HomeMy WebLinkAbout0035 BRIARWOOD AVENUE - Health (2) 35 BRIARWOOD AVENUE, HYANNIS
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TOWN OF BAR}N��STABLE
LOCATION �� �� _ V� SEWAGE#
VILLAGE OjAkW ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY 16C 4 .
LEACHING FACILITY: (type) f .�_. (size C_
NO.OF BEDROOMS
BUILDER OR OWNER PAOL
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PERMIT DATE: , t6 T COMPLIANCE DATE:
Separation Distance Between the: 1
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist (.� Feet
on site or within 200 feet of leaching facility)
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching fac'lit)+ _�`E_~L1' Feet
Furnished by W► (�(� I
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Commonwealth of Massachusetts 11-9b 9" 089
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
� < 35 Briarwood Ave.M
Property Address
Leonard Pudt& Harry Feitelson
Owner Owners Name
information is ✓ e
required for every Hyannis Ma 02601 4/15/2016
page. Cityrrown State Zip Code Date of Inspection E+
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When filling out forms A. General Information S'
#-
on the computer,
use only the tab 1. Inspector:
key to move your
cursor-do not Sean M. Jones
use the return Name of Inspector
key.
S.M.Jones Title V Septic Inspection
Company Name
74 Beldan Ln.
Centerville Ma 02632
City/Town State Zip Code
774-248-4850 smjonestitle5@gmail.com SI4522
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
4/15/2016
Inspectors 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
40�;d rS
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 5 35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is Hyannis Ma 02601 4/15/2016
required for every y i
page. Cityrrown 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:
The dwelling located at 35 Briarwood Ave Hyannis is served by a Title V septic system consisting of a
1500 gallon septic tank, distribution box and 2 leaching trenches. The system was found to be in
proper working condition at the time of inspection.
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):
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
�M 35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
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):
❑ brokenpipe(s) are re laced ❑ Y ❑ N ND(Explain below):
P ❑ ( P )
❑ 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-3113 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
35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
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:
❑ 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:
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
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
page. Citylrown 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. [Phis
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
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): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 gpd
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
,M 35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ® Yes ❑ No
Water meter readings, if available(last 2 years usage (gpd)):
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: seasonal use
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-3/13 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
GM
35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
page. Cityrrown 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:
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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
4�M ,•�''� 35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
_
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:
system installed 12/16/99 per town records
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 3.5
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.):
Joint were ok, no leaks, vented through the roof
Septic Tank(locate on site plan):
Depth below grade: 3
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 gallons
Sludge depth:
6"
t5ins•3/13 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
M 35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is Hyannis Ma 02601 4/15/2016
required for every H y 'i
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle 3
Scum thickness Y
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
10"
How were dimensions determined? opened covers, took
measurements
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 needs to be cleaned now and again every 2 years for proper maintenance. Water level was
even with outlet invert, tank was structurally sound . Inlet and outlet covers are on risers.
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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
_
page. Cityrrown 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17
Commonwealth of Massachusetts
4 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
page. Cityrrown 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.):
Distribution box was video inspected and found to be in good condition, no rot, water level was even
with outlet 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.):
*If pumps or alarms are not in working order, system is a conditional pass.
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
15ins•3/13 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
M 35 Briarwood Ave.
Property Address
P
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
® leaching trenches number, length: 2
❑ 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.):
s.a.s. consists of 2 leaching trenches 36'x3'x2'. Vegetation was normal, no signs of past hydraulic
overloading
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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
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.):
I
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.):
t5ins-3113 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
35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
_
page. Cityrrown 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
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t5ins•3/13 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
° 35 Briarwood Ave.
GSM
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
page. City/Town 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: 12'+
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: 7/11/99Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health-explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map.
Design plan states that no groundwater encountered at 132"and system is 6'+above high water
elevation.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 or 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Leonard Pudt& Harry Feitelson
Owner Owner's Name
information is required for every Hyannis Ma 02601 4/15/2016
page. Cityrrown 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
k
` Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
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.
Important:When A. General Information
filling out forms
on the computer,
use only the tab 1. Inspector: lX uJ
key to move your
cursor-do not Michael Kellett
use the return Name of Inspector
key.
Aardvark Environmental Inspections
ILA Company Name
P.O. Box 896
Company Address
East Dennis MA 02641
City/Town State Zip Code
508-385-7608 SI 3742
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
03/15/11,
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.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
page. Cityrrown 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):
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
page. Cityrrown 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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
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:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform
bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be
attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than '/z day flow
Commonwealth of Massachusetts
Title 5 Official Inspection Form
lu
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
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.]
❑ ® 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.
