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HomeMy WebLinkAbout0142 CAPTAIN ELLIS LANE - Health 142 Captain Ellis Lane Hyannis A= 250-120 6 oFTHe ram, Town of Barnstable o Regulatory Services Thomas F. Geiler,Director MASS. Building Division t639.Ar�D MAr a Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 May 9, 2008 Matt Waddington Realty Executives PO Box 1780 Sandwich, Ma 07563 Re: Inspection 142 Capt'n Ellis Lane, Hyannis Dear Matt: As you are aware, the Zoning Officer, Amnesty Investigator and a Building Inspector inspected the aforementioned property on Wednesday, May 71" during which numerous photographs were taken to document the findings. I am informed that multiple problems were identified including some unexpected but very serious.issues. Everyone appears to agree that a lot work is.necessary in order to prepare this property for a future conveyance. The following is a list of some of the issues and concerns discussed on May 7th: Zoning • The dwelling as configured does not currently flow as a single-family home. • Considerable reconfiguration is necessary in order to restore the structure to a single-family dwelling. • All un-permitted kitchens & improvements must be removed. • The property is limited to 4 bedrooms but may have as many as 8 or 9 bedrooms. • The division of the existing single-family home into a multi-family was performed without the benefit of permits and inspections. • The driveway and parking area exceeds the allowed impervious surface for rental property per Chapter 170-9 Rental Properties - Parking Building • The crawl space was excavated. • The water heater was observed to be almost buried by the excavated sand. • A block wall was created and appears to be a makeshift form of support. • 'The,height of this wall exceeds 4'and requires engineering. 1 • An interior stairway wall show signs of buckling as a direct result of the removal of necessary load bearing supports. • An exterior stairwell was also constructed without a permit and does not meet code. • A front entrance has been modified in.such way that run off is channeled into the interior hallway. • It appears the dwelling is in danger of collapsing in on itself, therefore the services of a structural engineer is required to properly assess all structural conditions and risks. • A copy of the resulting analysis must be submitted to this office. Please contact this office if you find you require additional information or clarification. Sincerely, Tom Perry Building Commissioner I TP/rc g JAComplaint Inv Reports\142 Capt'n Ellis Lane Letter.doc : End pictures 1 r' °pTHE Town of Barnstable Barnstable Tp� • Regulatory Services Department A"me;caCft ,i nAR24STAULE. a N F T N 39 Public Health Division Epp i6 g q. �e I. TfD MAtR' 200 Main Street Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL 7006 2150 0002 1041 8160 October 29, 2008 Paul Tetreault 397 North Main St. So. Yarmouth, MA 02664 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 142 Captain Ellis Lane,was inspected on October 29, 2008 by Jaime Cabot, Health Inspector for the Town of Barnstable. The inspection was conducted on the basis of an inspection. The following violations of the State Sanitary Code were observed. 105CMR 410.503: Protective Railings and walls- Exterior stairway does not comply with Mass. Building Codes. 105 CMR 410.450: Means of Egress- . Front entrance does not allow for safe passage as per Building code. You are ordered to correct the above violations within thirty (30) days of your receipt of this notice by obtaining the required building permits to bring all egress to code. You may request a hearing before the Board of Health if written petition requesting same is received within"ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE B F HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable . Q:\Order letters\Housing Violations\142 capt.ellis.tetreault2.doc OF THE T°� Town of Barnstable Barnstable P� ~ °1 Regulatory S ' r : ment ,t,e;cacrt,r. BARNSTABLE, 1 a MASS. �� Public p d O 39 ♦ ar •_ AlFO MAt A. 200 Main Street, Hyannis MA 02 1 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 ` Thomas A.McKean,CHO CERTIFIED MAIL 7006 2150 0002 1041 8160 October 29, 2008 Paul Tetreault 397 North Main St. So. Yarmouth, MA 02664 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 142 Captain Ellis Lane, Hyannis MA was last inspected on April 17, 2008,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: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. 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 Agent of the Board of Health Town of Barnstable C:\Documents and Settings\cabotj\Desktop\tetreault.doc SE N N61ER:COMPLETE THIS CTIO :omplete items 1,2,and 3.Also complete A Si ture �1 tem 4 if Restricted Delivery is desired. ❑Agent Tint your name and address on the reverse X _ . " o� fiTAddressee >o that we can return the card to you. g, Received by(Printed Name) C. Dat of Delivery attach this card to the back of the mailpiece, )r on the front if space permits. 'q�`'� Z 1 k t 5 0� krticle Addressed to: D. Is delivery address different from item 1? ❑Yes If YES,enter delivery address below: ❑ No �(Z+LAVVZ tZ 0 OLI" "A\0 gZ 0 V-11.i t./1A 3. Service Type - l1, PKCertified Mail ❑Express Mail ❑Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes J Uncle Number 7006 215 0 0 0 0 2'' 10�41 816 0 riansfer from service label) turn Receipt, 102595-02-M-1540 F 5 r'y: � 7 Cabot, Jaime From: Cabot, Jaime Sent: Tuesday, October 28, 2008 9:52 AM To: Anderson, Robin Cc: Perry, Tom Subject: 142 Captain Ellis Road , Hyannis Hello Robin, Last week John Handel came in with a sketch plan proposing the removal of a kitchen on the first floor and resizing of several rooms at the property at 142 Capt. Ellis Road, Hyannis. Handel is seeking guidance on Bedroom count from The Board of Health, as the property has been foreclosed on and has a failed septic system. I am not aware of any requirement that the Board of Health provide guidance on the layout of floor plans other than determining bedroom count(or a room count). As the property is in a ground water protection zone; State designated zone Two. The property would be limited to two bedrooms unless grandfathered by a pre-existing use of more bedrooms. Please confirm for me that(4) bedrooms is the correct design criteria for the septic system. (Please see Tom Perry's May 9, 2008 letter to Matt Waddington) Thank you, Jaime /0 I 610 1 pF'fHE Tp� Town of Barnstable Barnstable Regulatory Services Department r Wcal fly �j% nARNSTAnLE, . 9 r1AS5. 16,9. P 'c e i 'sion p°Tfd MAt° 2O0 °Ire ni A 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL 7006 2150 0002 1041 8160 October 29, 2008 Paul Tetreault 397 North Main St. _ So. Yarmouth, MA"02664 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 142 Captain Ellis Lane, Hyannis MA was last inspected on April 17, 2008,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: Backup of sewage into facility or system component due to an overloaded or clogged SAS. • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. 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 Agent of the Board of Health Town of Barnstable C:\Documents and Settings\cabotj\Desktop\tetreault.doc TOWN OF BARNSTABLE V LOCA 0O 1 9,,r 4 SEWAGE 'S63 %II,LAGE an-oi 1444 ASSESSOR'S MAP& LOT 2S0 - 4 INSTALLER'S NAME&PHONE NO. I fiIlf-P� SEPTIC TANK CAPACITY 00 i LEACHING FACILITY: (type) P, .r"ao (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: _— 0 9� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any_wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by c a � W Vl Ql O 0 Q � ` w W � S Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes application for 13isposal Opstrut Construction 3pQrmit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. I 9'/0 W1 Ci 1 d P2. Owner's Name Address, d,Tel.No. Assessor's Map/Parcel �� - /Z�' Ovt 7,eUe461, e\TO417 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Jj_:A'S SC:�i�Vff C Type of B ding: t! 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) CAP gpd Design flow provided S gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. e 2 C�1nYt t� Description of Soil Nature of Repairs or Alterations(Answer when applicable)�41ul �Z,%C��I7�i, 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 ari of to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by —1 Date Application Disapproved by Date for the following reasons Permit No. so-3 Date Issued 11�2—(-I_4 n cso ok No. �J' � ee ®o THE'COMMONWEALTH OF MASSACHUSETTS Entered in computer: t PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplication for Misposal 6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 'L e 4f)VO, — 1 tS �2, Owner's Name„Address,and,Tel.NLL o. // C Assessor's Map/Parcel 510 - !2 1,1t 7•etW674� e 7ah,7 ` Installer's Name,Address,and Tel.No. A Designer's Name,Address,and Tel.No. 5����`/14 Type of Building: Dwelling No.of Bedrooms 7 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) CAP gpd Design flow provided �� S S gpd Plan Date Number of sheets Revision Date r Title Size of Septic Tank Type of S.A.S. py iQ�� C�1�✓�Y)9�$ ~ Description of Soil Nature of Repairs or Alterations(Answer when applicable) A//.,t,/ Z4 2r_4 { Date last inspected: Agreement: `�%�; i''' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and-not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed "�� ��`--'` Date —`7 U • Application Approved by Date Application Disapproved by t Date for the-following reasons Permit No. :2-Df)(g 5y3 Date Issued 1O2—q_v - r THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS - Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( graded( ) Abandoned( )by e T4 i at /4/Z � ��}i it C—AaS has been constructed in accordance J� with the provisions of Title 5 and the for Disposal System Construction Permit No. ;o&d— '�03 dated /O2 _y^y" Installer o ✓hP/i Designer 1-)R�/1 r7 QA.4 e�k � �fd,2P i #bedrooms Approved design flow gpd fti The issuance of this permit.sha91 not be construed as a guarantee that the system will coon as designed Date / 7S / n Inspector No. a O-D 7 03, Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS 30isposal *pstrm Construction permit Permission is hereby granted to Construct( ) Repair(u)� Upgrade( ) Abandon( ) System located at /LIZ• n 41-7 f[i S 2 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be c mpleted within three years of the date of this permit:,' ' , Date ���—D Approved by r r Bk 23295 PoSOO `4613967 12-04-2008 a o 9 s 4-3a DEED_RESTRICTION WHEREAS, of (owners Warne) \�� �1 N S -- �2-7 No {(� �� -mot 7� MA (address) c� t�� �'_"'— is.the owner of (4-2 C (address) M G / �t S �4 vtQ located at MA(hereinafter referred to as ' and being shown on a plan entitled "Subdivision of Land in MA, Property of et al, duly recorded in Barnstable County Registry of Deeds in Plan Book Page_ ( ` Or on Land Court Plan Number WHEREAS,Tcw t IF j a o lk as the.owner of said lot has (owner's name) 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 disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum ' Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condifion:to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a'single family home on this property, is requiring that the agreement for the'restriction on the number of bedrooms in any house constntcted on the lot be put on record-with the Barnstable County Registryyof Deeds by recording this document, y Y Bk 23295 Pg 301 #60967 NOW, THEREFORE, Pro�� - ,-r.��wc�;�oes hereby place the (owner's name) following restriction on his abovd-referenced land in accordance with his a�rQ�mentu�the_.T.airq..o�.S.atnstahfe--Ba�rdm€-I��It#;w-I�ie{��rest�tierr-s�ra-It . run with the land and be binding upon all.successors in title: , 1. {4,�ZCo4-r,,__► E(��s may have constructed (address) upon the lota house containing no more than°7au,r_ ) bedrooms. agrees that this shrall be.permanent deed (owner's name) restriction affecting located on MA, and . being shown on the plan recorded in Plan Book ZBR , Paged . Or on Land Court Plan z t7 For title of see the following deed: Book -78AR-&- , Page ) 32, Or Land Court Certificate of Title Number Executed as Pled lnstrurilent day.of 2 . r . --- Owner's signa ure ` Owner's signature Owner's signature COMMONWEALTH OF MASSACHUSETTS ss 200 Then personally appear d�e above-named ef'R�Q.CL 47 known to a to be the person who executed the foregoing instrument-and acknowledged the same to be % free act an ee 7;i ore ' :Lk.�,u [ j �i � ' .`' x °` -Notary �i r/ �. Public l f�d0/? J C r.1� . `, F My co I►i � fate) LATRUE BLE COUNTY Y Or DEEDS deodr OPY,ATTESTgAANSTASI.E REGISTRY OF DEEDS . .szADE,REGISTER r Town ®f Barnstable Regulatory Services Thomas Fe GefleIr,Director BARNSfABLE, _ ' • Publk Hc�a th Division S. ATE p 3.1�' Thomas McKean,Director 200 Main Stireet,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installler & Designer Certification Form Date:/Z b ' Sewage Permit# W--7625ssessor9s Map\Pa>rceR Address: ��5/lc� G2��3 Address: 4yz"//c � On u }"� 1�S 2✓ was issued a permit to install a (date) l(in 1 er) septic system at based on a design drawn by ]� (address) dated 'J9-0e? (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. i I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical.relocation.of any component of the septic system) but in accordance with State &_Local Regulations. Plan revision or certified as-b y designer to follow. DAVID Vt fallTignature) D. FLAHERTY, JR. N No. 1211 � a GISTS Vt. r SANI TAR\a� ( esigner's S' ature4 (Affix Des ig amp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMIPLIATWE WILL NOT BE ISSUED tri�t I L BOTH THIS FORM ANC AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc Barnstable � r Town of Barnstable Regulatory Services Department j'edsac j p M Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F:Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO �C1K+v 1-lraN�El. �AvL April 24, 2008 S 1.. 12 1 d �-b Countrywide REO Marketing V � L.O.- Q�'. 2270 Lakeside Blvd. Mailstop RLS-3-32 Richardson, TX 75082 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 142 Captain Ellis Lane,Hyannis MA was last inspected on April 17, 2008,by Shawn Meelroy, 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: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. 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 TH BOARD OF HEALTH Thomas McKean, R.S., CHO. Agent of the Board of Health CERTIFIED MAIL# 7006 2150 0002 1038 7237 Q:\SEPTIC\Letters Septic Inspection Failures\142 Captain Ellis Lane.doc vl �1 •. � � Al' 93 i L.O.'\a C2iG z q 00 �-- 42 cvr _ 2 N - t i l cony � �®6 . I. .;.:lb i, - 14 . I 4 W ALA_ y -— : �— � 4?„ n r� N • w r-4 ►ter 5 d 71 40 0 i e•ylTA nor D - 44 wt �� (L- rL �� Ao 4 1-7 S 7T '121 - I QQ 2 i l I Ck - t aej ,i1 c�e c L �c P t r ✓i I I -7 Cr- P-T-n - J c 4' I�GS L ✓1 �Gt(,�� n Cz- K�t-j C) C-CM'' V 121 I r' cry�t _ "c YIX�e�S O C�✓��I.�> s2 C-O - (!>'r ao Psi -0oor � CZ) 2 VS Floor e cXcDor o.g�- vi , ,� G. COO wp cis - C12 Zoi li D. _ Ln le P,V _ w L, { _ I o 44 it pl 1 } n _r r 1 d `( Tv r r o I dr( t? /n r 41 i 4 4 ` li7: 4-1 f5 i 44,, \^, tCNi 6 � 1 � . y -75 TI i 1 Town of Barnstable P# Department of Regulatory Services HARNS=LK Public H 'Health Div ision Date 200 Main Street,Hyannis MA 02601 Date Scheduled D Time Fee Pd. Soil Suitability Assessment for Sewage Dis osal. Performed By: - `�"�G"'L/ S � i// Witnessed By: ._ 0 LOCATION& GENERAL INFORMATIO �/. Location Address Owner's Name/ rs �tis ✓� ���� Address -79706,97,v,,l - Assessor's Ma /Parcel: / � ?'� �SvV✓P Engineer's Name NEW CONSTRUCTION REPAIRG SZ 96 Telephone# 7-3eo[dU Land Use ✓, !'t Slopes(%) Surface Stones G G Distances from: Open Water Body ��� ft Possible Wet Area �O ft Drinking Water Well ft Drainage Way ft Property Line 7/7 =` ft Other Ro 4!!ia ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands fn proximity to holes) Cam' r `I / V� ?OP ZGl V A(+ Parent material(geologic) Depth to Bedrock A1 A Depth to Groundwater. Standing Water in Hole: ��� Weeping from Pit Face Estimated Seasonal High Groundwater T AP/ DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: d Depth Observed standing in obs.hole: ti ,e_in. Depth to soil mottles: Af in. Depth to weeping from side of obs.hole: in, Groundwaterr�Adjustmeflt ft. Index Well# A///} Reading Date: It//4- Index Well level Adj.factor, Adj.Groufldwater Level PERCOLATION TEST Date✓z ' Thne oLV Observation p4e_/4 Hole# / Time at 9" Depth of Pero O Time at 6" jStart Pre-soak Time @ �7 ' �Z Time(9"-6") � End Pre-soak Rate MinJlnch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable.Conservation Division at least one(1)week prior to beginning. Q:\SEPI'ICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole#_L_ Depth from Soil Horizon Soil Texture .Soil Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency,% ravel 0- SC OEM o aoy s/. ef a. % "? r 6 CW41d' Z 1-1v DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,% ravel /v ya Oo y? 4 �O . �a✓! DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Cons* ten t Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No= Yes Within 100 year flood boundary No— Yes 5 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? a S If not,what is the depth of naturally occurring pervious material? - Certi_ ficatt°n � I certify that on 9D (date)I have passed the soil evaluator examination approved by the f Department of En ironmental Protection and that the above analysis was performed by me consistent with . the required trainin xpe 'se a ex described in 310 CMR 15.017. Signature Date /Z Q:\SEPTICIPERCFORM.DOC II .> s r. 44-1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 2 o zGu L �:- Property A501-16 UL� cJ�T �� �/ r✓��Z miss Owner Owner me information is required for every �V page. City.own 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 filling out forms A. General Information on the computer, use only the tab key to move your 1. Inspector: cursor-do not use the return key. Name of Inspector / �,D �S &-Cle 9'/ Z;tz ;t3 Company Name o /7Z9 P Y Corn an rggs����/C City/Town f� l� State 6,z 9 ZZip Code Telephone NurD¢�c,� Ucense 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 , 7Zm f, z' ❑ Needs Further Evaluation by the Local Approving Authority /` t Inspector's Signature rDate t The system inspector shall submit a copy of this inspection report to the Approving Authority(Boa%d 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. ,Sins•11110 71Ne 5 Offldal Inspection Form;Subsurface Sewage 01aposal System-Page 1 of 17 Commonwealth of Massachusetts MEMEW Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owner's Name information is required for every l/ page. City(rown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary:Check A,B,C,D or E 1 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: -Ilk 4� d a/--L l rv� Ya l B) stem Conditionally Passes: ❑ On r more system components as described in the"Conditional Pass"section need to be replac or repaired.The system, upon completion of the replacement or repair,as approved by the Boar f Health,will pass. Check the box for"y " "no"or"not detenmined"(Y, N, ND)for the following statements. If"not determined,"please exp The septic tank is metal and ove 0 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltra or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replace h a complying septic tank as approved by the Board of Health. A metal septic tank will pass inspection if it is struct Ily sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years is available. ❑ Y ❑ N ❑ ND(Explain below): i i i 15ins•11/10 Me 5 Official insp ection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4412 /7PT Property Address Owner Owners Name information is required for every page. City[Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ Obse ion of sewage backup or break out or high static water level in the distribution box due to broken bstructed pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspectio ' (with approval of Board of Health): ❑ broken pipe(s a replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is remove ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or placed ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to bro 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( lain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain low): C) Further Evaluation is Required by the Board of Health: ❑ Conditions e " ch require further evaluation by the Board of Health in order to determine if the system is failing to p ublic health, safety or the environment. 