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0095 FIRST AVENUE (HYANNIS) - Health
95 FIRST AVE. ,HYANNIS A= 267. 002 r' f l No... �f{ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH roWf� OF..fl_A1 ./�.FT.64-f-._..................................... Appliratinn -fear Biiipviial Workfi Tomitrurtion Pprutil Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: . ;4 i d r ss or Lot No. ner /' /yk------- 1./, le,es_--------_--------------- --------------------------- ............... Address Installer Address Type of Building Size Lot_.,1��.42�®__-Sq. feet U Dwelling—No. of Bedrooms-------------- .Expansion Attic ( ) G:frbage Grinder ( ) Other—Type of Building ------__._-_-------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) G4 Other tures -------------------------------------- W Design Flow........... .. .......................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid cal�;acity104r4r allons Length---------------- Width------.......... Diameter................ Depth---------------- x Disposal Trench—No._.h_ __-QG�/i tl�------------------ Total Length-------------------- Total leaching area----------------....sq. ft. Seepage Pit No_____________________—lamerer-------------------- Depth below inlet-................... Total leaching area_�...A------sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- Test Pit No. I................minutes per inch Depth of "lest Pit.................... Depth to ground water...-_--..--.---.--.----- (i, Test Pit No. 2......_---------minutes per inch Depth of Test Pit.................... Depth to ground water--.-:------.-_-.----.--. P� -----------------------------------------•--...-•--•----•---------•---•----•--•------•--------------......................................................... 0 Description of Soil---------N;4/' D------------------------------------------------------------------------ V ----------------------------------------------------------------------------------------------------------------------------------------•------------------------------------ W ----------------------------------------------------------------------------------------------------- --------------------- -------------------------------------------------------------- --------------- UNature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- ----------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been '/sy the board of ealth. Signed�e/� _`'�.. _ fvP�'. . /�i v �l�G�iC(� �(#��Ci/ Date Application Approved / ----- •... a' �� �/�OaId US Date Application Disapproved for the following reasons:----------- "r___.___/_,tc�,�XC __© _.-_ _________________________ ----------------------------------------------------------------------------------------•-----------•------------------------------------------------------------;.-------------------------------------- Date PermitNo �r2z7---••------------------------------- Issued........................................................ Date No..-•-01q.---..... F��.'":Gt., ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... i )�r'`V S.lfi ` ......................................... Appliratiuit -fur Dispoii tl Works Tomitrurtiuit Vrrutit Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at: eE ti n- ddress or Lot No. T-- !l----------------------- Owner Address Installer Address / Q Type of Building Size Lot./t,<./ d-®.-.-Sq. feet U Dwelling—No. of Bedrooms._----_--.--3---------------------------Expansion Attic ( ) G.rirbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other_fixtures ------------------------------------------------------ W Design Flow-----------JF4---------------------------gallons per person per day. Total daily flow--------------------------------------------gallons. Septic Tank—Liquid capacity/P gallons Length................ Width---------------- Diameter_____..._..__-__ Depth---------------- W Disposal Trench—No.__i+_ ®--_- Width___________________ Total Length_______-_-__.------ Total leaching area--------------------sq. ft. �Tlc •t• .-!' Seepage Pit No__________________ )iameter.................... Depth below inlet-------------------- Total leaching areaa:�,�-____-_Sq. it. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date---------••----------------------_----- ,� Test Pit No. I................minutes per inch Depth of "lest Pit--._---_-_-_--_..__- Depth to ground water-.--------.----------.-- LL, Test Pit No. 2________________minutes per inch Depth of Test Pit.__--___--..-__--__- Depth to ground water........................ --••--------••------------------------------•--•-------•-------------------------------•-•----•-----......................................................... O Description of Soil----_-__. _. x -------------- W UNature of Repairs or Alterations Answer when applicable...................