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HomeMy WebLinkAbout0005 PATRICIA STREET - Health r'5 Patricia Street Centerville A = 246 - 052 F No.2-15SLOR - UPC 12534 smead,c®m • Made in USA vscy w �U�idridt3Ro63UC7U� SFJhlffiy5} $ ;�fiRtUIRfAAEJ15 6iili�SP1fm�G�GRRi COMED SOU KING i:�L'r'L4.�irw'an�tS6+t3 Commonwealth of Massachusetts - Title 5 Official Inspection Form ` Subsurface Sewage Disposal System orm -Not for Voluntary Assessments �` _ Property Address Owner Owner's Name l J 1 information is A✓I hl O/T_ /� 0otd�oZ 'g d� required for every page. City/Town State Zip Code Date of IrApecti6n 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 Inf rn � on the computer, l use only the tab atio -_ _ 0 key to move your Name of Inspector cursor-do not �/(/Yi 0 use the return key. Company Name _ 0 dox Company Address 4E---qSA- / //T 0c)4 (fd' CitylTown SV? n� i I 71 State / ^� Zip Code Telephon Numbe License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 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 mainten ce of on-site sewage disposal systems. After conducting this inspection I have determined that the tem: 1. Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails P".' O / g o1 c'7 Inspector 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 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.7t26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form;Not for Voluntary Assessments u Property Address Owner es information is Owner's Name /y� required for every tat @� ( ��(%X � p2� page. 6ty/Town State Zip Code Date of I specti n C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) Syste asses: 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Oisposal System•Page 2 of 18 Commonwealth of Massachusetts �n a Title 5 Official Inspection Form ±= Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Owner Property Address P IN a� t , Owner's Name information is required for every R-5 4 #IS 04 page. CityFrown state Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ 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 ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 �a Title 5 official Inspection Form �I Subsurface Sewage Disposal System Form -llNot for Vpluntary Assessments Property Address Owner !Ow:n�erftName �� information is C46011.0 �J A required for every //%f page. City/Town 1 State Zip Code Date of Ins ectio C. Inspection Su ary (cost.) ❑ 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 Elackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ElDischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doe•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form �n Subsurface Sewage Disposal System F - of for yoluntary Asse sments Property Address / Owner Owner's Nam Tevi";) information is e� N�,s D/ A4' 6d6 ;�L required for every G page. City/Town State Zip Code Date of Ins ection 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 '/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: ❑ LJ' Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ 1!?� 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. ❑ lf� 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.] ❑ Z e system is a cesspool serving a facility with a design flow of 2000 gpd- ,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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts �. Title 5 Official Inspection Form += i Subsurface Sewage Disposal S e Form -Not for Voluntary Assessments Property Address e,04 J Owner Owner's Name information is �t Q;4 a�/�ae e0 required for every Ty TTT '/ A44 -/ ®c page. City/Town State Zip Code Date o 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 aH inspections: Yes o ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ Z?/`� 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 I' Commonwealth of Massachusetts = I? Title 5 Official Inspection Form is Subsurface Sewage Dis osal System r -Not for Voluntary Assessments �t Property Address Owner Owner's Nam information is Jf /� ,Q required for every Ghh� �"'J `vc)-6�/ol- page. City/Town State Zip Code Date of Ins ection D. System Informa ion 1. Residential Flow Conditions: 3 Number of bedrooms (design): — Number of bedrooms(actual): DESIGN flow ba n 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Description: / /.boo 6c" //Coll / a'4 / co Gr tot M (�'�► 6,2,E �oc10 Sind �p Number of current residents: O 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 [ �o _ information in this report.) Laundry system inspected? ❑ Yes [�1�o Seasonal use? ❑ Yes !o Water meter readings, if available (last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes No Last date of occupancy: Date 15insp.doc•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts �n p Title 5 Official Inspection Form 11. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address f Owner / Q(44� Owner's Nam) information is C�2S� �N� �� jDateof a required for every � _v�_ rG� page. City/Town State Zip Code ection 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: Was system pumped as part of the inspection? ❑ Yes o 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 Title 5 Official Inspection Form �I Subsurface Sewage Disposal System FoUri i Not for Voluntary Assessments Gt"'�, SZ� Property Address GVI� •W` G'i Owner Owner's Name 1 /i J information is &s required for every Gi 1iK�f 9 0 /pZ d page. City/Town —� State Zip Code Date of Inspe ion D. System Information (cont.) 4. Type of Sys / Septic tank, distribution box, soil absorption system +�q, ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date ''nstal a (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes No 5. Building Sewer(locate on site plan): Depth below grade: feet Material of constructi;140 ❑ cast iron PVC ❑ other(explain): /Q T Distance from private water supply well or suction line: — -feet Comments (on condition of joints, venting, evidence of leakage, etc.): oinsp.doc•rev.1/21,2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 f Commonwealth of Massachusetts I? Title 5 Official Inspection Form (n Subsurface Sewage Disposal System rm -Not fo,,r;Voluntary Assessments Property Address Owner �; i Owner's Nam information is required for every C►'M'Y��s ��y/ page. City/Town State Zip Code Date of I pection D. System Information (cont.) 6. Septic Tank (locate on site plan): Depth below grade: feet Materi construction: concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years 'Sepik, P G IS age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: - �o no Sludge depth: 'rx/ /> 3 Distance from top of sludge to bottom of outlet tee or baffle 