCHMARK REPAIR PLAN VA 1 Nb 1`` / P.K. NAIL SET �\ 1 1 ( / SHEDS ELEVATION 30.00 1 ,3826 / I 2 .4 ....RT6AMAIN ST �° / N I I / 0.4' / /^h/ BARNS TABLE, MASS % PBRICK ATIO / 28.2- / -4/ DATE: OCTOBER 29, 2019 , ~ \ WF#3i o�` DBCK /PROPOSED N \ / .� �, \ \ 1,500 GALLON OWNER/APPLICANT: \ \ \ 1 O TI (2) o / I \ ( \ EXIS NG COMPARTMENTI EST. OF MAX KUMIN \\ 1 O DWELLING SEPTIC -1 \ \ I ' T-FND.=27.8 TANK S U S A N K. H A R R I S 1 PORCH SLAB=20.1 ��/ / �\ � RAISE II \ / / 152 BALTIC STREET \ 1 PLUMBING PU�AP, CRUSH, B R 0 0 K L YN , NY 11201 \\ SAN FILL TANK SKH5@KU . EDU \ F 4\\�� IN ACBADANE SHEET 2 OF 4 \ \\\ WITH TITI� \5 \ \\ \ // / �� / ��y�OF as � \ \ \ \ \ ' � Ic / / \ I\ \ \ \ \ \ / / / �� EDWARD V PREPARED BY: �\ \ \ . \ \ / �/ / \ / d STONE IN,� I / / d No.28980 EAS SURVEY, INC. P . O. BOX 1729 0 20 30 40 ' e \ ,Z� t°j SANDWICH MA 02563 1, 1 \\ / v o CELL (508) 527-3600 GRAPHIC SCALE: 19-0130 EAS.SURVEY@YAHOO.COM 1 INCH - 20 FEET 1 I / 'ws - RAISE COVERS TO WITHIN 6" OF FINISH GRADE DWELLING TCF = 27.81 FINISH GRADE FINISH GRADE RAISE TO WITHIN 6" _ GRADE 25.9 ELEV. 23.5 OF FINISH GRADE ELEV. 22.5" ELEV. 21.4 FINISH GRADE ELEV. 22.4 v EXISTING 4" PVC 12'OS=0.68 /A-I GROUND ELEVATION 20.6 4" PVC SCH 40 v SCH 40 18'®S=0.03 INV.= 2 M13 M - :• :v, INV.= 20.54 20.00 _10_""TEE. 14"TEE INV.=- 5' CAS= 0.02 T- 1' MIN.-3' MAX. COVER /�,/.- <r'"r: �INSTA 19.80 . 10'C�S 0.01 OP ELEV 5'-7- 1 1 - GAS 0000019.500 0 00000 `o 4=6 / BAFFLE .. - - 2. 41' LIQ:LEVEL _.- : 000 0 0 00000 -�`. - 40 POLY LINER -- 000 0 O O 0 '`� MIL L MINIMUM MINIMUM 6" 00 00 - 0 0 0 00 00 TOP = 19.7 880`GAL. _.--. 440 GAL 3 OUTLET - - _ _ - -0 x8-6%3'-O" CHAMBERS BOT 17.2 BOT. H 20 D83 THREE 5' 0 0 0 546 1 INV.=18.80 INV=18.50 > ci - - - STRIPOUT TO - PROPOSED 1,500 GALLON (2) - C2 HORIZON COMPARTMENT SEPTIC TANK INV.=18.60 S.A.S. (13.0' x 33.5') a 16.5 PER 310CMR STRIPOUT (23' x 43.5') 15.255 19-0130 ELEV. 11.4 SIDE VIEW SITE & SEWAGE REPAIR PLAN OF #3826 DATUM: �'��D �aa MAIN s/ - /Qr 6A VERTICAL DATUM: - 00000 0 0 00000 MSL± / BARNSTABLE GIS F J. 00 O O 00000 - BENCH MARK USED: 11 00 0 00 00 0 0 IN MAG NAIL CENTER OF SIDEWALK EL=30.00 -- �P 0 0 00 0 0 0 0 QO #2 GALV. SPIKE BEHIND BARN EL=18.13 �iSTE�` BARNSTABLE', M ASS SANirAR� G �- 4.0' --�-- 5:0' DATE: OCTOBER 29, 2019 13.0' - END VIEW OWNER/APPLICANT: CONSTRUCTION NOTES: EST. OF MAX KUMIN 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE S U S A N K. H A R R I S ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. WORK ON THE SITE. 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER 152 B A L TI C STREET 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. BROOKLYN, NY 11201 WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND S K H 5 @K U . E D U MATERIALS OVER THE SEPTIC TANK, DISTRIBUTION BOX AND LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. S.A.S. AREA IS PROHIBITED 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN SHEET 3 OF 4 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT GENERAL NOTES: ELEVATION OF THE OUTLET PIPE. 