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HomeMy WebLinkAbout0029 FOREST GLEN ROAD - Health 29 FOREST ., liYAN 1S -A=290-022 LOT 22 o k i No. Grp-f�V .0 Fee--,�� THE COMMONWEALTH OF MASSACHUSETTS Entered in c puteMn r:I PUBLIC HEALTH DIVISION -'TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliLation for ;Disposal *pstrm Construction Permit Application for a Permit to Construct( ) Repair(/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Po R sue" ST Owner' Name Address,and Tel.No. 14y0­nntS ,MQ eC'er� L Itc:, M:tle� Assessor's Map/Parcel ,2& _ o l 61Q Fort rt-Sr-_L.s,t t c.r• * I Installer's Name Address,and Tel.N ti 36- Designer's Name,Address and Tel.No. "3.�uc'e tu.vc,,kU. tef gner �t s� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided &VO gpd Plan Date %/"3 6_�26 o Number of sheets I Revision Date Title Size of Septic Tank i 5�1-0 Gft(, Type of S.A.S. 3 -,7 00 C-41. Clnc����el S �O iC 10 Description of Soil ?Cr- P l.pu Nature of Repairs or Alterations(Answer when applicable) PceAp A, t e ur,e cuss uais - 5 1 1 Soo J tc' i+c a ii cS e�lSi `,�`rio ' Ck " _ G a � Cti-Th GS tr e � 1 S -3yr X to' Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in r 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 Date 1 Application Approved by Date t3l Application Disapproved by Date for the following reasons Permit No. 7? Date Issued No. Fee s. THE COMMONWEALTH OF MASSACHUSETTS Entered inoofiiputer: Yes PUBLIC HEALTH DIVISION -*O—M OF BARNSTABLE, MASSACHUSETTS ' 0(pplication for Disposal 6pstem Construction 3permit Application for a Permit to Construct( ) Repair(V�Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components `. Location Address or Lot No. o Cj Fc,2 e 5-r t SrOwner's Name Address,and Tel.No. L*A&&th1 NA, - eTeri Le'k(c. M' lley �Cj FcItSY�- + Assessor's Map/Parcel 0266 — p/ �..,, Installer's Nam Address,and Tel.Npp. ��-3d6- Designer's Name,Address and Tel.No. u rvice P o,,C-C V Tar zq& "9P✓io/ HC,So� 81 t�o.�a S?.d�•��,�� i Type of Building: Dwelling No.of Bedrooms o2 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) I, ' I Other Fixtures i Design Flow(min.required) e�6 gpd Design flow provided ayo gpd Plan Date /1-3 D—'26od.o Number of sheets Revision Date Title Size of Septic Tank 15-00 GM. Type of S.A.S. 3 --5-00 G i /'S - 30 X 10 Description of Soil 196 I?c r P l A u ! 6 h Nature of Repairs or Alterations(Answer when applicable) vh p A Q e rY1 c y r Cc sso as is - Tn s`+c I 1 I S oo�A I. 5 e2ie Ta r �IS1f�b Twn Y1oX 3 -TOO 2ic-1• C- C-eh6l,S w,T� 5� 5-MAt e rd.S .2,A8 T•1r cn S�4/eS Date last inspected: j i r `�Agie'ement: 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. r Si Date -3 A-�Q/ Application Approved by `Date , � /! Application Disapproved by Date \. for the following reasons Permit No.C--)Oc G 77 Date Issued 3 A� •�--� 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 56'i eA\�%cCh3;r,' / at "kq. FOg.� VQ wes-r C,nn,s 06,T has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 77 dated Installer f vcf- "1 ���51 eT Designer aw r✓J! NfQ so o ' #bedrooms C�, Approved design flow 3110 gpd The issuance of this permit shall not be construed as a guarantee that the system will ction as desi/gtn�ed. (�e _- Date Inspector No.`_:�r— 07 - Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS 13isposal *pstem Construction 3permit Permission is hereby granted to Construct( ) Repair(t j Upgrade( ) Abandon( ) i System located at ,29 FO2eS:%-f w J and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction rniist be completed within three years of the date of this permit. Date t� � I Approved by/ f Fr. f Town of Barnstable �►+E Regulatory Services Thomas F.Geller,Director ` '"ASS ; Public Health Division �� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date:y - _oZ( Sewage Permit 'D Assessor's Map/Parcel of /` 01.� Installer&Designer Certification Form Designer: lJ �MI) A%/ Installer: INP �— Address: � CJG -I Address: 07 r On "/5"oZ,( � was issued a permit to install a (date) (installer) � ', '.11 t1 septic system at �Q 1"DIC W t7 V ✓- based on a design drawn by •-� y,A (address) M ,Qb dated /� k (designer) certify that the septic system referenced above was installed substantiallyaccordin g to -the.-design, which may include minor approved changes such as lateral relcation.oft he distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the.septic system referenced above was installed with major changes (i:e.0' greater than 1. .lateral relocation of the SAS or.any vertical relocation of any component of the septic system);but in accordance with State &Local u� �1-tions. Plan revision or certified as-built by designer to follow. Stripout(if rp acted and the soils were found satisfact ­11 OF qs DAVID y (Installer's Signature) g M Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for H annis Ma. 02601 7/8/2010 y every 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: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC. Company Name r� P.O.Box 763 Company Address Centerville Ma. 02632 rerun City/Town State Zip Code (508)428-4028 S14454 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310.CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 7/8/2010 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. I � t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewag Disposal System•Page 1 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 29 Forest Glen Rd. i4^M Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 ` every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes","no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 a Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface-water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system,component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface.of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form _ a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 29 Forest Glen Rd. Property Address Joseph La riore P P Owner Owner's Name information is required for H annis Ma. 02601 7/8/2010 y every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or El El tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 � I Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d NA 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy,of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 2001 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 24"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. feet suc o e r rr Y feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank (locate on site plan): Depth below grade: 18"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a-copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallon Sludge depth: 5" t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is Hyannis Ma. 02601 7/8/2010 required for Y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 27" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined? measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumptank eve two ears.lnlet and outlet tees are in place.No evidence of Ieakage.Tank appears every Y structurally sound. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom-of outlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts L W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No 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.): Box is Ievel.Box has two outlet Iaterals.No evidence of solids carryover.No evidence of leakage. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 8'x33'x6" ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy dry soil.No signs of hydraulic failure.No ponding or damp soil.Leaching was dry at time of inspection. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 29 Forest Glen Rd. .Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to :. at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate ter supply enters the building. Ch eck one of the boxes below: where public water 9 P PP Y ❑ hand-sketch in the area below ❑ drawing attached separately wf r C�00 J - - - - t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for Hyannis Ma. 02601 7/8/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of leaching 15' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: As-Built ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 29 Forest Glen Rd. Property Address Joseph Lapriore Owner Owner's Name information is required for H annis Ma. 02601 7/8/2010 y every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist E Inspection Summary:A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems)completed E System Information—Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 08/07/2007 12:17 (508)862-9399 CONFIDENTIAL PAGE 1/3 ATTY.: TTIomas McKean, Health Dept. Head Residents of =,!�A', 7 1, T(),: (508) 790-6304 Forest Glen Rd. I Hyannis,MA 02601 August 8,2007 Town of Barnstable _ hegu?abry Sitrvices Building Division j 7&1'),4,W11 Street F 1:t ax.:li::l,MA. 02601 AT'TT4.: Thomas Perry,Building Commissioner % I Re. 29 Forest Glen Road,Hyannis < a �= Eli - ' Dcar Building Commissioner Perry- = %a 'Ve are following up on our letter of July 8, 2007 concerning the legal violations nd ( � rn� I 1_!1:--t:i_reatening dangerous conditions that exist with the above-referenced property. Inspector Roma who was handling this case contacted us to inform us that it is no longer a building/zoning department matter,because the file had been turned over to the Town Att.orney's Office, and is being dealt with by Bob Smith,the town attorney. j Bob Smith's office was contacted on August 7, 2007 for a status report on this property. j Po:b ; rr,ith returned the call but had no knowledge or recollection of any matter with his office 1??lathing to the above-referenced property. Moreover, Attorney Smith stated that even he did ! have such a matter pending with his office,that it would in no way interfere with,suspend or j rs:move the Building/Zoning department's on-going enforcement obligations with the property. I We understand that the various building,zoning, conservation and health departments 11a.'Te been dealing with this property for some years now, and the neighbors have sent in written co.nr.lairts dating back as early as May 8, 2007. i i - I � loowever, it would appear that at least since our letter of July 8, 2007,nothing has been done. The dangerous conditions remain, the homeowner is unlawfully occupying the premises, and as far as matters have been reported,to us from your department,the Building Department lia.>, ashed its hands of this matter and is allowing the unlawful conduct and dangerous co a�+_.tions to go unchecked and unenforced, .hfte-;reviewing this letter,we would appreciate your contacting us personally to inform US 0,F trl:e Current status with this property and let us know what further enforcement actions the i ! Building Department is prepared to take,if any. V i I , Thank you. Very truly yours, Brian Wasser,et al. Encl.s. (7 238-0090 I ;,A_: Councilor Miln; Barnstable Health Dept,; a Barnstable Conservation Dept. I i 08107120U 12.:17 (508)862-9399 CONFIDENTIAL PAGE 2/3 Residents of F"ED TO: (50" 790-6230 Forest Glen Rd. Hyannis,MA 02601 June 8 2007 Town of Barnstable Regulatory Services Building Division '00 Main Street Hyannis,MA 02601 AT TIN.: Thomas Perry,Building Commissioner Ike: 29 Forest Glen Road,Hyannis h ear Building Commissioner Perry: The above-referenced property has been an abandoned construction project for approximately 3-4 years. We have left a number of voice-mail messages'tirith the various Regulatory Service departments over the past two or three months voicing concerns about this property. Darcy from E Conservation returned a call and informed us a little bit about the on-going situation from her &tparttnent's perspective,but we have yet to hear first-hand from other departments. Ij Apparently, Regulatory Services has been having problems with this property owner for a �I long time now. in attempting to preserve a neighborly atmosphere,we remained quiet and patient hoping to see some progress. Regrettably,matters have not improved, and in some cases, have worsened. I Concerns that are visible to us include: use and occupancy of the property without an occupancy permit; in-groud pool without protective fencing or adequate lighting; 1 abandoned construction site whose pen-nits are believed to have lapsed; and f iclear-cutting of the lot when owner/builder represented at Conservation Hearing that only a few trees would be cut to permit access to front door of house. As we are not privy to inspections-of this property,we have no way of knowing what other violations or dangerous conditions exist. We were informed that the propemy owner has refused to pay a court-ordered fine concerning the property. Children play in this neighborhood and the two homes on either side of this construction site house minor children. We are concerned that an abandoned construction site represents an attractive nuisance to children and the public at large. 08/07/2007 12:17 (508)862-9399 CONFIDENTIAL PAGE 3/3 i I i A.,pool with neither adequate lighting to announce its presence nor a solid,permanent fence to enclose its life-threatening dangers away from the public is a horrible statistic and nears story waiting to happen. The Town of Barnstable need not appear on the nightly news over some tragedy that is readily foreseeable and can be avoided. i j The hidden dangers,illegal use of the property,and unsightly unfinished conditions at 29 Forest Glen Road are also detrimental to the neighboring property values. We have had to apply for tax abatements due to the decrease in market value caused by this neglected property. This property poses not only a financial loss to