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HomeMy WebLinkAbout0398 BEARSE'S WAY - Health Hyannis P@ A 292 033 = _. i� I' I I �p r I I i i 'fl P O Q � o p 1 6 � o i i o i d i I 0 o Mr A n v E y 08/19/2013 09:40AM 17744139468 MEYER AND SONS PAGE 01/01 Town of Barnstable Regulatolry Services Thomas F.Geiler,Director • esa.s Public Health Division Thomas McKean,Director - - 200 Main Street,Hyannis,IVIA 02601 Office: 508-362-4-644 Fax: 50a-790-6304 Installer & Designer Certification Form '� cc Date: Sewage Permit#&4'�� Assessor's yZaplParcel Y"4.e_�14nC, r Designer: �_ � Installer- Address: _�o -—l.� Address: 0 B Gam/ ' Or. a (� was issut:d a permit to install a (da ) (installer) iOleo �, e-s zl °'Y''S septic system atbased on a design drawn by (address) X S iJG�r-'dated 9 Z' (desi0ner) ,,,,�e 1 certify that the septic system referenced above was Last&led substantially according to tl:e des,gz:, which may include minor approved changes such as lateral relocation o tt:: distribution box andlor septic tank. I certify that the septic system referenced aoovc was installed with major changes (i.e. greater than W lateral zelocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State 8c Local Regulations- Plan reviskn or certified as-built by designer to follow. OF �ss� DAR N r, (Izz5tall Signature) e� $4#1 TAtttp� Designer's Signature) (Affz.Desigae,'s Stamp Here) PL ASE RETURN TO BARkNg LE PUBL C HEALTH DIVISION. CERTIFICATE OF COMPLUMNCE WILL YOT BE ISSUED UJ4T1L__80T1f THIS FOP.NI AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. Tli k`rK YQU. Q:Hcalth/Scptic/Desi�mar Cenifkation Forte 3-7$43dfdoc r, TOWN OF BA.RNSTABLE LocAI'lONU&eses SEWAGE VIL AGE ASSESSOR'S MAP& LOT INSTALLER'S NAME&P'HONE.NO. SEPTIC TANK CAPACM /SISD LEACHING FACILrff (ttM) �i I . (size) y NO.OF'BEDROOMS 7 bUILDER OR OWNER. PERMIT®ATE: - COWLIANCE IRATE: Separation ISismnce Between the: Maximum Adjustil,Groundwater Table to the Bottorn of Leaching Facility FGe{ Rivate Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) ! Feat Edge of Wetland and Leaching Facility(If any well s exist within 300 feet of aching tli I ee Furnished by �' �. i a � A 3 s' y( rrr- s�-. \I• TOWN OF BARNSTABLE LOCATION< 7� p��/'S' ,�5� G�T SEWAGE#� "019� VILLAGE -0d7 ASSESSOR'S MAP.&P CE=/5�J INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) �/,L, C, (size)- NO.OF BEDROOMS /. OWNER PERMIT DATE: i3 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 ori7 site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist 300 feet of leaching facility) Feet FURNISHED BY � o _ 5/ �� J L I ..L: , No. ` / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es 01pplication for Mi.5pooal �bpgtem Congtruction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address o Lot No C ner's Name,Address,and Tel.N �Assessor's Map�am!l' < Installer's Na ddress,and Tel.N n ame, s el. Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �) Design Flow(min.required)���L/ gpd Design flow provided -/7�,%-% a)3 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 0 —;,e-Z06U Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ,r Date last inspected, Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He,3hh. �— Signed ri , Date Application Approved by Date ,l Application Disapproved by: Date for the following reasons Permit No. �� U3 a l Date Issued Fee +.�~ MONWEAUTH OF MASSACHUSETTS Entered in computer: THEC OM PUBLIC HEALTH DIVISION - TOWN OF BARNSSTABLE, MASSACHUSETTS es 0[ppYication for 3kgpoaf bp9tern Cowaruction Permit ' " Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. �Wner's Name,Address,and Tel. N _ / � ;56-i /gy 111 Assessor's Ma /�mGl . Installer's Names ddress and Tel No.�� � ����� D inner lame, ddG�s a&eI Lo.Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( I ) Cafeteria( ) �• Other Fixtures Design Flow(min. required) �y(/ gpd Design flow provided � Q3 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank f QQ() Type of S.A.S. 5 00 (:�;yP. Description of Soil a Nature of Repairs or Alterations(Answer when applicable) - I 4 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 He 'th. r Signed / Date Application Approved by Date _ _ 3 r Application Disapproved by: Date for the following reasons Penpit No. g 0 3 ( Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance s THIS IS TO CERTIFY,that the On-site-Sewage Disposal System Constructed ( ) Repaired (A' ) Upgraded Abandoned( )by / / at / l beb/n ccoon`s'trucctteed7inn accordance with the provisions of Title 5 and th isposal Egstem Co structio PetmitsNo. "r�J _�%�'► �/G ,�d1 d — Installer '/% Designer e #bedrooms - lApprove'd desigr}'flo t gEd f The issuance of this pe it s al not a construed as a guarantee that the system w un tt n s�esjgneDate „/' �Inspector No. �0( 3 � _. �. Fee THE COMMONWEALTH OF MASSACHUSETTS--7r= f 'Y PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Xigpo9;a1 *p5tem Construction 3permit Upgrade is hereby granted to Construct Repair ) Aband n ) System located at and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be years o e o �completed within three yeaf the date this pe L Date Approved by A5- �j Town of Barnstable °PTME' 1•� Regulatory Serviees Thomas F. Geiler, Director Public Health Division Thomas McKean,'Director 200 Main Street,Hyannis,M_4 02601 Office: 508-862-t644, Fax: 508-790-6304 Installer & Designer Certification Form 2 � p Date: �'t� I'3 Sewage Permit J Assessor's Map\Parcel �-t2- Designer: V"l Installer: —T-- 0 nS Address: P 0 —1,7 Address: Z �A� Onissued a permit to install a (date) -5-7 (installer) t/' 6 P1 /S septic system at & l L based on a design drawn by �WS (address)M nl'� dated (designer) tA n 4 1 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 thl= distribution box and/or septic tank. ' I certify that the septic system referenced above was installed with major changes (i.e. greater than I lateral relocation of the SAS or anv 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. OF MgSS9� . ! DAR N /�~ i M —' (Installer's Signature) N 114 SOI TAR��'� Designer's Signature) (:affix Designer's Stamp Here) PLEASE RETURN TO BARNST LE 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. Q: Health/Septic/Designer Certification Form 3-26-4.1doc Town of BA MStable. P# Department of Regulatory Services KA ' Public Health Division Date , q tee$ 200 Main Stree4 Hy#nnis MA 02601 3 Date Scheduled ' Time r*� Fee Pd. D i . k` Dis sentf e Suitability Assessmp Performed By: J ! Witnessed B 1 LOCATION fr GENERAL INFORMATION Location Address 31 g/y0G tU� � y Owner's Name ll�n� b Z y/ Ct�rv�iah�l IN N)S I Address Assessor's Map/P4rcel: �Z/1S;/pp I Engineer's Name M q t.jt.(-j 11 AC- NEW CONSIRU(�MN REPAIR Telephone# SvS 3&©— 3311 Land Use ',�e f OQ,)ZA1, Slopes(90) U ./ Surface Stones Distances from: Open Water Body 2-490 ft Possible Wet•I Area�ft Drinking Water Well l�S y ft i Drainage Way 6� ft" Property Line }�U ft Other ft ; I SKETCH:(Street name,dimensiods of lot,exact locations of test holes&perc tests,locate wetlands in proxitnity to holes) plw..., �t 7/2 [13 i ® t; o A I � W 00 ; i i i i 1 . . f►� Parent material(gedlogic) �/'�W�iS ' Depth to Bedrock a' 4--•--• Depth to Groundwater. Standing Water in Hole:' `` ' Weeping from Pit Pace Estimated Seasonali#igh Groundwater JA � i DtTERMINATION FOR SEASONAL HIGH WATER TA 3LE Method Used: I In, Depth dbperved standing in obs.hole: in. Depth to soil mottles: I in, troundwater Adjustment Depth tolweeping from side of obs.hole: Adj.{aaFOr,,._4 Adj.Groundwaterlevel.,,,,n, Index Well# _ Reading Date index Well levdl ...�. PERCOLATION TEST Date---- l'ne Observation 1 Time at 9" Hole# to Time at 6" .....---- Depth of Pere Time(9"-6',) Start Pre-soak Time.@ -- . L v End Pre-soak Rite MinJlnch Site Suitability Assessment Site Passed Site Failed: Additional Testing Needed(YIN) Original:.Public k:e$lth Division Observation Hole Data To Be Completed on Back ***If percolafii6n test is to be conducted within 100' of wetland,:you must notify the Barnstable C44servation DiNision at least one (1)wedk prior to begin g r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil ' Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel 04 �Zu 1/L te6 Sri 1*41 101 38t% L36rl G �s e �L•5`f& DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) of-12'' ill N and _[X�.Coo-­w Fi., DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Hori Soil Texture Soil Color 'Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel T7 DEEP OBS ATION HOLE LOG Hole# Depth from Soil Horizon So exture Soil Color $all Other Surface(in.) (USD (Munsell) Mottling (Structure,Stones.Boulders. Consisten ra I Flood Insurance Rate Map: , / Above 500 year flood boundary No— Yes y_— Within 500 year boundary No-V Yes. . Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least-four feet of naturally occurring pervious material exist.in all areas observed throughout the area proposed for the soil absorption system?. Xia If not,what is the depth of naturally occurring pe ious material? Certification I certify that on 1066 (date)I have passed the soil evaluator examination approved by the Department of Environ ental Protection and that the above analysis was performed by me consistent with the required twiRing,expertise and experience described in 3,10 CMR 15.017. Signature Date 7 1 Q:\SEPTICIPERCFORM.DOC Postal L (Domestic rti InformationFor delivery a Lrl cc Postage $ rp ti Off' Certified Fee O QjCstmark C3 Return Receipt Fee � O (Endorsement Required) Were Restricted Delivery Fee �2 b 0 (Endorsement Required) ,a '�H O Total Postage&Fees Is J r-9 _ r'U. / o ' David Holt , Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA' 02632 - Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for yourrmailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may 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 Fo m 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 COMPLETE THIS,SECTION. • • ON DELIVERY ■ Complete items 1,2,and 3.Also complete Signature item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. ece d y(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 ress different from item 1? ❑ s 1. Article Addressed to: If YES,enter delivery address below: ❑No "David Holt Today Real Estate 1533 Falmouth Road/Rte 28 3. Service Type ❑Certified Mail ❑Express Mail Centervs!!e, MA 02632 ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7012 MO 0000 2850 7756 (Transfer from service labeq PS Form 3811,February 2004 i i ;Domestic Return Receipt _ 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid i USPS I Permit No.G-10 • Sender:. Please print your name, address, and ZIP+4 in this box • __Town of Barnstable t - Public Health Division 200 Main Street " Hyannis, MA 02601 ;i1tllir}'flli'I�i��1'1;���il; l il' �SME Town of Barnstable Barnstable Regulatory Services Department U4MM10cft '"w^ r 1639 Public Health Division ( I �0 �EDN1�a 200 Main Street, Hyannis MA 02601 200� Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0000 2850 7756 April 13, 13 David Holt Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA 02601 • The septic system located at 398/400 Bearse's Way, Hyannis MA was last inspected on 10/29/2012 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • The system was in hydraulic failure. You are ordered to repair or replace the septic system within sixty (60) days 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 Thomas McKean, R.S. CHO os Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\398 Bears's Way Hy May 2013.docQ:\SEPTIC\Letters Septic Inspection Failures or Future Eval\398 Bears's Way Hy May 2013.doc r Town of Barnstable Barnstable • v/P�HE rah,O iyl �y��l Regulatory Services Department • DA LE,MASS. a Public Health Division � 1639 �e� 2007 rfD Via, 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7008 3230 0002 5178 2749 November 20, 2012 David Holt Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA 02601 • The septic system located at 398-400 Bearses Way, Hyannis, MA was last inspected on 10/29/2012 by Shawn Mcelroy, a certified septic inspector for the State of • Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: t • System is in hydraulic failure. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. O, Failure to repair/replace the septic system within the deadline period will result in future -- enforcement action. PER ORDER OF THE BOARD OF HEALTH a McKean, R.S.'CHO Agent of the Board of Health 2i Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\398400 Bearses Way,Hy nove2012.doc ' Postal CERTIFIED MAIL.��CEIPT (Domestic Mail Only;No,far-Lurance Coverage Provided) u1 For delivery Information visit our website at www.usps.conng O L co Postage $ru Sds Certified Fee O Postmark O Return Receipt Fee Here O (Endorsement Required) CIOl t� O Restricted Delivery Fee r OdY O (Endorsement Required) to .r rq �o O Total Postage&Fees 1$ b'w S�•`�� rR L ru o Kent O'Haven 41 Cleveland Way Buzzards Bay, MA 02532 Certified Mail Provides: ■ Amailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: fa. Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail& ■ Certified Mail is not available for any class of international mail. 0 ■ 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 3600,August 2006(Reverse)PSN 7530-02-000-9047 Town of Barnstable Barnstable AlAnMcaCity Regulatory Services Department anaxsrnsu. I I MASS,39. Public Health Division Zoos 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 250 7589 April 3,2013 Kent O'Haven 41 Cleveland Way Buzzards Way, MA 02532 We received your facsimile stating that you no longer own this property and that the bank now owns it. The septic system located at 398/400 Bearse's Way, Hyannis MA was last inspected on 10/29/2012 by Shawn Mcelroy, a certified septic inspector for the. State of Massachusetts. I The inspection of the septic system showed that the system "Failed" under the guidelines of 1995,TITLE 5 (310 CMR 15.00) due to the following: • The system was in hydraulic failure. However,.at that time the property was supposedly under contract with Today Realtors, 1533 Falmouth Road/Rte 28,Centerville, MA. The realty company was requested to repair or replace the septic system within sixty (60) days from'the date they received the i notification dated 11/20/2012. When we had not received any information as to the status of this order to repair; by March 14, 2013, we sent a notice to you after doing a search for the apparent new owner, (i.e. the Registry of Deeds, and the Assessing Division) and found You to be listed as the•. current owner since 2008. You mentioned that"the bank now owns this property", but not the name of the bank. According to the Registry of Deeds,you are the owner of this property; not the bank. QASEPTIOL.etters Septic Inspection Failures or Future Eval\398 Bears's Way Hy Mar 2013.doc Failure to repair/replace the septic system within the deadline given in the last letter dated: March 14, 2013 the deadline being May 14, 2013 may result in the future condemnation of the dwelling. If we can't get this situation resolved you will be ordered to appear before the Board of Health to explain your circumstances in this matter. PER ORDER OF THE BOARD OF HEALTH �Coma McKean, R.S. CHO Agent of the Board of Health Copies: Registry of Deeds Assessors Department and, Board of Health f j j QASEPTIC\Letters Septic Inspection Failures or Fuiure Evall398 Bears's Way Hy Mar 2013.doc I. https:H72.8.52.132/ALIS/WW400R.HTM?W9SN8=0%27Haven&W9GN8=&W9IXTP=A&W9ABR=*DD&W9TOWN=... BARNSTABLE LAND COURT REGISTRY DISTRICT JOHN F. MEADE, REGISTER Land Court List by Name Search name: 1,FO'HAVENJ ' Gtors/Gtees: All Parties Town: Barnstable Document types: Deed document group __ 4 Database searched: lLand`Record.Gtor/Gtee .N Indexov 01,2012 thru Mar 28;2013, This may not be a complete listing of all Land Court entries under the name you are searching. Not every document registered in"the Land Court since 1899 has been indexed in the computer. Documents 568,471 to the present have been fully indexed by grantor and grantee in the computer. Documents 384,866 to 568,470 have been indexed by grantor but not necessarily by grantee. Documents 1 through 384,865 may or may not have been indexed in the computer. Reference should be made to the actual certificate registered in the Land Court to verify all activity for a particular title. These listings are not covered by MGL c. 185 s. 46. t<Frevious, � ;Next Show Print Cart„_,: F;Cu�rLLOwner, r� r&;Votes' Liens_ _,Print Listing:' ;;Rec Land°t Rec Ind Plans_ Document Desc Town Full Name Certificate# Document Type Date Recvd Doc# Abs View Prt Add Sorry, no (more) matching names found <Previous,; Next 7.;Sho'�w_P�int Ca74-; _Curr,Owner,, �Tr&Votes _ Liens ,'Print Listing; Rec Land. -�Rec Lnd�lan-sr I HOW TO USE THIS PAGE To see the next page of available names, click on Next>. To see the previous panel displayed, click on <Previous. To view an abstract, click on the document icon with "ABS". To view an image, click on the document icon with "DOC". Please note that if the icon "DOC" is not shown, that means the document image is not.available. To refine your.search to a name that is displayed, click on the name hyperlink. 1S l i I 1 I , 1. https:H72.8.52.132/ALIS/WW400R.HTM?W9SN8=0%27Haven&W9GN8=&W9IXTP=A&W9ABR=*DD&... 3/28/2013 http://www.town.bamstable.ma.us/Assessing/propertydisplay 13.asp?streetno=398&streetname=bEARSE%27s&addressbut... Select Language Assessing Division Property Lookup 2013 367 Main Street,Hyannis,MA.02601 Select A Search Method Street Address ' Map/Block/Lot ' i Street# Enter full or partial street address. Owner Last Name I 398 bEARSE's I _",Search Street Address 11 Reset I � , Parcel# I Address Owner �292159— 398—B EARS E'S WAY`-0 HAVE N,'KENT Detail—' Mapes 292160 402 BEARSE'S WAY BOURGEOIS, RONALD Details Map 292075 405 BEARSE'S WAY HUFNAGEL,MARK F&BARBARA J Details Map 292162 i 406 BEARSE'S WAY PAIGE,CARL S&SHIRLEY L TRS Details Map t 292031 410 BEARSE'S WAY LUCIEN, NANCY Details Map 292030 j 416 BEARSE'S WAY VROTSOS,ANDREW&JEAN A Details Map 292076 419 BEARSE'S WAY TARANTINO,CRAIG S Details Map ' 292191 431 BEARSE'S WAY GENNARO, EMMA L TR Details Map 292007 436 BEARSE'S WAY LEVIN, BENAMIN E TR Details Map 1 + 292006 I 460 BEARSE'S WAY BEARSES WAY, LLC Details Map 292077 489 BEARSE'S WAY OLDE NORTHEAST REALTY LP Details Map 1 292303 ? 489 BEARSE'S WAY CHRISTYS REALTY LP Details Map ' 1 293009 516 BEARSE'S WAY 516 BEARSES WAY LLC Details Map t 293008 I 528 BEARSE'S WAY BALISE CAPE COD PROPERTIES, LLC Details Map 293007 548 BEARSE'S WAY DERUYTER, PAUL A S TR Details Map 293047 574 BEARSE'S WAY BALISE CAPE COD PROPERTIES, LLC Details Map 293046 j 594 BEARSE'S WAY THIRTEEN SAC SELF-STORAGE CORP Details Map 293003 700 BEARSE'S WAY REARDON, BRYAN W TR Details Map 293002001 ; 720 BEARSE'S WAY WOOD,GILBERT C TR Details Map 293002 ! 730 BEARSE'S WAY WOOD,GILBERT C TR Details Map 294060 740 BEARSE'S WAY WOOD, GILBERT C Details Map f 294044 I 756 BEARSE'S WAY RUSSELL, FRANCIS R TR Details Map !