1. System will pass unless Board of—Abaftli determines in accordance with 310 CMR 15.303(1)(b)that the system is not functionin manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water El Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt ma 1:51m;•t M 0 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 3 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Name Information isj�y�/� required for every 7/ J page. City/Town ' State Zip Code Date of Inspection B. Certification (cont.) YA- 2. S stem will fail unless the Board of Health(and Public Water Supplier,if any) deter lines,,that the system is functioning in a manner that protects the public health, safety a d environment: ❑ The tem has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a su ce water supply or tributary to a surface water supply. ❑ The syste as a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system ha a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic to and SAS and the SAS is less than 100 feet but 50 feet or more from a private water sup well**. Method used to determine distanc . **This system passes if the well water analysis, erformed at a.DEP certified laboratory, for fecal coliform bacteria indicates absent and the presenc f ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure c da 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 El N�- than%day flow t5ins•11/10 Title 5 Dffldal Inspection Fo=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 Z2 c�l Property Address Owner Owner's Name information isy�N�f required for every page. City/Towd ` 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. ❑144 � Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑/uI, Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ Aljl Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ 'v/&� 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 20009pd- 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) I ar e Systems: To be considered a large system the system must serve a facility with a design of 10,000 gpd to 15,000 gpd. For large systems, 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 fe a surface drinking water supply ❑ ❑ the system is within 200 feet of a trib to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public wa ply well If you have answered"yes"to any question in Section E the system is considered a ' ificant threat, or answered"yes"in Section D above the large system has failed.The owner or operator any large system considered a significant threat under Section E or failed under Section D shall upgrad system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. t5ins•11110 Title 5 official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments I i Property Address 1-14 y0& Owner Owner's Name �j�� information is 4N�,s required for every 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? ❑ tp 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? Ij ❑ 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 S tl Abs o tion System(SAS)on the site has been determined based on: 7--,W Vd- ❑ 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): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): t5ins•11110 Title 5 Official Inaped ion 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 Property Address �I��GJCZ Owner Owners Name information is �2— required for every page. Cityrrown State Zip Code Date of Inspection D. System Information l Description: �� a S 7; eO_ 3, C3 _ sZrV,; c old v,�orl i Number of current residents: 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 [X No Seasonal use? ❑ Yes [ No Water meter readings,if available(last 2 years usage(gpd)): G 1,160 Detail: 'X-7.5-%_ Y7aoL q 1 o 'e 730 Sump pump? ❑ Yes No Last date of occupancy: Date Co al/Industrial Flow Conditions: Type of Establish t: Design flow(based on 310 C 5.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., 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: t51ns•11110 Title S 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 Property Address Owner Owners Name information is required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last d e of occupancy/use: Date Other(describe be o 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): t51ns-11110 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 8 of 11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owners Name x information is / �2— required for every , page. Cityrrown State Zip Cade Date of Inspection D. System Information (cont.) Approximate age of all components,date installed(if known)and source of information: cjI (,fVf r2-4- 095 (Z-OQ,•-os P 2M tT cunt Pt.IAN1 A Were sewage odors detected when arriving at the site? ❑ Yes No Building Sewer(locate on site plan): A � Depth below grade: feet Material of construction: ❑cast iron X40 PVC ❑other(explain): �--; Distance from private water supply well or suction line: , 7/ '"WIn feet Comments(on condition of joints,venting,evidence of leakage, etc.): 41 Septic Tank(locate on site plan): W�l Ycs¢✓ Z��ll� YtS�e✓ Depth below grade: et 1 Material of construction: I YL ter 1 concrete El metal El fiberglass El polyethylene ❑other(explain) If tank is metal list age: y' g years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No 41A t L0 —!�" �C 5 av� LY1 jxlh Voyi Dimensions: Q 4�I Sludge depth: t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owners Name ' L information is required for every 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 l rt Z tt Scum thickness Distance from top of scum to top of outlet tee or baffle 1 ZK Distance from bottom of scum to bottom of outlet tee or baffle How were dime ion determined? � O. 4 C Q SS v, �) Comments(on pI ggecommer�datiQ�ls�, inlet and oukt the dr baffle condition,str ctural iq grity, liquid levels a related to outlet invert,evidence of leakage, etc.): �500 1'1eYr�Z( L�'�� I /� ApS V'LS��� IC13(lQys Gc9c-4) Cin a 4- a U VWA Gr ase Trap(locate on site plan): Depth belo rade: feet Material of construction. ❑concrete ❑metal �E] erglass ❑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•11110 Title 5 C fidal Inspection Forth.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 Property Address Owner Owner's Name information is required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) L�/QComments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid lev as related to outlet invert, evidence of leakage, etc.): i ` IA- Tight or Holding Tank(tank must be pumped at time of inspection) (locate �sitep l" Depth b ow grade: Material of co truction: ❑concrete ❑ metal ❑fiberglass ❑polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: A rm 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 XNo t51ns•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owner's Name information is 111441WI J�• required for every // 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 Comments(note i9 box is level and distribujion ..tje ,gqual,any eyad n solids carryover, any evi ce of leakage into or out of box,etc. : �� (� Pump Chamber locate on site plan): Pumps in ing order. ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump ch er,condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan,excavation not required): If SAS not located, explain why: Ss�sus -tea t5ins•11110 Title 5 Offidal Inspection For:Subsurfaos Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Property Address Owner Owners Name / information is �Z' required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: leaching chambers number: Y ❑ leaching galleries number: ❑ leaching trenches number,length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note con '' n of soil,signs of Wdraulic failure,level of ponding,dam soil,condition of vegetation,etc.): � , d J /T/ N� Ce Is(cesspool must be pumped as part of inspection) (locate on site plan): Number and con I tion Depth—top of liquid to inlet I Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Property Address �i�rt/pEZ Owner Owner's Name information is required for every � y��l page. Citylrown St to Zip Code Date of Inspection D. System Information (cont.) Com ents (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Privy(locate on site plan): /'J '7' Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of riding,condition of vegetation, etc.): t5ins•11/10 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Sub$urface Sewage Disposal System Form-Not for Voluntary Assessments Property Address Owner Owner's Name information isy�/I/�r required for every page. City(fown 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 A-- 3 2- � r 3 —4. I ' r � Y fw, 4 ez 33.5' I C. 4 3-S�b a� c�a�cbers t5ins•11/10 Me 5 Mist Inspection Fomr 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 Property Address Owner Owners Name information is required for every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: Check Slope I06 [j Surface water NO Check cellar CIV [ Shallow wells (�o wJer w re( 44 1 '> lz � Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: Obtained from system design plans on record �/ c—�r-S �t11�� s�t I If checked,date of design plan reviewed: c Date ITO ❑ Observed site(abutting property/observation hole within 150 feet of SAS) 0`3 Checked with local Board of Health-explain: tZ4 k tf I Z-off— a?,> tf's 5�h ❑ Checked with local excavators,installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high gro nd water elevation: 31�J � 4� 2515 ' 4_ vy.e ^e ; F/jCpUn Fev. to +-hoes , Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•11/10 title 5 Offidal Inspection Form:Subsurface Sawage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Cj&.