--------------.---------------------------------------.-..--._--.--..-..-.-.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with rF^~f the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been 'ssued.by the board of Health. `� - =- Signed �'�j _ !� .� t� fv�� fi' "' � d+>V 1jF ly+fvjC" l' Date ApplicationApproved BY---•-•-------------••--•------•-•--•-•--•--------------•-----•--- •-- e, --...._ , =-------------------Date-------------- Application Disapproved for the following reasons:------------ . _% -___.___-F__.CTk'...__. -- i-- ~ ----U --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- f Date PermitNo......... f................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS tf� BOARD OF HEALTH Tq&t(/V...................OF... /t'..�5 �..��.......................................... (Itrrtifirate of fauutpliattre TH TO CERTIFY T h dividual Sewage Disposal System constructed ( ) or Repaired ( ) by -le---..... 1...•- � . 5-.................. ...........................................:.......................................................... Installer / /t/ — _ / v/ ------------------------------------------------------------------------------- ............ has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No--------�-&____________________ dated.-------/--- ----!'r THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector----------•--•----•••-•--•-•----------•--•-------•---•---•----------....------.----- THE COMMONWEALTH OF MASSACHUSETTS BOARD�OF HEALTH I leA,1ri-14 d4 /T ....................... ... OF...; /...................................................................... No......................... FEE........................ %spo al Varkii Tlumitriurtiuit Prrutit Permission is hereby granted...7 ��A/t/_i< � J 2V1.-// /=r 5................. to Construct ( ) or Repair ( ) an Individu 1 Sewage Disposal System at No.. t/15-�- �- -`- / �il �{�/S....... Street as shown on the application for Disposal Works Construction Permit No_____________________ Dated-------.---------------------------------- ---------------------------------------------------------------------------------------------------•---- Board of Health DATE...................------------------------------------------------------------ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS �sT Town of Barnstable Inspectional Services Department MASS. g Public Health Division i63p• ♦0 '°'E ► 200 Main Street, Hyannis MA 02601 Office:,508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7021 0350 0000 1549 3655 May 14, 2021 WAECHTER, WILLIAM H & DIANE PO BOX 489 WEST HYANNISPORT, MA 02672 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 95 First Avenue,Hyannis, MA was inspected on 04/15/2021 by James Ford, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Stain lines to the inlet of leaching pit. It is unknown if there is an H-20 under driveway. You are ordered to repair or replace the septic system within two (2)years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas Mckean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\95 First Avenue Hyannis.doc THE rp�y Town of Barnstable �R� B g Inspectional Services Department ►u►'�"m Public Health Division 200 Main Street, Hyannis MA 02601 Thomas A McKean,010 otl-Ice 5()8-862-4644 FAX 508-790-6304 ` Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLIN E CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or o'�structed pipe. sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Backup of se��a ❑ Structurally unsound septic tank or SAS ONE l YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box is above the outlet invert due to an overloaded or clogged SAS or cesspool ❑ A ortion of the SAS, cesspool; or privy is below the high groundwater elevation P ❑ A portion of the cesspool is located within a Zone i to a public well well ❑ A portion of the cesspool is located within Tl lsest °e1�passes f the wivate water ater)analysis with no acceptable water quality analysis ( ) indicates the well is free from pollution). TWO 2 YEAR DEADLINE CRITERIA f� ❑ Single Cesspool NI I ❑ Any "conditionally passed systems" (broken cover; relocation of a pipe; relocation ofa driveway due to 11-10 components; etc) C� ❑ leaching facility with standing liquid level at or above the Invert pipe (per Town Code §360-20 h) �,. OT ER f FT Repair deadline:_ � � — -- --- -- — O\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Stanton, David From: Jim <Jfordseptic@comcast.net> Sent: Tuesday, May 04, 2021 10:57 AM To: Stanton, David Cc: McKean, Thomas; Tripp,Vanessa Subject: RE: 95 First Ave Hyannis inspection Hi David, Answers to your questions 1. House is occupied 2. The side wall of the pit