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HomeMy WebLinkAbout0074 FROST LANE - Health 74 FROST LANE H_ YANNIS A = 289 157 J� I I Town-of Barnstable 7 of P# Department of Regulatory Services � : Public Healt r+iss h Division 200 Main Street,Hyannis MA 02601 Date 0 d Date Scheduled Time _ Fee Pd, 0 Y Soil Suitability Assessment or Se f ge w Performed By: �t(�QfMPnI'?i� . iSposaly �� CS Witnessed By: ✓1 uV. 1 LOCATION & GENERAL IFIf O7Nam, TIOi`1Location Address (�`� Ve�� Owner'Addres5 L Assessor's Map/Parcel: Z 6. f a $ ^,`C / Engineer's Name L, NEW CONSTRUCTION .REPAIR ✓ ���Z f:�'I.��✓/�$C � �� E�tyrwPertnS -- Telephone# Z LandUsc S�!29e- fomdx / fe5ldenf• _ `'� .�09-273-Q377 • r7G� Slopes(%) ('z Distances from: p Surface Stones O en Water Body possible Wet Area " - �ft Drinking Water Well --�_ft Drainage Way ft Property Line 7 IQ _ Ft Other ft SKETCH: (Street name,dimensions of lot,exact locations of test holes&.perc tests,locate wetlands in proximity to holes) see. p if oCWJ Pa m Parent material(geologic) Depth to Bedrock. '7 13C) to3s Depth to Groundwater- Standing Water in Hole: t3© Weeping from Pit Face y 130 b S Estimated Seasonal High Groundwater 7 130 �,`ss Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE p/ree t Obseruoti�n Depth Observed standing in obs.hole: > t 30 Depth to weeping from side of obs.hole: > t3p tn, Depth to so]]mottles: 7 (30 Index Well#__ Readin Date: - In, Groundwater Adjustment - tn, g Index Well level_, Adj,factor ft. Adj.Groundwater Level Observation PERCOLATION TEST z�ute 112-�9 Hole# Time at 91, Depth of Perc n n 30 Time at 6" Start Pre-soak Time @ /©`G(a 7.� _ ---- -= Time(9" 6") End Pre-soak 0-:16 fi1`1 — ""_ -- --- Rate Min./Inch 2 Site Suitability Assessment: Site Passed e Failed: Additional Testing /V Needed(YIN) Original: Public Health Division Si[ Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notifythe Barnstable Conservation Division at least one (1) week prior to beginning, Q:\S EPTICIP ER CFO RM.D OC DEE,P.OBSERVATION HOLE LOG Hole#Depth from Soil Horizon Soil Texture Surface(in.) Soil Color Soil Other (USDA) (Munsell) Mottling (Structure,Stones;Boulders. ravel l S to Yr 3h - 0- 30 -- l3 Ls 1oYf 5/6 - - DEEP OBSERVATION HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) (USDA) Other (Mansell) Mottling (Structure,Stones,Boulders. Consistency,%Grave- l) 3/1 _ SIOU� 5 - - 30-13© G M-C S 2-5 Y"A, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Surface(n.) Other i _ (USDA) (Munsell) Mottling (Structure,Stones,Boulders, P-115i5tepcy,4' Gravel DEEP OBSERVATION HOLE LOG Hale# Depth from Soil Horizon Soil Texture Soil Color 5011 Other Surface(in.). (USDA) (Munsell) MOttlin g (Structure,Stones,Boulders. -Consj2tency, I Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes ._ Within 500 year boundary No Yes Within 100 year flood boundary No✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? _YeS If not,what is the depth of naturally occurring pervious material`s Certification I certify that on J0-27-9 I (date)I have-passed the soil evaluator examination approved by the Department of.Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and perience described in 310 CMR 15.017, Signature . Date ti �' Q QAS EPTICSPZRCFO RM.DOC I 6 . COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTA L L AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 74 Frost Lane . _ Hvannis, MA n601 Owner's Name: George Holland, Owner's Address: - Date of Inspection: June 10, 2009. Name of Inspector: (Please Print) James'M. Ford .. Company Name: JamesM. Ford . Mailing Address: P.O.Box 49 Osterville.MA.02655-0049 Telephone Number:. (508) 862-9400 CERTIFICATION STATEMENT I certify that I have.personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and'complete as of the.time of the.inspection. The inspection was performed based on triy 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 1.5.000). The system: Passes . Conditionally Passes eeds Further Evaluation by the Local Approving Authority F ils Inspector's Signature: Date: June 29, 2009 The system inspector shall submit,a copy J 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 systetir owner and.copies sent to the buyer, if applicable, and the approving authority. Notes and Coirttnents . ****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. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 74 Frost Lane Hyannis, MA Owner: George Holland Date of Inspection: June 10, 2009 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes:. ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or.more system components as described in the "Conditional Pass"section need to be replaced'or repaired. The system,upon.completion of the:replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is innninent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or breakout or high.static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or.obstructed pipe(s). The system will pass inspection if(with approval_of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 1 I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 74 Frost Lane Hyannis, AM Owner: George Holland Date of Inspection: June 10, 2009 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 CNM 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless.the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that.protects the public health,safety and environment: The system has aseptic 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 I 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 and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5.ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 74 Frost Lane Hyannis, MA Owner: George Holland Date of Inspection: June 10, 2009 1). System Failure Criteria applicable to all systems: You must indicate either"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 '/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 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 coliform bacteria and volatile organic compounds indicates that the well is,free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)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 detennine what will be necessary to correct the failure: E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 - gpd You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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. 