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 How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): '04 IN�/f ✓� /I r0 /��C,� /O� Gar ✓) c7 Con C- /46oyt • _ �Pg !y S t5insp.doc•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts a Title 5 Official Inspection Form +" Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address �e,tAI j � Owner Owner's Name �" information is /�, O required for every eS_T / 7 b1�S O+�r / '(te v-Co page. City/Town State Zip Code Date of I spection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene El 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 P Title 5 Official Inspection Form rlIa Subsurface Sewage Disposal System orm -Not for Voluntary Assessments L Property Address / Q I/I of C� '► �_ Owner Owner's Namecj'e3� information is \/ � �� required for every p�j (f 0 d�10 u page. City/Town State Zip Code Date of I/spection 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 (0 ire r 9. Distribution Box(if present must be opened) (locate on site plan): v1 it Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any be la t,./J evidence of leakage into or out of box, etc.): ✓!� Ste/ s �� t5insp.doc•rev.7/26/2018 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 Commonwealth of Massachusetts 1. I? Title 5 Official Inspection Form u Subsurface Sewage Disposal Sys m Form -Not for Voluntary Assessments —sessments Property Address Owner Owner's Name information is required for every V page. City/Town State Zip Code Date of In pection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: Yes ❑ No' <Dv�Y A0f Alarms in working order: Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): 00 0*4 Tl 0 14 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; J�IA--�O/f �'✓/�is s4� ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: ---- --- ------ --- l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System F rm -Nafor Voluntary Assessments r IS 411,4f11 C-t--%- 5-� V Property Address / ✓ - �✓I of q/I "� Owner Owner's Name }— information is (� Q required for every e awl AA fo I p� V a-0 page. City/Town State Zip Code Date of Ins ection 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.): —_ use, 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 14 of 18 Commonwealth of Massachusetts .. Title 5 Official Inspection Form Subsurface Sewage Disposal Sys t Form -Not for Voluntary Assessments _ ,-,,, Property Address T Owner's I /l S wner's Name information is IT'4 required for every T G.?�If a�' page. City/Town I State Zip Code Date of In pectin 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 g failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•page 15 of 18 Commonwealth of Massachusetts e Title 5 Official Inspection Form o Di Sewage ewage Disposal System Form -Not for Voluntary� ry Assessments v Property Address Owner Ow &Je4 ner's Naminformation is /�required for every Gt4✓4If Pic), —0 page. City/Town State Zip Code Date of spect n D. System Information (cont.) 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 buildin eck one of the boxes below: ❑ nd-sketch in the area below drawing attached separately It r/T t5insp.doe•rev.7/26/2018 TiUe 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 16 of 18 8/12/2020 ShowAsbuilt(1700x2800) TOWN OF BAMSTABLE .._ .......! ........... ...LOCATION. CF7............ .SEWAGR#t ..-kl.5.o111 VILLAGE_�,6✓ro,�p?T ASSESSOR'S MAP 8c P.41:CEL p7.,��.._D.�g INSTALLERS NAME Rr PHONE NO.00k'W aa';— SEPTIC TANK CAPAC SoD &n+r /� � o "------- LEACHING FACILITY':(typeyK&,,*y raw(sizc)!D 7 NO.OFBEDRROOOMS OWNFR_�'/2A .- PERbtff DATE: COMPLIANCE DATE: Separation Distance Between the: .-..... ...............Maximm Adjusted Groundwater Table to the Bottorn of Leaching Facility................_fees.... Private Water Supply Well and Leaching Facility(If any walls 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 ... ...... L.. .. ----. Q Ecn-ro;3 Cad-1r, / o E _._G..... __ _.t..... .. .._. o� f Vo2T. ry, _.... . ..... 3,� _.... _... .... ... _ ...... .._. _....... . ._._......... . ___ ... ...... . .. __.... https://itsqldb.town.barnstable.ma.us:8431/Home/ShowAsbuilt?mp=246052&sq=1 1/1 Commonwealth of Massachusetts Title 5 Official Inspection Form i, o Subsurface Sewage Disposal System orm -Not for Voluntary Assessments Property Address Tzvt li Co Owner Owner's Name information is Ps uANt /� /1 / (A� L required for every L�, ylo� page. City/Town State Zip Code Date of I pecti 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 ❑ O served site (abutting property/observation hole within 150 feet of SAS) Checked pi� cal Board of Health- e­plainx �/ !yt S S pf ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how ou established the igh ground water elevation: , WI If 05 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 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments Property Address Owner Owner's Nam information is 11 �f, 1 \ required for every �S Ad1Nr.S aiT / ,!/'J" d�(.U � �� a 0 page. City/Town State Zip Code Date of nspe ion E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: L�J A Spector Information: Complete all fields in this section. ;//B.*,-Iertification: Signed & Dated and 1, 2, 3, or 4 checked C. Inspection Summary: 1, 2, 3 r 5 completed as appropriate 4 allure 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 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 . . ...... SYSTEM PROF�E A6BE �1tR.l.Is APPAowukiE I+cw ��j �I . MAFIKED Access .. sYstt=M....... caws To wt He:6 OF F1N::CRAOE E asnncPPOADE I ns /e p .: . . . . . ..: ... '... 1 WNPAPABIE'YFµ4 FOR rs.txATla+ INSPECTION Poor to�WITHW s'oF:fRTAi.GR/OE �: f7.0 ..... ..... R7[SIAF�:REOYOTEO oViR sTSTEiI >T70 \... .;. 777......�- ... .... .. ....I��MiNDR7M.75<.T"tTAhA�OVOI'PREIASf .. MAtIMMUA1:PmE RHTCH?o 8E 1 PEA:FOOT . ... FOR .... ... .... .. .. .:. :: .:::INSTAt1_.iNt£f:' .. .". .. .. UNI�10:8E�A�A.910 H � ABOYE PRECAST .... 4b5k`HKf PVC- .. .. :OUTLET INVERT � � 2 oG.Ne1E.W PEASTONE. .. BF MADE TTATUT1064T. I .. .... �. .. .FIFES IEVFJ.15T�a' PITCH:: - tip - R $PIPE JORTTS YO ..RFOR PRMOSEWRIX ONLY AND ROTR:PUR USE FOR.]AT LINE STAKWO DR ANY �: oR1ER PURPosE PIPE FOR:SEP1iC SYSTEM TO Sa4 4U-4 PYC. a awsHm SfDHE OR 1�alF78CAL '- " 9.COMPONENTS NOT TO BE BAfXFlLLED:OR . . :. ...COMPACTOR.:(isszl(2D :. 3..4 TO t 1/2"DOUBLE:WASHED STONE CONGEALED wDTGWi.ALsPEcnoN BY BOARD a .:. OE?tT1 of FkO1V 4:: . ..:: .:. (OR.Eau}I: .. -./ .. ... k-' :: HEALTH ANO PERWISSIOWOBTAINE;Ff1,OW BORE .. ... .... ....... .. OF HEALTH 1$ .... . TEE-SUM.:.'..::. -;.:. .... iSEE PUMP.A. " .. .. SOund < :.M DEPm'i1B_......: .. DETAIL .... CONTRACTOR BE ... FOR .::. 