neighboring homeowners, but to the Town of i Barnstable as well; eroding an already strained tax base. i In summary, We would like to be kept informed about the progress of bringing this property into compliance with all laws and regulations and especially the curing of dangerous and potentially fatal conditions. If we can be of any assistance to these ends please do not h!sitate to contact any of us. We understand that your department has the right to fine violators on a daily basis,for I each and every violation that remains uncured. We also understand that your department does not like to impose such extreme, daily fines in most cases. However, it appears that this is not 1 the typical case. Where homeowner has shown disregard for the safety and welfare of others, and disrespect for the laws, regulations, and even Court orders,we believe more stringint fines and j enforcement actions are warranted to bring this homeowner into compliance, Ij Thank you. i Very truly yours, t f� i 1 I� q A/WA:51 Z �J:' FD1Lo.3T GLEN E➢. a E �F / A L4) .) , f i cc.: Councilor M'ln TOWN OF BARNSTABLE LOCATION �,/9 �n-�r� rIry /Q/ SEWAGE VILLAG ASSESSOR'S MAP & LOT 290—022 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY IJ—da e oC LEACHING FACILITY: (type) F,C (size) 1 /3 7 16 NO. OF BEDROOMS BUILDER OR OWNER Zoc' PERMITDATE: COMPLIANCE DATE: 3 Z 0 3 Separation Distance Between e: Maximum Adjusted Groundwater Table to the 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 ©� Feet within 300 feet of leaching facility) Furnished by �'�aa �aoo _� - � ,. , F d' �� , � Q O_ 0 f y -__.. � � A � No.1i v�� O�7 ` y Fee/" e THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for 0igpogar Opgtem Congtructfon Permit Application for a Permit to Construct(>.Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 2 R467-04E" R01530 Owner's Name,Address and Tel.No. Assessor's Map/Parcel �'/D �g i Z 61*44-RIZ i 46F /,. a01a Installer's Name,Address,and Tel.No. signer's Name,Address and Tel.No. 5Q� `2 C-I?,o �� /O � C�61�5✓ , �vr�cj T#tu cA� `f Type of Building: Dwelling No.of Bedrooms 2- Lot Size Z X 0 sq.ft. Garbage Grinder( ) Other Type of Building )?AFsfPW 7/ -c-No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow PD6,4h o` , gallons per day. Calculated daily flow gallons. Plan Datetoo Number of sheets Revision Date Title Size of Septic Tank 1�c� ��lc�n 1°" ci�Y s' ' Type of S.A.S. Description of Soil I_VA/� >�ni� $ a'rL �a ® /v 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 Certifi- cate of Compliance has been issued by this d f Signed Date Application Approved b Date Application Disapproved for the following reasons Permit No.G zy/— 5� Date Issued A -S�r�> r _ _; Fee r G.a Ent red in computer: - THE COMMONWEALTH OF MASSACHUSETTS p r s PUBLIC HEALTH DIVISION -TOWN,OF BARNSTABLE., MASSACHUSETTS s ZippYication for Mioppol,6pgtem Con.5tructton Permit + Application for a Permit to Construct(> Repair( )Upgrade( )Abandon( ) O Complete System D Individual Components Location Address o Lot No. Zq hoRX-61- GLOW RoA-Z Owner's Name,Address and Tel.No. 6Q 6Q HyAWlais ^4 0%.Vo 1 c\a�4 7�,r i ALncG7' a Assessor's Map/Parcel /O Z 2- Installer's Name,Address,and Tel.No. Designer's Name,Address.and Tel.No. S�'12 0—�9� f �r 63 CArr, ALDaAu LAIOC, 7/` �Jr % 61s7-.Q rat.Lr z6 i f Type of Building: - t Dwelling No.of Bedrooms Z- Lot Size 2 1 10c sq.'ft. Garbage Grinder( ) Other Type of Building ,?t Fj t.Pc!7/4---No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /1 D G D A F loot gallons per day. Calculated daily flow 7.2.0 gallons. Plan Date' ®O Number of sheets Revision Date Title Size of Septic Tank /400 fAON Type of S.A.S. Description of Soil; 4 dAlf..y rl N-- S*A.16 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: ,Agreement: . Ca 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;Certifi- - { Cate of Compliance has been issued by thisJ3oard f He th Signed / Date--3 Application Approved by { Date ®6 t Application Disapproved for the following reasons Permit No. :5F e. — Date Issued —042"EO1 —————— THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTJYY,that the(fin-site 5fwage D' .posal System Constructed( )Repaired( )Upgraded( ) Abandoned'( )by �� G'' ! C_e at 2 9 Fo It Ex7 67t-Al ROB s A4 A 0260 fi has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Perm -40 71 :? 5'dated Installer Designer The issuance of Ws p rmit shall not be construed as a guarantee that the system d n 1 e1d' Date 3 20 3 Inspector 3 t L - ----/-.---- ram----------------------.