• 29406100A 800 BEARSE'S WAY SLEDJESKI,JEANNE MARIE Details Map i29406100E 800 BEARSE'S WAY MORIN,JAMES M&MARY E Details Map 29406100C 800 BEARSE'S WAY BATEMAN, ROBERT&SUSAN& Details Map 29406100D " 800 BEARSE'S WAY MORIN,JAMES M&MARY E Details Map 29406100E 800 BEARSE'S WAY TULLIS,ANDREW Details Map 2940610OF 800 BEARSE'S WAY WELLS FARGO BANK, NA Details Map 2940610OG 800 BEARSE'S WAY WHITE. SUSAN D Details Map http://www.town.bamstable.ma.us/Assessing/propertydisplay 13.asp?streetno=398&streetname=bEARSE%27s... 3/28/2013 i Loop Up Print http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292159 • Owner Information -Map/Block/Lot: 292/ 159/-Use Code: 1040 Owner Map/Block/Lot GIS MAP►! 292/ 159/ JOHAVEN,KENT/ Property Address Owner Name as of 1/1/12 41 CLEVELAND WAY ! /3 98 BEARSE'S WAYS �BUZZARDS_BAY, MA.-02532 Co-Owner Name Village: Hyannis Town Sewer At Address: No GIS Zoning Value: RB . Assessed Values 2013 -Map/Block/Lot: 292 / 159/-Use Code: 1040 2013 Appraised Value 2013 Assessed Value Past Comparisons Building $ 97,600 $ 97,600 Year Total Assessed Value: Value Extra $ 1,700 $ 1,700 2012 - $ 162,800 Features: 2011 - $ 161,200 Outbuildings: $ 0 $ 0 2010 - $ 195,300 Land Value: $ 63,600 $ 63,600 2009 - $ 232,400 2008 - $ 230,500 2013. Totals $ 162,900 $ 162,900 2007 - $ 230,500 . Tax Information 2013 -Map/Block/Lot: 292 / 159/-Use Code: 1040 Taxes Hyannis FD Tax (Residential) $ 325.80 Community Preservation Act $42.81 Tax Town Tax(Residential) $ 1,427 $ Fiscal Year 2013 TAX RATES HERE 1,795.61 . Sales History- Map/Block/Lot: 292/ 159/-Use Code: 1040 History: Owner: Sale Date Book/Page: Sale Price: OHAVEN, KENT 5/16/2008 C185964 $220000 JANEDY, JOHN &CONSTANCE 10/9/2003 C170852 $215000 FENUCCIO, RICHARD P JR& 8/15/1988 C115016 $105000 OREILLY, DANIEL M TR 10/15/1985 C103688 $2400000 JONES, ELIZABETH C 10/12/1973 C60213 $0 . Photos 292/ 159/-Use Code: 1040 http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292159 3/28/2013 Loop Up Print http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292159 . Sketches- Map/Block/Lot: 292/ 159/-Use Code: 1040 ' 1 .4A ❑ � 1 As Built Cards:Click card#to view: Card #1 . Constructions Details- Map/Block/Lot: 292/ 159/-Use Code: 1040 Building Details Land Building value $ 97,600 Bedrooms 4 Bedrooms USE CODE 1041 Replacement Cost $123,552 Bathrooms 2 Full Lot Size (Acres) 0.18 Model Residential Total Rooms 8 Rooms Appraised Value $ 63: Style r Duplex Heat Fuel Gas Assessed Value $ 63 Grade Average Heat Type Hot Air Year Built 1945 AC Type None Effective depreciation 21 Interior Floors Carpet Stories 1 Story Interior Walls Drywall Living Area sq/ft 1,440 Exterior Walls Vinyl Siding Gross Area sq/ft 1,476 Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp F . Outbuildings & Extra Features-Map/Block/Lot: 292/ 159/-Use Code: 1040 Code Description Units/SQ ft Appraised Value Assessed Value Open Porch-roof- http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292159 3/28/2013 Loop Up Print http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292159 FOP, ceiling 36 $ 1,700 $ 1,700 . Sketch Legend 1 Property Sketch Legend 132N a Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor, Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished) FUS Second Story Living Area(Finished) TQS Three Quarters Story(Finish( BRN Barn GAR Garage UAT Attic Area(Unfinished) , CAN ; Canopy GAZ Gazebo UHS Half Story(Unfinished) CLP Loading Platform GRN Greenhouse UST Utility Area(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UTQ Three Quarters Story(Unfinis FCP ; Carport KEN Kennel UUA Unfinished Utility Attic FEP tI Enclosed Porch MZ1 Mezzanine, Unfinished UUS Full Upper 2nd Story(Unfinisl FHS Half Story(Finished) PRG Pergola WDK Wood Deck FOP Open or Screened in Porch PTO Patio 1 4 f I I t , I • 4 f , i I I I 4 1 � 1 f{ 4 11 r I t i !( 1 i I http://www.town.bamstable.ma.us/Assessing/printl3.asp?ap=0&searchparcel=292159 3/28/2013 Town of Barnstable Barnstable Regulatory Services Department r Public Health Division I �iOlFp 9. p�m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-190-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7012 1010 0000 2850 7589 April 1„ 2013 Mr. Kent O'Haven 41 Cleveland Way Buzzards Way, MA 02532 ERA=0=00 P `TYAzT-.&E-NIM R.ONNIE `TAL CODE, � 1 v The septic system located at 398/400 Bearse's Way, Hyannis, MA was last inspected on 1/29/2012, by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. 'inspection of the septic system showed that the system "Failed" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • �Thestem was in hydraulic failure. y v At that time the property was suppose y uri er contract with Today Realtors,,,�����`� 1533 Falmouth Road/Rte 28,Centerville, MA. The realty company was-e� ;O� repair or replace the septic system within sixty (60) days from the date they received the notification dated 11/20/201 When we had not received any infor tion as to the status of this order to repair; by March 14 2013, we sent a notic to you after doing a search for the apparent, new,owner,Le. Registry-of Deeds Assessing Division - and found yo to be listed as the current owner since 2008. U - You men ne. a ank,Abut not the name of the banl-0 e e C:\Documents and Settings\flynnj\Desktop\Town of Bamstable.doc mis Tfs an ing as gr�e�-is b�g�ted? A`,ail ru to repair/replace the septic system within the last letter dated: March , 4 '20.13 the deadline being May 14, 2013. If we can't get this situation resolved you will be ordered to appear before e Board of Health to explain your circumstances in this matter. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health i Copys: Registry of Deeds Assessors Department and, Board of Health { i i I fi I E f CADocuments and Settings\f1ynnj\Desktop\Town of Bamstable.doc Town of Barnstable Barnst�b'l Regulatory Services Department " �MAM� Public Health Division 2007 200'Main Street, Hyannis MA 02601 Office: 508-8624644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010'0000 2843 2270 March 14, 2013 Kent O'Haven . 41 Cleveland Way Buzzards Way, MA 02532 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 398/400 Bearse's Way, Hyannis MA was last inspected on 10/29/2012 by Shawn Mcelroy; a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to-the following: ': • System is in hydraulic failure. You are ordered to repair/replace the septic system within sixty (60) days 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 T o c CHO Agent of the Board of Health QASEPTIC\Letters Septic Inspection Failures or Future Evall398 Bears's Way Hy Mar 2013.doc s: ( Otero iM►la s TAF, Orl ' W(o rJ i A LLSO }� A -L4r L . tVA ci 1 uarwasuon ssew■e 1.4,'o 0 i.n7 use 77 i � . . Town of Barnstable �rnslable g g Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA 02601 zoos Office: 508-862-4644 Thom�e F.Geilor,�J(rectot FAX 508-790.6304 Thomas A.McKean,CHO CERTIFIED MAIL 0 7012 1010 0000 2843 2270 March 14120.13 Kent O'Haven 41'Cleveland Way Buzzards Way,MA 02532 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 391V400 Bearse's way,Hya�nis MA was last inspected on • 10/25/2012 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails"under the guidelines Of 1995'ITFLE 5 (310 UMR 15.00)due to the following; • System is in hydranBc failure. . You are.ordered to repairheplace the septic system within sixty(60) days 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 c CH0 Agent of the Hoard of Health . Q:ISEPT[C1Lettda Septic inspection Felturrd or Puauo Svafl398 Barrs's Way Hy Mar 2013,doc Z .abed £t:£-o6cLaot uor4zr%4ruon rEew65 LVQ £Ln7 'uer 77 f �Imr Town of Barnstable Bares Regulatory Services Department 'ca "AMSTABM ^ r Public Health Division Eo►P 151 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO I CERTIFIED MAIL# 7012 1010 0000 2843 2270 ' I March 14,2013 Kent O'Haven 41 Cleveland Way Buzzards Way, MA 02532 ORDER TO COMPLY WITH'STATE ENVIRONMENTAL CODE. TITLE 5 • The septic system located at 398/400 Bearse's Way, Hyannis MA was last inspected on 10/29/2012 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995. TITLE 5 (310 CMR 15.00) due to the following: I • System is in hydraulic failure. You are ordered to repair/replace the septic system within sixty (00) days from the date r 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 T o c CHO Agent!of the Board of Health • i QASEPTIC\L.etters Septic Inspection Failures or Future Eval\398 Bears's Way Hy Mar 2013.doc w ,l r Sot- -r9d 04- O � �iaro pwie S' 1v►a- tC�.^�y . Fro.,`, 1414 V W(a.tf o -�+ Q-•r� � ..[.