is dark up to the inlet pipe, its clean above the pipe. 3. Up to the pipe 4. Dark water stain 5. Under driveway and had to use a camera.There is no info if it is H-10 or H-20 loading 6. There is no D-box 7. Its title 5, 1000 gal.tank 1000 gal. pit The septic application dated 1973 states 3 bedrooms, It's a 1000 gal. pit with V stone.The owner back in the day installed 3 more bedrooms. At 6 bedrooms you can have 12 people living there! At some time the liquid level was up to the inlet pipe. If it was made for 3 bedrooms why would you allow 6 bedrooms?There is 1 person living there now. Barnstable is totally different on stain lines than every other town? I will not pass a system with a stain line up to the inlet pipe. Thanks Jim Sent from Mail for Windows 10 From:Stanton, David Sent: Monday, May 3, 20218:43 AM To:Jfordseptic@comcast.net Cc: McKean,Thomas;Tripp,Vanessa Subject: 95 First Ave Hyannis inspection Good morning Jim, Tom is on vacation this week, but these are the questions he has people answer before further review of"Needs Further Evaluation by the Local Approving Authority" for the stain line part. As for the unknown if H-20 under a driveway,there is a policy, attached, for the answer. As for the 6 bedrooms on a 3 bedroom system, the Town currently does not enforce this. Please answer the questions below and e-mail the responses back to us for future review to make a determination. Has the home been vacant for a while? What was the degree of staining? What was the extent of it? What was the coloration? Were there any other indications of failure? Did he/she notice any staining in the d-box? Is it a cesspool or a Title V system? Thanks, -�269:4 - ooa- c Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 95 First Avenue V� Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hy p annis ort `/ MA 02672 4/15/2021 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information filling out forms on the computer, use only the tab James Ford key to move your Name of Inspector cursor-do not Ford Septic Services, LLC use the return Company Name key. P.O. Box 49 rae Company Address Osterville MA 02655 City/Town State Zip Code »� 508-862-9400 S 12482 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑ Passes A d 2. ❑ Conditionally Passes 3. ® Needs Further valuation by the Local Approving Authority ,i(7) 4 ❑ Fails �f 4/21/2021 Insptt 's nature Date Th inspector shall submit a copy of this inspection report to the Approving Authority (Board of DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts �P Title 5 Official Inspection Form < Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 95 First Avenue u� Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hyannisport MA 02672 4/15/2021 page. Cityrrown 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: 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018, Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 cam, Commonwealth of Massachusetts Ilp Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u- 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is p required for every y West H annis ort MA 02672 4/15/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system wile pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ® Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner,which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hy annisport MA 02672 4/15/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less;than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: ****The House has 6 bedrooms, The septic was built for 3 bedrooms. The leach pit is under the asphalt driveway and unknown if it is H-20 loading. The leach pit has high staining line used camera to inspect. 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ` Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is p required for every West Hyannis port MA 02672 4/15/2021 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 cesspool is less than 6" below invert or available volume is less than 1/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the 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 coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ( ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of'the following, in addition to the questions in Section CA. Yes No ❑ ® the system is within 400 feet of a surface drinking water supply ❑ ® the system is within 200 feet of a tributary to a surface drinking water supply ® the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 L c Commonwealth of Massachusetts p Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hyannisport MA 02672 4/15/2021 page. Cityrrown 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? El ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 c� Commonwealth of Massachusetts �v Title 5 Official Inspection Form e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �.�!% 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hy p annis ort MA 02672 4/15/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: Number of current residents: 1 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 years usage (gpd)): Detail: unavailable Sump pum ? El Yes ® No P Last date of occupancy: currently Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form �li; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is p required for every West Hyannis port MA 02672 4/15/2021 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 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: 2019 ? 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 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is p required for every West Hyannis port MA 02672 4/15/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: 0 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): Approximate age of all components, date installed (if known) and source of information: installed in 1973 per septic application Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer (locate on site plan): 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments `............ c�!% 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is p required for every West Hyannis port MA 02672 4/15/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 10" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal. Sludge depth: 2 Distance from top of sludge to bottom of outlet tee or baffle 25 Scum thickness 1 Distance from top of scum to top of outlet tee or baffle 5 Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The Tees were present. There was no sign of leakage. l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 i c Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hyannisport MA 02672 4/15/2021 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): N/a Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): N/a Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 cam, Commonwealth of Massachusetts ,p Title 5 Official Inspection Form 11 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments >� 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hy annisport MA 02672 4/15/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): N/a *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 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.): N/a t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form I, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hyannisport MA 02672 4/15/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a * 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: 1 gal. 1' stone ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title.5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18 C Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hy p annis ort MA 02672 4/15/2021 page. Cityrrown State Zip Code 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.): The pit was dry. The stain line was up to the inlet pipe. The pit is under the asphalt driveway and unknown if it is H-20 loading. A camera was used to inspect. 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.): n/a 4 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 ,*A, Commonwealth of Massachusetts. Title 5 Official Inspection Form �� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments eM !% 95 First Avenue Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hyannisport MA 02672 4/15/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy (locate on site plan): Materials of construction: N/a Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level ofi ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts �- Z Title 5 Official Inspection Form lip Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .............. !% 95 First Avenue V Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hy p annis ort MA 02672 4/15/2021 page. Cityrrown 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 POcc,k b a O A Q 3 � a16 �s a as �s` 3 C a� t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 r C� Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments !% 95 First Avenue V� Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hy p annis ort MA 02672 4/15/2021 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 high ground water: fee +/- eet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Topo and water contours maps ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 r - c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c 95 First Avenue V Property Address The Estate of William Waechter Owner Owner's Name information is required for every West Hy annisport MA 02672 4/15/2021 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® 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 ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or,attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 1_)PrAK1iV1hiN1 95 HIGH SCHOOL ROAD EXTENSION HYANNIS, MASS. 02601 Harold S. Brunelle Sj11U1`e 0Btectori Save .2iUed BUSINESS: 775-1323 00 CHIEF EMERGENCY 775-2323 To Town of Barnstable , Board of Health - T. McKean Town of Barnstable , Conservation Commission - From ; Fire Prevention Bureau, Hyannis Fire Department Subject ; The installation of above ground storage tanks . Date Persuant to the applicable sections of 527 CMR - Fire Prevention Regulations , this Department has inspected the following location for above ground storage . ADDRESS 95 First Avenue Al cam? a 2— OWNER/OCCUPANT Wrechter. Frank PHONE : 775--316 SIZE OF TANK (S) 330 gal. Steel Oval / BASEMENT COMMODITY STORED • : # 2 fuel oil PURPOSE FOR STORAGE- : HEATING THIS INSTALLATION IS-: PRE-EXISTING A REPLACEMENT NEW This installation complies does not comply with the required installation regulation listed below. FIRE _PREVENTION OFFICE RaxxxRAxxx1)XX F WxaTy9y1 HFAN'NIS FIRE DEPARTkIENT ? v � Z 6 T ®® TOWN OF BARNSTABLE - UNDERGRUUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. Z6 7 PARCEL NO. �,�2- TAG NO. ADDRESS OF TANK: �J ��/�5 A Vc V I LL6d'ET �/ i4 A $ Ppf,T Nufnb�r Ytr��! MAILING ADDRESS ( IF DIFFERENT FROM ABOVE ) : P SOX `/ 71p U,-), 6,7-9, OWNER NAME: LlL L 1,411 IJ lLly)� yU/l r--CH/�K PHONE: 77S ,q 3/& F INSTALLATION DATES _S60L 97 BY a SNa T1Y& 90qo1,//c-,.7,ya � J v INSTALLER ADDRESS P*-M,S 1,AAM004 0Q6,W -CERT.NO. *TANK LOCATION ABOVE BELOW / /V �, rDUMOmreK ON ' FUEL/CHEMICAL UMMKC'rO nUZLDINOI CAPAC I TY� TYPE OF TANK ' IZ AGE P4/ YRS. FUEL/CHEM I CAL TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ ] NO DATE CONSERVATION [ ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. [ AA,;eA- ., ] DATE 4t-13Sp - PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD 77'w"f TOWN OF BARNSTAB``LE — UNDERGHUUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. 2— 7 PARCEL NO. L90Z TAG NO.�S� � � �I6ST-11✓� VIAGEr �`/ /� 1✓�//S Po,�r" ADDRESS OF TANK:__ Numbmrr •tr��tn MAILING ADDRESS ( IF DIFFERENT FROM ABOVE ) : P OWNER NAME: /A�G L IA m Dl1-If NF w1q 456H 4;-K PHONE: INSTALLATION DATE: Sclo 97 BY: �Oa7N T �v(,-, ZyC INSTALLER ADDRESS:�57 ) '72-`6 �A Tf�,S•1,AAM0+lrl( i/� )d bi 4/ 'CERT.N0. *TANK LOCATION. ABOVE BELOW �(� J�j ,/� /"� r ' ' 'ow. Z as TANK LOCAT Z ON W S TH "wommCT TO nu 2I-D I NO.) o CAPACITY -3. TYPE OF TANK G iL AGE &!�WYRS. FUEL/CHEMICAL TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE I LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND . ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ ] NO DATE CONSERVATION [ ] CHECK IF N/A C� DATE s BOARD OF HEALTH TAG NO. [ % / ] DATE PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THLS CARD, TOWN OF BARNSTABLE - UNDERGRUUND FUEL AND CHEMICAL STORAGE REGISTRATION • MAP NO. Z6 7 PARCEL NO. TAG NO.13 .5'0 ADDRESS OF TANK: ��� S/ �I✓ . VILLAGE: POR Numbmr Ytrqw�t n J MAILING ADDRESS ( IF DIFFERENT FROM ABOVE ) : f �.� 4 6� .21 rx�' UoI 1,,72N OWNER NAME: (,t1 L 4 1A ry lvf-- PHONE: 77, - 4 ��6 INSTALLATION DATE: .S ,ol `�7 BY rf+1/ � �: c�ki ,✓ts, a ✓i' t AI'%GS 1'.47/4 � 1� INSTA"L:LER ADDRESS: ��f MJyT/t l"/A O0 66b C E R T .N0. *TANK LOCATION. ABOVE ) BELOW IV1 v (DC�ORsaa TANK LOCATION WITH RQOPQCT TO �UZlD2NO) l�• CAPAC I TY�0 TYPE OF TANK G4.4- AGE ��'�YRS. FUEL/CHEM I CAL TESTING CERTIFICATION [ ] PASS [ ] ,FA,IL DATE LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ZONE OF'"'C-ONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ ] 'NO DATE CONSERVATION [ ] CHECK IF N/A DATE BOARD OF HEALTH TAG N0. DATE PLEASE PROVIDE A SKETCH SHOWING THE,.TANK. _LOCATION ON THE BACK OF THIS CARD_ 1 002. TOWN OF BARNSTABLE - UNDERGRUUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. Z6 7 PARCEL NO. TAG NO. ADDRESS OF TANK: _ ��1,6`m5 f'I Vc VILLGET �/ �{/✓lVl-S pd�r /vumb�r •lr��t nn MAILING ADDRESS ( I F DIFFERENT FROM ABOVE ) : l'. �x �� 71/� OWNER NAME: L11-1-1AI-7 -t /,/IA-M "rt--C1// j6K PHONE: 77r-4 _SEAT 97 BY. �OyT/� SR0nf H�}T�i✓� INSTALLATION DATES INSTALLER ADDRESS:cS 70V/-XS PA-7fi,S v l,�r,MOal'ff �i� Da C E R T .iVO. *TANK LOCATION< ABOVE BELOW w (ommonIaG TANK LOCATION WiTN nummm CT TO nuILDINO) CAPACITY3,30 TYPE OF TANK ` AGE ,A/9� YRS. FUEL/CHEMICAL TESTING CERTIFICATION C ] PASS C ] FAIL DATE LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION C ] YES C ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED C ] YES C ] ®NO DATE CONSERVATION [ ] CHECK IF N/�A�+ DATE BOARD OF HEALTH TAG NO. C N> w` ] DATE * PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD a