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Home My WebLink About0265 FIFTH AVENUE (HYANNIS) - Health 265 Fifth Ave-��`rtl!) Hyannis A=245-037 i o r o n I o I c h IY n 4 fl of d o , t e e I� � TOWN OF BARNSTABLE LOCATION D 6 SEWAGE# Zo/ 0�/-N- VILLAGE NAari s Pao► T ASSESSOR'S MAP&PARCEL 2 q 5-D37 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY / J a S T !o 0 o w T c, �A LEACHING FACILITY:(type) 3,- >^'fyfreprd a-r (size) i Z X 3a NO.OF BEDROOMS OWNER PERMIT DATE: - >ZL / COMPLIANCE DATE: 17 Separation Distance Between the: i Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility r Feet Private Water Supply Well and Leaching Facility Of 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 e y rN �. n c 4 r TOWN OF BARNSTABLE L( CATZON ;295 Fi>!5�4 c)e • SEWAGE# VLLAGE GJ • t`- u k w s -� ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) /!i e_ (size) 11 NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility S• 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 �� :u > . 7//��6 1 6Z, n H � X i Q May 12 2019 20:11 HP Fax page 23 Syr_ 03:� Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments t 265 Fifth Ave ' ,.:J Property Address Janice& Kullin Schade Owner Owner's Name l Information is required for every West Hyannisport MA 02672 5-9-19 " page. CitylTown 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. `"tpttR II I ufllll/r�i Important:When A. Inspector Information [go(a1��a'`` filling out forms on the computer, r JA M ES G use only the tab James D. Sears key to move your Name of Inspector c>: SEARS cursor-do not Capewide Enterprises a• n o . � use the return Company Name �4l! ...RTiF� key. 153 Commercial Street �� Company Address Mashpee MA 02640 City/Town State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification 1 certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above:the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails � ¢Qil a�. 5-10-19 spector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Mnsp.doc•rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 16 May 12 2019 20:12 HP Fax page 24 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form •Not for Voluntary Assessments 265 Fifth Ave Property Address Janice& Kullin Schade Owner Owner's Name information Is required for every West Hyannisport MA 02672 5-9-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary:Complete 1, 2, 3,or 5 and all of 4 and 6. 1) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Note:Outlet Tee has a zable filter. The system is a 1500 Gal.Tank Pump Chamber D Box and 32 chamber's. 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for'yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old' or the septic tank (whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltrabon or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5insp.doc rev.712612018. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 May 12 2019 20:12 HP Fax page 25 Commonwealth of Massachusetts Title 5 Official Inspection Form Ih Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice&Kullin Schade Owner owners Name information is West Hyannisport MA 02672 5-9-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection summary (cont.) 2) System Conditionally Passes(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumpsialarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ NO (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ NO (Explain below): distribution box is leveled or replaced ❑ Y ❑ N ❑ NO (Explain below): i ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed, ❑ Y ❑ N ❑ NO (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: l51nsp.coc-rev.7126/2018 Tithe 5 Otfidel Inspection Form:Subsurface Sewege Disposal System•Page 3 of 16 s May 12 2019 20:12 HP Fax page 26 Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice&Kullin Schade Owner Owner's Name Information is West Hyannisport MA 02672 5-9-19 required for every - page City(Town State Zip Code Date of Inspection C. Inspection Summary (cunt.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning In a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 5D 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 CEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other; 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7126/2018 Title 5 Official Inspection:Farm:Subsurface Sewage Oisposal System-Page 4 of 18 May 12 2019 20:12 HP Fax page 27 Commonwealth of Massachusetts Title 5 Official Inspection Form C to Subsurface Sewage Disposal System Form -Not for Voluntary Assessments no, 265 Fifth Ave `Jf Property Address Janice&Kullin Schade Owner Owners Name information Is required for every West Hyannisport MA 02672 5-9-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in assepoW is less than 6"below invert or available volume is less than day flow 4"cNiwG' Required pumping more than 4 times in the last year NOT due to clogged or ® obstructed pipe(s).Number of times pumped; ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal conform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd: ❑ ® The system falls. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure, 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well 15insp.doc-res.712612018 Title 5Oftial Inspection Form:Subsurface Ssm@e Disposal System•Page 5 or 18 May 12 2019 20:13 HP Fax page 28 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice& Kullin Schade Owner Owners Name information Is required for every West HyannispOrt MA 02672 5-9-19 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C,5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of 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 localion of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)1 t5insp,doc rev.7/26/2018 Title 5 Offival Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 May 12 2019 20:13 HP Fax page 29 Commonwealth of Massachusetts Title 5 Official Inspection Form .p Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice& Kullin Schade Owner Owner's Name information Is West Hyannisport MA 02672 5-9-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. 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 Description: 1500 Gal.Tank- 1000 Gal. Pump Chamber D Box and 32 Chamber's. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes,discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2017-55,300Gals 9 ( Y 9 (gP )) 2018-29,900Gai's Detail: Sump pump? ❑ Yes ® No Last date of occupancy, NA Date f6inap,doc•rev.7r2612018 Tile 5 Official Inspeclion Form-Subsurface Sewage Disposal System-Pepe 7 of 18 May 12 2019 20:13 HP Fax page 30 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice & Kullin Schade Owner Owner's Name information is West Hyannisport MA 02672 5-9-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Dace Other(describe below): 3. Pumping Records: NA 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: t5insp.doc-rev.7/26/2018 Tide 5 Official Inspectlon Form:Subsurface Sewage Disposal System-Page 8 of 18 May 12 2019 20:13 HP Fax page 31 Commonwealth of Massachusetts Title 5 official Inspection -Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 265 Fifth Ave �"+• Property Address Janice& Kullin Schade Owner Owner's Name Information is West Hyannisport MA 02672 5-9-19 required for every City/Town/Town State Zip Code Date of Inspection page. Y D. System Information (cont.) 4. Type of System: ® Septic tank,distribution box,soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records,if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest Inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ® Other(describe): Pump Chamber Approximate age of all components, date installed (if known)and-source of information: 2011 Permit # 2011 -045. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 17" 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.): 4" PVC SCH -40. t5irtsp.doc-rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 f May 12 2019 20:14 HP Fax page 32 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice& Kullin Schade Owner Owners Name Information is west Hyannisport MA 02672 5-9-19 pagrequired for every Cityllrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 7" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑polyethylene ❑other(explain) If tank is metal, list age: yes Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No 1500 Gal, Precast H-10 Dimensions: 1" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 29" 0" Scum thickness Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 18 How were dimensions determined? Asbuilt-Plan-Tape Sludge Judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank and inlet cover at 7".Wloutlet cover plastic at grade.In and outlet tee's No sign of leakage or over loading.Note: Outlet tee has a zable filter. t5insp.doc-rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 L May 12 2019 20:14 HP Fax page 33 Commonwealth of Massachusetts Title 5 Official Inspection Form " Subsurface Sewage Dlsposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice & Kullin Schade Owner Owner's Name information is required for every west Hyannisport MA 02672 5-9-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): S. Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Nnsp.doc•rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 o118 May 12 2019 20:14 HP Fax page 34 Commonwealth of Massachusetts Title 5 Official Inspection Form 4� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice& Kullin Schade Owner Owners Name information is West Hyannisport MA 02672 5-9-19 required for every page City/Town State Zip Code Date of Inspection D. System Information (cunt.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): 1 "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 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.): D Box is 16"x16"-at 2" below grade. Box is clean and solid wlfour line's out. 2" in w/Tee. No sign of solid carry over. 151nsp.doc rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 er 18 May 12 2019 20:14 HP Fax page 35 Commonwealth of Massachusetts l Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �y 265 Fifth Ave Property Address Janice&Kullin Schade Owner Owner's Name information is required for every west Hyannisport MA 02672 5-9-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in workingorder: Yes ❑ No Alarms in working order: ® Yes ❑ No' Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is 1000 Gal. Precast Tank.Tank and inlet cover at 21" w/outlet cover plastic at grade. Chamber is clean w/one pump. Pump and alarm working. * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number, ® leaching chambers number; 32 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow,cesspool number: ❑ innovative/altemative system Type/name of technology: 15insp.doc•rev.7r2612016 Title 5 Official Inspection Form'Subsurface Sewage Disposal System Page 13 of 18 May 12 2019 20:14 HP Fax page 36 Commonwealth of MassachusettS Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 265 Fifth Ave Property Address Janice & Kullin Schade Owner Owner's Name information is West Hyannisport MA 02672 5-9-19 required for every page. atYR '^o^ State Zip Coce Date of Inspection D. System Information (cont.) 11. Soil Absorption System(SAS)(cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching i 32 infiltrators. Ck D Box rob area and camera out lines. No sign of over loading or Leac g s p solid car over.No sign of holding water. carry 9 9 12. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7126/2018 Title 5Official Inspection Form:Subsurface Sewage Disposal System•Page 114 of 18 May 12 2019 20:14 HP Fax page 37 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice &Kuilin Schade Owner Owners Name information is required for every West Hyannisport MA. 02672 5-9-19 page. Cityrrown State Zip Code Date of inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc,): t5insp.doc rev.7126/2018 7ille 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 May 12 2019 20:15 HP Fax page 38 Commonwealth of Massachusetts Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form -Not for Voluntary Assessments " 265 Fifth Ave Property Address Janice & Kullin Schade Owner Owners Name information Is requireequired for every West Hyannisport MA 02672 5-9-19 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately t5inep.doc•rev.728/2019 Title 5 Official Inspection Form!Subsurface Sewage Disposal System•Pege 16 of 18 May 12 2019 20:15 HP Fax page 39 May 01 19, 11;54a Capewide Enterprises 508-477-4977 p.11 TOWN OF BARNSTAB" LoCATI0x �L 6 F c y t A of SEWAGE 0 201 0�r VAIJ+GE,04—o,:Poa f ASSESSOR'S my&➢AxcEL .2 Y5-o37 IIISTALI�R'SNANffi�PNOA'ENO.A4eNla..�T s�F �» �362 su-ncTANKCAYACrTY /So o S r ,000 -/P- ra LEACHNG FACILnY(type)3,Z F,/faPra✓ (du) I A x J.Z No.OF BEDROOMS �1 A OWNER -0 S•4 A(JE PERMIT DAn: :fA/[/ CD?+ LIANCE DATE: ggwvdm D•utaooe BMweee the: Ma�timutaAdfuatadG:es+dwstar7ablebt6eBotta:ODfLearhillPFadl;ty s Pen Private bleat supply WW and Leathirs F"ty Of airy wells exist as 1t i aite a within X0 feet of ie"kioe fa ti►ley) Fed Edg:of WCiioad WA L&0Wng facildr(If eoy WMIMdaetwtvothm 300!ms of beching hasty) Ft� PURN PM BY s • jo ' 11,V wad (9 3 )93:z4., QJ=03t o i� ri 3`!. r 33 tjoC, f3 S• '� s-, crt0r'a may= y� ' i , May 12 2019 20:15 HP Fax page 40 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 265 Fifth Ave Property Address Janice &Kullin Schade Owner Owner's Name iM is requairedired for every West Hyannisport MA 02672 5-9-19 o page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to N ground water: 9fi' feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans an record If checked,date of design plan reviewed: 8-27-10 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: T.H.on Design plan B-27-10 8'G.W.. Bottom of chamber's at T below. Bottom of chamber's at 5' above T.H.Depth. Before filing this Inspection Report,please see Report Completeness Checklist on next page. 15insp.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 May 12 2019 20:15 HP Fax page 41 Commonwealth of Massachusetts Title 5 Official Inspection Form a� Subsurface Sewage Disposal System Form Not for Voluntary Assessments v� 265 Fifth Ave Property Address Janice & Kullin Schade Owner owner's Name Information is West Hyannisport MA 02672 5-9-19 required for every State Zip Code . Date of Inspection page- E. Report Completeness Checklist Complete all applicable sections of this form Inclusive of: B{ A. inspector information: Complete all fields in this section. ® B. Certification: Signed& Dated and 1, 2, 3,or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4(Failure Criteria)and 6 (Checklist)completed Z D. System Information: For 8:Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included CPAoW Gw t5lnsp.doc rev.71262018 Tifle 5 Official Inspection Form:Subsurface Sewage Disposal System Page 18 of 18 YD Nb.ao 1 V r 0 Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: O,OPUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes Rpplication for Disposal * stem Construction VPrmit Application for a Permit to Construct( ) Repair(Upgrade( Abandon( ) ❑Complete System ❑Individual Components Location Addrerss or Lot No. �frfiNy✓/j 1 Z 7- Owner's Name,Address and Tel.No. Assessor's Map/Parcel �Z j 3 2 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. �70cv r�4F 2, 77 Type of Building: Dwelling No.of Bedrooms Lot Size kA 0 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) G gpd Design flow provided ® gpd Plan Date 7 oZ a D /(� Number of sheets Revision Date Title /- Size of Septic Tank / ��0 Type of S.A.S. 3 a ssy t�1 Description of Soil Nature of Repairs or Alterations(Answer when applicable) . Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Heali. Signe Date vZ Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 0- d/J r 7 Date Issued Fee I� , THE COMMONWEALTH OF MASSACHUSETTS' Entered in computer I < , t; Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 4plication for )Disposal � stem Construction Permit Application for a Permit to Construct( ) Repair(Upgrade( " Abandon( ) ❑Complete System ❑Individual Components Location Add or Lot No. �yi�Nr� /3 �D C T Owner's Name Addres jand Tel.No. f�L7Y AvE 7 5 Al Assessor's Map/Parcel 2 y-5- 3 7 Installer's Name,Address,and Tel.No. -�- -^ ..., Designer's Name,Address,and Tel.No. 6 oV �/ s-v f 3 elz Type of Building: - i Dwelling No.of Bedrooms I Lot Size 6D J41 D sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( Cafeteria( ) Other Fixtures G:- Design Flow(min.required) G/ gpd Design flow provided- f�U gpd Plan Date /a d d Number of sheets i Revision Date o.• Title` _ t Size of Septic Tank Type of S.A.S. 3 s:; e) 4Zv c 4r y Description of Soil L- Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in •, :accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. �.� Si ne,.d. Date Application Approved by , t-� S Date C�?- Application Disapproved by Date ` for the following reasons Permit No. a- �I U / Date Issued ." . _----------------------- ----------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage"Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by ,l GL /f -1 . i at S F1 7 �? y has been..constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit'No.'*7 011- Oq-S dated 3 -; - / l Installer #bedrooms 'Ap roved design flown gpd The issuance of t is pe it shall not be construed as a guarantee that 1h'�ystem will fu tinasn desig�ed. Date 3 I'� II Inspector _ = - - ----- ------ �J Fee MV r THE COMMONWEALTH OF MASSACHUSETTS �a PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS a� Misposal *pstem Construction ermit Permission is hereby granted to Construct( ) Repair(/) Upgrade-( Abandon( ) System located at G 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. a Provided:Construction must be completed within three years of thhate of this permit. L /// ,�.Date 3 �� jApproved by � I L�V�� A w Town of BfIIJCnStaUB IKE rb JDepactmcixt of Regulatory Services + BAFLNETA➢LE, 4 Public Health Division ]Date RUB& � 200 Main Street,Hyanais NIA 02601 � �L Dote Scheduled P' 1,16 Time u Fee Pd. y!/ Soil Suitability, Assessment for Sewage Di posal Performed By;' 44[G Al � Witnessed By: D� ILO C A 7 ION &roGlCN ER-A L INF ORNDMON I nlolien Address a ^^ y q.�if/` Owner's Name W- "' / �� Address �w . Assessor's Map/Parcel: Engineer's Namc t7 r NEW CONSTRUCTION REPAIR Telephone It 6L" 36 tx �ST Land Use �( Cyr Slopes(9b) G Surface Stones Distances From: Open'Water Body VNft Possible Wet Area Sr G�ft Drinking Water Well ft Draihage Way ft Property Lhre I ft Other Yt , f�SKETCH: (Street name,dimensions Of lot,exact locations OF test holes Bcperc tests,locate wetlands'hi pratinuly to holes) -7 � �,f� _ � A/ Parent material(geologic) 2 (g g )O"' V\ Depth tU Budrock / N Depth to Groundwater: Slanding Water in Hole: A Weepllig I'lonl Pit ptlt:e l Estimated Seasonal High Groundwater �i 9. / !, DETERMINATION FOR S]EASO.NA]L ]EIJ[GH WAT ER YABI,?' Method Used; VJ Depth Observed standing in obs.hole: _ lu, Depth IU 5g11 ltlutllssl, ''Ip, Depth to weeping from side of obs,licit: Lin, Urtlulldwater,Adjuslrrrent— Index Well B Reading Date: Index Well le Adl,fllCtor__ Aql,OwUndwater Level ]PERCOLATION COLA7CJ[ON TEST Observation Hole# Time at 9" Depth of Pere 1 Time at G" Start Pre-soak Time @ ` Time(9"-0") End Prc-soak �C lid Rate Min./inch Site Suitability Assessment: wile Passed Sit.G-Failed. Additional Testing Needed(Y/fl) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If gaercolaitiou tesf is to be conducted within 100' of wetland, you must RiI'slt notify tile. Barnstable Conservation Division at least one (1) weeis prior- to beginnh.og. Q:\SGPTf,C\PERCFORN1..DOC I IDI]EIC][b.�1( SIEI[�1T1�7[ION]Elf®)L + ][,OG —ffg Depth from Soil Horizon Surface(in.) soil Texlure Soil Color(USDA)< Soil(Mansell) Motoulders.avel Depth from P 0 ��VATI0N H0 LE 0r, Soil Horizon Soil Texture JE)IOle # Surface(in,) Soil Color (USDA) Soil' Other (Mansell) Motffirih (Structure,Stones, Boulders. Consi ene %C avel a 161Z OBSERVATIONHOLEi LOG Depth tram Soil Horizon # Surface(in.) Soil Texhire Soil Color (USDA soil ) (MunsGll) Mottlln Other g (Structure,Stones,boulders. Cons_mist_c qa t]r,vel7 a Depth from 1D)E1 E1110-BS1RRVAT1ON-r-1O LR g' x Soil Horizon Hole# Surrace(in.) Soil Texture Soil Color _ (USDA) 5011 (Mansell) Mot111119 (Structu e,S(p it?ne5; Boulders, Con 2tency p6 Ornv n ] 1®adl Insgirance]Gage 1Vga p. Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within 100yearnoodboundary No� Yes Depth of rt�unf!LU'VIous MaterPQ➢ d)oe.s at least four feet of naturally occurring pervious matel9al exist in all areas observed throughout area proposed for the soil absorption system? tile If not, what is the depth of naturally occurring pervious matoria'h? �� I certify that on ]department of Environment (date)I have passed the soil evaluator examination approved by the a].PI.OtcctIOQ'and that the above analycjs was performed by me consistent with She rec)ttired trai ing, exp rtise and experience described in CIO CMR 15.017. Signature D a t0 w? Q;15,EPTICU'ERCt^ORM.D0C FROM :down cape engineering inc FAX NO. :15083629880 Mar. 18 2011 11:20AM Pi P-ah-1k. Health Divi,;iou Thom �. cKezm,Direcior 200 KniuStrert,Hyannis,MA 02601 OML;r: 508-80-4044 Fax: 508-790-6:104 &Desip-jaet. Date: jrm-witfl. Asmaor's 6 1VY 11 cr, On. wu is.mied a permit to insttjl a septic syskmac based on a design drawn by ZJ U0 VT CeTtify that the septic imstaUed substariti ally according to t 'I I Lie, atf Sim, mjicb. may bic hid-- ini.n.or approve'd chaugos such lateraj.j.-c�ocatj.on- of te I di:Aidbution bole and/or snptir.tank, I cerfify that the Septic SyL7-em refmenccd abovc vms iastab-d with mqjor chauges (i.e. gpatnz than 10" lateral relOWilit')rj of th,- SAS oT anyvel-Lival rulooatjou of atly-c.ojupo-jLe.nt of thc sc.,pticsystern) but in acccmdance with, State & T.ocal 1"-\'egu1aL1on,--i. Plan TeViSiUn Or cortdflM.as-bidIt by de:iign.tr'to Follow. �OF 044,9, IIANIELA. yG OJALA CIVIL ND' 46502 /CNAL (Allix Dcsigno,3:'s Sl-amp Hoic' MIFASF, 11�T CTERTIFIC,VVE OF L QRN �Q RATAK57i.A.B7U, vh-r I - "N --r —'- * ' '-' AJ�0*) A,13-HT T.U,T C'14,R.D CQJ LAIqCE W.U.J., NO'). A J.,'-4AJ.b'4;P ON..U, AUTU 'I AW 11Q.j. JR,4jW.VMT, 1R.FrTUVED BY i R AJ R WS T. --R PTTRTI( )rf J)ICM te'I. (508)362-4541 939 main street rt 6a fax'(508)362-9880 yarmouth port mass 02675 down cape en,l ineefing, inc structural design September 20, 2010 civil engineers &land surveyors Daniel A.Ojala,PE.,PL.S. Arne H.Ojala P.E.,P.L.S. Barnstable Board of Health Timothy H.Covell,P.L.S. land court 200 Main Street Andrew R.Garulay,R.L.A. Surveys Hyannis, MA 02601 site planning Re: 265 Fifth Avenue, West Hyannisport Dear Board Members: sewage system designs The enclosed represents a variance filing for the upgrading of a failed(increased pumping)older Title 5 septic system. No increase in habitable space or in the number of bedrooms is proposed. The system is designed based on the existing 4 bedrooms. inspections The following variances are requested under Maximum Feasible Compliance 15.405: permits 1(a): reduction in setback, SAS to lot line (10' to 5') I(b): reduction in setback, SAS to foundation(20'-to 14'); septic tank to foundation (10' to 7') landscape architecture Variances requested under Barnstable Board of Health Regulations: Art I: Section 360-1: Septic tank to be 60' from edge of wetland (40' variance); SAS to be 78' from edge of wetland(22' variance). Due to severe site restrictions to include the presence of wetlands on two sides of the property, and relatively small amount of useable upland, setback variances are requested in order to maintain the greatest distance possible to the wetlands. The base of the leaching facility is 5' above the groundwater elevation, which is affected by the proximity to a tidal water body. We had seta monitoring well and taken automated readings throughout a new moon cycle (highest and lowest tides for September) and have designed the system based on this (NGVD) elevation. We feel that by granting these variances,the same degree of environmental protection can be attained without the need for strict adherence to the Title 5 and Town of Barnstable Regulations. truly yours,,T! , �4 Daniel A.. Ojala,PE, PLS SEE Down Cape Engineering, Inc. i EE P 2 4 REC'D cc: Janice Schade �A C1111 '\T TROY WILLIAMS ;��5� 16 1996 rt SEPTIC INSPECTIONS , ; r Certified by MA Department of Environmental Protection 'K e�y � (508) 760-1819 40 Old Bass River Road 9 South Dennis,MA 02660 Commonweafth of Massachusetts COPY Executive Office of Environmental Affairs Department of Environmental Protection WUHaun F.Weld Trudy Coxe Gove wr .SOCW-Y Argeo Paul Celluccl Davld B.Struhs LL Governor l ommise rrr SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION J Property Address: o1 GS S Aga J� Address of Owner. /t/I✓S. f y O w Date of Inspection: 7//5'/9 6 (If different) C1u Name of IosPecp yy W i /tx,M Company Name,Address ernd Telephone Number. Q L {Do-4 Ala icltn S / / V o'!-" CERTIFICATION STATEMENT i 44 k • 016 3.2 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: asses Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails �Q Inepectou's Signature s /^%�' r Date The System Inspector shall submit a copy of this inspection report to the Approving 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 of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A, B. C,or D: A) SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 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 determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not) The septic tank is metal,cracked,structurally unsound, shows substantial infiltration or exfihmtioN or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a yonforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A // CERTIFICATION (continued) Property Addresw Owner. ---,.- Date of Inspection: 7 / s 5, 6 B]SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution boa is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will pars 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 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING 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 analysis 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 nitrogen is equal to or less than 5 ppm. 9) OTHER (revised 11/03/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Add.... a 6 s a fC, A je Owner. Date of Inspection: � D] SYSTEM FAILS: N� I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to failure. determine what will be necessary to correct the Backup of sewage into facility or system component due to an 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 IN day now. 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 a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 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 analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for ooliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: ^f l-1 The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 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 following 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 compliance 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. (revised 11/03/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: ;2 SA Owner. Date of Inspeotio i �S �6 Check if the following have been done: Pumping information was requested of the owner,occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. N,�j As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. ZThe system does not receive non-sanitary or industrial waste flow V The site was inspected for signs of breakout. V All system components,excluding the Soil Absorption System, have been located on the site. The septic tank manholes were uncovered,opened, and the interior of the septic tank was inspected for condition of baffles or /tees, material of construction,dimensions, depth of liquid, depth of sludge,depth of scum. �/ The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. 1//The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 0?t; s sfh lqver . Owner. Date of Inspection: REsmENTIAL FLOW CONDITIONS Design flow: 2n� Number of bedrooms:.►L Number of current residents: a Garbage grinder(Yes or Laundry connected to system(yes or no): YFs Seasonal use(yes or no):_yg5S Water meter readings, if available: L Last date of occupancy: !.'c<.G.S. , I (�+c c COMMERCIAL/INDUSTRLAL• Type of establishment: Design flow:_gaallons/day Grease trap present: (yes or no)_ Industrial Wa ste Holding Tank present: es 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 and source of information: System pum as part of inspection: (yea or no) "0 . If yes,volume pumped _____gallons Reason for pumping: TYPE 9F SYSTEM _ Septic tank/distribution box/Boil 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: C.- . a 7 Y Gcrr s /10✓i a r Sewage odors detected when arriving at the site: (yea or no) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner. Date of Inspection: 7 SEPTIC TANK: (locate on site plan) Depth below grade: Material of construction:Zconcrete_metal_FRP_other(ezplain) Dimensions: X Sludge depth: S'' Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: ,3/' Distance from top of scum to top of outlet tee or baffle: G Distance from bottom of scum to bottom of outlet tee or bafffe:_ a 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.) o �. f t s r ,, / �( o f 4 w e v-Z sue'yti d o y h a /VG X f c,c 41 ) CS .J c'Lu r�. ALL.a GREASE TRAP:JUI 4 (locate on site plan) Depth below grade: Material of construction: _concrete_metal_FRP_other(ezplain) 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: 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.) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Ot S gv-e- . Owner. —7-3 i-J Date of Inspection: 7115 TIGHT OR HOLDING TANK: A11A (locate on site plan) Depth below grade: Material of constriction:_concrete_metal_FRP_other(explain) Dimensions: Capacity: ¢allons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee,condition of alarm and float switches, etc.) DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: Comments: (note+ if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) e-!i y"/ '-j ; c -.�' b.� �s b a a •✓ -1— -�.�— /:.-, t c PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 11/03/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C // SYSTEM INFORMATION(continued) Property Address: �b S A 14-U e- . Owner. D Date of Inspection: —)/(5 /y SOIL ABSORPTION SYSTEM ms)- z (locate cn site plan,if possible;excavation not required, but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: leaching per, number:_ leaching chambers, number._ leaching galleries, number: leaching trenches, number,length: leaching fields, number,dimensions: O k c )l �( [ () rX l r ec•` �+c/ overflow cesspool, number: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.) d / W K �„� A Inv / Cti u i c� rt 0 s� Iry S l y v., r c, c .�, c-� r., s✓- a s k -1" /o t s s h eN uv r cr CESSPOOLS:f�j9 (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer- Depth of scum layer: Dimensions of owspool: Materials of constriction: Indication of groundwater: Mow(cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY• Y11i9 (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.) (revised 11/03/95) 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Al e . owne Date Inspection: � SKETCH OF SEWAGE DISPOSAL SYSTEM:- Include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' N� f 4-o S w I We- s - �oo 1 r L 116 II i DEPTH TO GROUNDWATER 1 i Depth to groundwater:-feet, S C adjusted high groundwater level method of determination or approximation:] ,_,.&k c4-^ 4 / C4 W � L It G../ ••d� .�. J��-� C. k J S T Mn c ?"S v �f�C1_Lt.� . 1.. c L.► A S "3 / 9 Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: G S— /�j�j� Aut . Lot No. Owner: — ( U w Address: Contractor: Address: Notes: STEP 1 Measure depth to water table tonearest 1/10 ft. .............................................................................. .Date month/day/year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: O Appropriate index well.................................................... �►iW„? © Water-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to &A 6 7, water level for index well ........................... month/year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A),current depth to water level for index well (STEP 3), and water-level zone (STEP 26) ! U determine water-level adjustment .......................................................................................... STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water levelat site (STEP 11 ............................................................................................................. 1 f. Y s oFIHETa,. Town of Barnstable Bar statite. Board of Health AFAmedcaCft BARNS—TABLE. ' - v MASS. Ok 200 Main Street,Hyannis MA 02601 i679- - APED MA'I A 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi November 24, 2010 Ms. Sarah Ojala Down Cape Engineering 939 Main Street, Route 6A Yarmouth Port, MA 02675 RE: 265 Fifth Avenue, Hyannis, MA A= 245-037 Dear Ms. Ojala, You are granted variances, on behalf of your clients, Janice and Kolin Schade, to construct a replacement onsite sewage disposal system at 265 Fifth Avenue, Hyannis, Massachusetts. The variances granted are as follows: 310 CMR 15.211: The soil absorption system will be located 5.0 feet away from the property line, in lieu of the ten (10) feet minimum setback required. 310 CMR 15.211: The soil absorption system will be located 14 feet away from the foundation, in lieu of the twenty (20) feet minimum setback required. 310 CMR 15.211: The septic tank will be located 7 feet away from the foundation or crawl space, in lieu of the ten (10) feet minimum setback required. Section 360-1, Town of Barnstable Code: To construct a soil absorption system 78 feet away from the edge of a wetland, in lieu of the minimum 100 feet separation distance required. Section 360-1, Town of Barnstable Code: To install a septic tank 60 feet away from the edge of a wetland, in lieu of the minimum 100 feet separation distance required. Q:\WPFILES\OjalaSchadeFifthAveSepticVariance2010.doc f �1 The variances are granted with the following conditions: (1) No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The system shall be installed in strict accordance with the engineered plans dated September 2, 2010. (4) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the submitted plans dated September 2, 2010. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to its close proximity to wetlands. Sincer y yours, Way e IVIller, M.D. Chairman Q:\WPFILES\OjalaSchadeFifthAveSepticVariance2OI O.doc FR011 :down cape engineering inc FAX NO. :15083629880 Sep. 24 2010 04:18PM P2 Y , t t Li TME' DATE: / /2 O F19E: a I anruvsTnaraa. 163 �-' Town of Barnstable 3GEEb. DATE;- Board of Health 200 Msiin Street, Hyaulnis M..A 02601 OlYlcc; SfIK-i362-4G44 Wayne A.Miller,MU. TAX 508-71)0-6304 1wi chi Saway21"u6i Paull.C<mniff.I).M,1). VARIANCE REQUEST Fes( RISC LOCATION Property Address: .. � A.s,Sessor s Mop and Parc;c:t Number: Size of T,clt; 010 Wotlands Within 300 Ft. Yes A Business Name: No Subdivision.Nar ee " APPLICANT ISNAIITE: 1�100 40k Phone Did the owner of The property authorize you to rcprosent him or her? Yes No PROPERTY U e R'S NAME CONTACT PERSON e � ��,�1�)�� Name: rR,fl I C p-, t_ Cj)j`I' .._ .. Name:MAI A t _ Addres ;Iad- Q:A, r Address: .�d� Phon'�gs' r c j _ Phone: .. ._ " reduction in setback, SAS to Jot line(I W to {') 1(b): .reduction in setback, SAS to fmindation (20' to 14'), scp�t:ic tank.to f inidmion _ (10' to 7') Variances requt-,steti under Barnstable Board of health lz_egulatious: "irt 1: Section 360-1: Septic tank to be 60' f_rom. edge of wuUalid(40' variance); SAS to he 78' f ron-i edge of wetland (2'?' vari an ce). . Four(4)coplea of the completed vacianec rcqucat farm v Four(4)copies of engineered plus SU1rlUit nd(e.g.septc.system plane) t,•'` :•Crnnpleted sewn(1)page checklist confirming review of engintei-ed septic system plan by$11t11tllttlllg Cllgineer Or registered sanlitflnall `:•'Four(4)copies of hibeled dimensinnd floor plans 3vtlnnitted(e.g.house phins of restaurant kitchen plans) 5igrrd letter sUbrig that the properly omier authorized you to represent him/hcr for this request _✓ Applicant underslatids Hutt the abutters must be notfi ied by certified mail at Icavt ten days prior to plccting date ut uppl:oant`s expoise (for Title V anil/or Iocal sewitge regulation vi unces only) Full menu submitted(for gre=trip Mrianeo requests only) Variance request application fee conec:ed(no fx for lifeguard modirication ren.ewalR,grcaae tnip variance renewals[same owncrile mm only], outside dining wv iance renewals[same uvmerAeasee only 1,and wiriincos to repair fuiled sewage diRposat systems[only if no expansion to the building proposed]) _ Variant a request submitted Lit least 15 days prior to meeting date V AIUANCE ApI•ROVED Wayne Miller,Cjf-.Iirman NOT APPROVED Junichi Sawayanagi R�iASONFOR 13NAPPROVAL_ Paul I.Cunniff,D.M.D. c:\llarxie\decollils\,AppData\LCC1I\Microsoft\'Aindnwa\Temporary Internet Fili-p\Content.out I nr3le\Ed1J9P55'7\VAR=REQ.DOC tel.(508)362-4541 939 main street rt 6a fax t508)362-9880 yarmouth port mass 02675 down cape ea4ffineeii7g inc. structural design civil engineers&land surveyors Daniel A.Ojala,P.E.,P.L.S. Arne H.Ojala P.E.,P.L.S. Timothy H.Covell,P.L.S. land court Andrew R.Garulay,R.L.A. surveys September 20, 2010 site planning Dear Abutter: A public hearing has been scheduled for the Barnstable Board of Health to take action sewage system designs on a request for variances from Town of Barnstable Regulations for the subsurface disposal of sewage for the proposed Title 5 septic system at 265 Fifth Avenue, West Hyannisport. The variances requested are as follows: inspections 1(a): reduction in setback, SAS to lot line (10' to 5') 1(b): reduction in setback, SAS to foundation(20' to 14'); septic tank to foundation permits (10' to 7') landscape Variances requested under Barnstable Board of Health Regulations: architecture Art I: Section 360-1: Septic tank to be 60' from edge of wetland (40' variance); SAS to be 78' from edge of wetland(22' variance). Said hearing will be held in.the Hearing Room, South Street, Hyannis, October 12th at 3:00 pm. Plans and the application describing the proposed activity are on file at the Board of Health office, 200 Main Street, Hyannis. It is recommended to check with the Health Department to confirm date and time if you are interested in attending. Sincerely, Sarah B: Ojala Down.Cape Engineer ng, Inc. cc: Abutters file Barnstable Board of Health barnboh kbutterReport . Page 1 of Board of Health Abutter List for Map & Parcel(s): '245037' )irect abutters (no set distance) and the properties located across the street. dotal Count: 5 ( jal Close Map&Parcel Ownerl 0wner2 Addressl Address 2 Mailing Country Deed CityStateZip COADY,JOHN C ET C/O SEASIDE PARK W 245035 AL TRS IMPROV ASSOC BOX 494 HYANNISPORT, USA 5667/047 MA 02672 245037 SCHADE, KOLLIN & 4858 ADRIAN LN HERMANTOWN, USA 10333251 JANICE MN 55811 BARREIRO, W 245038 FELISBERTO& P 0 BOX 47 HYANNISPORT, USA 9734/092 DONNA MA 02672 MAGLIOZZI, WELLESLEY, MA 245136 ROBERT G & 108 BROOK ST 02181 20998/019 DOROTHY M BARRETT,JOHN ET W 245137 ALS C/O FRENCH BOX 494 HYANNISPORT, USA 1453/117 MA 02672 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 9/23/2010. ittp://66.203.95.236/arcims/appgeoapp/AbutterReport.aspx?type=BOH 9/23/201( Town of Barnstable Geographic Information System September 23,2010 �5135002 � #40 245039 #241 245135001 #246 2 -•,5::.:::.::•::::::..:::.::.:.::i:.::.:::::};::.'.:,:;::::#253i{`ii.i;�:':�:.::.:i:fEi'•}:'.E .::, ...;..;; .... :. 2.45136 ':'._::: .:::'.'.'.'.' :....:.. #264 i-`.•:`: :..']: ::?,•riti'::`•:fI[:i: x > a >- LL rJ N - fc C 6 ...:........ ::.••5•,•.;is;�;cii i; :`,�.'{j�z?,�;i�:�.�.ii i;': '':'!ii'ii;.:.:;�,•..�: #3'- 266001 #0 0 46 Feet DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:245 Parcel:037 Board of Health Selected Parcel N boundary determination or regulatory interpretation. Enlargements beyond a scale of Abutter List Type-Direct abutters(no set distance)and the properties located 1"=100'may not meet established map accuracy standards. The parcel lines an this map { €. are only graphic representations of Assessor's tax parcels. They are not true property across the street. Abutters boundaries and do not represent accurate relationships to physical features on the map such as building locations. Buffer '+ ✓;,', c �t September 22, 2010 From: Property owners at 265 Fifth Ave. West Hyannisport, MA Janice and Kollin Schade Re: Board of Health Variance Application for septic system Dear Board Member: I authorize Down Cape Engineering to represent me at the Board of Health Meeting on October 12,2010 in the above matter regarding application for variance approval. Thank you. If you have any questions,I can be reached at(218) 591- 1261. Thank you. Janice Schade 4858 Adrian Lane Hermantown, MN 55811 FORM30 ,C&W HOBBSS WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOAqD OF, H ALTH CITY/TOWN V. DEPARTMENT DRESS GSM Sv6J�¢ `� TELEPHONE Address ,Q&— �. _ Occupant Floor Apartment No. No.of Occu is ` V1 ✓ � No.of Habitable Rooms 9"' No.Sleeping Rooms No.dwelling or rooming units No.Stories Name an T address of owner I L i' _:(mot i C �hadQ r t(A Q , Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage 9 Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: ` Roof Gutters, Drains: Walls: Foundation: Chimney: I BASEMENT Gen.Sanitation: 0 Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ElN Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line.- H.W.Tanks 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 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, F es,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: General Building Posted 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 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 PENALT O J Y." D INSPECTOR TITLE A DATE TIME ` � •M• A.M. THE NEXT SCHEDULED REINSPECTION P.M. � , ~ . , . ^ . ` - . ` 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to ` exist in residential premises, shall bo doome'd conditions which may endanger or impair the hoahh,or safety and well-being of person or persons occupying the premises.This listing is composed of those ^ item�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 |i 105 CIVIR 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 doao in every case and therefore is nbtino|udod �thio listing. Failure to include shall in no way be construed ooad�erminokion that other vio|okioneornondiUonamayn��bofoundtofaUwi1hinthinoato0ory. NorohaUtoi|umVoinu|udoo#oolthodu1yoftho|ooa| health official V»order repair or correction of such vio|ation(o) pursuant to105CIVIR410.83O through 410.833 nor shall failure Vo 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 quantity, pressure and temperature, both hot and cold"to meet the ordinary needs of the occupant in accordance with 105 CIVIR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CIVIR 410.201 or improper venting o,use ofaspace heater or water heater ao prohibited by1O5CMR41O.2OO(B) and 4102O2. (C) Shutoff and/or failure 1orestore electricity mgas. (D) Failure Vx provide the electrical facilities required by105CIVIR41O.25U(B). 41O.251KV. 41O253 and the lighting in com- mon amarequivod by 105CIVIR410254. _ (E) F�|unaV»pmvdeaaa�oup�yofwater. . (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by105CIVIR 41O15OK\ (1)and 41O.3O0� - (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 ofan emergency 1U5CIVIR41O.450. 410451 and 41U.452. (H) Failure vo comply with the security requirements of 105 CIVIR 410.480(D). (|) Failure Vo comply with any provisions of1O5CIVIR410.00O. 410.001nr410.6O2 which results inany accumulation ofgar- 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 CIVIR 460.000. (See M.G.Lo. 111 @>@ 18O through 10Ql (K) Roof,foundekion, or other structural defects that may expose the occupant or anyone else 1ofire, bume, nhook, accident or other dangers orimpairment to health orsafety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and o|octhou|wiring standards or failure to maintain such faoi|dooaoare required by 105 CIVIR 410351 and 410.352. ooaoko expose the occupant or anyone else tofire, bumu, ahook, accident or other danger o/impairment Vo health or safety. (M) Any defect in asbestos material used as insulation orcovering on a pip*, boiler m furnace which may result inthe ve|oauo of asbestos dust orwhich may result inthe release of powdorod, crumbled or pulverized asbestos material in violation of 105 - CMR41U.353. (N) Failure to provide a smoke detector required by 105CMR 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 nf the owner of said condition orconditions: (1) Lack of.a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven ov any defect that renders either inoperable. I (2) Failure to provide a washbasin and shower or bathtub as reqqired in 105 CIVIR 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 p|umbing, hoa1ing,gmsfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain uoafe handrail or pmteoUwo railing for every stairway, porch ba|oony, roof or similar place as required by 105CWR41O.5O3KV and 41O.503(B). ` (5) Failure Vu eliminate rodents, 000kmaoheu, insect infestations and other pests aorequired by 105CIVIR 410.550. (P) Any other violation of 105 CIVIR 410.U0O not enumerated in 105 CMR 410750(A)1hmugh (0)shall be deemed to be a con- dition whiohmayendangorcvmato/ial|yimpairdhohoahhoroafetyundwoU'U*ingofan000upanAuponthefai|unaof1homwnor 10 remedy said condition within the time no ordered by the Board ofHealth. | � h� a� �� ;�� m � (%� -YI�.