•-. C., n S� ova � tj 00 o pa prn, p',_f a6ad EED694809 uor}mn vuo> **awes oes E w-a Uer ZZ { Town of Barnstable Barnstable' t Regulatory Services Department Public Health Division I I' 200 Maid stet,Hyallnis MA 02601 2007 Office: 508-8624644 Thamsa F.Geilbr.Dirmor FAX 509-790.6304 Thomee A.McKean,CHO CERTIFIED MAIL 0 7012 1010 0000 2843 2270 March 14, 2013 _. Kent O'Haven 41 Cleveland Way ' Buzzards Way,MA 02532 f ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE.TITLE 5 1 The septic system located at 391V400 Bearse's Way,Hyalllnis MA was last inspected on 10/29/2012 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts, E The inspection of the pe septic system shower that the system "Fails"under the guidelines of 1995'1TTLE 5 (310 UMR 15.00)due to the following; I • System is in hydraulic failure. You are ordered to repairh+eplace the septic system within sixty(60)days 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 ' f c CHO Agent of the Board of Health . Q;ISEPTICIetten Septic hmpw ion Fallum or Fugue HYa11398 Bain's Way My Mar 2013.doe Z s6ad EED69L809 UQPr1}ru0D ffaWoS l,ve E60Z uer ZZ /-;71.,l,, RECEIVED 33 J TROY WILLIAMS AUG,, 1 12003 — L SEPTIC INSPECTIONS TOWN OF BARNSTABLE Certified by MA Department of Environmental Protection 1 _ (508) 385-1300 19 Hummel Drive South Dennis, MA 02660 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: '398400 Bearses Way Hyannis,MA Owner's Name: Rick Fenuccio Owner's Address: 30 Morgan Way Barnstable,MA 02668 Date of Inspection: August 6,2003 Q Name of Inspector: Troy M.Williams O Company Name: . Troy Williams Septic Inspections Mailing Address: 19 Hummel Drive South Dennis,MA 02660 Telephone Number: (508)385-1300 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP appro-s•ed system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system- ✓ Passes Conditional]%- Passes Needs Further Evaluation by the Local Approving Authority /Fails Inspector's Signature: Date: S The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of I lealth or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments Although system meets the minimum requirements set forth by the Massachusetts Department of Environmental Protection,certification is not to be construed as a guarantee of future working condition of system,piping or components. This Inspection represents the conditions of the system on the Date of Inspection noted above. ""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. Title 5 Inspection Form 6/15/2000 pace 1 of 11 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 398400 Bearses Way Owner: Hyannis,MA Date of inspection: Rick Fenuccio August 6,2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 Chi 13.303 or in 310 CMK 15.304 exist. Any failure criteria,not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Boar of i iealth,will pass. Answer yes, no or not determined(Y,N,ND)in the for the following statement . If"not determined"please explain. -- The septic tank is metal and over 20 years old" or the septic tank( ether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is ' minent. System will pass inspection if the existing tank.is replaced with a complying septic tank as approved b e Board of Health: •A metal septic tank will pass inspection if it is structurally soun ,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled uneven distribution box.System will pass inspection if(with approval of Board of Health): b en pipe(s)are replaced bstruction is removed distribution box is leveled or replaced ND explain: The syste equired pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspectio (with approval of the Board of Health): broken pipe(s)are replaced 'obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 398400 Bearses Way Owner: Hyannis,MA Date of Inspection: Rick Fenuccio August 6,2003 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health ut order to detenmine if the system is failing to protect public health. safety or the environment. I. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1A 5.303(1 )that the System is not functioning in a manner which will protect public health,safety and the r ironment: — 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 rsh 2. System will fail unless the Board of Health(and Public Wale upplier,if any)determines that the system is functioning in a manner that protects (lie public h'ea ,safety and environment: The system has a septic tank and soil absorption sy em (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water s ply. The system has a septic tank and SAS an . he SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and S and the SAS is within 50 feet of a private water supply well. The system has aseptic an- nd SAS and the SAS is less than 100 feet but 50 feet or more frortl a private water supply well•*. thod used to determine distance "This system passes if a well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile gamic compounds indicates that the well is free from pollution from that facility and the presence of onia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteri a triggered.A copy of the analysis must be attached to this form. 3. Other: 3 i Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 398-400 Bearses Way Hyannis,MA Owner: Rick Fenuccio Date of Inspection: August 6,2003 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow ✓ Required pumping more than 4 times in the last year .QT 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. _ io% Any portion of cesspool or privy is within.100 feet of a surface water supply or tributary to a surface water supply. _ �L/.s Any portion of a cesspool or privy is within a Zone I of a public well. 6Lb Any portion of a cesspool or privy is within 50 feet of a private water supply well. . &L-i 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 %Vater quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the resence of ammonia nitrogen and nitrate nitrogen is equal to or less than S ppm,provided1hat no other failure criteria are triggered. A copy of the analysis must be attached to this form.] NO (Yes/N6)The system fail. 1 have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303. therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a desi flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteri ove) yes no _ the system is within 400 feet of a surface drinkin ater supply the system is within 200 feet of a tributary a surface drinking water supply the system is located in a nitrogen sitive area(Interim Wellhead Protection Area—1 WPA)or a mapped Zone 11 of a public water suppl ell If you have answered"yes"to any estion in Section E the system is considered a significant threat,or answered "yes"in Section D above the l e system has failed.The owner or operator of any large system considered a significant threat under Sec' n E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system o.- should contact the appropriate regional office of the Department. 4 Page 5 of I I. OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 398-400 Bearses Way Owner: Hyannis,MA Date of inspection: Rick Fenuccio August 6,2003 Check if the following have been done. You must indicate"yes"or"no"as to each of the followine Yes No __ l".:;aping information was provided by the owner. occupant.or Board of I Iealtl, _.._ _✓ 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? ✓ tiave large volumes of water been introduced to the system recently or as part of this inspection? ni/q 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 nk inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of s udge and depth of scum? _✓ __ Was the facility owner(and occupants if different frbnt owner)provided with information on the proper maintenance of subsurface sewage disposal systems ? The size and location of the Soil Absorption System(SAS)on.the site has been determined based on: Yes no ✓ _ 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)13 10 CMR 15.302(3)(b)) 5 Page 6 of l 1 OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 398400 Bearses Way Owner: Hyannis,MA Date of inspection:Rick Fenuccio RESIDENTIAL August6,2003 FLOW CONDITIONS Number of bedrooms(design): 'W Number of bedrooms(actual): Y f.Z+2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x k of bedrooms): yti u Number of current residents: e Does residence have a garbage grinder(yes or no): No Is laundn on a 'Parate sewage system(yes or not No (if yes separate inspection required) Laundry system inspected(yes or no):A1,9 Seasonal use:(yes or no): No Water meter readings,if available(last 2 years)usage(gpd)): d L -o 3 2- -c %S�Hsu Sump pump(yes or no): Aio Last date of occupancy: <d COMMERCIAWINDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gl,d Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): _ Non-sanitary waste discharged to the Title 5 systei 1 es or no): _ Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL.INFORMATION Pumping Records Source of information: Wass stem pumped as an of the inspection Y P P P ,p (yes or no): �9 If yes, volume pumped: gallons-- How was quantity pumped determined? Reason for pumping: - TYPE OF SYSTEM ✓Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool —Privy Shared system(yes or noj.(if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval Other(describe):. Approximate age of all components. date installed(if known)and source of information: 7 t Z 9 Fl a cr -LTG H Were sewage odors detected when arriving at the site(yes or no): Are 4 6 Page 7 of I I OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 398-400 Bearses Way Owner: Hyannis,MA Date of Inspection: Rick Fenuccio August 6,2003 BUILDING SEWER(locate on site plan) Depth belu%k grade: /$ ''t Materials of construction: _cast iron __3,/40 PVC_ other(explain): Dktance fron, private water supply well or suction line: At/ 4 Comments(on condition of joints,venting,evidence of leakage,etc.): ro SEPTIC TANK: Z(Iocate on site plan) Depth below grade: /a " Material of construction: ✓concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age: _ Is age confirmed by a Certificate of Compliance(yes or no): —(attach a copy of certificate) Dimensions: S 'k ion' x / Sludge depth y'- _ _ Distance from top of sludge to bottom of outlet tee or baffle: -2 '8" Scum thickness: -n-.., (�7 Distance from top of scum to top of outlet tee or bafllc: 6 Distance from bottom of scum to bottom of outlet tee or baffle: /'/ How were dimensions determined: 6i 6. Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural inteerity, liquid levels as related to outlet invert,evidence of leakage,etc.): l ✓ C__'L ti, I, F cti4.�A p l 4-f hJ..a✓.h_..a..3. GwJ`.w. /Vu_�.V��t1...c1.o� to .� o✓ c��.y.