>?T ��ts Property Address k4nS��-t, Owner Owner's Name infomtation is H� 4/ _ required for every Wt page. City/Town State Zip Code Date of Inspection I 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 i I I t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Town of Barnstable Barnstable bcatd Regulatory Services Department 1Ce ,� Public Health DivisionI.F 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO April 24, 2008 GK# pj -7&"7— 12 t O S-v l2 — 3701 Countrywide REO Marketing t�• , �. o� 2270 Lakeside Blvd. oX� Mailstop RLS-3-32 Richardson, TX 75082 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 142 Captain Ellis Lane,Hyannis MA was last inspected on April 17, 2008,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: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. 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 TH BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health CERTIFIED MAIL# 7006 2150 0002 1038 7237 Q:\SEPTIC\Letters Septic Inspection Failures\142 Captain Ellis Lane.doc Commonwealth of Massachusetts ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ar 142 Captain Ellis Dr QS0 - 1 oc.D Property Address 1 , " t G�] Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 r `�1 Owner Owner's Name C information is required for Hyannis MA 02601 4-17-08 every page. City/Town State Zip Code Date of Inspection Inspection results trust be submitted on this forme.inspection formes may not be altered in any way. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA i02536 City/Town State EZip Code xa 1-800-495-0905 S13971 Telephone Number License Number 1 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 16.000).The system: ❑ Passes ❑ Conditionally Passes Fails ❑ Needs Further Eval tion by the Local Approving Authority 4-17-M 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 DER 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 Bander the conditions of use at that time.This inspection does not address how the system will performs in the future under the same or different conditions of use. t5insp•03108 T:He5 Otficn:Inspection Form:Subsudam Sewage Dish!System•Page 1 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. City/Town State Zip Code Date of Inspection B. Certification cunt. Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: I have not found an information which indicates that an of the failure criteria described ❑ Y Y 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. Answer yes, no or not determined (Y, N, ND) in the❑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. ND Explain: ❑ 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 ❑ obstruction is removed t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of,Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cunt.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. 4 ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. t5insp•03108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cunt.) C) Further Evaluation is Required by the Board of Health (cunt.): ❑ 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 fort. 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 ❑ ® 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. t5insp-03/08 Tttie 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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`fifes"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. t5insp•.03108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts ; Ville 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for y H annis MA 02601 4-17-08 every page. City/Town 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 (f any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp-03/08 Title 5 Official Inspection Form:Subsurface Sswrage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. City/Town State Zip Code Date of Inspection 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 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 Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: 3-08Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day Y(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: Last date of occupancy/use: Date Other(describe): t5insp-.03l08 + Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 7 of 15 N. Commonwealth of Massachusetts - Fills 5 Official inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (f known) and source of information: 1983 Were sewage odors detected when arriving at the site? ❑ Yes ® No t5insp-03108 Title 5 Off ial Inspection Fonn:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (coot.) Building Sewer(locate on site plan): 18" Depth below grade: 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: 12"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" Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 5" - *, Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Tape t5insp-03/08 Trite 5 Official inspection Forth:Subsurface Sewage Disposai System-Page 9 of 15 Commonwealth of Massachusetts ; Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Flame information is required for Hyannis MA 02601 4-17-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) 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 in good condition. Recommended pumping for solids. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene. ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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): t5insp-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 r •4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) 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 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.): Stain lines above invert indicates back-up. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No t5insp-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 2-600's ❑ leaching chambers number ❑ leaching galleries number. ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): Both leach pits have dear signs of hydrolic failure with stain lines into risers. t5insp-03108 Tine 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 1i Commonwealth of Massachusetts Tile 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is Hyannis MA 02601 4-17-08 required for y every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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.): t5insp•03/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 13 of 15 w . .. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 142 Captain Ellis Dr Property Address Countrywide REO Marketing 2270 Lakeside Blvd Mailstop RLS-3-32 Richardson,TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. Cityrrown state Zip Code We of Inspection D. System Information (cant.) Sketch Of Sewage Disposal System: Provide a sketch 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. t -r-_ t qA,^ V/ t5insp-03108 t ZS s 05221#nsrr�t-am:&dMft a SWi2ge OMPOsat System•page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 142 Captain Ellis Dr Property Address. Countrywide REO Marketing 2270 Lakeside Blvd Mailstop,RLS-3-32 Richardson, TX 75082 Owner Owner's Name information is required for Hyannis MA 02601 4-17-08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cons.) 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: 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: Town maps show groundwater at greater than 12'. t5insp-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 • Town of Barnstable Op THE Z Regulatory Services ,s,,,B Thomas F. Geiler,Director MAS& 9� i639. Public Health Division pTED MA'S A Thomas McKean, Director. 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report;this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and-interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the"Disposal Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic System Inspector who conducted the inspection. 