1. :: 11EPIH-. f a.: BELOW _ ` ',I.,°c o H , . LOCUS MAP Ace.c.m.E'L.I'll:o A� SCALE 1�2000't . . .. �UTILITIES PRIOR TO COMMENCEMENT� . .. LEACHING 1t.ANY UN:WITAki MATERIAL ENCOUNTERED ASSESSORS:MAP.246 PARCEL 42 AP=2T SEPTIC 53 D BOX FOUNt1ATi0N PUMP CHAMBER FACILITY" VARIANCES:i ... .. ..:. •THE:.iNSTALLER''SNALL.VERIFY THE LOCATIONS OF:ALL : -. .. . ..:-: .: -. - MAXIMUM FEASIBLE,COMPLIANCE- .: :PROTECTION:STRICT AND:hTE All BE:REMObED 4'BENEATH AND:AR(UHD THE .... gPOD:IEACHiN6 FAC9lT'. .:: " LOCUS IS YARiM AP OVERLA UTILITIES AND:ALL BUILDING:'SEWER OUTLETS AND:ELEVATIONS ELECTRICAL PERM[T.REQUIRED FROM - ' LOCAL.UPGRADE APPROVAL. " T2 EXISTING LEACHING:FACILITY SMALL.aE PUMPE ESTUARINE.Y7AlERSHm'PRO PRIOR TO IN$TAEUNG ANY:PORTION OF-SEPTIC SYSTEM -! TOWN OF BARNSTABLE PRIOR:TO ANY - :: AND RETIOVED OR PUMPED AND FILLED 10TH CLEAN ELECTRICAL COMPONENT INSTALLATION. SµO. .. µYARD TO .. .. . ...: ::AUVM AN)rnTma PAPdt.... .: .. .... .. 13.SEY+ER:,UNE TOOa.RT FTtONT. .. 310 CMR. 1�4D5(1)(e)^ LEGEND m��T t,,I _ i 'REDUCTION IN SYSTEM LOCATION:FROM .. "FOUNDATION OR CRAWL SPACE .. N�ORRPPLUUL�. CENT MPU1 R TO VERIFY MAN'ao�a me, a _. -c : FROM 20 TO �2 LINER : UTY TO PROPOSED WEN UtE'S--ELEVATOR':' .. pg r- E7,S1Mo CUIITDUR ': 3PARArz OKAlf,iR01 AUP 4bi� ANC OCATI N PRIOR m INSTALLATION.OF ANYc.zsim Rala< REDUCTION IN SEPARATION OF:SAS TO A_ - LITY SAND ADJ FROM 9' TO 4• t4.CaaCY OP EXSTINe F1ECTRICAL SYSIEM TO 4 e W MIP. ACCOMMODATE PROPOSED ELECTRICAL PUMP PRIORtae.t7 gPgrzy Eryp[airs) 31 D CMR 1$405(f}::. TO INSTALLING ANY COMPONENT THl REDUCTION IN SEPARATION OF'SAS TO SYSTEM DESIGN ��E FJ WAA c�taasE om" l D-5 um*m icuEl _ S:2 GARBAGE DISPOSER IS -NOT ALLOWED Tim,116, CATCH BA i R FROM $ TO 2 (LINER) 'I'�P'' DESIGN.FLOW 3 BEDROOMS 110GP0 330 GPD .. Z,HVDAuir .11 E w t7 G'l` 1c.LiN�'f LOW ... ......... •k s sHr M 45'v RLMEt Y :SEPRC TANK: 334.GPDi-(Z) Ti wq LOT AREA x .. -- l.. 9849t SF :i/ PER .. TEST HOLE LOGS L� -..... . _ i' ¢P NOT FOUND eoTrw: tav USE A 1500.GALPTIG TANK(FRAIO POLY.T'ANK OK) ` ENGINEER: OAV1D FLAHERTY R 5, SE2755 :: R :. . . .. "1 PAYED SIDES. �98 FT(fi7)•"(74) :48 GPD :. WITNESS`.OAVLD STANTON_R DRIVE: : :: ... (BOTTOM 386;._SF{74) .28$GPO:.: OCTOBER EI 2008 is cram. an ., BRICK MF - 333 GPU.. .. DATE :..,_ _.._ _. CP - , 'TOTAL 450 S F _..... .. .. :. PUMP aXM Fat MYFRS's1ae4 4/10'!UP Pu19P PAT10. ... .. - .: .. . PERC. RATE < 2.MIN iNGN".:; __ : :: o- SEE ROTE:PEs .. ._ ... --- REGA�IMG TNIS cP ,b cAUaoN.umines lN:.AREAa - , EXISTING_3 SEv�R.twe : ifn :PER PBAN TWITHA3'STOA7L ENDS AND 3.5 NFILTRATORS SATSIDES CLASS I SOILS: Pg.::t 2392 :.: PROPOSE COMPONMT y-LUNG .: INSTALLATION AREA(SEE NOTE 0RPDDF 6 FNDN. ... O . :i .. .. .. .... .. ELEV. .. ELEv. .. .. :. .. .. :.... .. 2h APPROVED. DATE BOARD OF HEALTH - 1 :APPRO FILL 28�w f7ll 4, TITLE '5� SITE PLAN -.. 30' _ MA ..: _ - OF 10YR 4/2 --1oYR 4�2 � 5 PATRICIA ST: _ ':36 34" : ..STEVE9 SEVRA LIKE CIR OF C SASIIR - WTHIN II OF..WATOR UNE 2 - W.: HYANMSPORT, MA `zE ELEVATION 14 9 - LS 10YK 5 6 .' i>.tOYR 5/8.:- $'REMOVAL pF UNIWAME SOL _ . . .. . 48• / 48'' 12 0 : REOV,RED:AAWNa PMWtM OF - T 1 - 3 PREPAAm FOR 120 LEACMING.'FAOLRY,00'Mi TD -- PROVIDE VENT YAM CHARCOAL FILTER FRANK: TENAGLIA . SUITA9tf:Spl LAYER.REPEACE : AN BUCSCREEN.:(F11YAL PLAfZVENT - .. . 'C ... .: G Ym.SAND ENGINEER ,wTM HowONNER CONSULTAnON) va xxc .. - W uLCLEMi`AND E RneY' - �• �l .. GATE: MS MS .. REMOVAL( to - a11 40S 382-4541 lOY 7/4 1OYR 7/4;: L°q!/Es _9880 oANIFI oANIs IY A /AttF/A�ol1K, Y '.:. . - . .., OBI. WELL INFO- AAA ipaALA "N � d /f CUjld to = f , 7.0 WELL MtW-29 G' ,. �e IL CIE!< .iB77 - - - .. .. ZONE_ C ...-. ;_ '-:.: �� �oaA Ro„t Nd4bEoa Y 9 1,20� $:0' 120" .: 8 0 DATE-: SEPTEMBl72 2008 s r t s` 938 AYnln Sfre� . ... _.. : REALXNGr &T Scide i 20 ti.4 (T ykc rc :. e .. _. :. ADJUSTMENT 4' ... ..,.: _ c ..:: ... .. q rs \. _ p T ,:.. VO-( \ DATE : DANIfL:A. OJAU1 P:.E P.LS YARMOU JNPOR7 MA QZ 75 ,:-CH 242 T:Y.4GLiA 6wT:NOF) TOWN OF BARNSTABLE LOCATION ,S 'Poa.".4/rnjA �i �/ SEWAGEQ-A5)`3 00y' VILLAGE 1 'ASSESSOR'S MAP&PARCEL �� ©S INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY(1'5-06) jpbc>S�Pr/� S'�D �cllh LEACHING FACILITY:(type) (size) 3_ X 7 NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY ® pc C P4 T Eco-I�,3< 25,3 f3QP '� / Q:Z .13 TOWN OF BARNSTABLE ._ LOCATION e��� �T SEWAGE # VILLAGE SESSOR'S MAP & LOT INSTALLER'S NAME&PH NE N0. SEPTIC TANK CAPACITY 'LEACHING FACIL=: (type) (size)f NO. OF BEDROOMS BUILDER OR OWNER Al -1- PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by . ,4 �� �? '0 pa.`f ro ct.�f' 1� Noy Fee THE COMMONWEALTH OF'MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpYitation for bisposar Opstem Co=stem Vermit Application for a Permit to Construct( ) Repair( ) Upgrade( Abandon( ) ❑Individual Components Locat�Qn Addressor lot No. .55 Owner's Name,Address,and Tel.No., :� !'� r)2 J C 1y4 � 2' �� �( Tom'. 0 o Assessor's Map/Parcel 4 S ? Installer's Name Address,and Tel.f4o. Designer's Name,Address,and Tel.No, rtc,,v tile f 3 6 2 '7 7 3 6 o c r S" S-o 3 G Z Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(A/ Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 336 gpd Design flow provided 3 3 3 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank ? 19v Type of S.A.S. 7 Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to pla a the s stem in operation until a Certificate of Compliance has been issued by this Boar o H th. Signed �' Date / Application Approved by Date Application Disapproved by Date for the following reasons Permit No. a 120 O( Date Issued 0 q — ——_-----------— ----------- o. FeefO O- __ - •. � n9-CDC) 0 �v N ',* THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS Disposal bps,tem Construction Permit Permission is hereby granted to Construct Repair(/ ) Upgrade(4;-) ---Abandon( ) System located at ti+. It and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. q Date Approved by / 1 N%z `` Fee l THE COMMONWEAL"TH'Of`MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for disposal Opstem Construction Permit Application for a Permit to Construct( ) Repair Upgrade( �-Ab4don( ) [Complete System ❑Individual Components Lo_c%Address or Lot No.S/, ( ;,�.j., j�ey:,r o r Owner's Name,Address,and Tel.No., Assessor's Map/Parcel "z 4- Tr '`i 4 Installer's Name Address,and Tel."No. Designer's Name,Address,and Tel No.