� ti y�l �.J , p c-4- GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete_>tc.): rglass_polyethy a_other (explain):Dimensions:Scum thickness: Distance from top of scum to top of outletDistance from bottom of scum to bottom e: Date of last pumping: Comments(on pumping recommendationtlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leak 7 Page 8 of I I OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 398400 Bearses Way Owner: Hyannis,MA Date of Inspection: Rick Fenuccio August 6,2003 TIGHT or HOLDING TANK: (tank must be pumped at time of in ection)(locate on site plan) Depth below grade: Material of construction: concrete metal__fibergi _polyethylene other(explain): Dimensions: Capacity: gallons Design Flo%%: gallons/day Alarm present(yes or no): Alarm level:__ Alarm in workin der(yes or no): Date of last pumping: Comments(condition of alarm an oat switches, etc.): 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.):f/�11(]+L 1 4 r . l✓O V tom-- I ►.C ca r d,a.� 1..� ' h A J o r.�' Y'/ � -Y'1� �o T 1-. �� }' S PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): ' Alarms in working order(yes or no): Comments(note condition of pump chamber,condition pumps and appurtenances,etc.): 8 Page 9 of l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 398400 Bearses Way Owner: Hyannis,MA Date of Inspection: Rick Fenuccio August 6,2003 SOIL ABSORPTION SYSTEM (SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why. Type leaching pits. number: leaching chambers, number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): 7�-•�:. ,-� .ter�"9 (a/con f [h '15.��:+-S>` utv� � ,J. q.�' �.� T CESSPOOLS: (cesspool must be pumped as part of inspection ocate on site plan) Number and configuration:__ _ Depth-top of liquid to inlet invert: Depth of solids layer: — Depth of scum layer:_ Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no . Comments(note condition of soil,signs hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: ---------__ Depth of solids: Comments(note condition of soil,signs of hydraul' allure, level of ponding,condition of vegetation,etc.): 9 Page 10 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 398-400 Bearses Way Hyannis,MA Owner: Rick Fenuccio Date of Inspection: August 6,2003 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference IancLnarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. . I I A z3 S' A 5r y` � O 1St,o j�lt•� 30 1 OP�+ � l i' 01 0 •. O ,l 2 i . 10 ` Page I I of'I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 398400 Bearses Way Owner: Hyannis,MA Date of Inspection: Rick Fenuccio August 6,2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water - -- Adjusted high ground water elevation /C-L Feet Please indicate(check)all methods used to determine the high ground eater elevatiow Obtained from system design plans on record- If checked,date of design plan reviewed: _Observed site(abutting property/observation hole within 150 feet of SAS) --- Checked with local Board of I lealth-explain:��? Checked'with local excavators, installers-(attach documentation) Accessed USGS database-explain: r ,, 2 30 2 2,7 You must describe how you established the high ground water elevation: __._.M ter.S .-L� /3c�r., 1..�+�.__(�. f�♦ �o 4. ci V , L apr+i. H Gwt_. — — — — This report has been prepared and the system inspected as of the date of inspection. This report is not a warranty or guarantee that the system will function properly In the future. There have been no warranties or guarantees,either expressed,written or Implied,relating to the system,the inspection and/or this report. - 11 TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date Owner Tenant Address ° Address Complance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities O 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 0 6. Heating Facilities Q 7. Lighting and Electrical Facilities PVINv ! , 1 8. Ventilation 9. Installation and Maintenance of Facilities i 10. Curtailment of Service IN� ' r o I V 11. Space and Use 12. Exits O 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing PART II 37. Placarding of Condemned Dwelling; �' �✓J` �� 61IJ �� Removal of Occupants; Demolition Person(s)Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here HOBBS&WARREN.INC. Postal CrCERTIFIED MAIL,. RECEIPT A (Domestic OFFICIALFor delivery information visit our website at www.usps.comg nj ri Postage $ Ln Certified Fee fU Postmark O Return Receipt Fee / Here O (Endorsement Required) C3 Restricted Delivery Fee �N! i 2JV O (Endorsement Required) \ rU Total Postage&Fees $ m 0 � David Holt '�- ' Today Real Estate 1533 Falmouth Road/Rte 28 i Centerville, MA 02601 I I Certified Mail Provides: A mailing re t -, It A unique identifier for your marpfeoe^^ +_ • 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 C9VERACC:IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. r For an additional fee,a Retum 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 USPSO 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°. + 0 If a postmark on the Certified Mail receipt is desired,please present the arti- i cleat 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 anPInquiry.~ PS.Form 3800,August 2006(Reverse)PSN 7530-02-000.9047 F 1 SENDER: COMPLET&THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sig item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address 9p,Ott a,-rgv�se y 5 rX r_ ❑Addressee so that we can return the cwto-' L•Y,l'.t -'- „4:,r,, B. Received b Print Name) C.IDate of Deli ery ■ Attach this card to the back of the mailpiece,,., �. or on the front if space permits. NOV )ar)1l r D.-Is delivery a different from item 1? ❑Yes 1. Article Addressed to: 1 [ If YES,enter d6llery address below: ❑ No fl tiw. ;ib David Holt Today Real Estate DIVIST101,4 . 4� 1533 Falmouth Road/Rte 28 3. Servicelype Centerville, MA 02601 f' ❑Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number i fj i j j i + c�l�; �7 0 0 8 3 2'3 O '0 0 0 211517 8 12 7 4 9 �72� (Transfer from service label) I' '{ 1000211517 ' PS Form 38131;February 2004 ; i Domestic ReturnReceipt io2sss-o2-nn-isao UNITED STATES POSTAL SERVICE "' ii$"tttaq Mail •:�.•r .`���:::�;�!.� � �•��.�':i�:`!� `laid j 4 Ys.. -MCy 0R "•'i'�.."'3 J '"'� gmmr • Sender: Please print your name,'address,s, an is bo .� r . ' Town of Barnstable j Public Healtlnivision, I 200 Main Streety.li',��;�1j Hyannis, MA 02601 I III II,LglilillI till&M111111Ii1II III-it I►_,IIIII111 IIIIII11111 I �1 h. R TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION Date if) Iq q 0 g Owner Tenant " RaILY Address Address I ° Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities / O EQ. , " 'Q 6. Heating Facilities PASCLOA 7. Lighting and Electrical Facilities 8. Ventilation AN 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural +. Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal t 16. Sewage Disposal 17. Temporary Housing PART II SMO /�0, 37. Placarding of Condemned Dwelling; /��`�" Removal of Occupants; Demolition e Person(s)Interview d Inspector lem-/M If Public Building such as Store or Hotel/Motel specify here HOODS$WARREN.INC. i V Town of Barnstable Barnstable INE 1p } ty Regulatory Services Department m"a� Public naRN'TrAB`e.J Health Division a c ��pA t679 `�0 2007 rfD Ja, 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7008 3230 0002 5178 2749 November 20, 2012 David Holt Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA 02601 The septic system located at 398-400 Bearses Way, Hyannis, MA was last inspected on 10/29/2012 by Shawn Mcelroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • System is in hydraulic failure. You are ordered to repair or replace the septic system within sixty (60) days 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 a McKean, R.S. CHO Agent of the Board of Health Z2i I I i i Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\398-400 Bearses Way,Hy nove2012.doc • Commonwealth of Massachusetts 7ew'1611 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection 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. o A. General Information c 1. Inspector: Shawn Mcelroy ' c Name of Inspector rJ Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 10-29-12 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•11/10 Title 5 Official Inspect Subsurface Sewage isposal S tem•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt c@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y,,N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available._ ❑ Y ❑ N ❑ ND (Explain below): i t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. ' 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt c@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is y required for every Hyannis MA 02601 10-29-12 I page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: j ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: I I D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ N. The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w, 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes"or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form h Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every yH annis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: Occupied Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No 10-2012 Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment:, Design flow(based on 310 CMR 15.203): gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No I Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1980's Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 16"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.): Good condition. Septic Tank(locate on site plan): Depth below grade: 10"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: 1500 Sludge depth: 12" t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts ` Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y( 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) . 