4 L Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 74 Frost Lane Hyannis, MA Owner: George Holland Date of Inspection: June10, 2009 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 signsof 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: Yes No ✓ _ 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) [3,10 CMR 15.302(3)(b)]. i 5 Page 6 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 74 Frost Lane Hyannis, MA Owner: George Holland Date of Inspection: June 10, 2009 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2. Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example:.110 gpd x#of bedrooms): 220 Number of current residents: I Does residence have a garbage grinder(yes or no): n1a Is laundry on a separate sewage system(yes or no): 'n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persoris/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: None on file Was system pumped as part of the inspection(yes or no): If yes,volume pumped: eallons--How was quantity pumped detennined? 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation 512899 per as-built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 74 Frost Lane Hyannis. MA Owner: George Holland Date of Inspection: June 10, 2009 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Corrunents(on condition of joints,ventin evidence of leaka e g, etc. g , SEPTIC TANK: o✓ locate( n site plan) Depth below grader 5" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate)_ Dimensions: 1500 gal. Sludge depth: 2„ Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: S" Distance from top of scum to top.of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions detennined: Measuring stick 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. The liquid level was even with the outlet invert There did not appear to be any silts of leakage._ GREASE TRAP: None (locate.on site plan) Depth below grade: 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): . 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 74 Frost Lane Hyannis, MA Owner: George Holland Date of Inspection: June 10, 2009 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grader Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons . Design Flow: gallons/day Alann present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Connnents(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): The D-Box was normal. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 I Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 74 Frost Lane Hyannis, MA Owner: George Holland Date of Inspection: June 1.0, 2009 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: leachingc _ , chambers,number: 1 S 00 al. chambers 2 x 13 x 1 .S - 6 Per Q as built leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): A camera was used to inspect The Chamber. There did not appear to be any signs of failure CESSPOOLS: Norte (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 or no): Coimrients"(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 o; Page 10 of 1.1 OFFICIAL INSPECTION FORM. NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 74 Frost Lane Hyannis..MA Owner: Geor ze Holland Date of Inspection: June 10, 2009 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all w ells'within 100 feet Locate where public water supply enters the building. (34k Q l A�� A a � O 3 _ o 3 Gb, 3..L Y 10 . Page I I of I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .PART C SYSTEM INFORMATION(continued) Property Address: 74 Frost Lane Hyannis, MA Owner: George Holland Date of Inspection: June 10, 2009 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 25 +/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: . Topographic and water.contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how.you established the high round water elevation: Y g g I atwn: Using Barnstable topographic and water-contours snaps the maps were showing approximately 25'+/-to ground water at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed.as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 .z tF1t DATE: v - ,(ry- y • FRR: s sARMAau, MAW 0659. .� Town of Barnstable y Board of Health 367 Main Street,Hyannis MA 026t01' N S �l Office: 508•790-6265 "� r�ti oFe Su (t j. ask,R.S FAX: 508-790-6304 q qq y (Tyo p t bh A.Mu (.D. i VARIANCE FQUEST FORM +t LOCATION Property Address: 1� 7 4 Assessor's Map and Parcel Number: q 15-1 Size of Lot: Pf 3.S-/ .S Wetlands Within 300 Ft. Yes Subdivision Name: No X Business Name: H IA.,. APPLICAN CONTACT PE . ON Name: �AALL1-w oorJ CorLp. Name: Tr.N4, P9sIrQ-4,-cI-j Address:- t o (lj A-e E pS Address: Phone: Phone: FAX: — :7A _ o—I—1 o FAX: VARIANCE FROi<1 REGUL TA ION(LiS,ues.) REASON FOR VARIANCE_.(May attach if more space needed) �It�cklist(to be completed by office stgi-person receiving variance request application) _✓ four(4)copies of plan submitted(including septic system plans and/or restaurant floor plans) Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage'regulation variances only) tJLA Full menu submitted(for grease trap variances only) _Variance request application fee collected(no fee for lifeguard modification tene"Is.grease trip vtritnce tenemis]tune a-mllessee only 1.outside din'.ng,vsrisnce renews?s[Unit ownrrAea n only).and auis—ep to repair failed tewtge disposal systems tonly if no expansion to the building limpoted]) Variance request submitted at least I5 days prior to meeting date VARIANCE APPROVED _ Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S_P.H. REASON FOR DISAPPROVAL_ Ralph A.Murphy,M.D. Q:/WP/VARIREQ tel.