- <-o7 -7;,7.rIa"C 7y f3E o�s�'�/ s-o 3G2 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(Ikl Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 Q gpd Design flow provided -3, 3 3 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank w ,y, Type of S.A.S. '1116 v i e-Alt- i n/f/�T2 A T o ,,. Description of Soil 1 Nature of Repairs orAlterations'(Answer when applicable) Date last inspected: Agreement: .Y+ - 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 H 11th. Signed Date Application Approved by Date Application Disapproved by /V Date for the following reasons Permit No. 170 q oa� Date Issued ---------- -------------------------------------------- ----- - -- ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed G/r Repaired( ) Upgraded( ) Abandoned( )by 'at S /�4 7 i l / �r has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. "!�l/7 dated Installer G Designer D ryr �y Z #bedrooms . Approved design flow V 3 3 (� gpd The issuance of this permit shall not be construed as a guarantee that the system illl'func'tioyn as de/signed. Date / 7, �, L ,�— Inspecto - - --- IV. Septic Variances (New): A. Daniel J. Ojala, Down Cape Engineering, representing Frank Tenaglia, owner - 5 Patricia Street, Hyannis, Map/Parcel 246-052, 9,849± sq. ft. three (3) variances from (a) SAS to foundation and catch basin and (b) setback, SAS to foundation. Dave Flaherty, Down Cape Engineering, presented the plan and is requesting a one foot variance to ground water. They would like to avoid the mound above the ground. And it would be cost prohibited to build a wall around it and avoid traffic from hitting it. The plan consolidates the four septic systems currently on the lot into one system. The staff has no objections to the plan and believes the variance should be granted. One room on the plan is in question of being closed off. Rather than open the doorway to a six foot opening, the owner would like to keep as is so they can close the room and use the air conditioner in there for relief. They agreed to a three bedroom deed restriction. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to approve with the condition of a recorded three bedroom deed restriction. (Unanimously voted in favor.) { yam' Gn I j - sLOPE To DR REDUCTION IN Jtrr�^ 0.25" WEEP HOLE ADJ. G.W.— CHECK VALVE FROM 5' TO 4' 8" MYERS SRM 4 9 - SUBMERSIBLE 4/10 HP.PUMP 310 CMR 15.405(f): S— sys (OR EQUAL) REDUCTION IN SEPARATION OF SAS TO CATCH BASIN— (LINER) FROM 25' TO 20.5' CHAMBER � � `� _ 92 95' �C�� 's,(NOT TO SCALE) S. �E WA LOT AREA �X ' �� 9,849f SF 1 CP ? O OT FOUND I N >> PAVED DRIVE / F ) i '°° ' BRICK GPM C P P ATI 0 rpM4 4/10 HP PUMP l 1_ CA SEENOTE #13 V- G REGARDING THIS CP 16 / ¢ J EXISTING 3 SEWER LINE UTILITIES IN AREA OF Q BR DWELLING N / D COMPONENT 12'2 p 3 11ON AREA (SEE NOTE #10) I O100TOP OF FNDN O O EL. 17.5' Co ' v GL r x 1 � '0 a ; SHED •• II '; X 1 k \ TH-1 'Y �p ELEVATIO `s SLEEVE SEWER LINE *•� �\�O f WITHIN 10' OF WATER LINE � m_2 01 3. 6 / _ UITABLE SOIL PROVIDE VENT 5' REMOVAL OF UNS AND BUGSCREE REQUIRED AROUND PERIMETER OF AND FiOMEOW LEACHING FACILITY. DOWN TO WTH{ SUITABLE SOIL LAYER. REPLACE haawiC NTH CLEAN MED. SAND. ENGINEER \OL t REMOVAL T AND CERTIFY A Venue 10 G 'ELL INFO— �,AMIW-29 r s C \ SEPTEMBER 2008 Scale:1'= 20' .87' :SIG— � \ — TMENT— 4 0 10 20 I, 30 40 50 FEET DATE 4 FROM :down cape engineering ire FAX NO. :15083629980 Jun. 22 2012 02:25PM PI 7ff PI-Rib'Ife- T., 200-114,aiu S eeo., H%ljmnk,.K,4,(6ma'.5 50840,4644 508-7)0-6304 'aqium Form A WA P, D's r" 0 win E n, Instaikm 64;1)-WcX'4 QQ Ad&ess- On 1S.SLLed a pcimit lo Lius[�dl a gel7diG fySf('131 Lt. based cm a derugii dravm,by (adr.".[rss) 'F'— lit -i 6 11. j- ,*,I I ncjj.f-;thaf. [lit; scptio Above w,9.q iaqlmlled --,,ubs:UuIJLdly aunordlag to (1c,--,j.gn, which ulay L'Urbidte cuj2--if)j", App).ovEl.d. c,jS.1.jpeR such as latuxal n"lo".14flun (it the dlistri,bution box,,iudior tsiik- .1 CE1701y di;0 t.W- septic sy:-IMITI 7(�-Fcnmced abovu ivm, witli.uanj, Pes, c, gjC,,qt,).,fj.l,,3.n 1 1- atj,.-,jLjj j-(-.(0c,2f.:.cj.ra of tp .AS or an:y veMica� relot:,ation of aiff COmplul.eW of the.Sc.ptir. ^y-,tcm) but lu will Lov"q 1. TevlEloll of c eT-6(l e.J.a. -t--)-.6L(t. by de:-,I gn.0 'Lu u W. Of. DANIGLA. OJALA CIVIL No.46602 a-rf INAL Env F"j) Static.t) F.,�BT,R PT.TLF,ASE, 14RT-UTcT4 -1-0 f t.FF7 MAC' HEALI'll DIVIt"Lum'. (-,'Tl,.'RT.TFTlrATE Ulr Cu F RNI AIND A(314CU.1i 1, ATI�E lljAAT4(:.E KOT .7� T.R. '0 pFtHe rp� Barnstable Town of Barnstable Al AmedcaChy 'nA"i6;S Board of Health 1 : p ► t �1 ASS. O� �9�o�b'7 9''t — 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi January 28, 2009 Mr. David Flaherty Down Cape Engineering 939 Main Street, Route 6X Yarmouth Port, MA 02675 RE: 5 Patricia Street, Hyannis A = 246-052 Dear Mr. Flaherty, You are granted--variances on behalf of your clients, Frank Tenaglia, to construct an onsite sewage disposal system at 5 Patricia Street, Hyannis. The variances granted are as follows: 310 CNfR 15. 405 (1) (b): To install the soil absorption system 7.2 feet away from the foundation (crawl space) wall, in lieu of the minimum twenty (20) feet separation distance required. 310 CMR 15. 405 (1) (h): To install the soil absorption system four (4) feet above the adjusted water table, in Lieu of the minimum five (5) feet separation distance required. 310 CMR 15. 405 (1) (f): To install the soil absorption systeqI.t,cknty (20) feet away from a catch basin, in lieu of the minimum twenty-five (25) feet separation-distance required. These variances are granted with the following conditions: (1) No more than three (3) bedrooms are authorized at this property. Dens, study rooms, offices, finished attics, sleeping.lofts, and similar-type rooms are. considered "-bedrooms''' according to the MA Deoartment of Environmental Protection. (2) The applicant shall record a properly worded deed restriction, signed by the property owner, at the Registry of Deeds restricting the number of Q:\WPFILES\FlahertyTenaglia5 Patricia Jan2009.doc i.r bedrooms at this property to three (3), before the applicant obtains a disposal works construction permit. (3) The septic system shall be installed in strict accordance with the engineered plans dated Oetober2,;2008 and signed November 22, 2008. (4) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the plans. The existing septic system has failed. This variance is granted because the proposed'..--.plan appears to meet the maximum feasible design standards contained within the State Environmental Code, Title 5 and local Health Regulations. Si/eIyours, *V linegller, M.D. irm QAWPFILES\FIahertyTenaglia5 Patricia Jan2009.doc DATE: FEE: + BARNSTAB[.E, MASS. C 1639. � REC. BY E0 Town of Barnstable j SCHED. DATE: I Df Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION T Property Address: P r// 5 • Assessor's Map and Parcel Number: l 10 Size of Lot: U Sri Wetlands Within 300 Ft. Yes Business Name: No -K7 Subdivision Name: APPLICANT'S NAME: /l� E GN /N � � Phone Did the owner of the property authorize ou to re resent him or er? Yes No PROPERTY OWNER'S NAME CONTACT PERSON �. �J� 4 Name: � �/✓/� � �/ Name: I Address: P/rk, /1'Address: �3 L/J��&p4� Zi✓ , /(/�L 2 c - Phone: 5��" i 3 73 Phone: 9 Z - VARIANCE F ,04 REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space ne ded) iV �an/ 0' ZLOZ Grp&f 0 r cn 5 0 NATURE OF WORK: House Addition ❑❑❑❑❑❑ House Renovation ❑ Repair of Failed Septic Systems' 2�t Checklist (to be completed by office staff-person receiving variance request application) `// Please submit copies in 4 separate completed sets. 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 (forTitle 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 owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building prop ed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Paul J.Canniff,D.M.D. REASON FOR DISAPPROVAL C:\Documents and Settings\decollik\Local Settings\Temporary Internet Fi1es\0LK1\VARIREQ.D0C 1. 0/200 15: 10 FAX 5087788044 UES la002 3T- Re: ,9-�..O`G�`J9— C' 7 �oq - DCE# To Whom It NfiY Concern, Please be advised tha01/ 'e are the Iegal owners of record a have authorized D ' Ca e p En iieerm Inc.to act as our w representatives for 1) Conservation Commission, 2)Natural Heritage Endangered Species Program/MESA filings, 3) Board of Health meetings and 4) any other hearings at the above referenced property. arne(s) signature(s) (date) t I or 2•I�O r � 141 PB8764150 7008 01,50 0000 9265 4308 01 01 s D5 . 3Z0 nEc 31 08 5 7 4 5 YARMOUTfi PORT,MA 02675 -i o li Au h v a, Sea Mist Properties LLC V 46 Tilden Commons Drive Quiuncy, MA 02169 x 0mg Nam b ca7z 02 of/4/09 •SEA MI-7 RROPERTIES L.L.0 d L N COW HOPKINTON MA 01746-166S E 0 _ .. E T RETURN TO SENDER C..^ f l�r 74 amai% C., '���t:t.rr�9�:��Jt�r�rl.�.� rr.�,•�t:..���rr�11t+g;:;�'}t;ti��aq�J;� 1 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY I ■ Complete items 1,2,and 3.Also complete A. Signature I item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee I so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. • D. Is delivery address different from item 1? ❑Yes I 1. Article Addressed to: If YES,enter delivery address below: ❑ No •4.• i i !�l ( �r r 3. Service Type a Certified Mail ❑ Express Mail Registered ❑ Return Receipt for MerchandiseCAI ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes \� _ i \ 2. Article Number 7008 0150 0000 9265 4308 (transfer from service lab, T' --1 -_ __ - - - - _ _ - _ _ - _ - - _ ( IC ' t i I PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1 s40 I tel. (508)362-4541 939 main street rt 6a fax(508)362-9880 yarmouth port mass 02675 down cape engineering MC. structural design civil engineers&land surveyors Daniel A.Ojala,P.E.,P.L.S. Arne H.Ojala P.E.,P.L.S. Timothy H.Covell,P.L.S. land court December 15, 2008 Andrew R.Garulay,R.L.A. surveys Re: 5 Patricia St. (I site planning W. Hyannisport, MA Board of Health Hearing sewage system Dear Abutter: designs A public hearing has been scheduled for the Barnstable Board of Health to take action on a request for variances from Title 5 Regulations under CMR 15.000 and inspections Town of Barnstable. Regulations for the subsurface disposal of sewage for the proposed septic system at 5 Patricia St. West Hyannisport. The variances requested permits are as follows: Variances requested under Maximum Feasible Compliance 15.405: landscape architecture (1)(b): reduction in setback, SAS to foundation(20' to 7.2')(liner proposed) (1)(1f): reduction in separation of SAS to Adjusted Groundwater(5' to 4') (1)(f): reduction in separation of SAS to catch basin(25' to 20.5')(liner proposed) Variances requested under Town of Barnstable 360-18: Reduction in four foot depth of naturally occurring pervious soil above adjusted high groundwater elevation- From 4' to 1' Said hearing will be held in the Selectman's Hearing Room in Town Hall, 367 Main Street, Hyannis, January 13, 2009, at 3:00 pm. Please check with the Health - - - Department to confirm date and time. Sincerely, David D. Flaherty Jr., R.S. Down Cape Engineering, Inc. cc: Abutters file Barnstable Board of Health 14 5 � o91 1 a 05 .320 DEC7311 6450 265 42785742 08 7008 0150 0000 9 -- _ ._ S 7 d 2 YP.RMOUTH PORT.MA 02675 y C ,9� O1 caFc 4 �� O�4,0 S& p�ti Road sG0cu yso tipTgp 3 o Fq 9 0 \ o cn a �RTgS S Ca in O p c O 91y� �Gfe E � co \90 do M `t d VEIN 1.. SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature I item 4 if Restricted Delivery is desired. ❑Agent I ■ Print your name and address on the reverse X ❑Addressee I so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery I I ■ Attach this card to the back of the mailpiece, I I or on the front if space permits. 0 1. Article Addressed to: D. Is delivery address different from item 1? El Yes I f •—.- __---_ If YES,enter delivery address below: ❑ No IF IL In/YJ • � ' 1 l�l I I 3.J rvice Type I AlCertified Mail ❑ Express Mail l I �\ ' Registered ❑ Return Receipt for Merchandise � �� ❑ Insured Mail ❑ C.O.D. I �, 6 4. Restricted Delivery?(Extra Fee) ❑Yes 12. Article Number 7008 0150 0000 9265 4278 I ,� lit I (transfer from service late , , ; PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 tel.(508)362-4541 939 main street rt 6a fax(508)362-9880 yarmouth port mass 02675 down cope engineering, inc structural design civil engineers &land surveyors Daniel A.Ojala,P.E.,P.L.S. Arne H.Ojala P.E.,P.L.S. Timothy H.Covell,P.L.S. land court December 15, 2008 Andrew R.Garulay,R.L.A. surveys Re: 5 Patricia St. site planning W. Hyannisport, MA Board of Health Hearing sewage system Dear Abutter: designs A public hearing has been scheduled for the Barnstable Board of Health to take action on a request for variances from Title 5 Regulations under CMR 15.000 and inspections Town of Barnstable Regulations for the subsurface disposal of sewage for the proposed septic system at 5 Patricia St. West Hyannisport. The variances requested permits are as follows: Variances requested under Maximum Feasible Compliance 15.405: landscape architecture (1)(b): reduction in setback, SAS to foundation(20' to 7.2')(liner proposed) (1)(h): reduction in separation of SAS to Adjusted Groundwater(5' to 4') (1)(f): reduction in separation of SAS to catch basin (25' to 20.5')(liner proposed) Variances requested under Town of Barnstable 360-18: Reduction in four foot depth of naturally occurring pervious soil above adjusted high groundwater elevation- From 4' to l' Said hearing will be held in the Selectman's Hearin Room in Town Hall, 367 Main Street. Hyannis, January 13, 2009, at 3:00 pm. Please check with the Health Department to confirm date and time. Sincerely, David D. Flaherty Jr., R.S. j Down Cape Engineering, Inc. cc: Abutters file Barnstable Board of Health .• CERTIFIED MAILT,,, RECEIPT (Domestic ii4aii only; ul fU For.delivery information visit our website at www.uspsxomo� ,n .D -\\ ru Postage $Er Q Certified Fee ? 0 O BOG. O Return Receipt Fee ll C-418r ark p (Endorsement Required) OL_ t,L0 Mere �{ w 0 Restricted Delivery Fee Q (Endorsement Required) �o y Ln r-j Total Postage&Fees 0 Sent ToCO r -- -------------- � Street,Apt No.; 0 or PO Box No. City,Stflte,Z/P+4 PS form 3800,August 2006 See Reverse for irisiructions Certified Mail Provides: r A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery" ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the.post office for postmarking: If a postmark on•the Certified Mail receipt is not needed,detach and affix label with postage and mail. i IMPORTANT:Save this receipt and present it when making an inquiry. " PS Form 3800.August 2006(Reverse)PSN 7530-02-000-9047 Postal CERTIFIED MAILT M RECEIPT iv (Domestic Mail,. Provided) ru m _r � m � `n Postage $ Er Certified Fee �aUTHpaa i p Return Receipt Fee Postmar C3 (Endorsement Required) pZ o�C Here 0 Restricted Delivery Fee ' �I D C3 (Endorsement Required)Ln r-q Total Postage&Fees $ S` ! C3 k Sent To CO 0 1 ... . . .. ...............f- Street,Apt. C3 or PO Box No. ------------------------ Crty,State,ZIP+4 :00 0,. 'Certified Mail Provides: ■ A mailing receipt o A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified .Mail. For Valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed.detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800.August 2006(Reverse)PSN 7530-02-000-9047 Postal (DomesticCERTIFIED MAIL,I M RECEIPT CO Only; .•. r- ruFordelivery information visit our website at w%nw4.usps.comO ui 11 f1J Postage $ , Er O Certified Fee 7 0 ♦�MO C3 Return Receipt Fee p ♦? Here 0 (Endorsement Required) �.. C� � a0 Restricted Delivery Fees (Endorsement Required) 1Lp r-I Total Postage&Fees ✓ N p �' O V Sent To CO ka--------------------------------- -- - C Street,Apt.No.; or PO Box No. City,state,ZIP+4 :r. August 2006 Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders. ■ Certified Mail mby ONLY be combined with First-Class Mails or Priority Mails ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. e For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail. receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3600.August 2006(Reverse)PSN 7530-02-000-9047 U.S. Postal Service,&'q CERTIFI ED MAIL,. RECEIPT Ln (Domestic Mail Only;No/nsurance Coverage Provided) co IW For delivery information visit our website at www.usps.Come Ln OFFICIAL US Opp^ Postage $ , �{.L (Here MovCertified Fee p� Q p p Return Recei t Fee p (Endorsement Required) - Ojp Restricted Delivery Fee(Endorsement Required) tiC p � Total Postage&Fees $ p r Sent To — co P�Qq 1 Gt p Lf..keil ........... -- p Street,Apt.No.; or PO Box No. Ciry,State,ZIP+4 PS Form 3800,August 2006See Reverse to?111'Stl LICtions Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For Valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is riot needed.detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800.August 2006(Reverse)PSN 7530-02-000-9047 .o CERTIFIED MAILN1 ru (Domestic Er fl.l • ,p FFICIAL US Ln ( � Postage $ oZ Er O AR Certified Fee Q PYMpG�y pO Return Receipt Fee H Tom'' O (Endorsement Required) oZD W O Restricted Delivery Fee (CJ� O (Endorsement Required) No rr-9 Total Postage&Fees �� j 5, OO o Sent To CO o -------------- - ._... ------- ---- Street,Apt.No.; O or PO Box No. N --------------------------------------- i Clry,State,ZIP+4 :M Auqrjst 2666 See Reverse f6,�nj'Ir.c6b,',s Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail& ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800.August2006(Reverse)PSN 7530-02-000-9047 .• tERTIFIED�IVIAILhq RECEIPT cc (Domestic Mail Only; M m For delivery information visit our welosite at vv,ww.usps.como m OFFICIAL ru Postage $ LN Q.. O p Certified Fee U �� Return Receipt Fee !!J `! p (Endorsement Required) � - 0 mHere O Restricted Delivery Fee n (Endorsement Required) u 7 0 r-q Total Postage&Fees O ETo :002006 See Reverse for Instructions Certified Mail Provides: s A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an Inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 Postal CERTIFIED MAIL ,. RECEIPT m .. . • . m For delivery informati � I -11 [C3 Postage $ Er Certified Certified Fee Return Receipt Fee 1 O Q O (Endorsement Required) 0( p Restricted Delivery Fee W U (Endorsement Requred)Total Postage&FeesSent To P�g✓ ------•----- 1-r'`- --.._... Street,Apt.No.; or PO Box No. City,State,Z/P+4 -------------------•---------------------------- ...... PS Form :.. AUgOst 2006 See Reverse for InstrUCtions Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: • Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. • For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT,Save this receipt and present it when making an inquiry. . PS Form 3800.August 2006(Reverse)PSN 7530-02-000-9047 11 SENDER: COMPLETE THIS SECTION COMPLETE THISSECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sig ture I item 4 if Restricted Delivery is desired. X gre t)&�td en■ Print your name and address on the reverse dre see so that we can return the card to you. B. Received by(Printed Name) C. D elivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item ? Fo es 1. Article Addressed to: If YES,enter delivery address below: 3. FRegistered ice Type j I ertified Mail ❑Express Mail I / ❑ Return Receipt for Merchandise It/ ❑ Insured Mail ❑C.O.D. O"""'r < 4. Restricted,$gliu�r�14?(Extra Fee) ❑Yes `iy'a'i i t wV. ,t.�a 71 F lsn 5 1;�.. � �i ZN �� +� �;a ;Y�• ale V1 FJ r t( �'i `"'i; i 70b8 0150 �0000 9265 4322 J /a ra r fr servic { �Ft`rt�ar^ 004 Domestic Return Receipt 102595-02-M-1540 C UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid I I USPS Permit No.G-10 i I I j • Sender: Please print your name, address, and ZIP+4 in this box • ` I I , dovM cape engirrleer*w. Inc. j CIVIL ENGINEERS LAND SURVEYORS I ON main st. yaM0jft6 me OaB'� I I + x` ,I F tel. (508)362-4541 939 main street rt 6a fax(508)362-9880 yarmouth port riiass 026Y5 down cape engineefing, MC. structural design civil engineers& land surveyors Daniel A.Ojala,P.E.,P.L.S. Arne H.Ojala P.E.,P.L.S. Timothy H.Covell,P.L.S. land court JgCember 15, 2008 Andrew R.Garulay,R.L.A. surveys l Re: 5 Patricia St. W. Hyannisport, MA Site planning Board of Health Hearing sewage system Dear Abutter: designs A public hearing has been scheduled for the Barnstable Board of Health to take action on a request for variances from Title 5 Regulations under CMR 15.000 and inspections Town of Barnstable Regulations for the subsurface disposal of sewage for the proposed septic system at 5 Patricia St. West Hyannisport. The variances requested permits are as follows: Variances requested under Maximum Feasible Compliance 15.405: landscape architecture (1)(b): reduction in setback, SAS to foundation(20' to 7.2.')