--- -,- _ .. - _ - No. Q(J L�' Fee f 6_,. THE COMMONWEALTH OF MASSACHUSETTS _ PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 30igpogal *pgtem Con!6truction Permit R 4 Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at cal FOA ES-r 45 L.E'N 90*h t (�y_q 1 f'1,d 14 + O 2-4 b I and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constjuction st be completed within three years of the date of permit. Date: 3 2 3 Approved by r TOWN OF BARNSTABLE LOCATION v79 rf/ 6IO � SEWAGE#A:7/ -3rJ VILLAGE �ygfa eS ASSESSOR'S MAP& LOT Z90 022 i INSM(►L.LER'S NAME&PHONE NO. � �ofLST��e o✓ f/ "5��6 SEPTIC TANK.CAPACITY LEACHING FACII.ITY: (type) FxC� (size). ? $ 6 I NO.OF BEDROOMS BUILDER OR OWNER s� PERMITDATE: COMPLIANCE DATE: Z L�3 eo l°r O t Separation Distance Between e: Maximum Adjusted Groundwater Table to the 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 .�9 B it >L i 000 - 33 Bj. 3�s)-�/ ' - -- - - - - - - /7 FJ a I own .of 11s;r11stable Department of IIeallh,Safely, surd E[IV irounl ell lal Services �1 Public I1cM111 Division IN(e 51 367 Main Slrccl,I lymmis NIA 02601 unnererem� 1 MANI M6 bt� Dale Scheduled �!3 n q _ 'I"isle dD flay lice I'll.� ,Soil Suilabililp Assessll ent 10* r Selvage Disposal Performed Illy: b,+A1(L7L .�D(+lqI ,/j \Vilncssed Ily: LOCATION & GI,NERAL INIFOI!N.i. :TION* Location Address Z—or 7-Z /--*2-9 Owncr's Nnme /�GFftE9 /1r4S/fA1zvza, Fri r GLEd1 l�a �oC,16,e :b) Address —lot/ 117'-I-nAj rl C Assessor's Map/Parcel: Z V 2-�- Iinginccr's Nnmc \\ -�, / - �CJAN d v sfzJ S o 7u v NEWCONSTRDC"LION }G Rlil'AIR 'IciclrhoncI/ .5-0 yip_/q0/ Land 1)sc Slopes(1o) 'oZtlr/u Surface Slopes Oislances from: Opcn WOIcr Ilody D60 It Possible Wel Area It Drinking Wnler\Vcll Il Drninnge Wny II Property Line ,20 •4`� Il Olhcr Il S K ETCI 1: (Slrccl prune,dimensions of Inl,exncl Iocalians of lest holes R perc Icsls,locate wetlands in proximily to holes) F,4w(_ETT 5 PQ1Jo 57) q ' 0 a A t G—I CIV /'0 A,0 Parcol malcrial(geologic) (-IJ7-v+Il-SN Depol to Iledrock Aid/ OS Depth to(iroundwnler. Standing Water in Ilolc: liar 06S Wceping from Pil pncc N'sT O�j Estimated seasonal I ligh(irollildwalcr N o T D S DE`I ElmlINATLON FORS I ASONAL IIIGII � A`l'I�IZ.'I'AIjLI, Method used: Depth Observed slanding in obs.bole: in. Depth to soil mottles: Depth to weeping from side of obs.hole: in. Groundwnlcr Adjoshi nl Index Well it I(r.ndinR Dnlc: (ol{{� Index Well level a9. Adi.NcIor.3�— AQj.Gioundwntcr Level ' '' PrLtCOL;A'I'ION 'CLS'I' Observation I lute ll y '( l'T Lime n19" 112S., 3 C Dcplh of Pere 4}~_ rr Tlme nl 6" 11•'1-9:ls, 11:JI.,30 Silo Pre-sonk'I imc (0 /I 03 II:.LS 'I imc(9"•G") '/S"J'EL jo f4FG End 11rc-soak I(olc Min./Inch L�N10Z L/�F+lps Site Suilnbilily Asscssmcnl: Sill:Pnssed V Site foiled: Additioul'Testing Needed(YIN)�• Originnl: Public Ilealtb Divislon Observation (tole DIIIII To lie Completed on Back j Copy: Applicnnt DEGE ' 013SIOtvATION IiOU- LOG llole /1 / i Dgrlh liom Soil Ilorizun Soil Texlorc Soil color Soil Other Surlircc(in.) (USDA) (t`lunscll) Holding (Shuclorc,Slimes,Ilooldems. (�Aulsjgo!gy CD- ----- 0 FIX ,16 /0YA 413 Na— 4D" n S-16 109s j=.u.43LE a 0$�1 /(D -X°!o A- J E-L DEEP OBSERVATION 11OLE11,0C; Hole It I)clrth liner Soil Ilotizon Soil I'cxlnrc Soil Color Soil 0111er Sorlocc(im.) (I ISDA) (Nlooscll) Mollling (Slluclurc,Slnncs, Ilouldcres. — — Lo,41--I/ VCAY 0—l3 rrnlE S+'o /a YA Ila A"r-031 yRtA;LE - - -- _ ---0 04— --- --�3— -—--9 W _5414D /o k/A C-1g No r e3f FM AS lL .23 iZarr 6-A,+0ELy L.oOfe - — ----- - - ---- — C r _— ce4A-je sum a.S y �/4 /vw ®g3 /G UFUT 0118RAZVA`l'ION 11C)LI, LOG We fl _ Dclrlh Pom Soil Ilorizon Soil-fcxlurc Soil Color Soil Oflier Smlircc(in.) (USDA) (Monscll) Linlll!ng (Slnrclurc,Slrnres,Ilooldc•res. r DEEP 0118VWNIATION 110LE LOG 11(ilc It Uclrlh Burl Soil I lorizon Soil•I•cxlorc Soil Color Soil Olhcr Surrfacc(in.) (IISDA) (Nunscll) Nlollliog (Slilmorc,Sloom Ilouldcres. I�I�)uU11SIIM,!lcc Itr a 11'lr h Above 5OO year flood boundary No 1'cs Wilhin 500 year buunif;oy No 1•e5 Wilhin 100 year flood boundary No T ycs 1)c.pllt of N_iltl�stll ccuri'i)){;_ ' Lf tms_[VI;ilcrii)-I I)ocs ;I( least Lour feel of naturally ocelll'I'i11g pervious 111,11C1'lal exist III all areas ol)scl'vctl 1111-ollghoul the area proposed for the soil absorption system? YFS If nol, what is the depth of naturally occurring pervious Inalcrial'? �:ct_tircalililt I cerlify that oil ItLS (dale) I have passed the soil evaluator cxamilmlion approvc(I by the I)ep;lrllllcnl of I;nvitonnlcnla) t'rolectioll and (hat the above analysis was perfornictl by nle consistcnl will, tilerc(Iuircd training, experlisc It (I x pericncc(Icscribed in 310 CNIR 15.017. Signature _...G -- Dalc a-�t6`oo No. FEE COMMONWEALTH Of MASSACHUSETTS Board of Health, 44 2j-SD A g C r MAT APPLICATION FOP, DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct Repair( Upgrade( Abandon( - Complete System ❑Individual Components Location 29 i-ES j eaw ",+V #y,41,Vovj.S Owner's Name Ap$C-AT ML/,ecH1vie Map/Parcel# a9C Q Address f?0, g„* JCS /'4?