201, Distance from top of sludge to bottom of outlet tee or baffle Scum thickness 4" 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 ? Tape 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.): Tank is in good condition with baffles installed and no sign of leakage. i Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form b u Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is H required for every y annis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 I Commonwealth of Massachusetts ` Title 5 Official Inspection Form "s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): Good condition with water at working level and stain lines above inlet invert. 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.): I Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit"F"was filled beyond capacity at inspection. Pit"G"was holding 12" of water at inspection with stain lines above inlet invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): I I i t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately O � r 3 5 D - 3k r 0 3R t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 20 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: i You must describe how you established the high ground water elevation: USGS and town maps show groundwater at greater than 20'. I Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 398-400 Bearses Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 10-29-12 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 MRVP # Assessor's office (1st Floor) Assessor's Map and Parcel # Building Department (4th Floo _ zoning INSPECT FEE $50.00 RE-INSPECTION FEE $15.00 Request For A Housing Inspection For Certification Under the MA Rental Voucher Program Your Name /Ql G#AAd (V 2 . F Affiliation (Circle One) Owner Real Estate Agent Tenant� �5 6 3 '7 r Your Address �[ Telephone Number (Day) .3 6 a - F 3 9-a (Night) Address of Property Wherg Inspection is Request d Unit/Apt.# 3 8 &e-Wt5e 5 4/-4 Name of Owner .SSE AddressZ� Mailing Address (if different) Telephone Number (Day) v �2�f (Night) Will there be any children under the age of six 6) who will be occupying the rental unit? (circle one) es No Was the dwelling constructed prior to 1979 es No ------------------------------------------------------------ FOR OFFICE USE ONLY: Certification The dwelling, dwelling unit, pr rooming unit located at was inspected on y ism Health Inspector for the Town of Barnstable and was found to be in compliance with the provisions contained within 105 CMR 410.00, State Sanitary Code II: Minimum Standards of Fitness for Human Habitation. However, this certification does not include a determination as to whether this unit contains any lead paint because under 760 CMR 49.02 Massachusetts Rental Voucher Program, a separate lead paint inspection must be conducted. Inspector's Signature=I< Date '' ��. •7k, i�+t,v�"-..:,t.y+r.�`..ry. .. ..t.M-, .''►.....�ti 1....+.is..�� ' .p...,..w_ +1.^-.�...}a�•t.-.+•.v. .,w��v,,.,)y,y.,,.c ..,n-„3"''.,/y^.,�,. ..t''. MRVP Assessor's Office (1st Floor) As-sessor's Map and Parcel # Building Department (4th Floo Zoning >>-7 ii � • INSPECT_ICNFEE $50.00 i - - RE-INS-PECTI'ON FEE $15.00 Request For A Housing Inspection For Certification Under the MA Rental Voucher Program 1 Your Name /Ql LN A/lt? rieAlVC61 D 72 Affiliation (Circle One) Owner Rea_ Estate Agent Tenant�1 3 U Al p2 t4v w4 - We s; /j,4,7N sT.A/ Your Address j Telephone Number (Day) 3 (Night) U Address 'of Property Wher Inspection is Requested �• Unit/Apt.# Name of Owner Address Mailing Address (if different) Telephone Nu er., (Day) S M—if (Night) Will there be any children under the age of - six (6) who will be occupying the rental unit? (circle one) es, No Was the/ we � '�ng constructed prior to 19797 es No ------------------------------------------------------------ FOR OFFICE USE ONLY: Certification The dwelling, dwelling unit, or rooming unit located at was inspected on y ra' Health Inspector for the Town of Barnstable and was found to be in compliance with the provisions contained within 105 CMR 410.00, State Sanitary Code II: Minimum Standards of Fitness for ;Human Habitation. However, this certification does not include a determination as to whether this unit contains any lead paint because under 760 CMR 49.02 Massachusetts Rental Voucher Program, a separate lead paint inspection must be conducted. Inspector's Signature Date TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION Date Owner �� ��� .— �'` L$Tenant Anzfff! -zz— _. Address a�(s AddressrZ^ f�713 Y Compliance Remarks or Regulation$ . Yes No Recommendations /L�..a Ott •/sr, S K� .p <9y,�f p Z-v g 2. Kitchen Facilities,=7,� � �� � 3. Bathroom Facilities V V L 4. Water Supply .. 5. Hot Water Facilities v' • 6. Heating Facilities ��� �. � �o �����•� `` �3=��-��� 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 21vw 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal �l�Z�/ZL� > 16. Sewage Disposal 17. Temporary Housing PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Person(s)Interviewed �' Inspecto a If Public Building such as Store or Hotel/Motel specify here HOBBS&WARREN.INC. T MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH f SUBMETERING OF WATER AND SEWER CERTIFICATION FORM I In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation (State Sanitary Code Chapter 1), the following dwelling unit is eligible for the imposition on the tenants of a change for water and/or sewer service. ! . PROPERTY INFORMATION I� Address: yUb ' "C's' L✓a" Unit# VO 0 #Of units in bldg. I City/Town: /r 4;a.a S MA Zio Code: 0 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becoming eligiblelfor the imposition on tenants of a charge for water and/or sewer.The devices must meet the following specifications: ± f Showerheads with maximum flow rate not to exceed 2 Y'gallons per minute(2.5 gpm) Faucets with maximum flow rate not to exceed 2 2110 gallons per minute(2.2 gpm) Ultra low flush water closets (toilets)not to exceed " 1 6110 gallons per flush(1.6 gpf) The submetering equipment used to measure the quantity of water,used for each dwellin ,unit and common area n lust meet the standards of accuracy and testing of the American Water Works Association or similar accredited associ ion. A licensed plumber must.install the water closets and submetering equipment. I Submetering equipment information: Sim cc a�✓/� i^ - %BSc,`S Manufacturer Model# Licensed Plumber Certification I Z_ /'3c> 1 1 L4 Print Name of Plumber s License# I Iiite' P14OV4E s-S -zg Z=7z L4 I certify that*I have installed the submete quipment listed above in accordance with accepted plumbing standards. I also certify that I have(check one): LThistalled one or more water clo is not exceeding 1.6 gallons per Bush, or ❑ determined that all existing w closets d o ceed 1.6 gallons per flush The required plumbing permit issued by the city/town is attached'. (! I Signed under the pains and-penalties of perjury, i Sikh ensed.Plumber I' Property Owner Certification 4 I certify that: (1)This dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer age in accordance with the water submetering law(MGL c. 186, §22); (2)All showerheads,faucets,and water closets In this dwelling unit are water-conservation devices that meet the standards specified above;.(3)The water submeter measuring. the use of water in the dwelling unit was installed by a licensed plumber and is in compliance with the standards 1 specified above.I will provide to the tenants of this dwelling unit,prior to occupancy, a.written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certificate form. I ce dyj that all information included on this certification is true and accurate to the best of my knowledge. Signed under the pains and penalties ofpediny, / Print Name of Owner Signature of Owner Date Received b Board of Health/Health Department l Y eP ame Date \�IDPH/CSP Submetering Certification Form 3105 ` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBIN(G� WORK CITY != . r1t�il�l�S MA DATE /z 3 cti i PERMIT# JOBSF E ADDRESS b v"6E JAF'-S E.-S OWNER'S NAME OWNER ADDRESS 7 9/ i kk 1, . 1U4, TEL SoU 36 c FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL D RESIDENTIAL( � PRINT CLEARLY NEW:[1 RENOVATION:[]' REPLACEMENT:�� PLANS SUBMITTED: YES 11 NOEr -FIXTURES 7. FLOOR- BSM 1 2 3 4 5 6 7 a s 10 11 12 131 14 BATHTUB G� a CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER ;L a I i DRINKING FOUNTAIN I 9; ��I '� �L_ FOOD DISPOSER F_ �—� FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK' �� �'�Z. ✓� I �r "' LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK _ F�i__ :I- i t � ttL TOILET I URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO El IF YOU CHECKED YES,PLEASE INDICATE THE COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY E BOND 0 OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts Genera-Laws,a� at my signature on this permit application waives this requirement. -� CHECK ONE ONLY: OWNER E] AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the deta0s and information I have submitted or entered regarding this application are t y the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in com ertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME L LC-L 2-eL- - ' LICENSE# Z oZ SIGNATURE MP® JP3_ CORPORATIONEj#=PARTNERSHIPE]# LLCD.# COMPANY NAME CO rLJM&rUG f ADDRESS P,0 l3ox AZ V8 r CITY �ST/Z)H'L6 STATE 7JP OZG Ll y TEL mpg -ZS?_ FAX CELL- !EMAIL L C�;s.v�.�r�egxcc �►oL,CC 5 The Commonwealth of Massachusetts Executive Office of.Health and Human Services Department of Public Health a � 'r Center for Environmental Health MITT ROMNEY Community Sanitation Program GOVERNOR 250 Washington Street, Boston, MA 02108-4619 KERRY HEALEY LIEUTENANT GOVERNOR RONALD PRESTON SECRETARY PAUL J.COTE,JR. COMMISSIONER MEMORANDUM TO: Massachusetts Local Boards of Health FROM: Paul Halfmann,Assistant Director Community Sanitation Program DATE: May 2,2005 RE: Submetering of Water Revisions to 105 CMR 410.000 On December 16, 2004, the Governor signed Chapter 417 of the Acts of 2004, entitled An Act Authorizing Water Submetering in Residential Tenancies(hereafter referred to as the "Act"). This Act became effective March 16, 2005. The Act, codified as M.G.L. c. 186, §22, authorizes landlords of residential property to separately charge tenants for actual water and sewer service costs provided that all of the comprehensive requirements of the Act are met. Among its many specific provisions,the Act: • Prohibits water submetering unless the dwelling unit is separately submetered or, for single-family rentals, the water usage is under the complete control of the tenant, to ensure that tenants are only charged for water actually used; • Requires"landlords to have licensed plumbers install any water submetering devices at the expense of the landlord; • Requires landlords to certify in writing to the local Board of Health that the dwelling unit is in compliance with the requirements of the Act prior to separately charging for water or sewer service and to have a written agreement with tenants; Requires water conservation devices on all showerheads, sinks and toilets, at the landlord's expense, prior to separately charging for water or sewer service; Page 1 of 2 • Permits water submetering only in new tenancies created after the effective date of the Act, except that water submetering is not permitted in public housing dwelling units; • Provides a process for tenants to report leaks, contest bills, and question the accuracy of water submeters and to only pay for water costs resulting from actual use; • Requires landlords to remain as the water company customer and to be responsible for payment of water supplied by the water company; • Prohibits landlords from shutting off water to a residential dwelling for non-payment of water or sewer costs but permits landlords to pursue all other legal remedies to collect bills, including deducting unpaid bills from security deposits; • Authorizes the Department of Public Health to promulgate such additional regulations to the state sanitary code as it determines to be necessary to implement this section. Enclosed you will find a copy of the revised regulations, 105 CMR 410.000, and the SUBMETERING OF WATER AND SEWER CERTIFICATION FORM. Any landlord planning to charge tenants for the use of water and sewer must use the certification form attached. The Community Sanitation Program is in the process of placing the certification form and revised regulations on our website, http://www.mass.gov/dph/dcs/dcs.htm. A copy of M.G.L. c. 186, §22 may be downloaded by visiting, http://www.mass.gov/legis/laws/mgl/l86-22.htm. I Page 2 of 2 -ASSESSOR'S MAP NO. PARCEL gCG- /O o"1( Gv LOCATION SEWAGE PERMIT NO. VILLAGE SX/-0-50 I N S T A LLER'S NAME & ADDRESS Aft � � ►� � fps (- .�rn7n C��s �- A S U I L D E R OR OWNER 2 i Fz 25 D TE PERMIT ISSUED DATE COMPLIANCE ISSUED 2�� 1 j I QSs(TtiS MAP_ NO: Y 'PARCEL NO.. ' r *w ` BOARD OF HEALTH No.... _ _ TOWN OF BARNSTABLF ......._....._....._. ., i THE COWL ONWEALTH OF SSAC; USETTS P.O. BOX 534 BOARD OF HEALTH• .�M,�.. HYANIVIS, MASS. 02601 ...............Town...............oF.................Barnstable..........------........:............... Appliration for Biopnsal orks Chum ur#ion rani# ti A Application is hereby made for a Permit to-Construct ( ) or Repair ( X) an Individual Sewage Disposal System at: Barnstable Road .. .Iiyannis .......................................................... ...--- __. ... --_.. ... ..... -•Location-Address - or No.•� Captian Quarters 398. +4.02 Barnta �e Road,. Hyannis 02601 ...................... ••------•• •--•...__..................____•••----..._•-•---•-•------ •-•--....__...........••---•--...•-----••••----........................................_... .. Owner * Add r ss High Tide Systems .. •••• :.... Installer Address d Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms-Du4-Tex..........................Expansior}.Attic ( ) Garbage Grinder ( ) Oa. Other—Type of Building .......u.. ............... No. of persons....................... Shower's•,( ) — Cafeteria ( ) d Other fixtures . ---------------- = W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. -i GG Septic Tank—Liquid capacity............gallons Length................ Width._-_.-.--__-._-. Diameter. ......."._ Depth................ „iy Disposal Trench—No. .................... Width.............._..... Total Length.................... Total leaching`area._......__._........sq. ft. � Seepage Pit No..................... Diameter.................... Depth below inlet_:......_......__... Total leachin area..................s Oft .1M P� P g q�,,. .•,. s Other Distribution box ( ) Dosing tank Percolation Test Results Performed by........................•...........................................•--_.. Date_'.....=•=t.......................... ; Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..--........_.-_....,--. fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water----._.................. �+ ---•---------•-----------------------•----••-•-------------•------------•---•---............-•_...._............................ .......... Descriptionof Soil Sa d..................................I....................................................................... ... . U .................... ---------------------------•-------•------•-•--••-•--- ........................ U. Nature of Repairs or Alterations—Answer when apppplicable.i n st a l lat i on o f._a__1_5O 0...ga�:l on._.se.pt i e tanks distribution box and 2-1000 �allon� stone___packed leach_.pits. •-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal em.in accordance with the provisions of TITIE 5 of the State Sanitary Code - e ndersigned further agr snot to ace the system in operation until a Certificate of Compliance has b i th o lth. 1j Sig .- ..... ....-•--- ........ .......... .............. Y e 5/ Dates 6 y Application Approved ... ----•--------------------- Date Application Disapproved for the following reasons-........................................................................................................... ...............................................................�-•--•--...--••---.._.._............•---•----•----.......................................--/-•---•-•--....---...Date ..... PermitNo.................... ...�............. .... Issued....................................................... Date No... FEz.................-...... ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............To ...............OF..................Barns.t.a'.b.l.e....................................... Appliration for Disposal Work,64onotrudion Frrmit Application is hereby.made for a Permit to Construct or Repair ( X) an Individual Sewage Disposal System at: J,9 Barnstable Hyannis lia Road .............................................. ................................................................................................. Captian Location-Address 98 +402 Bairnsfil;%l74-Road, Hyannis 02601 ......................%!"Rq.................................................... . ...3.............................................................. Owner High Tide Systems Great Western Road So. Dennis, 02660 Instal I er Address U .�Il Type of Building Size Lot............................Sq. feet 4 Dwelling—No. of Bedrooms ................Expansior4Attic Garbage Grinder Other—Type of Building ............................ No. of persons............................ Showers Cafeteria aOther fixtures ...................................................................................... < "-*...­*.............*-------- W. Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid'capacity............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. f t. Z Other Distribution box ( ) Dosing tank ( ) 0.4 1­4 Percolation Test Results Performed by.......................................................................... Date......................................... 04 Test Pit No. I................minutes per inch Depth of Test Pit...._............... Depth to ground water........................ rzq Test Pit No. 2................minutes per inch Depth of Test Pit................__.. Depth to ground water........................ M ............................................................................................................................................................. 0 Description. of Soil............Sand.................................................................................................................................................. W ........... 