� q� �-'� a h� i� •/WiPLETE THIS SECTION COMPLETE • ON DELIVERY ■ Complete items 1,!!and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. XI //—,, El Agent■ Print your name and address on the reverse �IJC ❑Addressee so that we can return the card to you. B. R eived by(Printed Name) C. Date of Delivery M Attach this card to the back of the mailpiece, ,�1Q,SrAI� ` 1 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 p J D �� 1�--� ��►r�y� 1 3. Service Type 0 Certified.Mail El Express Mail ❑Registered ❑Insured Mail U C.O.D. 4. Restricted Delivery?(Extra FeW ❑Yes 2. Article Number I 1: 06? 081 1 0000 352j 9891.6 t (Ransfer from service fabeq i 70 : 1. .3 t , PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITEb STATES POSTAL SERVICE First-Class Mail Postage�Fees Paid LISPS Permit No.G-10 I I • Sender: Please print your name, address, and ZIP+4 in this box • I I I I � I I I 1 I � I I. Q Town of Barnstable I 03 Health Division I 200 Main Street I Hyannis,MA 02601 I I I I . I � Certified Mail#7006 0810 0000 3524 9896 Q�oFVE Teti Town of Barnstable BARN STAULE,.. Regulatory Services » » ' �$ MASS.. `�ma Thomas F. Geiler,Director pTF39 a"'°Y' Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 15, 2007 Kollin & Janice Schade 4858 Adrian Lane Hermantown, MN 55811 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 265 Fifth Avenue Hyannis, was inspected on November 6, 2007 by Meredith Morgan, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration in accordance with Chapter 170 of the Town of Barnstable Code. The following violations of the State Sanitary Code were observed: 105 CMR 410.300—Sanitary Drainage System Required. Observed four bedrooms when septic system is only designed for three. 105 CMR 410.503 —Protective Railings and Walls. Stairs to lower level lacking guardrail on one side. The following violations of the Town of Barnstable Code were observed: 1 70-10—Smoke Detectors and Carbon.Monoxide Alarms. No CO alarms on lst or 2nd floor; inoperable smoke detector in basement and in upstairs hallway. I Q:\Order letters\Housing violations\Rental ordinance\265 Fifth Avenue.doc You are directed to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by repairing or replacing inoperable smoke detectors and by installing CO alarms within ten feet of bedrooms. You are directed to correct the violations listed above within thirty (30) days of your receipt of this notice by providing guardrail for both side of stairs; by removing one bedroom by widening room entrance to be a five foot encased entrance or by upgrading system to satisfy the requirements of a four bedroom system. 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. ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Meredith Morgan, Health Inspector QA0rder letters\Housing violations\Rental ordinance\265 Fifth Avenue.doc FoRnfi10 • CIW HOBBSS WARREN'" THE COMMQNWEALTH OF MASSACHUSETTS BOA D OF HEALTH CI /TOWN W Pea& 2)1V a PARTMENT DRESSU �/ ��//��.,, �//�� LEPHONE tt � Address s� , � L,/M /71/,C. • Floor Apartmen o. No. of Occupan s No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units No.. ies Name and address of owner `r vir S c1hacu- 57 r-1'00 Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: y. Foundation: d- of ,5 Chimney: BASEMENT Gen.Sanitation: Dampness: 4 Stairs: Li htin : eJ STRUCTURE INT. Hall,Stairway: Obst'n.: i Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central (�Y N E ui . Repair TYPE: Stacks, Flues,Vents: -� PLUMBIN'11. Supply Line: f ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vents ELECTRICAL Panels, Meters,Cir.: X ❑ 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 Bedroom 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: General Building Posted 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 OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTJOU REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTI PE Y INSPECTOR TITLE DATE TIME '• � A M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. I 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shall 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 11, 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 quantity, 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 or 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. a CCU-V c y: } V._ '..�' � � �— � e _ �� _ .� � � �� a � ' `�� tel. (508)362-4541 939 main street rt 6a fax(508)362-9880 yarmouth port mass 02675 down cape engineering, inc. structural design civil engineers & land surveyors Daniel A.Ojala,P.E.,P.L.S. Arne H.Ojala P.E.,P.L.S. Timothy H.Covell,P.L.S. land court Andrew R.Garulay,R.L.A. surveys August 8, 2008 site planning Thomas McKean, R.S., CHO sewage system designs Director of Public Health 200 Main Street Hyannis, MA 02601 inspections Re: 265 Fifth Avenue, West Hyannisport permits Dear Mr. McKean: landscape Down Cape Engineering, Inc. has been retained by Kollin and Janice Schade, the architecture owners of the above-referenced property, to address the septic system/bedroom issue which was outlined in a letter from the Health Department dated November 15, 2007 stemming from an inspection of the premises for rental compliance. We have performed some research on this property and could not find anything on file at the Health Department in regard to plans, disposal works construction permit, or a compliance certificate. Information that we have been able to obtain includes a septic inspection report performed in July of 1996, the layout with dimensions of the existing rooms and the town assessment. The existing leaching facility, according to the DEP inspection report by Troy Williams, consists of a pipe and stone field, sized at 40' by I l' by 1' deep. There is also a 1000 gallon septic tank and d'box. Also according to the septic inspection report, it is original to the dwelling,.which was constructed about 1968. This system passed the DEP inspection in 1996. The floor layout clearly shows 4 bedrooms, all sized larger than the minimum 70 sq. ft. required under the Title 5 definition of a bedroom. They also meet the other criteria as outlined under the bedroom definition. The owners are being assessed by the Town at 4 bedrooms. Under the older Title 5 regulations (and Article 11), the leaching facility is sized for a 4 bedroom dwelling. According to the letter referenced above, the owners either have a choice of modifying the dwelling to make it a 3 bedroom under Title 5 definition........or by upgrading to satisfy the requirements of a four bedroom system". Absent of information otherwise, we maintain that the existing system is a 4 bedroom design under the older Title 5 definition and is grandfathered as such, and therefore does not require upgrading to a 4 bedroom system. We would appreciate your review and concurrence with the above. Thank you. Very truly yours, Daniel A. Ojala, PE, PLS Down Cape Engineering, Inc. enc. cc: Kollin and Janice Schade I SCHADE RESIDENCE 265 FIFTH AVENUE WEST HYANNISPORT 1 " = 10' kitchen living room a� basement with m washer/dryer dining stairs down closet closet closet DECK 11' x 10' , bedroom 9.6 x 1 D cn bedroom closet garage bath (u 18' x 12' :2 bedroom bath closet bath storage storage 12.5' x 16' :2 bedroom in a� v FIRST FLOOR BASEMENT WALKOUT LEVEL SCH ADE RESIDENCE 265 FIFTH AVENUE WEST HYANNISPORT 1 " = 10' kitchen living room L a� basement with washer/dryer dining stairs down . closet closet closet DECK 11' x 10' , bedroom 9.6 x 10 N bedroom closet garage bath a, 18' x 12' ° bedroom N bath closet bath storage storage 12.5' x 16' bedroom a� v FIRST FLOOR BASEMENT WALKOUT LEVEL r down cape engineering, inc. SIEVE SOILS ANALYSIS 265 5th Ave W Hyannisport.xlsx DATE OF REPORT: 9-24-10 (sample 8-27-2010) .JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 265 Fifth Avenue, W. Hyannisport, MA LOCATION: dce TH SIEVE ANALYSIS Weight Sample(Grams): 251.4 SIZE :WEIGHT RETAINED % RETAINED % PASSED (sum)---------------:---- ---------------------------------------- 1" 0.0: 0.0%: 100.0% 0.0: 0.0%: 100.0% ------------- -------------------------- ------------------------------ 1/2" 0.0: 0.0%: 100.0% 3/8" -------- ------------- .0:---------------- .0%-------------0.0% ----------- ................-...........v--------------- ----------------- -------- #4 0.0; 0.0%; 100.0% #10 ---------------------•---------------------•-----------------. #20 116.8 46.5%: 53.5% •-------------L..--....-..-_••-•--•_-..-.A---------------------L_____--•-••--•_-•• #40 200.0: 79.6%: 20.4% '-------------i--....---..............__-Y--------'----------'-r.__....._--------- #50 224.5; 89.3% 10.7% #- u--------- --------------------- ----------------------o-•------------ o- #80 2-4-34; 96.8/o 3.2/- #100 247.6� 98.5%: 1.5% ------------------------:-A #200 250.5: 99.6%: 0.4% -------------:.. ......