-3-pVS 'MILS A40J-o8 Lot# Telephone# Installer's Name T6? Designer's Name Dantri�L J (I vSa�/ Address Address 67 CAPS, l+LoE-AtJ LJ`i USi�TR*LLE Telephone# Telephone# Lco 8 Q�p (9 C Type of Building A��O�°`�i to L Lot Size 3.0 �QV � sq.ft. Dwelling-No.of Bedrooms a 1 p e Poi F-0 Garbage grinder ( ) Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures Design Flow (min.required) tea- gpd Calculated design flow Design flow provided *Aa4 gpd Plan: Date C, 6/ O o Number of sheets / Revision Date Title jyjS iPL FA-(.E S',ra4(-E b l S/0.34 L 5 YS t-rA,\ Description of Soil(s) cC (Q E SA lv D Soil Evaluator Form No. // Name of Soil Evaluator b, JD if eJJ ON Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place the system m ope ntil a Certificate of Compliance has been issued by the Board of Health. l Signed �✓ `' Date Lew 1c� 2 e. rS 0"j t No. FEE COMMONWEALTH]C.ALTH OF MASSAC1t1tUSETTS Bo,{ COMPLIANCE Description of Health, , MA. ERTIFICATE OF Description of Work: ❑Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned ( ) by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector: Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No."- - - ( �T�}�T..¶' LTH OF ( T(� Q FEE TS Board of Health, �T , MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met. Form 1255 Rev.5196 A.M.Sulkin Co.Boston,MA Date Board of Health A► 12 4- { 42-0- 12'-8' 9'8' 7_4• rr' ----------- w, 1 6'o'x6'8' 6 0'x6=8' v 9 m qDining Roam N v Living Roam a ,7 d x a S 0 b R Kitchen , k N Q O N b e-0. Hall s-0---,� 2'0-t-4'0--,f2 0 a s'——*—s s• 6 Hall 3 O-x 6-8• 2-8'z 8-8' a S k !n �' 2-8-x 6'8- + m CD 4 cy Foyer office TV Room h Bathroom �' o 2 0'x 5LO' 2'0'x 5'0' 3 6' 510 3'6' 2 O'x5'0' 2'0'x5-0' 121401 T WOO `sr �S Proposed Plan. _ Y S�'1 Lot 29 Forest Glen Road Hyannis,MA 02601 Prepared By.- Robert McKechnie Box305 Ma sM Marstons Mills,MA 02648 508-420-5717 �•/ rti 1r-0• 4211• 12=8' g 8• 7-0' ----------------------------- N t 6'0'x 6=8' 6'0'x 6=8' g Open to Dining Roam Below 9 iv fs-0' Open to Living ,Room Below a Balcony d x a b 13=8•--- 9'10' w Walk In Closet N 6 N O 9 O Q 9=8' -0• b w x 2'-8'x 8=8' m 3 T 6 ,� I Fiooa • � ro „ Laundry Room Foy e� 8'x 6= t1=t0' 9 h q x m N Master Bedroom ? Master Bath I h � I 2'0"x5-0' 2-0'x5-0' 3.5' 8c7• 6-0•�y 18-0' 'II p Proposed Plan: Lot 29 Forest Glen Road Hyannis,MA 02601 Prepared By. Robert McKechnie PO Box 305 Marston Mills,MA 02648 508-420-5717 Cus Yv�� J_ �ff-�s�l�1CCLT 3' 42 0' f4 I f2t9•6Wx88' I 3-0'x5 • 8"om �7,-�' x xa6^'-0 Lvng N <2' = 10dk- ; a - Dining Enm 0 2=8'x 6=8' d� x x 20'6' 1'—*---104' .;er 9 2' •x6' " 2 •xs Kitchen N d x 4 3'-0'x6=8' b m ' a Bedroom 5 v S o d Bathroom Pantry 2 'x 6' 4=8' 1540' 4'0'---`---9 - 23' 12, m 0'x6=8 - 3'x 6'- N o Closet k 184 Storage 4-4 Storage Bulkhead Utility --x 13,1:r e?�,Far Proposed Plan: Lot 29 Forest Glen Road Hyannis,MA 02601 Prepared By Robert McKechnie PO Box 305 Marston Mills,MA 02648 508-420-5717. SCg1.E - - _ � CL. � ® L -------------- o? 9 „0- ,,0-,Z X„8-, 1'-71�'100 1 ,,..; I • N co cn M 1 6 6 8 \ x Mco 21- 4'-9" ,r'3'-3" ------------ � 3-0"x 6'- co „00.06 X&E8 9'-2" co ao CQ r •� I co 'J x o co M ,r 00 i M 3�„ 26 00 »8;9 X"9-,Z cV ® cry o ® t 101-3' ' ®ca I I 00 0) I r s 2� I x 4'-8" 4'-0 x 2'-811 x 6- It \ 9Kt 13' 8„ �r r 33'-0" k, t 0 SRfi yy t M xn s g�` iu I f QUk, � � •.tea 7„, 4it G 1• xx Laundry/attic en to Living acc ss Open g .. � .j Room Below -4" T-0" w � s x Walk In j rj x}a 0) ,M Closet 5`-6" P A =w --- ---- ---- a - . 4'-0"x 6'-8" CO 2 0" I T-0" 6,_4;, o - - 30"x6'- co ct `t 00 Master Bathcn _ M rS�ii Master o r t;. Bedroom ' 2'-0"x 4,81 Cp i 1„00*0k X 2106 X 0 Proposed Plan: N N - Lot 22, # 29 Kitchen Forest Glen Road!.. . N Hyannis,-- M� A 02601 10'-6" 1' 24'-4" -1 11 Prepared By. 4'-911 \5„ 2'-5" i 10'-3" 11'-8" F --------- N , -8"x 6'-8' 3'-0" 6x 8" 8 5`-0"x 6'8" CO N t- 4-6 0 , Robert MCKechnle PO Box 305 _ Marstons-r. Millsy MA Bath Office ®en 02648 508-862-2430 rn „ 2, 0"x 4' 8" 51-10 1-2 1'14' Z36 Ass,�Louc Public Health,Didision Town of Barnstable PO Box 534 Hyannis,Massachusetts 02601 Fax(508)775-3344 Phone(508)79'M265 38'-0" 6�-6„ 22'-10" 4'-0"x 4'-8" - 6'-0"x 6'8" S.D 00 d Dining Area - FIRST FLOOR Living Room N w 1„00*0k xLl10G M„8t� xen Proposed Plan: N Cn = X I Lot_22, # 29 Kitchen - _ o Forest Glen Road - N o _ Hyannis MA 0260 Prepared By: 4'=9" --------------- -8 x 6'-8' '-o"x 6'-,8"B "_' 5'-0"x 6'-8" CO 4 -6 Robert McKechnie PO Box 305 _ Marstons Mills, MIZ Bath Office Den 02648 o 508-862-2430 ° �NrRY 2'-0"x 4'-8" -4 - 4n It Living �x Ent Bedroom co N X Proposed Plan: co - 9 7'8" ,5'40„ o ------------- Lot 22 # 29 7'-1" 3-0"X 6`--8" N 6-7'-- 2-2- Q o Forest Glen R® ad 2-88 ca 2'-8 . 6' - d- x � -0 3`-0" , w yartnis, MA 02601 j x U N co I X co Hall (p c ,- . Bath o I 3, o„X 6, 8„ w3, 0„X 6' 8„ Prepared By.. - th w MEWA ------ \ Closet " � � ----------- . o >0�o,, „-- o" / „ �3 8 Robert McKechni ' 61_411 storage PO fox 305 - 81-611 Marstons Mills, MA 02648 - � Utilit / 508-862-2430 y 6'-Q,, storage Public Health ®ivision 1 T-4" Town of Barnstable _ PO Box 534 4 Hyannis,Massachusetts 02601 Fax(508)775.3344 Phone-(508)790-6265 J 38`-0 1 6'-6" 22'-10" 4`-0"x 4`-8" 6�T x 6�8" Sp 0 .. � Co 1-p Dining Area �; Laving Room " FIRST FLOOR i 11100'06 x&Ck A N 0 x Proposed Plan: N CO OJ 02 " Lot 22, ## 29 X a� Kitchen Forest Glen Road N ! J Hyannis - MA 0260 I 10,6„ + _ {' Prepared �y: 24=4" `� 4-9 t-5 2-5 10-3 III-all -8"x 6`-8' ,-0„8"B , „ , „ ,v 5_0x S_8C N 4.6 o Robert McKechnie r N PO Box 305 Marstons Mills, MIA Office Den Yo_ 02648 Bath N 508-862-2430 oN 2'0"x 4=8" # -4„ -21' Y36 i Public Health Division GaRss ��o`J` Town of Bamstabte 5'--3 PO BOX 534 =: Hyannis.Massachusetts 02601 _ Fax(508)7T5-3344 Phone(568)79M265 i:, 4 8'41" ' . 13'-4" 15`-11" 3=0°x 4`--8" 6,_Q„x 6, 8" SD - ;ao v � OD_ - y - 2--10-S BASEMENT Bedroom/Rec Room x Entry o " Proposed Plan: y X co w - Lot 29 - -10" r " Forest Glen Road 15'-90" 441 Q„x 6' $" 2'-8'�x 6' 2, $„ Hyannis, M i W - 02601 �O . o X x _ w Mall OD ' Prepared By. °o y x , ; . 3'a„X 6'-$„ 3'-Q„X 6, 8" Bath ------ --------- W N Closet �, 10=0„` /" ; Q„ 3'$„ ., Robert McKechnie PO Box 305 = Storage 6=4" , g Marstons Mills, MA o $,-6„ \ N 02648 9'-6" 6'-0" .508-862-2430 -=- Utility/Storage -- Bulkhead l 1 T-4„ ( , r 38`-.0" Laundry/attic acc ss Open to Living Room Below . -4 1 7 0 SECOND FLOOR 2, 8„x 6'-8" , y o Walk In Closet 'rOposed Plan: 5-6 Lot 22, # 29 6'-2" 6�-2" S _ Forest Glen Road N : 4�pfJx 6�8�� CO 2�0" 1T-0" 6'-4" Hyar�jiK l �0260_� o ---- M . 3 0„x 6`- n, o Co N Prepared By: co Robert McKechnie r Master Bath PO Box 305 cn- N Marstons Mills, MA Master 02648 Bedroom 508-862-2430 2 0 x4 8 41 PubliC Health OW191on Town of Bamsfable - PG Box 534 2-01,x 4-8 Hyannis,Massachusetts 02601 Y - 33 44Dow Coau tr a Fax 508).775 Phone _ - (508)790-0265 r - - � 9 Fog r &LEhr XOr40 14 w IrNIN -Ooi,,E Ir 69-cuN0wff7EA ?Ajrr<_rioh/ PL-ily OF SEPTIL SYSTEM 1500 GALLON SEPTIC TANK SCALE : I =.10 1 MODEL TK•1500H(SHEA CONC.1OR EQUIVALENT A 5 S 6 S S o S MAP /PAR tE 4 : .? o 1 TSST PIT DATA _ FINISHED GRADE — — ,4Aeff 3/too f Sf Performed B: Danief B. Johnson 24"MA24"DIA9'YMIN) 24"DW 3" 3 H.20 Witnessed By: Donna Miorandi F, �Date: December 20, 1999, 4"SCH 40 FLOW LINE 4"SCH 40 i 10 14" ZABEL FILTER A-300 -------- j TP-1 M. • 99.0) i 4"SCH 40 TEE SEPTIC TANK TO MEET C LIQUID LEVEL REQUIREMENTS OF GAS BAFFLE 310 CMR 15 226 FOR /lPrR�krr"grF 0" - 13" O,A 10YR4/3 Loamy very fine sand I 4"SCH 40 WATERTIGHTNESS, fR c-Err e"ID ��GE of 13" - 26" Bw, 10YR5/8 Loamy fint- sand TEE ETC A8 dr.v EL= 96.;t °NQ 26" -12.0" Cl , 2 . 5Y7/4 (,ravely r'c,,3rs sand No bserved 9c r '-'� �— -`Z_�.� I No OhservHd GrHWr ciw �t �r ! d 6�' (MIN 1 - COMPACTED MECHANICALLY _ CRUSHEC►STONE erw�+� '� �-� � -- --�" �---. . _ $�•3 97 Adjusted Groundwat(.ar STABLE LEVEL BASE <-USHEIA —� — stf~rI( TAW caatfN'aulNS for r'L x 5' Ir'w x !wr ,a9 63' ` ` \ 4 6r w,►3 /vw�� �•�►.� w�E of ��" lr, t?,A 10Y144/ 1 l,,l, ttl`1! Vwt y r ) ticy hctt,d 4 tie r4rfo 1l" - 2-i„ 1:1W, 10Y16/11 I,1lattly Ct ►1t, n.-mil WET«n►L1 " DISTRIBUTION BOX -- I if ! i �?fl" r � , % , ►Y //4 c1te4Vely rr:,t1 1 67 — — — No rat.a��► V�y<A k;4i►,1W'I' "•20 b _ _ ; No f)It i t vaid fir't,,ltlrlweiI rj t REMOVABLE COVER 4"SCH 40 OUTLET LATERALS gJ Q 97 Act` u�►toci Gr',auttdwcilt,t DISTRIBUTION BOX TO MEET SHALL BE SET LEVEL FORA REQUIREMENTS OF 310 CMR MINIMUM OF THE FIRST TWO 15.232(WATERTIGHTNESS. FEET AND CONNECTED TO — — ` _ ! PXRM TSOM '1 IT DATA _ 1 CONSTRUCTION,ETC(. 2 EACH DISTRIBUTION LINE 94 1 1 WITH SOLID SCH 40 PVC PIPE -- f4ro- » ! Date : [1E'ce�rtlkterr 20, 1999 NO. OF OUTLETS 2 4"SCH 40 6" h1-1 OF _ - 9S ( Sall Class: Class I (U . /4 G/SE') Oo 0 IN) o co m— MECHANICALLYCRUSHFD / 36 STONE (<-3/4"DIA.) / ( STABLE LEVEL BASE PR-oPosEO "'- ... ..- ""• 50, d,,FGEK n3 I Pere Rate: < 2ME'1 ('T1�-1 and '1'F'-1 ) A aEi)400 '► tfOJ -1q /i3 • 9� rRo••, EDbE 33 I Ff£� I o;•, oo / OF nth of Pere Test : 40N - 58�� (TP_1 ) Np AISr✓R-$ 42 - 60 ( I'f 2. ) ._ i i — L o n -- __ -_ _.�. - ------- --- __. _ _._._._. _.-_ _�.. _,_-_._. _ - ._ �EALHING FIELD LENGTH OF LEACHING LINE 39 i SC>RlDt LZ Or ZLNATIONS "END"CROSS SECTION Inv. Out Foundation FINAL GRADE TO BE STABILIZED 96. •?0 \ FINISHED GRADE(SLOPE • 021 Inv. In Septic Tank 96. 50 \� 10 -to L�AuIiN� Inv. Out Septic Tank 96. 25 96 J C �ko�o / / pt-� / 99><a , /l.0 o d B✓fFf.� r u, „ q"ScM4o 3�1.>*l9wxo,$/'1 FR�� EQbE Inv. In Distribution Box 95 . 88 4"SCH 40PERF PVC I I I ( i ( (MINI 1�„ 18x3 `��o/ Pr-� S.,ol ors wErlANO I Inv. Out Distribution Box 95 . 71 I I \ ` •o o -- - -—- - - - an- —2"LAYE R I/e' 1/2" 1�.,,,t) I Inv. Begin Of Leaching Field 95 • 69 NO OFACTUAI DISTRIBUTION �_____ 4' / 2J DOUBLE WASHED STONE v , �Sw Inv. End of Leaching Field 95 . 50 LINES Z i I bA�[onI ( Bottom of Leaching Field 95 . 00 LLf L, 7_4 4_ 96r9 i yY SePrrc l0 LEACHING FIELD DIMENSIONS 1)RIFACE DIA _,._ 6 EN f-w-MILK I Adjusted '3w 89. 9 . � 6., • •�3/4" � 1112"DOUBLE WASHE ✓NDEIt (EC1JJND� ` T � ASl�^'`E E4. :roo,00 313'LX9'WX05'H � ---------. STONE to � © \ log 7ON of corvcFiTE -_- _ -•--- -_...._..___-_ - _ _ - •._-..� 8, END OF DISTRIBUTION LINES TO ACTUAL NO OFF DIiTIBUTION PIPES MAYVARY LEACHING FIELD TO MEET _.. BE LAPPIEl? RNLI.';_ VENTt11 FROM ABOVE DETAIL REFERENCE NO OF REQUIREMENTS OF 310 _ G'B 111 TYPE ►'' AN ANOPAnfitI ifORIITuiNiINF", ANOPtAN'AFIAI CMR 15252 r 1 Existing Contour - - - 98 - - - I �14IoSE0 1 1 - 91y�->,- J wRrfrt.l.fnlE t f0R_EST 1 - _ f I Proposed Contour ` FrCEw l R.o Ap `1 \ Test Pit Finished Floor Elevation FFE NOTES Basement Floor Elevation 1FF; 1 . All construction methods shall conform to the Title V (310 CMR 15) and the Barnstable (Hyannis) Board of Health j Water Line W Regulations. Over Head Wiro C)HW----- 2 • There are no known private or public wells within 100 feet of the proposed leaching area . The site is within a Zone II Groundwater Protection Zone . 3. No changes are to be made in the field without the approval •[ +y, of the Board of Health and the design enginoer'. ♦„ �' i • �A Isra� st ~" ��tuL ~�s �_ •� rrscrt Rv * "tee 4 • Proposed leaching field is nc�t dF i yned for use with PRaF�CE o CPT IC SYSTEM ,[� t w K 4D i R r� F,w qa rbagt4 disposal . Sc/►cE S ffiCwnJ i w �, ;, Knr'°• c►A; M,rewE�� PNecw .`�M[MAItA ! 5 . ('ontractor to notify Dig Safe •12 hours prier to s� i c�c.,nst. rvc�t Ion , (800) 344-7233 . �P�ovo�ED� I � c �` o '�O i f�. frupe�rt y 1 inc inf'Orm,,t ion taken from Subdivision, Fart. 8 of � o�. oo •E��Y 4 LOLLS j l,c,t 10 shown c,r1 1' 1 ,In 22825, F'i 1 eld wit h C'e't t of TitA e No. � � Pn,Nc Ess , i PINE Its II 1121 1 . � i 7,� RNOAt[ tsR[�t •I` 1 L f ( / . Deed rest re3 uirod for ths- `' ''r, AD �a iANt[Tt y prapF3rty for 2 Bedrooms ( , ►orrp AL A ,� maximum to be recorded at thr� harristabl(, Registry of l)eecica, r/,V� IO tAL prier- to i>BIlluawn(.e cat they se♦ )tis �stEt�1 permit b the PYN[ItAL Y too - PEo*ADED �R.��E .M oy • N,M rrA,,,cc • .,, harnst ai)l& tir.ard of Hba t Y f � G-R ` ,to rnaiAnA� 1 t� . � w[fr- oltrA Mpyy[f •'ram ' w ►MAAM• •.� t / IIACV I ��- 98><S ; '•ot 1r """ CALCULATIONS A.,0M 9 2 Bedrooms ( Proposed) f - �/5�� � 110 GPD/Bedroom X 2 Bedrooms = 220 GPD i f Percolation Rate - < 2 MPI ',TP-1 and TP-2) Soil Class : Class I (0 . 74 G/SF) •t scN )(�) , 36Zone I go 3' � 3t3I ( 1 Bedroom per 10, 000 SF) 96, p y pproximate) _ - Area of Property _ 23 100 SF a 0-4 o PER.r Area L=ACHIM AXXA: 99 + s9 7l `I°IL ��w x o/Shy 9S,00 ! n Leaching Field: 38' L x 8' W x 0 . 51H i (pie oe0;w) 11=� Bottom Area : 304 SF X 0 . 74 G/SF 225 CPD B`E 93•�q DlStftlB�T'�oN Total Leaching Capacity: 225 GPD 6oX , 9.t iSOo 6Al.coiv SF_P r/L ANA OF T w FC,= 89.9 ' _- IEL� SUBSURFACE SEWAGE DISPOSAL SYSTEM ,J�� lam' � •--i 29 FOREST GLEN ROAD, S?ANNI 8 APPROVED BY DRAWN BY _ .t 6/6/00 Danial ISJohnson D.D. Johnson aAz J 10 1 3.1(0 1 /40QFD 6v", (./Nf TV 0(.A o (L 4.rN T rr �•pd Robert MckKhmie (SOL) 420-5717 $g __..__._.-.._ __, .._ , f For: P.O. Dos 305, liarstons hills, 10► 02648 oto� O.ro ot�o a+,,+a G+4O OffO p�60 O♦>O Gs•8• 19+9p I�JO I+lo ItP10 it2o ��► �rJ ►'ll�ol ,ZtLo�4rE6�MOD/f/Er/J f1�e�lr, kra � /o buF/�f' � , _.I COAtiCCT[V NrTfj Lsrc. I _ •sm « � i I I DRAWING NUMBER FIDR� I %10 13 "J I12-4/01 ILNISe-a 1 RELacAM,7 a//vr*iA/ /014•Of%f1Cr 70 ✓e7(_. e4&) I�Ca ! rjl SIG/�D by; 63 captain JLld a+s sr. , Ostorviii., MR 02653 J-592