61 Commonwealth of Massachusetts Executive of E nvironmental Af f airs DEP Department of 1.9 ;�a Environmental Protection SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION CAPrq/A) CLUC 60 Property Address: 142 Capt. Ellis Lane. Hyannis, Ma. Address of Owner: Robert McDonough (if different) Date of Inspection: 07/04/96 Name of Inspector: Michael D eD ecko Company Name, Address and Telephone number: Atlantic Environmental P.o B ox 2384 - M ashpee M a 02649. Tel : (508) 4771420 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 inspection . The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. The system --x-- Passes ---- Conditionally Passes ---- Needs further evaluation by the local Approving Authority ---- Fails Inspector ' s S ignat cJt,, Date: 07/05/96 The system Inspector shall submit a copy of this inspection report to the Approving KY Authority within thirty (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 or the Department of Environmental Protection. The original should be sent to the system owner and copy sent to the buyer, if applicable and the approving authority. t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 142 Capt Ellis Lane. Hyannis Ma. 0 wners : Robert Mc D onough Date of Inspection : 07/04/96 INSPECTION SUMMARY: Check A, B, C, or D A)) SYSTEM PASSES: XI have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CM 15.303. Any failure criteria not evaluated are indicated below B)SYSTEM CONDITIONALLY PASSES: ---- One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair, passes inspection. Indicate yes, no, or not determinate (Y,N, or N D). Describe basis of determination in all instances. If "not determinated", explain why not. ---- The septic tank is metal, cracked, structurally unsound, shows substantial infiltration or exfiltration , or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. ---- Sewage backup or breakout or high static water level observed in the distribution . box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). ----- broken pipe(s) are replaced ----- obstruction is removed ---- distribution box is levelled or replaced ---- The system required pumping more than four 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 ----- obstruction is removed SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address : 142 Capt. E Ilis Lane. Hyannis M a. Owner : Robert Mc D onough Date of Inspection : 07/04/96 C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: ---- Conditions exist which require further evaluation by the Board of Health in order to de- termine if the system is failing to protect the public health , safety and the environ- ment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING INAMANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: ---- Cesspool or privy is within 50 feet of a surface of water ---- Cesspool or privy is within 50 feet of a bordering vegetated wetland or a small marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNC- TIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT. ---- The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. ---- The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well -- The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well ---- The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analy- sis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate notrogen is equal to or less than 5 ppm. D) SYSTEM FAILS: -- I have determined that the system violates one or more of the following failure criteria as defined in 310 CM 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to cor- rect the failure. --- Backup of sewage into facility or system component due to an overloaded or or clogged SAS or cesspool. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 142 Capt. Ellis Lane. Hyannis, Ma Owner: Robert Mc D onough Date of Inspection : 07/04/96 D) SYS T E M FAI LS (continued) -- 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 over- loaded or clogged SAS or cesspool. --- Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. =- Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). number of times pumped --- Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. --- Any portion of cesspool or privy is within 100 feet of a surface water supply ortributary to a surface water supply. ---Any portion of a cesspool or privy is within a Zone I 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 ana- lysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 142 Capt. Ellis Lane. Hyannis, Ma. 0 wner: R obert M c D onough Date of Inspection : 07/04/96 E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above : The design _flow of system is 10,000 gpd or greater Large System and the system is a significant threat to public health and safety and the environment because one or more of the fallowing conditions exist : --- 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 The owner or operator of any such system shall bring the system and facility into full compli- ance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please, consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST . Property Address: 142 Capt. Ellis Lane. Hyannis,Ma. Owner: Robert Mc D onough .Date of Inspection: 07/04/96 Check if the following have been done: -x Pumping information was requested of the owner , occupant and Board of Health. --x None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during the period. Large volumes of water have not been introduced into the system recently or as part of this inspection. --x As built plans have been obtained and examined. Note if they are not available with N/A. --x The facility or dwelling was inspected for signs of sewage back-up. --x The system does not receive non-sanitary or industrial waste flow. --x The site was inspected for signs of breakout. --x All system components,excluding the Soil Absorption System, have been located on the site. ---x The septic tank manholes were uncovered, opened and the interior of the sep- tic tank was inspected for conditions of baffles or tees, material of construc- tion, dimensions, depth of liquid, depth of sludge,depth of scum. ---x The size and location of the Soil Absorption System on the site has been deter- mined based on existing information or approximated by non-intrusive methods --x The facility owners and occupants if different from owner were provided with information on the proper maintenance of Subsurface Disposal System. L SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 142 Capt. Ellis Lane. Hyannis, Ma. O wnec R obert M c D onough Date of Inspection: 07/04/96 RESIDENTIAL: Design flow : '4 q U gallons Number of bedrooms : G 1-1 Number of current residents: oZ Garbage grinder (yes or no) : Nv Laundry connected to system (yes or no): u1.e.S Seasonal use(yes or no) : u(� Water meter readings, if available: 01 a Last date of occupancy :qku P .T COMMERCIALANDUSTRIAL : Type of establishment: Design flow : gallons/day Grease trap present: (yes or no) Industrial waste holding tank present (yes or no) : Non-sanitary waste discharged to the Title 5 system (yes or no) : Water meter readings, if available : Last date of occupancy : Other: (Describe) ...................................................................... Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS qnd source of information : . .................. System pumped as park of inspection(yes or no) :.....l .C>....... if yes, volume pumped : .................... gallons Reasonfor pumping :............................................................................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 142 Capt. Ellis Lane. Hyannis, M a. Owner: Robert Mc D onough Date of inspection: 07/04/96 TYPE OF SYSTEM i\ 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) --- Other (explain)........................................................................................... APPROXIMATE AGE of all components, date installed (if known) and source of information pie. ....! ,�...Ykvv ............................................................................................................. ................................................................................................................................................ ................................ Sewage odors detected when arriving at the site: (yes or no)....1`?�.... SEPTIC TANK : ... ...�.... (locate on site plan. Depth below grade: ..J.2.... Material of construction: .. . concrete ......... metal ........ FR P ........ other (explain) ................................................................................................................................................ Dimensions: !r? .�I*L* S N Sludge depth :.... ...... Distance from top of sludge to bottom of outlet tee or baffle:....... ?.................. Scum thickness:....O°........... Distance from top of scum to top of outlet tee or baffle: ............... Distance from bottom of scum to bottom of outlet tee or baffle 1.6. Comments : (recommendation for pumping , condition of inlet and outlet tees or baffles, depth of liquid level in re)ation to outlet invert, structural integrity, evidence of leakage, etc.)...................... SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAR T C SYSTEM INFORMATION (continued) Property Address: 142 Capt. Ellis Lane. Hyannis, M a. Owner: Robert Mc Donough Date of inspection: 07/04/96 GREASE TRAP : ...... ........... (locate on site plan) Depth below grade: ............... Material of construction: ........concrete.........metal........FR P........other(explain).... .......................................................................................................................................... Dimensions:............................... Scum thickness:........................ Distance from top of scum to top of outlet tee or baffle:....................................... Distance from bottom scum to bottom of outlet tee or baffle:............................... Comments: (Recommendation for pumping condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.)........................ ................................................................................................................................................. ................................................................................................................................................ '' ll TIGHT OR HOLDING TANKS:...:N ... (locate on site plan) Depth below grade:............... Material of construction:........concrete........metal.........FR P..........other (explain).......... ................................................................................................................................... Dimensions:............................ Capacity:....................gallons Design flow:...............gallons/day Alarm level:............................. Comments: (condition of inlet tee, condition of alarm and float switches, etc.) ................................................................................................................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 142 Capt. Ellis Lane. Hyannis, Ma 0 caner: R obert M c D onough Date of inspection: 07/04196 DISTRIBUTION BOX:.4�,(,S (locate on site plan) Depth of liquid level above outlet invert:..%'A ,��c Comment: (note if level and distribution equal eviden a of. solids carryover, evident of leakage into or out of box, etc.).�-�yx„� �S.�e9,��, ....° ....... l .................... �.,. ................. .......................................................................................................:........................................ PUMP,CHAMBER:...N v... (locate on the site) Pumps in working order: (}yes or no)............... Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.).................... ................................................................................................................................................ ................................................................................................................................................ SOIL ABSORPTION SYSTEM (SAS):...*. ..% " (locate on site plan, if possible, excavaidn not required, but maybe approximated by non- intrusive methods) if not determined to be present, explain: ................................................................................................................................................ ................................................................................................................................................ Type: leaching pits, number: ..,,?. e,—% leaching chambers, number:........ leaching galleries, number:........... leaching trenches,number ,length:..................... leaching fields, number, dimensions:................... overflow cesspool,number:.......... Comments: (note condition of soil , signs of hydraulic failure, level of ponding,tondi'o of veVekaki�ar ' d� c tc. ..�nrt.. .. o.�.�... .. Nv. i. ... . . .. .. ...... � .. �.. ... -�.►........ .r..!...... ....�3 V,�cyc- vvn N 0 who�Q , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property address: 142 Capt. Ellis Lane. Hyannis, Ma. Owner: Robert McDonough Date of inspection: 07/04/96 CESSPOOLS:....... (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: ...................... Indicator of ground water: ................... inflow (cesspool must be pumped as part of inspection) Comments: (note condition of sail, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) 'PRIVY : .... (locate on the site) Material of construction: ................................... Dimensions: ...................... Depth of solids: ................ Comments: (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.). . ................................................................................................................................................ ................................................................................................................................................ I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address : 142 Capt. Ellis Lane. Hyannis, Ma. Owner: Robert Mc Donough Date of inspection: 07/04/96 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate at wells within 100'. AS- HS a . 2 � 3 Os O � DEPTH TO GROUNDWATER: Depth to groundwater: :t...3 feet Method of determination or approximative: c. . ............................................... 1 LOCATION SEWAGE PERMIT NO• VILLAGE INSTA LLER'S NiME 'g- AIDDRESS B U I L D E R OR OWNER D-ATE PERMIT ISSUED DATE COMPLIANCE ISSUEDq � � ,- l!J v a a r � v )q-o • II 1 l Fzz- THE COMMONWEALTH OF MASSACHUSETTS �- BOARDPF HEALTH e . .. .... .�...........OF............ r� C .•��................................. Appliration for Disposal Works Tonstrudinn Verinit Application is hereby made for a Permit to Construct ) or Repair ( ) an Individual Sewage Disposal System at: ........... em", ....... ....................._..___.._...... Loca on Ad Tess or Lot No. ........ ,a.-/. --..-------•-•.... ...............••-••.......---•--•--.......... _......................--_ ... ��((/�//%j _Owner ••-•11• - -gam'�+ '^� �+ 'Address C?.�h. ..9C.i(�.... +....... .Lid.7K+r ............... ...a... .....1.3...8w:�.I; �.A........�����.. .................. ...... Installer Address Type of Building Size Lot.. ,c11..Sq. feet U Dwellingo. of Bedrooms............................................Expansion Attic ( Garbage Grinder (�8 -PL4.4 Other—Type of Building No. of persons............................ Showers — Cafeteria Q, Other fixtures ................... ......................... W Design Flow...............................QE_�? ....gallons per person per day. Total daily flow................V—.4.6............gallons. WSeptic Tank—Liquid capacity./2 gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length............. Total leaching area...................sq. ft. 3 Seepage Pit No.........�,...... Diameter......./p�.___ Depth below inlet... !,5........ Total leaching area. sq. ft. Z Other Distribution box ( L4---- Dosing t ( ) ~" Percolation Test Res is Performed by...... . _ .LPL. ....'_ ... .� .... Date_...��.:3��.G. ... Test Pit No. i+ .2-..minutes per inch DeptK of Test it..,lt�......... Depth to ground water...Q e.-Yg2 L7 Test Pit No. 2................minutes.per inch Depth of Test Pit.................... Depth to ground water........................ a {... 1 --. ... ......................6......-- .._.... o U/va lCv, o Description of Soil ............. .... ... i `'1 --.11:. ...•-•-•• --._...........------------._.. ----....--••---------------------------------------------•---------••--•--........................-----•--•----------------••-•-------•---•-••---..........•-•-•••---.................................. U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ......-•---•------...-•........................................................••----•-•---.....---..._..._.........---••-•----...---------..........---------.............._...............--•--...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITIM 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance I een iss d y the bo of hea f f _..._.. Application Approved By..... - ................:....... _ .�1.--•? Date Application Disapproved for the f ollouring reasons---------------•--•------•--••----•-•------....------•--•--...------••-------..........-----•-•-•-•••......--- ...._.__....••••••••••••••-•-••••---•••-•................•-••--•••--••-•---•-----•---•-•.......•••-•-•----•••-.....--•••-.......•--•-----------.__....•-------•-----....•----••----•...--••---••-•-•--- Date PermitNo..................................................._.... Issued......................................................_ Date 77 Fzim J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ... Application for Disposal Iforks Tonstrurtiott Errant Application is hereby made for a Permit to Construct A ) or Repair ( ) an Individual Sewage Disposal System at• . f ........... �;..:x?:t� '.. ....� - ............... =•-?--..�. Z7Z'E`1.............................--- -----_..._...._...... -Lora on-Address or Lot No. Owner (' ,> > -Address W v Installer Address . Type of Building Size Lot... ... :f :..Sq. feet ..� Dwelling—No. of Bedrooms.............. ..........._..__._.._._.Expansion Attic ( )Y� Garbage Grinder (;5 Other—T e of Building No. of persons............................ Showers — Cafeteria aOther fixtures ...................-.................................................................................................................................. W Design Flow...............................'?.:7.....gallons per person per day. Total daily flow..............Z-.' ....r.-.__.............gallons. WSeptic Tank—Liquid capacityJ _�Ogallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length........... Total leaching area.........µ.......sq. ft. Seepage Pit No......... Diameter....... -:2____ Depth below inlet...ti �`*....... Total leaching area. s . ft. Z Other Distribution box ( J.�^'' Dosing tank ( ) a Percolation Test Results � Performed b ._ �l ..�. r� Date..... Test Pit No. �. s,_1t'i f �.._..�- minutes per inch Dept of Test rt..,C.�:�.:._.___. Depth to ground water.._ �.. G>r Test Pit No. 2................minutes per inch Depth of Test Pit.............._..... Depth to ground water........................ P P P i�: :.....:.� ............ .. . OD � C �l ~ .............................. ...................... Description of Soil....... . � _._...-- -------------- U '•••.......................................... ...... .. . ............... ...----- _ -----•------..6....-------------------------------••----..__..........--------•------------------•----------• W VNature of Repairs or Alterations—Answer when applicable......................................................•........................................ ................................•------....................----......................-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1Z 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. ed............................•-------.......---•-•--.......------...