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
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): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
'< 35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
page. Cityrrown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 0
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
Seasonaluse? ® Yes ❑ No
Water meter readings, if available(last 2 years usage(gpd)):
Detail:
Sump pump? ❑ Yes ® No
Last date of Date occupancy:
Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
page. Cityrrown 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:
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
w inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
Commonwealth of Massachusetts
Title 5 Official. Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
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:
12/10/99 per BOH
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 3.7
feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: 3.0
feet
Material of construction:
® concrete ❑ metal ❑ fiberglass
g El polyethylene El 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 gal
Sludge depth:
3"
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M ' 35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle
29"
Scum thickness 311
Distance from top of scum to top of outlet tee or baffle 6„
Distance from bottom of scum to bottom of outlet tee or baffle
161
How were dimensions determined? measured
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
The tank was sound and tight with tees in place and liquid at outlet invert.
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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
page. Cityrrown 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
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owners Name
information is required for every Hyannis MA 02601 03/14/11
page. Cityrrown 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 Even
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.):
The box was level and tight with no sign of carryover.
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.):
Soil Absorption System SAS locate on site Ian excavation not required):
p Y ( ) ( P
If SAS not located, explain why:
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
page. ' City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
❑ leaching chambers number:
❑ leaching galleries number:
® leaching trenches number, length: 2@36x3'
❑ 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.):
This system has two stone trenches that are 36' long and 3 wide.,There was no sign of ponding or
failure in the stones.
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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
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.):
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal posal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is
required for every Hyannis MA 02601 03/14/11
page. Citylrown State Zip Code Date of ins
pection
D. System Information (cunt.)
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
t
�a c
TL
rfi
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
y 35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is y
required for every Hyannis MA 02601 03/14/11
page. Citylrown 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: 20.0
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers-(attach documentation)
® Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
USGS maps show an elevation of over 20.0 feet.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
T
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
35 Briarwood Ave.
Property Address
Timothy Phelan
Owner Owner's Name
information is required for every Hyannis MA 02601 03/14/11
page. Citylrown 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
THE TOWN OF BARNSTABLE
ypQ TOy,
e 0 OFFICE OF
i Heaa9TssL i BOARD OF HEALTH
Nl"& p
1639. \fie 367 MAIN STREET
HYANNIS, MASS.02601
July 30, 1999
Paul A. Phelan
30 Briarwood Avenue
Hyannis,MA 02601
RE: 35 Briarwood Avenue,Hyannis,MA
Dear Mr. Phelan:
You are granted a variance from the Board of Health "330 Regulation" which restricts sewage
flows to 330 gallons per acre per day within zones of contribution to public water supply wells.
The variance is granted to construct an on-site sewage disposal system at 35 Briarwood Avenue,
Hyannis, MA., with the following conditions:
(1) The dwelling shall contain no more than three(3) bedrooms as shown on
the submitted floor plans dated September 16, 1994.
(2) The applicant shall record a deed restriction at the Barnstable County
Registry of Deeds regarding the maximum number of bedrooms allowed
at this site.
(3) . The dwelling shall be connected to town water.
(4) The septic system shall be installed in accordance with the revised septic
system plans dated July 12, 1999.
(5). This variance expires July 30, 2000.
The variance is granted because there are numerous three bedroom dwellings in this area. It is
the opinion of the Board that the construction of one additional septic system in compliance with
the State Environmental Code, Title V and all other Board of Health regulations will not alter the
quality of the groundwater in the area.
Sincerely yours,
Susan G. Rask R.S.
Chairman Board of Health
Town of Barnstable
SGR/bcs
phelan2
AUG-16-99 MON 03:28 FM- LAWOFFICES FAX NO. 5087756029 P. 02
DEED RESTRICTION
WH:i'REAS, Timothy J. Phelan cf 11 Georgianna Road, Billerica,
MA 01621 is .he owner of Lot 22 located at 35 Briarwood Avenue,
Hyannis, Massachusetts (hereinafter referred to as "Phelan") and
heirg stiown on a plan entitled "Subdivision of Land in Hyannis and
Ilyarnisport, Mass . , Property of Alice S. Paine, et al, August 1928"
duly recorded in the Barnstable County Registry of Deeds in Plan
Book 38, Page 91;
WHEREAS, Phelan as the owner cf said lct has agreed with the
Town of Barnstable Board of Health to a restriction as to the
number of bedrooms which can be included in any home built on said
lot. as a pre-condition to obtaining a variance from the `town of
EarnsLab e Board of Health 11330 Regulation" and to obtaining a
1uilding permit for this lot;
WHEREAS;, the 'town of Barnstable Board of Health, as a pre-
condition to granting the variance from the 11330 Regulation" and
authorizing the issuance of a building permit for the construction
of a sinale family home on this lot is requiring that the agreement
for the restriction on the number of bedrooms in any house
constructed on the lot be put on record with the Barnstable County
Registry of Deeds by recording this document,
NOW, THEREFORE, Phelan does hereby place the following
restriction on his above-referenced land in accordance with his
agreement with the Town of Barnstable Board of Health, which
restriction shall run with the land and be binding upon all
successors in title :
1 . Lot 22 may— have constructed upon the lot a house
containing no more than three (3) bedrooI-::s.