(liner proposed) (1)(h): reduction in separation of SAS to Adjusted Groundwater(5' to 4') (1)(f): reduction in separation of SAS to catch basin(25' to 20.5')(liner proposed) Variances requested under Town of Barnstable 360-18: Reduction in four foot depth of naturally occurring pervious soil above adjusted high groundwater elevation- From 4' to 1' Said hearing will be held in the Selectman's Hearing;Room in Town Hall, 367 Main Street, Hyannis, January 13, 2009, at 3:00 pm. Please check with the Health Department to confirm date and time. Sincerely, David D. Flaherty Jr., R.S. Down Cape Engineering, Inc. cc: Abutters file Barnstable Board of Health Town of Barnstable Geographic Information System December 15, 2008 246168 246059 246050 ED #25 #28 #29 _ 246232 246179 #82� #71 v 246055 246058 ::. 03 246234 #18 017 246fS5-I r;�ps :::::•. F W W 0.5 4S.. . ......... r N X 54. lip .... .:•:.: ....... ::::.'...:::•.:::::.:;:::::.. C ::::....::-.'.:: :246'052 �:;::.' #32057 :5 H a a .n. z4s W. 235 #5s 6Q3 :.•..#AS..>;••::%::••.:.'. .•;..'...•...;;:..:.•..:::•�r.�+:(:::•:_,: AVENUE : • a :.24soa7 3 .k :34 x. S' 246237 #40 246036 0550 246071 57�L Fee #528 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:246 Parcel:052 Board of Health a boundary determination or regulatorySelected Parcel interpretation. Enlargements beyond s scale of Abutter List Type-Direct abutters(no set distance)and the properties located 1"=100'may not meet established map accuracy standards. The parcel lines on this map �}( are only graphic representations of Assessor's tax parcels. They are not true property across the street. Abutters boundaries and do not represent accurate relationships to physical features on the map {{/ � such as building locations. Buffer x/r f AbutterReport Page 1 of 1 Board of Health Abutter List for Map & Parcel(s): '246052' Direct abutters (no set distance) and the properties located across the street. Total Count: 8 Close Map&Parcel Ownerl Owner2 Addressl Address 2 Mailing Country Deed CityStateZip DOHERTY, 35 STRAWBERRY CENTERVILLE, 246037 FREDERICKJ& HILL RD MA 02632 USA 18764/116 MAUREEN A 246038 ONEIL, KEVIN M& 45 STRAWBERRY HYANNIS, MA 12737/142 NANCY P HILL RD 02601 246039 SHEFLER, GEORGE 1611 OTTER DRIVE TOMS RIVER, NJ USA 2761/150 08753 246051 SHEA, MAUREEN A C/O MELLON MORTG PO BOX 2885 HOUSTON,TX USA 3675/345 ESCROW DEPT 77252-2885 W TENAGLIA, ROCCO 246052 F CAROLYN TENAGLIA P O BOX 388 HYANNISPORT,• USA 1377/105 MA 02672 246056 SEA MIST 46 TILDEN QUINCY, MA 21208/125 PROPERTIES LLC COMMONS DR 02169 246069 SZYMANSKI, %SZYMANSKI, 15 CHADWICK AVE HYANNIS, MA USA 2899/217 RICHARD C JR RICHARD C JR&LISA 02601 246070 RIVERA, MAURO 0 34 STRAWBERRY CENTERVILLE, 13746/317 &AIDA G HILL RD MA 02632 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 12/31/2008. http://www.town.bamstable.ma.us/arcims/appgeoapp/AbutterReport.aspx?type=BOH 12/31/2008 ,. -: . m N f rD m 1 11 4_..._ _. 11.R _� 1 - - _-,` t____- ( -~00 LA1141PF`r 1 O� �3 _ Ul l3cv 8. O - co Ul 6Ev 1. �r .. 6 r � 1 M .- Z Z (7 EST FLOOR PLAN l!4".=I EXISTING CONDITIONS PLAN !VOTE:GROSS FLOOR ARFiA=1,730 SO.FT. S PATRICIA STREET, WEST HYANNISPORT, MA PRSPA"13 FOR ' MR. FRANK TENAGLIA T, GOGARTX DLSIGN & CONSULTING GROUP 2M SOUrH S-RlZr,NORWELL,MA 02061 1 781-659.6868 m �� DE,CEMAF.R 29,2008/ SHEET I OF I Town of Barnstable P# Department of Regulatory Services Public Health Division. DateBARMAKA MAS& � 10.7 �e� 200 Main Street,Hyannis MA 02601 ArFD M!�� I111 ap Date Scheduled Time Fee Pd. Soil Suitability Assessment for Se age isposal r Performed By: Witnessed By: �v' �. LOCATION& GENERAL INFORMATION Lccar'or Address C Owner's Name15 /eY1 /J w, H lq►1 �4�0 Address P, 7 Assessor's Map/Parcel: 0 p/ S a / Engineer's Name �Q L'/+� e NEW CONSTRUCTION REPAIR Telephone If Land Use Slopes(%) — Surface Stones- Distances from: Open Water Body ;11I 61V ft Possible Wet'Area _ft Drinking Water Well��ft Drainage Way Zy ft Property Line Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands�n proximity to holes) G m rn - xz v -0 Depth to Bedrock Parent material(geologic) k y - — 0 Depth to Groundwater: Stau.ding Water in Hole:_�� Weeping from Pit Face - Estimated Seasonal High Groundwater DP N TION FOR SEASONAL HIGH WATER TABL14C Method Used: .- Depth Observed standing in obs.hole: _in, Depth to soil mottles: N in. Depth to weeping from side s.holey --�� ln. Oroundwnler d ustment fr. [ I� Index Well H�1W Reading Date: l7 _ Index Well level Adl•factor AdJ•f7Prauntlwuter Level_`• t,.v -21 PERCOLATION TEST Date j1d. ThIlc /h^, .Observation ` Time at 9" - Hole# Depth of Perc T The At 6" Start Pre-soak Time @ Time ff'-V) End Pre-soak Rate Min./inch G y Site Suitability Assessment: Site Passed, Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one (1) week prior to beginning. Q:\S E PTIC\PER C FOR M-DOC DEEP-OBSERVATION HOLE LOG Hole# _ Dc`pth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. - 3o on i ten N raven DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil _. Surface(in.) Other (USDA) Other Mottling (Structure,Stones,Boulders. Con 's e c 96 G av I - ZV G 061, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Surface(in.) Soil Color. Soil Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency o Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) (USDA) Other (Munsell) Mgttling (Structure,Stones;Boulders, Flood Insurance Rate Man- Above 500 year flood boundary No-- Yes Within 500 year boundary No Yes Within 1W year flood boundary No Yes Depth of Naturlilly Occurring Pervious Material J Does at least foyr feet of naturally occurring pervious material exist in all areas observed throughout the 11 area propose/or the soil absorption system? If not, is the depth of naturally occurring pe vious material? Certification_. -- I certify that on (date)I have passed the soil evaluator examination approved by the Department of Env ron ental Protection and that the above analysis was performed by me consistent with the required traini ,expertise an experience described in 310 CMR 15.017. 