------.......----.. -- • -? .._.... -De Application Approved BY..... ...... .........--..................................................................._ --- ------------•----- nr Date Application Disapproved fo th follasuig reasons: ---••---•.........................•--...............--••---•--.......------•-----..............---•--.......-- ....................•----.....-----------•------......•-•------•--.......------------.......-•----•.......•---------•-------------------......------............................... .--------•-• Dom — PermitNo...................................................--- Issued......................................................_ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... (Irrtif irate of Tomphanrr I,S TO C RTIFY, That the Individual Sewage Disposal System constructed ---}-vr Repaired ( ) by..._._:( 'l.;r.�! G......- - ---•-------•-------------------------------------------------------------------------------------- __.._.._ ,.../ Installer at .. 5�j !c(_. L::................. . . has been installed in accordance/with the provisions of TITS 5 of The State Sanitary Cod s sc ibed in the application for Disposal Works Construction Permit Ivo.._.it..J._"_ Gr/__........ dated... _... , THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................... ................................ Inspector._..... ....................•--•----•-•--............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH New/ �... ...........................................OF...... ............................. ...................... � Dios rf�o traction frrntit Permission is he 'granted....._ ( --.............. ........................... ......._-__ to Construct ( or ( ) an,Indio' - , Cage D i's�d� 'stem atNo.................. ...2.. ..........._. ........._....:.r:___�� ��:__.._...._......... ............. 71 Street as shown on the application for Disposal Works Construction Permit No....,�'✓...... Dated.......................................... ...................... ...• --....------........•-•••-•--............---.........---...---........_ 2r�r t� / r DATE..................................1...._...._�._._.........-----.......... / Board of Health. FORM C-1255 CITY & TOWN FORMS, INC.369-9708 { 17' r July 2; 1984 p� Mr. Joseph Daluz Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Dear Mr. Daluz: We have first hand knowledge that the dwelling being built on Captain Ells Lane (map 250; parcel 120) is being constructed as a two family home with two kitchens in direct violation of the zoning bylaws for the area (RC-1) . We are sure that upon your department' s review of the construction you will. concur with this determination and take the appropriate action to correct it. Sincerely, Q V-c�Q.l L17 t:;;R a Cc: Mr. John Kelly, 3oaid of HeaIth Mr . Ed jenkina, Pi�-mh r;y "T ISpector Barnstable Selectmen Board of Appeals r� OFFICIAL USE O`L601 p Postage $ ra i Certified Fee RJ mark p Return Receipt Fee -Here M p (Endorsement Required) CL M p Restricted Delivery Fee (Endorsement Required) OTotal Postage 8 Fees $ \ �� rLI Sent To r, Pvl� T� yL&alLTA p - ---------------------- - •--•7- ---------------------- C3 Sire,,Apr. o.; f 3 or PO Box No. City te,Z%P+4 ._... A.Y4-------- ------- ovT K M 0 :rr Certified Mail Provides: , o A mailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. a Certified Mail is not available for any class of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. a 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"Retum Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. o 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". d 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 ON ON SENDER-'-COMPLETE,,THIS SECTION VER�, ® Complete items 1,2,and 3.Also complete A. Si ture (/ item 4 if Restricted Delivery is desired. �J ❑Agent X ® Print your name and address on the reverse WAddressee so that we can return the card to you. B. Received by(Printed Name) C. Dat of Delivery ® Attach this card to the back of the mailpiece, L"f^ �c t i 1 i 5 n�6 or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No ILT 42 VLA O%A 3 CJ I N o tLl" "A►u s? �G. �� �¢. (�V'1►-i MA 3. Service Type A(Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted'Deliveryl(Extra Fee) ❑Yes 2. Article Numbertiz 7 f (Transfer from service label) FT'1+7 0 0 6 215 0 0 0 0 2 10,41 �"8;16'0 t E urn Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No.G-10 i • Sender: Please print your name, address, and ZIP+4j-'ih this box • Town of Barnstable Z Health Division 200 Main Street N rn Hyannis, MA 02601 I 111��11,.111,11 fill„1„11111,1111,1111ti„�I,ii'i���ll����l�lst °q THE rOk- Town of Barnstable BaYnstaoie A!�-AMMca City E, Regulatory Services Department DAE MASS. " 39. Public Health Division Op i659, `g Ar�D—""A�A 200 Main Street Hyannis m y s MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL 7006 2150 0002 1041 8160 October 29, 2008 Paul Tetreault 397 North Main St. So. Yarmouth, MA 02664 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 142 Captain Ellis Lane, was inspected on October 29, 2008 by Jaime Cabot, Health Inspector for the Town of Barnstable. The inspection was conducted on the basis of an inspection. The following violations of the State Sanitary Code were observed. 105CMR 410.503: Protective Railings and walls- Exterior stairway does not comply with Mass. Building Codes. 105 CMR 410.450: Means of Egress- Front entrance does not allow for safe passage as per Building code. You are ordered to correct the above violations within thirty (30) days of your receipt of this notice by obtaining the required building permits to bring all egress to code. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations,please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THWB - F HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Q:\Order letters\Housing Violations\142 capt.ellis.tetreault2.doc Barnstable Town .of Barnstable Regulatory S ment AJtl-dmeacaCdy - BARIN STABLE, '\yo MASS. 0 ° 039. � Public 0 a AIfD MA't% 200 Main Street, Hyannis MA 02 1 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL 7006 2150 0002 1041 8160 October 29, 2008 Paul Tetreault 397 North Main St. So. Yarmouth, MA 02664 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 142 Captain Ellis Lane, Hyannis MA was last inspected on April 17, 2008, 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: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. 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 Agent of the Board of Health Town of Barnstable C:\Documents and Settint;s\cabof\Deskto \tetreault.doc 1 P . FORM 30 &w HOBBS&WARREN M THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN W \4 L�l o DEPARTMENT ADDRESST(�a }! TELEPHONE/ Addre occupant- VA c-A Floor Apartment No. No.of Occupants No.of Habitable Rooms No.Sleeping Rooms____ No. dwelling or rooming units No. S pries '"' Name and address of owner vk_ _,��u- ;sj' ° .��� Remarks Reg. Vio. YARD Out Bld s.: Fences: Vj �0 4 " y . Garbage and Rubbish VN c) ; �, �. ,r 417e) Containers: pvc;,,� '%;�If 0 {"\ . trt �z-L-4 .3 Drainage f Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: € . ': w, .g AI ko 5JL Dual Egress:and Obst'n.: ❑ B ❑ F ❑�M Doors,Windows: "J 'moo f;; 1 Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n. Hall, Floor,Wall,Ceiling: Hall Li `htin r > Hall Wih cws:- ti HEATING Chimneys: Central ❑ Y O'N` E ui . Repair ' TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tank(s)Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 IjBedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten., Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: J , General Building Posted IV I A Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE t OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." •f /% INSPECTOR " > . '' TITLE A.M. DATE t' 'C! � TIME ' P.M. A.M. THE NEXT SCHEDULED REINSPECTION Aw P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shali be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in giantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns,shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower cr bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. S ,OA-rA //v X41 D. l � 99 ,S,Evri Z. 7 4,✓'C Vt:�)X/S©'a =GG4 G Via. ��r E",� I 4FA _.pi,S�A� Pig'- lJ.S•� Z-Gao GAL. 4s/.3 57�c% ,o.rs .�•av�c 2.S M � Lao Trc�.�Ae.�•4 = Z 2 G 5.• 7 97. ZZ� X /.4 , _ aZG X?©, - 71v774 4-- . oA5_ 1GIV - BE3G G. Pp. Z ToTA t,., I>A14. --/oN,e,4 r45 1"/X/ ZNJ141- 4Ae c'ffIZS Z 2 `N 0 r cP� 5 ��P4S� OF M� �!'� ILLIAM W 1140 r•-? O� ALAN G ti �' w. •, o p No 19334 o z51pn N Z A o y9 J ryTt� -k k- 1 F r 5g / i 7Esr p zd 9� h/oc� G�ZQ�83 wl• To.�.�/Yl? �/c10.O y i e /.✓✓. - 97 S / ��� Z_Goo Di,Sr,' c�.S[. . !�v✓, �S� G,. mac i•v✓, PITS .. �� •�+ .?TONG 87 7- /. e-,E,2 7-/,Cy 7W,47r 7-H Zr 4,3.e Z e"5 4E 6 S/��G/�►/,,>� .�4iS/l SETB/tC1C �Cr'�/K�i•�c�S G-rdx�",���.c/y/E/�•vC. a 4e-Al,ST494.4er AAIV 1115 O$ ✓/Le-E AI,4.5�;% �/oT ��D 1 / ) f1�P.0/G4NJ- ,�G',✓.�L� B44T�/-7,�. Ff4-4.V/ AIO-r 2?4,5Err-.) oA./ .4N ,Sv,e✓.�y � .�= l>,G�S r'7�, s'Hc bc%N' Syo v L v TOWN OF BARNSTABLE .� /dcl� • S�4�LOCATION. SEWAGE#I _ VEU,AGE AJ �n ASSESSOR'S MAP&LOTI� '1a D INSTALLER`S NAME&PHONE NO. SEPTIC_TANK CAPACITY LEACHING FACILITY. (tyoc) S (size) — b 00 -s NO.OF BEDROOMS �+ BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water'Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet f leaching facility)/ � /"1' 08 Feet Furnished by c5 WVI —`Y13 a � Ir -0-9 W - r LONGVI. 0 20 30 40 EW No ACCES DRIV �'' � NOTE: S E / _ - / SEE 4 BEDROOM HOUSE 1,25' 1 GRAPHIC 20 FEET (2.5 STORY) .ON FILE & INCH AT THE BARNSTABLE \N1236'29'E S1'OCKADE FENCE 7 910'11"�? 