Phclan agrees that this shall be a pet-mranent deed restriction
affecting Lot 22 located on Briarwood Avenue, Hyannis,
Massachusetts and being shown or, the plan recorded in Plan Eock 39,
Paged 91 .
For title of Phelan see the following deed.: Book 4438 , Page
293 .
Executed as a sealed instrument this elm f qq _ . day of
August, 1999 .
Timothy J. ielan
AUG-16-99 MON 03:29 Ph LAW OFFICES s FAX NO. 5097756029 P. 03
COMMONWEALTH OF MASSACHUSETTS
s . August 9 1995
Thep. pe.rsonallly appeared the above-named Timothy J. Phelan and
acknowledged Che foregoing instrument to be his tree a-t and deed,
before me,
4Notar Pubic. 1
My commission expire. : � '10c ,
r
v
F
THE jO�y TOWN OF BARNSTABLE
e CFFfCE CF
BABT9TSBL : BOARD OF HEALTH
raaa
�00 1639.
2 MAY k� 367 MAIN STREET
HYANNIS, MASS. 02601
July 30, 1999
Paul A. Phelan
30 Briarwood Avenue
Hyannis, MA 02601
RE: 35 Briarwood Avenue,Hyannis, NIA
Dear Mr. Phelan:
You are granted a variance from the Board of Health "330 Regulation" which restricts sewage
flows to 330 gallons per acre per day within zones of contribution to public water supply wells.
The variance is granted to construct an on-site sewage disposal system at 35 Briarwood Avenue.
Hyannis, MA., with the following conditions: y
(1) The dwelling shall contain no more than three (3) bedrooms as shown on
the'submitted floor plans dated September 16, 1994.
(2) The.applicant shall record a deed restriction at the Barnstable County
Registry of Deeds retarding the maximum number of bedrooms allowed
at this site.
(3) The dwellinQ shall be connected to town water.
(4) The septic system shall be installed in accordance with the revised septic
system plans dated July 12, 1999.
(5). This variance expires July 30, 2000.
The variance is granted because there are numerous three bedroom dwellings in this area. It is
the opinion of the Board that the construction of one additional septic system in compliance with
the State Environmental Code, Title V and all other Board of Health regulations will not alter the
quality of the groundwater in the area.
Sincereiv yours,
Susan G. Rask. R.S.
Chairman Board of Health
Town of Barnstable
SGR/bcs
phelan2
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Made 8- -94 No.30078
ARCH-MAR.No e►zcouvcte .tl
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i
DESIGN CALCULATIONS
NUMBER OF BEDROOMS 3
GARBAGE GRINDER NOT ALLOWED
DAILY FLOW: 3 BR X 110 GAL/ (BR-DAY) 330 GAL/DAY
SEPTIC TANK REQ' D/PROVIDED MIN 1500 GAL
LEACHING CAPACITY (PRIMARY & RESERVE) :
2 X (36 X 2 ' +2 X (36 ' -+ 2 ' ) X 2 ' ) X 0 . 74 GAL/ (SF—DA) = 331 GPD
I
- zr•
i
I
SOIL TEST DATA P-8261
DATE : 08/16/94 �y
�
WITNESS : J. DUNNING ENGINEER: J.H. MILNE _ h�F1fAssq
EERNARD
#1 ELEV 30 . 6
cy
o JGHtd YOUNG u
0-18" TOP & SUBSOIL No.30D73
18-132" MEDIUM SAND W SOME GRAVEL v 9ARCH-MAR
NO WATER AT 132" ELEV 18 . 1 PERC <2 MIN/INCH
32.5 6' •MAX
9' MIN, 36' MAX 3" TOPSOIL, 2% SLOPE — 1'MIN, 3'MAX
i
' 1.25 LEVEL �� OFUPIPEND
0.17 ,MIN 4 ID PERF PIPE, 0.5% SLOPE
7.5 0.83 0.25 1.17 26.9 ... . 2" PEAS
TONE:
26.6 >• I
27.2 -� 26.8 " ' ." 26.5 3/4" TO
4.00 DISTRIBUTION 1-1/2"
1 d MIN BOX WASHED I
DB-3 H-10 (2) 36'L X 2'W X 2'H TRENCHES STONE
...._ 6" GRAVEL ON NATIVE SOIL OR 24.3
c+ r Y MECHANICALLY COMPACTED BASE, 6.2
,1500 GALLON SEPTIC TANK
TANK AND -I3=BOX
I ST-1500-H-10
I w
BOTTOM -OF TEST HOLE EL 18 . 1 LT in� °= Z•�L
�V
air 05/m/09 i
OF THE 1p DATE:
FEE:
BARNMEIM
}twSS
9� 1619• ��� REC. BY
Town of Barnstable
S CITED. DATE:
Board of Health
367 Main Street, Hyannis MA 02601
Office: 508-790-6265 Susan G.Rask,R.S.
FAX: . 508-790-6304 Sumner Kaufman,M.S.P.H.
Ralph A.Murphy,M.D.
VARIANCE REQUEST FORM
LOCATION I �f /Sl/ /✓�S
�
Property Address:
Assessor's Map and Parcel Number: a b Q 0 Size of Lot:
-7
Wetlands Within 300 Ft. Yes Subdivision Name: y/
No _
Business Name:
APPLICANT _ CONTACT PERSON 1
Name: 1141 .)o/ �! I O/ --k#,V Name: �-/w
�� (�'' 0 «i/v��' Address:Address: % /::�f�W Cd t,� 6/
f ' ry
Phone: Phone:
FAX: / FAX:
VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed)
-2c) 3 :5 acA
pt 0 rljd - 4-v,-
D j C y4V'6 k0 &,A-- p1
Checklist(to be completed by office staff-person receiving variance request application)
Four(4) copies of plan submitted(including septic system plans and/or restaurant floor plans)
Applicant understands that the abutters must be notified by certified mail at�1+6ast ten days prior to inting
date at applicant's expense(for Title V and/or local sewage regulation vaftances only)
Full menu submitted(for grease trap variances only)
Variance request application fee collected(no fee(or fireguard modification renewals,greas rariare: renewals(sasarne ow�ti♦ easee only outs a
dining variance renewals(same ownerileasee only].and variances to repair failed sewage disposal systems(only it n eap ion eS tfk flwldir�proa'-bsedj��9^
Variance request submitted at least 15 days prior to meeting date �J j y N
VARIANCE APPROVED Susan ask, R.S., airman
NOT APPROVED Sumner eu, an, M.S.P.H. .� .
REASON FOR DISAPPROVAL Ralph ," IV by .D.
Q:/WP/VARIREQ
I>
_. � •4 i � e �r
TOWN OF BARNSTABLE
yQi'THE T L Q-T
OFFICE OF ^
DA839TAM : BOARD OF HEALTH
MA6a 39 ��
O'E0 k�9 367 MAIN STREET / !
HYANNIS, MASS..02601
March 30, 1995
Paul A. Phelan
30 Briarwood Avenue
Hyannis, MA 02601
RE: 35 Briarwood Avenue, Hyannis, MA.
Dear Mr. Phelan:
You are granted a variance from the Board of Health "330 Regulation' which restricts
sewage flows to 330 gallons per acre per day within zones of contribution to public water
supply wells.
The variance is granted to construct an on-site sewage disposal system at 35 Briarwood
Avenue, Hyannis, MA., with the following conditions:
(1) The dwelling shall contain no more than three (3) bedrooms as shown on
the submitted floor plans dated September 16, 1994.
(2) The dwelling shall be connected to town water.
(3) The septic system shall be installed in accordance with the septic system
plans dated February 27, 1995.
phelan2
J
i
1.
f1 1
The variance is granted because there are numerous three bedroom dwellings in this area.
It is the opinion of the Board that the construction of one additional septic system in
compliance with the State Environmental Code, Title V and all other Board of Health
regulations will not alter the quality of the groundwater in the area.
Sincerely yours,
oseph C. Snow, M.D.
cting Chairman
Board of Health
Town of Barnstable
JCS/bcs
phelan2
;r
LAW OFFICES OF
PHILIP M. BOUDREAU
396 NORTH STREET
HYANNIS, MASSACHUSETTS 02601
(508) 775-1085
Telefax: (508) 771-0722
Philip M. Boudreau
Philip Michael Boudreau
Mark H. Boudreau
July .5 , 1994
Timothy J. Phelan
11 Georgianna Road
Billerica, MA 01821
.. W .�
Re: Lot 22, Briarwood Avenue )V; ri
Hyannis, Massachusetts
Dear Mr. Phelan:
In furtherance of my previous correspondence in this
matter, it would appear that the above-referenced property
has been held in ownership separate from adjoining parcels
at least since 1960.