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L. —�--� r' c60 .79 AC ... i1. SHALL SYSTEM PROFILE RKI:SYSTEM WITHCMAGNETICTTAPE ORALL BE NOTES COMPARABLE MEANS FOR FUTURE LOCATION. (NOT TO SCALE) 1. DATUM IS APPROXIMATE NGVD �%- ACCESS COVERS TO WITHIN 6" OF FIN. GRADE TOP FOUND. EL. 17.5' FROVIDE INSPECTION PORT TO WITHIN 3" OF FINAL GRADE 2. MUNICIPAL WATER IS EXISTING \ ' 17.0' MINIMUM 75' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 17.0 Locus INSTALL INLET 4. DESIGN LOADING FOR ALL PROPOSED PRECAST n/ UNITS TO BE AASHO H-110 TEE 1" ABOVE Ville ..a•Y 4"SCH4o PVC 4"bSCH40 PVC OUTLET INVERT 2" DOUBLE WASHED PEASTONE 5. PIPE JOINTS TO BE MADE WATERTIGHT. ,' _ PIPES LEVEL 1ST 2' LL i _ OR GEITEXTI E FABRIC Cb MIN. 2% PITCH 16.0' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE \*A=15.6' �°" 14L 500 WITH 310 CMR 15.000 (TITLE V.) GAL*B=15.5' 15.18' 1000 GAL t COMPARTMENT MENT o 0 0 0 0 o e COMPARTMENT 14" TEE °o°o°o°o°o°o 15.67 3.5' AT SIDES 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND W/ GAS BAFFLE °°°^°^°^°" NOT TO BE USED FOR LOT LINE STAKING OR ANY 15.87' 15.7' Sc:, 0.67' 3.5' AT ENDS OTHER PURPOSE. • °o"oa°q"a 99§$ o� 15.0' a°a Nantucket Q TUF-TITE EF-4 �_ - 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. EFFLUENT FILTER 6" CRUSHED STONE OR MECHANICAL Sound 9. COMPONENTS NOT TO BE BACKFlLLED OR DEPTH OF FLOW = 4 (OR EQUAL) COMPACTION. (15.221 [21) 3/4" TO 1 1/2 DOUBLE WASHED STONE CONCEALED WITHOUT INSPECTION BY BOARD OF TEE SIZES: SEE PUMP o HEALTH AND PERMISSION OBTAINED FROM BOARD OF INLET DEPTH = 10„ DETAIL OUTLET DEPTH = 14" BELOW 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP h VERIFYING THE LOCATION OF ALL UNDERGROUND & MIN.( 2 % SLOPE) ( 1 % SLOPE) OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF ADJ. G.W. EL. 1 1.0, WORK. SCALE 1"=2000'f FOUNDATION A=21' SEPTIC TANK/ 53' D' BOX 5' LEACHING 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 246 PARCEL 52 B=14' PUMP CHAMBER FACILITY VARIANCES SHALL BE REMOVED 5' BENEATH AND AROUND THE *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL PROPOSED LEACHING FACILITY. MAXIMUM FEASIBLE COMPLIANCE- LOCUS IS WITHIN AP OVERLAY DISTRICT AND THE UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS ELECTRICAL PERMIT REQUIRED FROM LOCAL UPGRADE APPROVAL 12• EXISTING LEACHING FACILITY SHALL BE PUMPED ESTUARINE WATERSHED PROTECTION DISTRICT PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM TOWN OF BARNSTABLE PRIOR TO ANY AND REMOVED OR PUMPED AND FILLED WITH CLEAN ELECTRICAL COMPONENT INSTALLATION. 310 CMR 15.405(1)(b): SAND. LEGEND � I D ALARM AND CONTROL PANEL REDUCTION IN SYSTEM LOCATION FROM 13. SEWER LINE TO CESSPOOL IN FRONT YARD TO I �J TO BE INSTALLED INSIDE FOUNDATION OR CRAWL SPACE- BE RE-ROUTED TO PROPOSED SEPTIC TANK VIA BUILDING. ALARM TO BE ON INV. IN 15.01' , , INTERIOR PLUMBING. LICENSED PLUMBER TO VERIFY 99- EXISTING CONTOUR SEPARATE CIRCUIT FROM PUMP 500 GAL P.C. SIDE OF S.T. 2" PRESSURE LINE FROM 2O TO 7.2 (LINER) FEASIBILITY TO PROPOSED SEWER LINES ELEVATION X 99 1 EXIST. SPOT ELEV. ALARM ON SLOPE TO DRAIN BACK TO PC 310 CMR 15.405(1)(h): AND LOCATION PRIOR TO INSTALLATION OF ANY FLOAT SWITCH 0.25" WEEP HOLE REDUCTION IN SEPARATION OF SAS TO COMPONENT. ss PROPOSED CONTOUR SETTINGS: PUMP ON CHECK VALVE ADJ. G.W.- 14. CONTRACTOR TO VERIFY FEASIBILITY AND 4" WORKING RANGE 8" MYERS SRM 4 ADEQUACY OF EXISTING ELECTRICAL SYSTEM TO 198.4 4" SUBMERSIBLE 4/10 HP PUMP FROM 5 TO 4 ACCOMMODATE PROPOSED ELECTRICAL PUMP PRIOR PROPOSED SPOT EL. PUMP OFF 8" SYSTEM (OR EQUAL) 310 CMR 15.405 ( ) TO INSTALLING ANY COMPONENT. TH1 fREDUCTION IN SEPARATION OF SAS TO TEST HOLE . . . nn CATCH BASIN- SYSTEM DESIGN: 2� SLOPE OF GROUND PUMP CHAMBER I FROM 25 TO 20.5 (LINER) GARBAGE DISPOSER IS NOT ALLOWED UTILITY POLE (Nor TO SCALE) FIRE HYDRANT p DESIGN FLOW: 3 BEDROOMS @ 110 GPD = 330 GPD NOTE WT&L SYMBOLS MAY APPEAR IN DRAWMG 1` I I �. \ �.., ,. USE A 330 GPD DESIGN FLOW S. E w � k INSTALL 127't OF 40 MIL POLY LOT AREA LINER AROUND 5' PERIMETER SEPTIC TANK: 330 GPD (2) = 660 = CP 9,849f SF AS SHOWN PER PLAN TEST HOLE LOGS _ �° ' '� / NOT FOUND / TOP EL. 1s.a' USE A 1500 GAL. SEPTIC TANK (FRALO POLY TANK OK) BOTTOM EL. 12.0' DAVID FLAHERTY R.S., SE2755 s I N� LEACHING: - ENGINEER: ' WITNESS: DAVID STANTON, R.S. 1� PAVED / SIDES. 98 FT (.67) (.74) - 48 GPD 25 w 75 100 / o, DRIVE BOTTOM 386 SF (.74) = 285 GPD DATE: OCTOBER 17, 2008 CAPACITY- GPM PUMP CURVE FOR MYERS SRM4 4/10 HP PUMP CP BRICK. TOTAL: 450 S.F. 333 GPD PERC. RATE _ < 2 MIN/INCH N y G) G A SEE NOTE #13 REGARDING THIS USE 8 STANDARD QUICK 4 INFILTRATORS AS SHOWN 12392 CAUTION! UTILITIES IN AREA OF EXISTING 3 SEWER LINE CP 16 ( ) CLASS SOILS P# PROPOSED COMPONENT Q PER PLAN WITH 3' STONE AT ENDS AND 3.5' AT SIDES INSTALLATION AREA (SEE NOTE #10) / �2.2' 3 BR DWELLING G ELEV. ELEV. p p p �O TOP OF FNDN �-, n EL. 17.5' �i 1 off - Q� � APPROVED DATE BOARD OF HEALTH MA FILL FILL 30" 2s" / _° ° 1 TITLE 5 SITE PLAN I► 5 Q A A CAx 'I ,. / OF LS LS 10YR 4/2 10YR 4/2 �� •D '-'" :"' / 5 PATRICIA ST. 36" 34" SLEEVE SEWER LINE \ .� TH_1 G WITHIN 10' OF WATER LINE �� BM - CTR OF C BASIN B B ��QO TH-2 ELEVATION = 14:9' W. HYANNISPORT, MA LS LS � � \ 7 , �. / PREPARED FOR 1OYR 5/6 10YR 5/6 5' REMOVAL OF UNSUITABLE SOIL 3• �6 �� 48" 12•0 48" 12.0' REQUIRED AROUND PERIMETER OF 1 / WI FRANK TENAGLIA LEACHING FACILITY, DOWN TO �,. - � PROVIDE VENT NTH CHARCOAL FILTER C C SUITABLE SOIL LAYER. REPLACE AND BUGSCREEN (FINAL PLACEMENT PERC WITH CLEAN MED. SAND. ENGINEER ch / WITH HOMEOWNER CONSULTATION) TO INSPECT AND CERTIFY �a�• DATE: OCTOBER 22, 2008 MS MS REMOVAL. �C O 10YR 7 4 10YR 7 4 ��h \ _ off 508-362-4541 ' / / �� \ fax 508-362-9880 ADJ. G.W. 11.0' ADJ. G.W. 11.0' y I - -- - - - - - - - ��ZNOFMgss9 ��ZNOFMgss�c downcape.com „ , OBS. WELL INFO- �O o�'� DANIEL c�Gs o` DANIELA. yG� down cope engineering inc. 108 G.W. 7.0 108 G.W. 7.0 WELL- MIW-29 G o� A. o OJALA `�� , ZONE- C A U OJALA CIVIL civil engineers 120" 6.0, 120" 6.0' DATE- SEPTEMBER 2008 \ J' °w �, �N04ss°2 4 land Surveyors READING- 8.7' Scale: 1"= 20' Nos S\O C oF�F Is 939 ti `'\� 1 ADJUSTMENT- 4' \ �,t_ � o s Main Street ( Rte 6A) Immommomm% z/0� YARMOUTHPORT MA 02675 0 10 20 30" 40 50 FEET \ DATE DANIEL A. OJALA, P.E., P.L.S. LICE #D8--252 08-252 TENAGLIA.DWG (DDF) I � I r u N hoo M � r Cj 00 0.1 �3 e.r-r 3. C�C> I E�>'E.,PIL i. i f } E�-Ev> Z. I � � TT 1 i k . FIRST FLOOR PLAN 111A" = F-09— EXISTING CONDITIONS PLAN NOTE : GROSS FLOOR AREA = 1,730 SQ. FT. 5 PATRICIA STREET, WEST HYANNISPORT, MA PREPARED FOR E MR. FRANK TENAGLIA JAN o z aos GOGARTY DESIGN & CONSULTING GROUP T 9 Down Cape Engineering,Inc. 283 SOUTH STREET, NORWELL, MA 02061 / 781* 659 6868 DECEMBER 29, 2008 / SHEET 1 OF 1