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES PREPARED BY: TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS 10. HE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS FOR SUBSURFACE DISPOSAL OF SEWERAGE. BAFFLE, 4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC EAS SURVEY, INC. 2 ACCESSIBLE WITHINAT LEAST ONE 3 ACCESS FINISH POINT V GRADE,ER KWITH ANY TEES AREMAINING .LL BE 1 SHALL IBESSLOPED 11/4 SHALL BE S INCH PER FOOT MIN. EXCEPT ULE 40 PVC SEWER EFORDTHE ACCESS PORTS ROFG HT TO WITHIN 12"HE SANITARY SYSTOEM FSHALL BE DE. BE FIRST 0 FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL P. O. B 0 X 1729 3. ALL COMPONENTS CAPABLE OF WITHSTANDING H-10 LOADING UNLESS 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION SANDWICH , MA 02563 OTHERWISE SPECIFIED. TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION AND APPROVAL. CELL (508) 527-3600 OF ALL UTILITIES PRIOR TO ANY EXCAVATION. 13. MAGNETIC TAPE ON ALL COMPONENTS. EAS.SU R VEY@YAH 00.COM i SYSTEM DESIGN EXISTING DESIGN FLOW USING H-20 CONCRETE LEACHING CHAMBERS I CERTIFY THAT I AM CURRENTLY,APPROVED BY VARIANCES REQUESTED 4 BEDROOMS AT 110 GPB/D 44Q GPD WITH 4' OF STONE ALL AROUND THE DEPARTMENT OF ENVIRONMENTAL PROTECTION A'.. . BOTTOM (13.0' x 33.5') = 435.5 S.F. TO CONDUCT SOIL EVALUATIONS AND THAT THE NONE r REQUIRED SEPTIC TANK (2 COMP) RESULTS OF MY SOIL EVALUATION ARE ACCURATE _ - SIDE WALL (13' +• 33.5') 2x2 = 186 S.F AND IN ACCORDANCE WITH 310 CMR 15.100 ___440 x 3� _ —_--_1,320GAL. 621.5 S.F. THROUGH 1 >. SE TANK PROVIDED = _1 500_GAL.PTIC _ _r. . ' - - 621 S.F.x 0.74 G/SF = 459 GPD ----- -- — — -------------------- SIZE OF-LEACHING FACILITY REQUIRED 459 GPD PROV > 440 GPD REQ. = 19 GPD RES. EDWARD A. STONE, CERTIFIED SOIL EVALUATOR •cHOF , DESIGN-PERC RATE '___<_2 _MIN./INCH NO (GARBAGE DISPOSAL / GRINDER ALLOWED) UEDWAARD LONG TERM APPL. RATE_0•74_GPD/S.F. STONE N E SIZE OF LEACHING SYSTEM PROVIDED: No.28980 440 + 0.74 SF/GPD = _595 S.F. MIN. REQ. i 19-0129 1-4 P#19-153 5 P#19-153 D.T.H. #1 SITE & SEWAGE D.T.H. #1 ib D.T.H. #2 0 D.T.H. #3 D.T.H. #4 85" INDICATES ADJ. GROUNDWATER D.T.H. #5 ib DATE: 10-1-19 DATE: 10-1-19 DATE: 10-1-19 DATE: 10-1-19 108" OBS. GROUNDWATER DATE: 10-12-19 REPAIR PLAN GROUND ELEV. 23.1 GROUND ELEV. 22.2 GROUND ELEV. 19.6 GROUND ELEV. 18.6 GROUND ELEV. 19.1 NO GROUNDWATER NO GROUNDWATER ADJ. GW. 11.4 ADJ. GW. 11.4 NO MOTTLING ADJ. GW. 11.4 #J(526 A A A A NO WEEPING A M,4/N S T - R T. 6A LOAMY SAND LOAMY SAND LOAMY SAND LOAMY SAND LOAMY SAND 10YR 4/3 10YR 4/3 10YR 4/3 1OYR .4/3 10YR 4/3 N 8" _ 12" 8" 6 8„ B B B B B B A R N S TA B L E - MASS LOAMY SAND LOAMY SAND LOAMY SAND LOAMY-SAND GROUNDWATER ADJUSTMENT LOAMY SAND 10YR 6/6 10YR 6/6 10YR 6/6 10YR 6/6 DATE OF WELL: OCT 2019 10YR 6/6 DATE: OCTOBER 29, 2019 30" 34" 24" 22" INDEX WELL: AIW-247 32" WELL ZONE: B Cd Cd Cd-1 Cd-1 WELL DEPTH: 22.55 Cd-1 OWNER APPLICANT: SILT LOAM SILT-LOAM SILT LOAM SILT LOAM DEPTH OF WATER: 9.0 SILT LOAM / / 10YR 6/2 10YR 6 WELL ADJUSTMENT: 1.85 (22") 10YR 6/2 EST. OF MAX _K U M I N 98„ 86 DEPTH OF ADJ. GW: 7.1 92" NO G.WATER NO G.WATER S U S A N K. H A R R I S EL. = 12.1 132" EL. = 12.2 120" EL. = 9.6 120" EL. = 9.6 108" EL. = 9.6 114" 152 BALTIC STREET C-2 C-2 C-2 FIE SAND FINE SAND BROOKLYN , NY 11201 2N5Y 7/3 2.Y 7/3 FINE 25Y 7/3D S K H 5 @K U. E D U B.O.H. EL. = 9.1 126" EL. = 8.6 120' B.O.H. DAVE STANTON DON DESMARAIS SHEET 4 OF 4 SOIL EVALUATOR SOIL EVALUATOR ED. STONE ED. STONE BACKHOE OPERATOR. BACKHOE OPERATOR. PREPARED BY: JOE DeBARROS DTH #1 Q5 INDICATES DEEP B & B EXCAVATING SOIL TYPE: t TEST HOLE SOIL TYPE: L E A S SURVEY INC. PERC RATE: <2 MIN. PER INCH PERC RATE: <2 MIN. PER INCH LOADING .RATE: 0_74 GAL/SF/MIN LOADING RATE: 0_74 GAL/SF/MIN P. O. BOX 1729 P-1 120" INDICATES SIEVETEST E 216" L = 1.1 SANDWICH , MA 02563 CELL (508) 527-3600 EAS.SU R VEY@YAH 00.COM