Accordingly, subject to the so-called 11330 Rule" which
we discussed, it would appear that the premises satisfy the
grandfathering provisions of the Barnstable Zoning Ordinance
and that a building permit should not be denied on the basis
that the lot does not meet the current dimensional
requirements of the Ordinance.
If you have any questions, don't hesitate to call.
Sincerely,
I
Phi ip Michael Boudreau
PMB/hcg
No. ! 4 Fee
" THE COMMONWEALTH OF MASSACHUSETTS ntered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01 '01ira�tion f0 33f6poal *r6tem (COttgt urttonrIndividual
it
Application for a Permtt to Construct( )Repatr( )Upgrade( )Abandon( ) Complete System Components
Location Address or Lot No. �$� /J F f Q4.��q.pt'd L�, Owner's Name,Address and Tel.No.
Assessor's Ma /Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.¢4-
* � �f Y/w m t�� ,U
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size J sq.ft. Garbage Grinder 0
Other Type of Building M No. of Persons `f Showers( —d� CafeteriaAo)
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets o2 Revision Date
Title
Size of Septic Tank /S-d 9 Type of S.A.S. % 4,61C V
Description of Soil pMi.0f CIA S 0AD eFm f f
Nature of Repairs or Alterations(Answer when applicable) ./y
Date last inspected: /V 91
Agreement:
The undersigned agrees to ensure cons ction and maintenance of the afore described on-site sewage disposal system
in accordance with the provis' tle En ' onmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been i e oar f e
Signed Date
Application Approved by Date f?a3'
Application Disapproved for Me following reasons
Permit No. 2 9— s a C) Date Issued
lk..
No:, s k" # t :� Fee —
'�.
e THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
t
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Yes
, .plicatto'n for Moon[ *pgtem Con.5truct�ionuVe mit
Application for a Pee_ t to Construct( )Repair( )Upgrade( )Abandon( ) Ik Complete System Individual Components
Ft
Location Address or Lot No. �S �h !Ot.t by G c d L 1, Owner's Name,Address and Tel.No. C'V*7/1
Assessor-Qq?arcel
08 h/J�1 h '13 �f � d �, , �✓�� �1 L` /C�1 /�]D¢p�
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.,q f� 0/vr A4,6a tA7 46
Type of Building: -
Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder(/0)
Other Type of Building 4"t,4 A No.of Persons ' Showers( ) Cafeteria)
Other Fixtures
Design Flow qO gallons per day. Calculated daily flow gallons.
Plan Date if-.in/ Number of sheets c Revision Date
Title
. Size of Septic Tank /5-0 0 Type of S.A.S. e2 ;f f,,4-C711
y Description of Soil ! C G.y1 S V/p 01111"'f C, /, lf,
r
Nature of Repairs or Alterations(Answer-when applicable) 141
Date last inspected: l
_Agreement:
ram' -The undersigned agrees to ensure a cons tion and maintenance of the afore described on-site sewage disposal system
in accor.dance'with the provfiitle En ' onmental Code and not to place the system in operation until a Certifi-
cate of Compliance has bee s oac
Signed Date
Application Approved by 4 4dkLde.4 4% Date "° �`
Application Disapproved for e following reasons
Permit No. g C/^ s 3 c) Date Issued
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIF ,..that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( )
Abandoned( )by A !
at V S OP/I 4L d00 )y l/lr,-, /->✓�, �/r�n r 1 �t9 Dhas been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. , � dated
Installer -rd P P 17/ Designer / , n G
The issuance of th's eItAtillio e/�onstrued as a guarantee that the s to -v�11�j u �jdo i�/ydesi i
Date G "/ Inspector / { i _A +�
J - i
No. �/ s U Fee _
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Digo.5al *paem Construction 3permit
Permission is hereby granted to Construct Q4 )Repair( )Upgrade( )Abandon( )
System located at f(4&4,,1 is
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:Co truction must be completed within three years of the date of th' rmit.
Date: Approved b �/
8
TOWN OF BARNN�STABLE
LOCATION .1 SEWAGE #
VILLAGE 'I �_ �S ASSESSOR'S MAP &LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY l�� CAL.,
.� �Z!
LEACHING FACILITY. (type) (size �� 3
NO.OF BEDROOMS 75
BUILDER OR O R ii q
TE: ` b � COMPLIANCE DATE:
PERMTTDA 1
Separation Distance Between the: 1
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) A� Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching fa 'lit�. Feet
or Furnished by
�.
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