11 U ......................................................................................................................................................................................................... ........................................................................................................................................................................................................ U Nature of Repairs or Alterations—Answer when applicable_.Ap��tallatlon of a 1500 Rq��lon. septic .........i........................................... .................... tank, distribution box and 2-100D gallont.. s ................................................................................................................ .......qp�...hacked leach pits. ............................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of T I T LE 5 of the State Sanitary Code-- .The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. -Signed.......... ...................................................... 8 6 ----------------------------- Application Approved B'___ y:! --------- . ...................................................... . .............................. I Date Application Disapproved for the following reasons:..........................................................................................................--- .................... ............**---------*..............*........*........ ---------------------------- - -------*-----------------*-------------------------------- - Permit No...........8.....6......A.h.............................. Issued................./0- --6 Date---------Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ..........................................OF.......:............................................................................. Tertifiratr of Toutpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or R ed X) epair by...... ......Gre.a.t...We stern._Road___..S.outh...D.e.nn.1 s....MA......0.2.6.60.............. ....... ............ .................. South................. ...... ........... 7 . ... . ... . .. Install'at.....39t_402...Barnstable Road,...9YanniS­1...MA......0..260..1 ....-..Ca.pti.an...Quart..ers ........... . has been installAd in accordance with the provisions of TI R. - 5 o Th�;tate Sanitary Code as,d i W &2. .......... X9 application for Disposal Works Construction Permit'No.............................. dated.d................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE -SYSTEM WILL FUINCTION SATISFACTORY. DATE... ----------------------------------------------------------- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 86- / ......................T.own ....OF...........Barnstble ('a,a, ................ .........;................................................................ No................ . FEz........................ Disposal Works Tonstnirtion .prrmit Permission is hereby granted....... ....�Y.stems . ............................................................................... ...... ..... to Construct or Repair an Individual Sewage Disposal System at No..r..9............�.Q 2...Ba.r.n.stabl.e...Roa.d_.,.-..gy��nni S.,....KA ....... ........................ ........ .. . ...... ...... ....:n...Qgptain Quarters ..... Street B�6 0 61 �; a ff as shown on the appliEc:ition forDisposal Works Construction Permit No.. D . .....5 ......1.86............. 2—, 1<i? AVWW.�-- ................................................................... ------- Board of Health DATE.----:.. .........eG.�l.......................... FORM 1255 A. M. SULKIN. INC., BOSTON i- 1l �yy���ua�• �ht i! f Y •yN I +i _ • P , L ` Z ' a n p. • • r iN:... , f�••R...'^`�.`+. `r _. �. iN:'� Q+I�. 'L4.Lni�-• w.", �_ ,;y d.��a ti" t• M1 ,,.,�� i 6 M1 •— re w. r' �. Ur •�1 t i ipJY)r _• a.�a j2 �y .+r � or• , � ti� ��.y�r. . ,i .�, it - !*� _,__� •4 t ._.. - �.,^ IS.A'"���1�1+a�'.�`, r � ��7V� TOWN.OF BARNSTABLE j C)CATION 398 & 400 Bearses Way . SEWAGE # VILLAGE Hyannis AS MAP & LOT �l`02 " OS-3 INSPECTED BY : GAME & PHONE NO.JCgM P. DIAC01`M & SON INC. 775-3338 SEPTIC TANK CAPACITY 1-1000 gallon LEACHING FACILITY:(type)2-1 e a h i n g pits (size)10 0 0 each NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER !�!1■AR OWNER Richardi Eenuccio Jr . INSPECTED DATE 7/.29/P8 i DATE COMPLIANCE ISSUED: YUO w<_-11 —VARIANCE GRANTED: Yes No �:,� i` I '�r j � ��. ' � �� �� . > �� � � j� �� � I ,,a, 4. - � �\ :�, . _ �� ADD ` �. -, HYANNIS LEGEND ' T13M = EL. 51 .7 CONCRETE 5TOOP PROPOSED CONTOUR ROTE 28 PROPOSED SPOT GRADE EXISTING CONTOUR \ + 96.52 EXISTING SPOT GRADE 6F , W— APPROX. WATER SERVICE +50.G 33 83 +50.8 TEST PIT LOCUS 398/400 BEARSE'S WAY \ pp 5 1 .2 TH-1 1 ' CO + TH-2/ 3� 1 LOCUS MAP G� 0 LOCUS INFORMATION TITLE REF: LCP185964 PARCEL ID: MAP 292 PAR. 159 T F� �� 1s +50.9 ? C� SEPTIC SYSTEM 2 S� +50.3 \. REPAIR PLAN �� LOCATED AT: '05 \ 398/400 BEARSE'S WAY lw HYANNIS, MA 0 49.3 PREPARED FOR 0 DEDECKO JULY 23, 2013 51 . 0 �d �.\* OF MgsJ' C! 1-12.5 D M Gr o� R No. 1 40 I MEYER & SONS, INC. N P.O. BOX 981 EAST SANDWICH, MA. 02537 (508)362-2922 SHEET 1 OF 2 h ELEV. TOP NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FOUNDATION INSTALL RISERS W/IN 6. OF FINISH GRADE FINISHED GRADE (49.50) (Existing) 52.20 F.G.EL: 51.0 F.G.EL: 51.0 F.G. EL: 50.0 •. � � � MAINTAIN 2% MIN SLOPE OVER LEACHING AREA t• BRING ALL COVETGWE 2" OF 3/8" DOUBLE WASHED 3/4" - 1-1/2" STONE OR FILTER FABRIC DOUBLE WASHED STONE :A17 4" SCH 40 PVC10• 14 ®®®® ®®®®TEE'S ARE TO BEEL= 95' 4" SCH 40 PVC IN E9 46r ®EL ARE TO BE 2 EFF. DEPTH ®®®®®®®®®®INV. CH 40 PVC a.:::QGAS EL.= 47.7INV. , .....a..• BAFFLE EL.= 47.37 INV. INV. 4 3 X 8.5 4 fir .. .. «•..... . . GAS BAFFLE EL.= 47.07 EL•= 46.90 ' EXIST. OUTLETS EXISTING 1,500 GALLON SEPTIC TANK EFFECTIVE LENGTH = 33.5' PROPOSED 1,000 GALLON SEPTIC TANK PROPOSED 08-3 H-10 DISTRIBUTION eox INV. ELEV.= 46.60 l BREAKOUT NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING OF ,(� �`� qs ELEV.= 47.60 PIPE INVERTS PRIOR TO CONSTRUCTION ��� fq TOP CONC. ELEV.= 47.60 2) 0-BOX SHALL BE SET LEVEL AND TRUE TO ?� �G • ---- GRADE ON A MECHANICALL COMPACTED SIX o R E M. INV. ELEV.= 46.60 �®® ®® INCH CRUSHED STONE BASE, AS SPECIFIED IN Y ®®®®®®® 310 CMR 15.221(2) \ v O' ow®®®®®®® 3) REPLACE EXISTING 1,500 GALLON SEPTIC TANK ®®®®®®E3 �Esisro BOTTOM EL.= 44.40 3.75' 5 FT. 3.75' WITH 1500 GALLON SEPTIC TANK IF FAILED, 2 DAMAGED, NOT H2O LOADING, OR UNDERSIZED. QNITMO ���7`' 4) INSTALL INLET & OUTLET TEES W/ SEPARATION 5.0 FT. EFFECTIVE WIDTH = 12.5' GAS BAFFLE AS REQUIRED SEPTIC SYSTEM PROFILE BOTTOM OF TESTHOLE EL: - 39.40 _ 5) SET 1,000G TANK ON 6" STONE BASE SOIL ABSORPTION SYSTEM (SECTION) . (500 GALLON (H 10) LEACH CHAMBER) GENERAL NOTES: SOIL LOGS P#:14050 DESIGN CRITERIA 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL NUMBER OF BEDROOMS: 4 BEDROOM DESIGN - MULTI FAMILY BOARD OF HEALTH AND THE DESIGN ENGINEER. SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: JULY 2, 2013 OF THE STATE ENVIRONMENTAL CODE. TITLE V. AND ANY APPLICABLE DESIGN PERCOLATION RATE: <2 MIN/IN LOCAL RULES AND REGULATIONS. SOIL EVALUATOR: DARREN MEYER, CSE 1614 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR WITNESS: DONNA MIORANDI, BARNSTABLE B.O.H. DAILY FLOW: 110 G.P.D. X 4 BR DESIGN FLOW: 440 G.P.O. = TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE GARBAGE GRINDER: NO (not designed for garbage grinder) DESIGN ENGINEER. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING Elev. SEPTIC TANK: 440 gpd x 2 = 880 gpd USE (2) TANKS (1,500/1,000) IN SERIES TP-1 Depth Elev. TP-2 Depth FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ENGINEER BEFORE CONSTRUCTION CONTINUES. 51.0 FILL 0" 50.9 FILL 0' LEACHING AREA REQUIRED: (440) = 594.59 S.F. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. � 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 50.0 A 12" 49.9 A 12" 74 )1 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF SANDY LOAM SANDY LOAM HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 49.50 1OYR 3/1 18" 49.4 10YR 3/1 18" USE THREE (3) 500 GALLON (H 10) PRECAST LEACH CHAMBERS W/ 4' 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. B B STONE ON SIDES & 3.75' STONE ON SIDES: 33.5' L x 12.5' W x 2'D 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED LOAD SAND LOAMYS 5/8 IOYR SANDTO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 47.84 38" 47.74 38'� BOTTOM AREA: 33.5 x 12.5= 418.75 SF 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE C C SIDE AREA: (33.5 + 12.5) X 2 X 2 = 184 SF THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. PERC O EL. 46.25 MEDIUM- MEDIUM_ TOTAL SQUARE FEET PROVIDED = 602.75 vs. 594.59 REQ'D 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. COARSE COARSE DESIGN FLOW PROVIDED: 0.74(602.75 S.F.) = 446.03 G.P.D. vs. 440 G.P.D. req'd 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION SAND SAND 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY 2.5Y 6/4 2.5Y 6/4 PROPOSED SEPTIC SYSTEM UPGRADE PLAN AND IS NOT TO BE CONSIDERED A PROPERTY UNE SURVEY 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. 39.50 '38" 39.40 '38" 3 9 8/400 B EAR S E'S WAY, H YAN N I S, MA 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. PERC RATE <2 MIN/IN. (-Cl-BSHORIZON) Prepared for: Dedecko 15. ALL PIPING TO BE 4" SCH 40 0 1/8-/FT (UNLESS SPECIFIED) NO GROUNDWATER OBSERVED Engineering b Surveying b SCALE DRAWN 16. PROPERTY IS NOT WITHIN A ZONE OF CONTRIBUTION TO TOWN SUPPLY WELL 9 9 y' yin 9 y' • I, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 MEYER&SONS,INC. AejJer & Assoc. N.T.S. DMM to conduct soil evaluations and that the above analysis has been performed b me consistent with the POSOX961 pe y (508) 375-0735 DATE CHECKED SHEET N0. requirements of 310 CMR 15.017. 1 further certify that I have EAST SANDWICH,MA 02537 q fy passed the Soil Eval. Exam in October, 1999. r 50&362-2922 07/23/13 DMM 2 of 2 I