131,35� BOARD OF HEALTH.NCE . t "`� X 70.7 f 69.5 70.1 / / 42�` X 70 8 PAVEMENT 71.1 S78.16,49„E I NOTE: ` 98-96' EXISTING LEACHING PITS TO Q / I �. BE PUMPED, SANDFILLED 71.5\ W �71.0 \ CRUSHED & ABANDONED IN i I ACCORDANCE, WITH TITLE 5. \\. 70.7 WALK X 69.5 / X X " ��i I \ X 70.0 ,� 3 / 69.6 70.9 PROPOSED DECK X 69.1 2 2 in X 70.9 —� FENCE #142 .0' _ — — P / _ RAWL LOT 25 _N UTILITY SPACE CELLAR CRAWL 2 3 9 5 7± S. F. 'Icy, I p-� J ' SPACE 0 �� W N �-1 -L �—� 20\cq 69.2 12 x22 �j PINES DT DTH #2 28.0' \ 2' � 1 0 X 70.6 7 8 14.0' PROPOSED 68.7 12.83'x33.50' BULKHEAD 00 S.A.S. 70.6 69.3 274 1 N84°58'11"W BENCHMARK 68.3� �1 NAIL ''SET IN 30" PINE i SHEET 1 OF 2 ELEVATION 72.00 _ PREPARED BY: SITE & SEWAGE REPAIR PLAN LOCUS INFOMATION EAS SURVEY, INC. #142 CAPTAIN ELLIS , DRIVE ' ASSESSORS MAP 250-120 141 R T. 6 A H YAN N I S, M A PLAN REFERENCE 288-18 Va�`tNo�rrti�sq ��NOF� ss9c P. O. B 0 X 1729 i ZONING DISTRICT RC-1 � DA D Gs o�'� EDWARD_ OWNER/APPLICANT: o A: SANDWICH PAUL TETREAULT 8c JOHN HANDEL ' OVERLAY DISTRICT NOT A ZONE II " � "E STONE No 11 o. 28 80 MA 02563 397 NORTH MAIN ST. FLOOD ZONE "c" sG,STE� ,ST y° 'PH. (508) 888-3619 SOUTH YARMOUTH , MA 02664 ' LOT AREA 23,957t S.F. ANITA10' A �J 1 FAX (508) 888-2496 DECEMBER 3, ' 2008 :f - 4 _ TOP OF FOUNDATION SYSTEM DESIGN ELEV, 69.45 ' RAISE COVERS TO WITHIN 6 OF FINISH GRADE FINISH GRADE 69.83 FINISH GRADE CENTER CHAMBER RISER DESIGN FLOW RAISE TO WITHIN 6" 4 BEDROOMS AT 119- GPB/D 14-0- GOD ELEV. 68.8 ELEV. 70.0 FINISH GRADE OF FINISH GRADE z• � � /jC�� - //� ELEV. 70.4 GROUND. ELEVATION 70.2 GROUND ELEVATION 69.8 REQUIRED SEPTIC TANK TOP _ �� /�� ��///�� .� �� �� .��, ---440 x-2-- ----880 GAL. 22.5'OS= 0.02 TOP ELEV 67.25 1 MIN.-3' MAX. COVER 1®4' S= 0.03 � ._ � SEPTIC TANK REQUIRED = _��0_GAL. " 18'CS= 0.018 2@12'S= 0.01 2" MIN 1/8"-1/4" ` SCH 40 2 MIN-3 MAX 4" PVC SCH 40 O'6Op0 o o ; Op0p0 DOUBLE WASHED SEPTIC TANK PROVIDED = INV.= O, O O o o O O O I PEA STONE :z V.= 7.76 67.31 10"TEE 14 TEE INV.= p p O O N SIZE OF LEACHING FACILITY REQUIRED 67.11 6., O''pOO OOO o o OO OOO OOO 3/4' DOUBLE GAS BAFFLE 3 OUTLET WASHED STONE I (THREE 4'-1O"x8'-6"x2'-9" CHAMBERS DESIGN PERC RATE _ _<_2 __MIN./INCH f; 4'-1" LIQUID LEVEL D-BOX LONG TERM APPL. RATE_�•_74_GPD/S.F. INV.=66.79 INV.=66.50 o v INV.=66.62 S.A.S. (12.83' x 33.50') n�. V 64.50 SIZE OF LEACHING SYSTEM PROVIDED: o a e, e e o � 0 440 _ 0.74 SF/GPD = 595 S.F. MIN. REQ. CONSTRUCTION NOTES: Lo Lo TEST PIT #2 RE-USE EXISTING 1500 USING 3 CHAMBERS WITH 4' STONE AROUND GALLON SEPTIC TANK 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND ELEV 58.8 BOTTOM OF HOLE ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING NO GROUNDWATER ENCOUNTERED SIDEWALL = 2(12.83+33.5') x 2 = 185.3S.F. WORK ON THE SITE.r BOTTOM = 12.83' x 33.5' = 429.8S.F. 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE TOTAL LEACHING AREA = 615S.F. WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT 615 S.F x 0.74 = 455 GPD IS TO OBTAIN SUCH"DETERMINATION FROM APPROPRIATE AUTHORITY. QQ,� 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING 455 GPD PROV > 440 GPD REQ. = 15 GPD RES. SITE CSC, SEWAGE MATERIALS OVER THE SEPTIC TANK, DISTRIBUTION BOX AND NO (GARBAGE DISPOSAL / GRINDER ALLOWED) S.A.S. AREA IS PROHIBITED REPAIR PLAN G DATUM : #142 CAPTAIN VERTICAL DATUM: MSL± D.T.H. #1 D.T.H. #2 E L L I S LANE GENERAL NOTES: BENCH MARK USED: TOWN OF BARNSTABLE DATE: 12-1-08 DATE: 12-1-08 IN 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E:P. GROUND ELEV. 70.7 GROUND ELEV. 69.8 TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS GIS DATUM. NO GROUNDWATER NO GROUNDWATER H YA N N I S, MASS FOR SUBSURFACE DISPOSAL OF SEWERAGE. 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE DATE: DEC. 3, 2008 ACCESSIBLE WITHIN 6" OF FINISH GRADE, WITH ANY REMAINING INDICATES DEEP 0/E/A O/E/A ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. DTH, #1 LOAMY SAND LOAMY SAND 3. SPLIT RAIL FENCE TO BE INSTALLED ALONG EDGE OF PAVEMENT TEST HOLE 10YR 4/3 10YR 4/3 OWNER/APPLICANT: BY PARKING AREA TO PROTECT SEPTIC SYSTEM. 10YR 5/1 1OYR 5/1 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATIONI B 4 B 6" P A U L TE TR E A U L T OF ALL UTILITIES PRIOR TO ANY EXCAVATION. INDICATES 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE 111 LOAMY SAND LOAMY SAND P-1 gO' PERC TEST 1 OYR 5/6 26" 1 OYR 5/6 28° 397 NORTH MAIN S T. 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER i NO GROUNDWATER ELEV =68.5 ELEV =67.5 FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. NO MOTTLES 7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF 1 SOUTH YA R M 0 U TH SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE NO WEEPING THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND I 10% GRAVEL SHEET 2 O 2 LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. I �`jN of MgSs S 60" 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN, q� ��NOF C C t' ti �`� �� COARSE SAND COARSE SAND 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT �o DAVID o� EDWARD ti� 10YR 7/6 10YR 7/6 ELEVATION OF THE OUTLET PIPE. D. N 132" 132' PREPARED BY: 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES FLAHE R A. ELEV =59.7 ELEV =58.8 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS 0. 1 STONE EAS SURVEY, INC. BAFFLE, 4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC �o $o �N 898 B.O.H. 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND �s T DONNA MIORANDI 141 R T. 6 A SHALL BE SLOPED 1/4 INCH PER FOOT MIN. EXCEPT FOR THE NITAR\ 5TE ��J SOILEDSTONE EVALUATOR. �/ FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALLE LEVEL ! BACKHOE OPERATOR. P. O., BOX 172 12.BCHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION �� 4� WARREN MIRANDA SANDWICH M A 0 2 5 6 3 TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW SOIL TYPE: �_ AND.APPROVAL. PERC RATE: <2 MIN. PER INCH PH. (508) 888-3619 13. MAGNETIC TAPE TO BE BURIED OVER THE TOP OF SYSTEM AND OVER LOADING RATE: 0_74 GAL/SF/MIN � FAX (508) 888-2496 PVC PIPING f �) 142 Ca,ptain Ell Residential - o Q 142 Ca tain Ellis p z � Q H annis , MA 02 601 o - Z Z LIJ J U co ca a 0 N Z LU r U IECC TABLE 402.1.2 INSULATION AND FENESTRATION REQUIREMENTS BY COMPONENT ASSEMBLY REQUIREMENT ACTUAL LLJ t � WOOD FRAME CAVITY WALL R=20 R=21 `Q WOOD FRAME FLOOR' R=30 R=30 DENNIS COLWELL -ARCHITECTS INC. vk D-°►R� '. -G r WOOD FRAME CEILING'z a R=49 ER=449 " '(` COLWINDOWS U=0.320 _ 'ti,. LJ 34 School Street, Suite 204, z� Z DOORS U=0.320 Us0.320 ' Foxborou h, MA 02035 - N F Q QQ n b SE �APP N SSA C H U E DIX 11 -R4 A SAA 07.5 PRESCRIPTIVE OPTION FOR ALTERATIONS RENOVATIONS AND REPAIRS. � M V ENVELOPE INSULATION SHALL MEET H I EXCEED G M TERI REQUIREMENTS(CHAPTER 4 SECTION 40O FOR CLIMATE ZONE 5, h. 5 08-241-212 2 f. 5 08-45 5-4466 OR FULLY FILL EXISTING CAVITIES WITH INSULATING MATERIAL WHICH MEETS OR EXCEEDS AN R-VALUE OF R=3.5/INCH � � 1 - z R402.2.1 CEILINGS WITH ATTIC SPACES. , q� . �P WHEN SECTION R402.1.1 WOULD REQUIRE R-38 IN THE CEILING,INSTALLING R-30 OVER 100 PERCENT OF THE CEILING AREA YYYV Y Y.dc-architect,com Of- REQUIRING INSULATION SHALL BE DEEMED TO SATISFY THE REQUIREMENT FOR R-38 WHEREVER THE FULL HEIGHT OF U UNCOMPRESSED R-30 INSULATION EXTENDS OVER THE WALL TOP PLATE AT THE EAVES.SIMILARLY,R-38 SHALL BE DEEMED TO LU SATISFY THE REQUIREMENT FOR R-49 WHEREVER THE FULL HEIGHT OF UNCOMPRESSED R-38 INSULATION EXTENDS OVER THE ., WALL TOP PLATE AT THE EAVES.THIS REDUCTION SHALL NOT APPLY TO THE U-FACTOR ALTERNATIVE APPROACH IN SECTION d I� R402.1.3 AND THE TOTAL UA ALTERNATIVE IN SECTION R402.1.4 a R402.2.2 CEIUNGS WITHOUT ATTIC SPACES. f\ WHERE SECTION R402.1.1 WOULD REQUIRE INSULATION LEVELS ABOVE R-30 AND THE DESIGN OF THE ROOF/CEILING - - Lr) ASSEMBLY GOES NOT ALLOW SUFFICIENT SPACE FOR THE REQUIRED INSULATION,THE MINIMUM REQUIRED INSULATION FOR - O SUCH ROOF/CEIUNG ASSEMBLIES SHALL BE R-30.THIS REDUCTION OF INSULATION FROM THE REQUIREMENTS OF SECTION R402.1.1 SHALL BE LIMITED TO 500 SQUARE FEET(46 M2) OR 20 PERCENT OF THE TOTAL INSULATED CEILING AREA, _ r WHICHEVER IS LESS.THIS REDUCTION SHALL NOT APPLY TO THE U-FACTOR ALTERNATIVE APPROACH IN SECTION R402.1.3 AND THE TOTAL UA ALTERNATIVE IN SECTION R402.1.4. - - m —G.C.TO VERIFY WITH CODE OFFICIAL TO CONFIRM ADDITIONAL ENERGY CODE COMPLIANCE REQUIREMENTS- x - - 0 N -� W 03 03 p Q rh Y (B 0 m _ o Rave 21 N €T R y � ° ° $$� � �58 ° :�° Q °� 4 �¢ R`s_ =a" o^ 's�§o � e i w � a 8E oR D � NUNN r ii I I 13 FHr:€° r�3ro?p PASfro z, vF€$FIao3a-oaf- Mtn ta �AFFa 'Tl � n E825 gee � m A� F Z a m I \ i LJ I ' =�s�.> >0 3aa `�z�o 3 a aaaaa- 3rnayES "s � 'o ;s Gg�eg881 ; gad ' 5 4 H F a€bs ° n � _�'rnoo�So°6 oT= aSIC�oAN °em: 6 o -Z - o � � m rnrn M. - ^ m �_ RR £7 � � o �o - Aa o° m0 " °D � n A o o � o� " o m EF0 — A gA 5( oO O �Z Op O g F °oZO 9 $ o NO �21- 0 �8 �i o 5 0 0 ci o �4 i ;E S F� zo= $ _ gig o g F ��a o� z� 4 0 Ro z 60 _ & o o oA C o m g £'z o f Oz 2� ^o A �, A n ro oa 8 Y o O = Fo m ?6 A po -^ a 3 o` 3 s z e:� 3^� m �m c RF &z ° o �03 o � �° ga g oA o o o ="S � R °oT aF $ c [Fnn ., o a _ ^= Go'o" m a� �m p og 90 g A- �'o^• o m z`o_z$ g�3 Go TM gR i � �` o £� 50� ° L 2 - £ £ A F nyx.••' c0 QO xO of 6 0 0 �4° G� N am £Om n.F �p0 g " ib ° �p� e'= 3 Q ° _m � 2 5 22 ��°° z F� FF FF F 'n^ - pN O y 0 n i O O ° N O O A •Y �' O OD s $ ; mO A F ° z°° S a 8 AOD O O S KF A� F m AO '°0 Q ° g°g E£ 9i F a0o u 40 o S O m m m m fz ^ �& x m m a o �' ; mo 'i NZO m oc =sr z'° ° $ po i omo ° z « o °- �" o ioe 5�3 zni ?So Ro o o�' igs ahnF AS s 5 _ 4o A 'Ao££yA ifoSego g °$"$ mo _ c£S Soo_ ° o9 oi o i op I 2 ° 9 o o ` o o 0 a mR�$0izop0A o9giZ 0A�g gk i 0 o O i o °o 0 oo o ° s o 4 oo z G0 Fc 0 PH i m IE ° o o" o o o A5 .; £ o p o _ � ao 'a ' 8 0 No z �' '?? 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