-----------------•---------------------------------------- PAN: 251.4: 100.0%: 0.0% -------------- ------------------------------------------------------------------- SAMPLE: 251.4; NOTE: TEST ON PASSING#4 ONLY, 9% RETAINED ON#4 <45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-3 (GRANULAR, COARSE SAND) (UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK #100 0%-20% OK #200 0%-5% OK = SAMPLE MEETS TITLE 5 FILL SPECIFICATION RESULTS: PERMEABLE MATERIAL-CLASS I <2 MIN./IN. MATERIAL NOFIHgss9 NONCOMPACTED �y DANIELA. GN SOIL DESCRIPTION: MED SAND, 0.74 GPD/SF MATERIAL ono OJALA a 0 CIVIL A No.465 T S/ONAL - �—lj, Zot MONITORM WELL DATA LOGGER REQ. INFO LOCUS: Sc h a ok-c DATE/TIME: JOB#: OPERATOR: 7A-W INSTALLATION: BAROMETRIC PRESSURE: q LENGTH OF CASING: BENCH MARK& ELEV: 7-0 C IYAk K ELEV. TOP CASING: ELEV GROUND: 76 P a cc�<-Ifl� �r DEPTH TO WATER: g TIME OF MEASUREMENT: l U i 3S TIDE LEVEL @ LAUNCH: Misr t`(C� N� I�►@��Mf. REMOVAL: DATE/TIME: ' � F BAROMETRIC PRESSURE: t � DEPTH TO WATER: TIDE LEVEL @ REMOVAL: SKETCH OF WELL LOC: a� :.� t -�bL ( CALC DATA: MAX GROUND WATER EL: 71q a bo TIME OF PEAK AFTER TIDE: Town of Barnstable Barnstable ti ° Board of Health q$ MASS. 200 Main Street,Hyannis MA 02601 1639. 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi November 24, 2010 Ms. Sarah Ojala Down Cape Engineering 939 Main Street, Route 6A Yarmouth Port, MA 02675 RE: 265 Fifth Avenue, Hyannis, MA A= 245-037 Dear Ms. Ojala, You are granted variances, on behalf of your clients, Janice and Kolin. Schade, to construct a replacement onsite sewage disposal system at 265 Fifth Avenue, Hyannis, Massachusetts. The variances granted are as follows: 310 CMR 15.211: The soil absorption system will be located 5.0 feet away from the property line, in lieu of the ten (10) feet minimum setback required. 310 CMR 15.211: The soil absorption system will be located 14.feet away from the foundation, in lieu of the twenty (20) feet minimum setback required. 310 CMR 15.211: The. septic tank will be located 7 feet away from the foundation or crawl space, in lieuof the ten (10) feet minimum setback required. Section 360-1,.Town of Barnstable Code: To construct a soil absorption system 78 feet away from the edge of a wetland, in lieu of the minimum 100 feet separation distance required. Section 360-1, Town of Barnstable Code: To install a septic tank 60 feet away from the edge of a wetland, in lieu of the minimum 100 feet separation distance required. Q:\WPFILES\OjalaSchadeFifthAveSepticVariance2010.doc L The variances are granted with the following conditions: (1) No more than four (4) bedrooms maximum are authorized at this. property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The applicant shall record. a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The system shall be installed in strict accordance with the engineered plans dated September 2, 2010. (4) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the submitted plans dated September 2, 2010. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to. its close proximity to wetlands. Sincerely yours, Wayne Miller, M.D. Chairman Q:\WPFILES\OjalaSchadeFifthAveSepticVariance20l0.doc °F 1ME T Town of Barnstable Barnstable Board of Health .AMSTABLE. _ p p► y MAM. 200 Main Street,Hyannis MA 02601 1639. 2007 fD MA A OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. BOARD OF HEALTH MEETING MINUTES Tuesday, October 12, 2010 at 3:00 PM Town Hall, Hearing Room 367 Main Street, Hyannis, MA I." Variance — Septic (Cont.): GRANTED Michael Pimentel, JC Engineering, representing Household'Finance WITH Corporation II, owner 41 & 43 Hiramar Road; duplex, Hyannis, CONDITIONS Map/Parcel 292-012, 0.22 acre lot, several variances request, report of cost estimates in comparison to cost.of sewer connection. Sewer hookup would be approximately $62,000 versus $14,000 for a septic repair of the tank itself. The owner would bear the cost of the connection which will allow three houses to hook up. The revised plan presented had a single tank. MA DEP confirmed this is allowed because the previous system was a single tank and the property is not increasing its flow rate. The Board voted to approve the revised plan dated October 1, 2010, with the following conditions: 1) pending a final staff review of the revised plan, 2) a four- bedroom deed restriction be recorded at the Registry of Deeds, and 3) a proper copy of the deed restriction is submitted to the Public Health Division. II. Variance Septic (New): GRANTED Sarah Ojala, Down Cape Engineering, representing Janice Schade, WITH owner— 265 Fifth Avenue, Hyannis, Map/Parcel 245-037, 0.83 acre CONDITIONS parcel, requesting several variances. The Board voted to approve the,plan with the following conditions: 1) four bedroom deed restriction, and 2) a proper copy of the deed restriction is submitted to the Public Health Division. 111. Modification of Comprehensive Permit for Living Independently Forever, Inc —Chapter 406: DISCUSSED Review plan to the Zoning Board for owner, Living Independently Forever, Inc. - 550 Lincoln Road Extension, Map/Parcel 272-025, existing affordable housing development "Life at Hyannis", currently 16 units. The modification seeks to permit a fifth two-story multi- Page I of 3 BOH 10/12/10 Bic 25288 P:9265 11204 DEED RESTRICTION WHEREAS, J h V/� (owners name) of ✓ ►ar h (-a4t — 4e_rmaj—o w n IVAJ (address) is the owner of cki Y at (,J, (addre located h✓lt.4 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 2-J Or on Land Court Plan Number WHEREAS / o i(� // ' ` �� I �10.'X' a JGh n d t 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-condition 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 perm.it for the construction of a single family home on t this property, is requiring that the agreement for the restriction on the number of , bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, deedr 6> f NOW, THEREFORE, Jan ,u. sa a �1�does hereby place the (owners name) following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: may have constructed (address) pon the lot a house containi g no more than r (�f)bedrooms. 0 I''� JQ� ��J agrees k that this shall be permanent (owners name) P nt deed restriction affecting located on A, and being shown on the plan recorded in Plan Book /9� , Paged Z M mow` Or on Land Court Plan � G For title of see the following deed: Book /03 Pa e _ Lu C I Or Land Court Certificate of Title Number -- g c': ` m CDo� Executed as a sealed instrument 3day of C Owner's pignature °- >_ Me Owner's signature t .v Owner's signature COMMONWEALTH OF MASSACHUSETTS ss 20 Then personally appeared the above-named known to me to.be the person who executed the foregoing instrument and acknowledged the same to be free act and deed, before me, Public Notary PAMELA J. MYHRMAN MY commission expires: : �, NOTARY PUBLIC-MINNESOTA MY COMMISSION EXPIRES 01/31115 (date) deedr BARNSTABLE REGISTRY OF DEEDS i SCHADE RESIDENCE 265 FIFTH AVENUE WEST HYANNISPORT 1 " = 10, F-1 kitchen living room L basement with washer/dryer dining stairs down closet closet closet DECK (D 11' x 10' , bedroom 9.6 x 10 N bedroom closet garage bath a, 18' x 12' :2 bedroom bath closet bath storage storage v 12.5' x 16' FA bedroom L aD v .FA FIRST FLOOR BASEMENT WALKOUT LEVEL n Lie - O&� Town of Bc7tmStE..We P# t'� 3 o l U Qy 1l-LE P 1DepartinGnt of Regulatory Services o r D Public Health Division )Date AAB 200 Main Street,Hyannis MA 02601 y� Date Scheduled_ Q 2`7 �6 Time l/4 Fee ll all• t-l)�' `oil Suitability Assessynenrtfor Sewage Disposal Perfonned By:�0 `�� `^ Wllnessed By.: ILO IC 7 ION a..�LrodtGGEN]C4 RA L J\Tr4 ORl\/.�17[ION Location Address � � / rN` - Owner's Naiite A�K W- aM Address Assessor's Map/Parcel �� Cugiueer's Name �0 L4)0--• NEW CONSTRUCTION REPALR Telephone It �J �� 3/14 Land Use ��C� slopes(%) 6 - Surface Stones Distance's From: Open Water Body Ft Possible WE[Arco 456-�—ft Driuking Water Well ft Dralhage Way �7` G(/ ft Property Line !A ' fl Other Ft 17 J15.1L'.'JL CH: (Street name,dimensions of lot,exact locations of lest holes SL pert tests,locate wetlands 4n pro)[inllly to holes) Y \n /- Parent material(geologic)w I`� Depth lu Rndroelt O C; - Depth to Groundwater. Standing Wafer in I-lole:4 9 Weeplllg 1'I'ol!1 Pit Pptt a Z-• Estimated Seasonal High Groundwater V.V >� ZTABIE s o --� Melhotl used: : w, Depth Observed standing in ohs.hole: lu, Deptla to still ITlolll..gs;__ Depth to weeping from side oFobs.bolt: •_,•_,I!I, dl'ot!I1rJWutuY Ad,JushTlnnt..e, `'rfC. r Index Well it Reading Date: Index Well le Adl,ftlCto!' ,�_ At{l,C)YlriilltlWatuY l eVel PERCOLATION TEST Va(w I'Luxi Observation Hole#p Time tit 9" Depth of Perc t Tlme at 6" t Start Pre-soak Time @ Time(9"-6") End Prc-soak eu„ Rate Min./Incli Site Suitability Assessment; .;ile Passed_ SiI.G Failed: Additional Testing Needed(Y/N) ' I Original: Public Health Division Observation Holt;Data To Be Completed on Back----------- ***It Percolatiou test.is to be conducted }within 100' of wedand, you must first noti y We Barnstable Conservation Division at least orie (1) Weelc prior to begiauruiug. QAS EPT10PERC FORM.DOC IDlR1El�.OBSE]f2�jA7[ION]Fg®>L,E'+ -------_ from Soil Ilorizon �O Hole #P Dept Soil Color Surface(in.) Soil Texture `. .. '—"--- (USDA), Soil• Other (Munsell ) Mottling (Structure,Stones;Boulders, (c�ocDe Can iste cy,7, ravel /jY/Z� �v ti /0 Laa3--Q- IM DERP Depth from ®�`�' i'_RVATION.�®][E LOG Soil 14OH20n S°il Texture I-TRleSurface(in.), Soil Color(USDA) Soi1Maltlinl GcJ Depth fromOBSERVATIO Soil Flortzon Soil Texttre Surface(in.) Soil Color. (USDA) Soil , (MunsG)l) Mottlin Other g (Structure,Stones,Boulders. Cop istene 4o Orwell ------------ 1m� P 013S ER VATION HOLE Depth fiom Soil.Horizon �'®� ]H ole# Surface(in.) Soil Texture Soil Color _ (USDA) s011(Mansell Other' Mottling (Structure,Stpne9;Boulders, Conastency p�praval � ^�T Flood Insui•arnce Rate Mg Ab°ve 500 year Rood boundnry No Yes Within 500 year boundary NO Yes Within 100 year flood boundary No Yes ]I�epat9>I u_�'j'�n��¢�1➢y_ o�bt¢�un�]��icwaous l�uteriA� ._. . _ � - _ Doe -at least-four feet of naturally occurring;perviOus ma area proposed for the soil absor tarlal exist in all are s observed throughout the .ption system? fif not, what is the depth of naturally occun'ing pervious mataria'17 Cei�ti-- �c�rGaon •. A certify that on D-P-G qq (date)I have passed the soil evil luakor examination approved y the Department of Environment a]PrOtection'and that the above analysis,was performed by me ons stent with ilia regtaired trai ing, exp rtise and experience described in CIO CMR 15.017, Signature Q,1S13G'TICU'ERCEORM.DOC I { LEGEND SYSTEM DESIGN: SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE NOTES MARKED WITH MAGNETIC TAPE. OR COMPARABLE MEANS FOR FUTURE LOCATION. 99- EXISTING CONTOUR GARBAG'�E DISPOSER IS NOT ALLOWED PROVIDE MIN. 20" DIAM WATERTIGHT (NOT TO SCALE) 1. DATUM IS NGVD a ey ACCESS COVERS TO WITHIN 6" OF FIN. GRADE X 991 EXIST. SPOT ELEV. DESIGN FLOW: 4 BEDROOMS 0110 GPD = 440 GPD 79' PROVIDE INSPECTION PORTS TO 2. MUNICIPAL WATER IS ExISTING WITHIN 3" OF FINISH GRADE a CrGi ville Be h I - \ 9.0 ACCESS COVER TO WITHIN 6" OF FIN. GRADE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 99 PROPOSED CONTOUR USE A 440 GPD DESIGN FLOW MINIMUM .75 OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 9.5 MIN. _ PRECAST H-10 8" MIN 4. DESIGN LOADING FOR ALL PROPOSED PRECAST UNITS a I [98.41 PROPOSED SPOT EL. RISERS (TYP.) TO BE AASHO H-LQ SEPTIC 'TANK: 440 GPD (2) = 880 2'o 4"OSCH40 PVC TH 1 •.`. Zr USE PROP. H-10 1500 GAL. SEPTIC TANK TEE PIPES LEVEL 1ST 2' S. PIPE JOINTS TO BE MADE WATERTIGHT. TEST HOLE $.5f*' s. m 8.76' YYY 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH I 2� SLOPE OF GROUND LEACHING: 7.05' PROP. 1500 GAL 310 CMR 15.000 (TITLE V.) H-10 SEPnc TANK 6.8 1067- 08-089.DWG(SBO)Cj LocU 4.72 SF/LF x 4' LENGTH = 18.88 SF PER QUICK4 4 0 000a00000000 °o0 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO Q Q� UTILITY POLE GAS WRE ::. ° 000n°o°00000 o° PLUS STANDARD LP CHAMBERS IN FIELD 4' L�. ,, ,- TUF-TITS EF-4 a 8E USED FOR LOT LINE STAKING OR ANY OTHER Nantucket FIRE HYDRANT CONFIGURATION ACME OR EQUAL EFFLUENT FILTER Q 8.67' 8,5' Y (OR EQUAL) Q 7.76' PURPOSE. �', _. W MOLDED IN GAS `C Sound , 440 GPD/0.74 GPD/SF = 595 SF LEACHING ` •``"g .:: 6" SUMP s. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING °o°o°o"o°o°o°o°o° �o°o°o°o"o"o°o"o° DEFLECTOR ' I °o°°o°o°o°°o o°°o°°o°°o 000°O°o°°o°°o°o°°o°°o°°e 12" INT. DIM. MIN. 32 STD. QUICK4 UNITS REQ D �o�o�o�o^g^o�o�oo o:!:2:20000g0000a , OVERALL DIMENSIONS TO OUTSIDE OF UNITS: 32 X 11.3 9: COMPONENTS NOT. TO BE BACKFILLED OR CONCEALED 595 SF 18.88 SF UNIT = 31.5 UNITS i°` 6" CRUSHED STONE OR MECHANICAL (NO STONE PROPOSED) WITHOUT INSPECTION BY BOARD OF HEALTH AND / / COMPACTION. (15.221 (2]) 5.O' PERMISSION OBTAINED FROM BOARD OF HEALTH. *THE INSTALLER SHALL VERIFY THE THEREFORE, USE GRAVELLESS SYSTEM OF (32) LOCUS MAP 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING LOCATIONS OF ALL UTILITIES AND ALL STANDARD QUICK 4 UNITS IN FIELD DIGSAFE (1-888-344-7233) AND VERIFYING THE BUILDING SEWER OUTLETS AND CONFIGURATION OF 4 ROWS OF 8 UNITS LOCATION -0F ALL UNDERGROUND & OVERHEAD UTILITIES . NOT TO SCALE ANY PRIOR TO COMMENCEMENT OF WORK. ELEVATIONS PRIOR TO INSTALLING A ( �'N% SLOPE) ( 1 x SLOPE) ( 1 % SLOPE) USE G-W AT EL. 2.76 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ASSESSORS MAP 245 PARCEL 37 PORTION OF SEPTIC SYSTEM (TIDALLY INFLUENCED, MW REMOVED 5' BENEATH AND'AROUND THE PROPOSED SET AND AUTOMATED LEACHING FACILITY. READINGS TAKEN DURING AND THROUGH NEW MOON 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND MA CYCLE: SEPT. 8TH TO THE REMOVED. APPROVED DATE BOARD OF HEALTH 17TH) 13. WETLAND FLAGGED BY HAMLYN CONSULTING FOUNDATION 24' SEPTIC TANK 2' PUMP D' BOX LEACHING 14. -INSTALLER SHALL CONFIRM THAT ELECTRICAL SYSTEM �o CHAMBER 15 5 FACILITY IS SUITABLE FOR PROPOSED PUMP SYSTEM EXISTING PROVIDE 24' LONG 4, DWEWNG LANDSCAPE TIE WALL WATERTIGHT MIN 20" DIAM. ACCESS COVER TO FIN. GRADE AT 1' HIGH. TOP WALL ALARM AND CONTROL PANEL ' 10.17 AT ELEV. 9 (SEE TO BE INSTALLED INSIDE DETAIL) BUILDING. ALARM TO BE ON SEPARATE CIRCUIT FROM PUMP PROPOSED WORK LIMIT LINE SHED INV. IN 6.78' TEST HOLE LOGS GUYWIRE EXIST. LEACH FIELD 1000 GAL. H-10 S 2" PRESSURE LINE 3.83 �X FENCE cn 5.35 ALARM ON 500 GAL.+ SLOPE TO DRAIN BACK TO PC ARNE H. OJALA, PE, SE -"T3 X X RESERVE 0.25 WEEP HOLE ENGINEER: 6:72 5 P8 FLOAT SWITCH 205 t M ��s`O X 5.1 SETTINGS: PUMP ON " CHECK VALVE WITNESS: DON DESMERAIS, RS (1.56 x 7.41 x •83 4" WORKING RANGE 8 MYERS SRM 4 DATE: AUGUST 27, 2010 \ °' X .13 , 9. 4 8- C 39 / 4 1 HP PUMP 9 X " SUBMERSIBLE / 0 U i 6 X 9.39 i ^� k PUMP OFF 8 SYSTEM (OR EQUAL) PERC. RATE _ < 2 MIN/INCH •` 1 -� 73' 2 PROP. VENT WITH CHARCOAL FILTER 2.53 000000 00�00 0 0 000o CLASS I SOILS P# N N 0' 5. 1 n C' �5 X 1 I J X 6.13 5/34 AND BUGSCREEN (FINAL PLACEMENT BY PUMP CHAMBER \ I k CONTRACTOR WITH HOMEOWNER . I I 5�32 CONSULTATION) (NOT TO SCALE) ELEV. ELEV. I I WATERPROOF/WATERTIGHT 4 0 4 , 3.90 I 5.37 oil ,� 1.67 X 2.33 EXISTING 0. ST I i X 10.3 1 0.0 DWELLING - I 8. 4 k I PROVIDE APPROX. 103' OF 40 MIL LINER AT 5' I _ OFF SAS IN AREA SHOWN. TOP AT ELEV. 8.8% ' 7 BOTTOM AT EL 4.8' FI LL FILL I I .3.53 g REMOVAL OF UNSUITABLE SOIL REQUIRED 48 6U - °j 5.71 OUND PERIMETER OF LEACHING FACILITY, ! 1 DECK �RLI 5.09 D WN TO SUITABLE SOIL LAYER. REPLACE A/B A/B Wq TH'CLEAN MED. SAND, TO MEET LS LS gppROXNE o X 4.8 69 S ECIFICATIONS OF 310 CMR 15.255(3)TOP FNDN .1 ELEV. = 12.79' o VARIANCES REQUESTED UNDER MFC 15.405: 10YR 2 1 1 OYR 2 1 k 1.53 'w 01 PAVED I BENCHMARK: USE CONC. SLAB 52 / 64" / • g DRIVEWAY I w HERE AT ELEV. 9.4 1(c): REDUCTION IN SETBACK, SAS TO LOT LINE (10 TO 5) BW BW' Q LOT 627 > 1(b): REDUCTION IN SETBACK, SAS TO FOUNDATION (20' TO 14'); ST TO FOUNDATION (10' TO 7') '0 36,120 SFt ` UNDERGARAG w 4.�4- _ I Q TOWN OF BARNSTABLE REGULATIONS: LS LS • # 3.88 cas 4 �S " 4 44I 4.67 SECTION 360-1 METER 8 f-+�'4.94 5.11 � REDUCTION IN SETBACK ST TO WETLAND (100' TO 60' AND 100' TO 73)' 72„ 10YR 5/6 4.3 84„ 10YR 5/6 : la 5.35 / REDUCTION IN SETBACK, SAS TO WETLAND (100 TO 78 , 3.0' j 1.62 :o % L S 4.7 4.41 96" OBS. WATER 2.3' 96" OBS. WATER 2.3' X 2.9b /1.71 ^j �4.5 SIEVE SAMPLE / I CS CS i •b•�4.10 / '� 10YR 5 4 10YR 5 4 ..58/7 I f 132 / -0.7 144 / -2.0 388 m�illillillill32 7 �� 3.99 LOAM AND SEED /'• X X EL. 9.5' .94 WOKEN GEOTEAWLE FABRIC _ 'tr"3•n GRAVEL (M/RAR) USED AS TIEB4CK 8�- PT _3� EDGE WITH M/R4f7 ATTACHEDOBYKJ^"SCREWS AT W CEN RS TE , TA -R CGE ED SP/K S ES BEACH STREET � 40 MIL. EL. 5' ;�:.� TITLE 5 ' ITE AN POLY 84RR/ER SECTION VIEW 6' x 6' P.T. LANDSCAPE TIE KNEE WALL 12' HIGH 6' DEEP OF Nor m xwia i 265 FIFTH AVENUE WEST HYANNISPORT BUOYANCY CALL: PREPARED FOR APPROX. MHW 1000 GAL H-10 ST WGT: 8240 LBS (SHOREY) -_�3 3 2.99 8.5 x 4.83 x 0.23 x 62.4 = 589 LBS UP (OKAY) 1 A ^t l c --- /'"'�' V CE SCHADE SEPTEMBER 2, 2010 ,I 2� OF L{yss� �cN OF Mass Scale: 1"= 20' I DANIELA. Oy DANIEL 9cyG G q OJALA n l`r A. ` 0 10 20 30 40 50 FEET IVIL JA n 10 A.�465 � 980 � off. 508-362-4541 o�'JANIF_ A IEi_ cy� downcope.com hyt Ssq fax 508-362-9880 OJALA r, A. C3 CIVIL OJA'-A down code engineering, 1/!c. tio. \,Nrr409 ,. civil engineers land surveyors -Z-24id "J� - su 939 Main Street ( Rte 6A) i DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 08-089 I j a o- o i TOP S. TANK EXISTING ELEV.=9.6' DWELLING Ville I j SHED rn GUYWIRE X X X X / ocus ' 9 i ' ` 70 / MAP w i k / I LOCUS EXIST = •� - - Sri i ,Q i / SCALE 1"=2000'f .' EXWE'nNG FI�3d �` / ASSESSORS MAP 245 PARCEL 37 o LOCUS' 1S WITHIN FEMA FLOOD ZONE A10 ! 1 / ELEVATION 11 AS SHOWN ON COMMUNITY PANEL #250001 0008` D DATED JULY 2, DECK 5 / 14jo 2008 � o ' TOP FNDN DATUM: NGVD ELEV. = 12.79' P VED ' 'w DR VEWAY o Q LOT 627 ' (` l0 36,120 SFf GARAGE UNDER 0 / s � '- SEPTIC SYSTEM REVIEW (1978 CODE): 00 I `l,• _. SEPTIC-TANK,:• 440 x 1.5 = 660 GPD (OK) LEACHING: 40' x 11' x 1 GPD/SF = 440 GPD (OKAY) 388'f X x X GRAVEL - _ EDGE j BEACH STREET APPROX. MHW 3�- --3 SITE PLAN SHOWING EXISTING CONDITIONS 2� OF off 508-362-4541 265 FIFTH AVENUE fax 508-362-9880 WEST HYANNISPORT downcope.com © ....—••• _ 'E OF-WATER down cape �eag�neering, inc. PREPARED FOR •" '�. N OF JANICE SCHADE MgSS9C �ZN OF MASS civil engineers o� DANIEL y ``A 'Qti land surveyors g� DANIELA. �s 939 Main Street R to 6A O j U O'vLA IL N AUGUST 1, 2008 YARMOUTHPORT MA 02675 Oo.4os8oP No.46502 tyND ss` o� F `�`¢ Scale:1"= 20' ,S/ONAL DATE DANIEL A. OJALA, P. ., P.L.S. 0 io 20 30 40 50 FEET 08-089