(508)362-4541 939 main street rt 6a yarmouth port fax(508)362 9880 mass 02675 dOWn Cape engineefing civil engineers& land surveyors structural design I Ame H.Ojala P.E.,P.L.S. June 9, 1998 - Timothy H.Covell,P.L.S. land court David C.Thulin,P.E. surveys Barnstable Board of Health 367 Main Street site planning Hyannis,MA 02601 Re: Local variance request for 974 Frost Lane,Hyannis sewage system Proposed 2 bedroom dwelling designs Assessors Map 289,Parcel 157 inspections Dear Board Members: - The attached is a request for a variance from the "330 Regulation". Our client wishes permits to construct a 2 bedroom dwelling on a 0.26 acre lot at the above-referenced location. This lot lies within a WP District as shown on the "Town of Barnstable Revised Groundwater Protection Districts", dated April 1993. The surrounding area is well developed with existing 3 bedroom dwellings, with real estate values ranging in the area of$84,000 to $120,000(source: latest assessors books). The projected sales price of this home:is under$100,000. This septic system could have been constructed in complete compliance with the 1978 Code without the need for variances. Under the Transition Rules regulation 15.005 (3)(isolated lot);the'system'is designed to the maximum extent feasible and is slated to be completed within 3 years of obtaining the Disposal Works Permit. A normal-sized'2 bedroom Title 5 septic system can be designed on this lot without the need for any other variances. The lot is serviced by town water. To require the installation of an altemative-type system with attendant monitoring would necessitate the expenditure of greater than 10%of the estimated real estate value of the proposed house and land. On behalf of our clients; we are requesting a variance from the-Town regulation to allow a 2 bedroom house on less than an acre of land within a WP District. In that the area readily supports 3 bedroom homes, we feel the addition of a two bedroom home will not appreciably add to the nitrogen concentration in the area. It should also be , noted that the area is slated for town sewer in the future. Very truly yours, Arne H. Ojala,PE,PLS Down Cape Engineering,Inc. COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 74 Frost Lane - Hyannis. MA 02601 Owner's Name: Barbara Knapp *- Owner's Address: Same Date of Inspection: October 9, 2001 OCT. i`7 401 01 Name of Inspector:(Please Print) James M. Ford TOW N Company Name: James M. Ford Map:2 HEALTH fJtrl. Mailing Address: P.O.Box 49 Parcel. 157 Osterville,MA 02655-0049 Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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 N ' s urther Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: October 9, 2001 The system inspector shall submi 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. Notes and Comments ****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. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 74 Frost Lane Hyannis AM Owner: Barbara Knapp Date of Inspection: October 9, 2001 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments- B. System Conditionally Passes: r One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: r 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 74 Frost Lane Hyannis, MA Owner: Barbara Knapp Date of Inspection: October 9, 2001 C. Further Evaluation is Required by the Board of Health: Conditions exist which require fin-ther evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the.public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. 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 and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 74 Frost Lane Hyannis, M4 Owner: Barbara Knapp Date of Inspection: October 9, 2001 D. System Failure Criteria applicable to all systems: You must indicate either`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 'h 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 I of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gPd• You must indicate either`yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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 I1 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. Y 4 Page 5 of 11 OFFICIAL INSPECTION FORM'- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 74 Frost Lane Hyannis, MA Owner: Barbara Knapp Date of Inspection: October 9, 2001 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? y ✓ 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: Yes No ✓ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)]. 4 5 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 74 Frost Lane Hyannis, M4 ; OwnerE Barbara Knapp Date of Inspection: October 9, 2001 FLOW CONDITIONS RESIDENTIAL, Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 Number of current residents: 1 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): Yes Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): 2000-49,500,gals.; 1999-47,250,gals. Sump Pump(yes or no): No Last date of occupancy: 'Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment: . Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): E GENERAL INFORMATION Pumping !Records Source of information: None on file-per treatment plant Was system pumped as part of the inspection(yes or no): 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: May 28199-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 74 Frost Lane Hyannis, AM Owner: Barbara Knapp Date of Inspection: October 9, 2001 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron ✓ .40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: S" Material of construction: ✓ concrete _metal fiberglass _polyethylene other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1500 gal. Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 5" Distance from top of scum to top of outlet tee or baffle: 10" Distance from bottom of scum to bottom of outlet tee or baffle: 9" . How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels, as related to outlet invert,evidence of leakage,etc.): Tees were present The liquid level.was even with the outlet invert.` There were no signs of leakage. GREASE TRAP: None (locate on site plan) Depth below grade: 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 74 Frost Lane Hyannis, AM Owner: Barbara Knapp Date of Inspection: October 9, 2001 TIGHT or HOLDING TANK: None (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): The D-box was level There were no signs of solids or leakage. There were no signs of backup or failure from the leach field. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of l 1 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) `Property Address: 74 Frost Lane Hyannis, AM Owner: Barbara Knapp Date of Inspection: October 9, 2001 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: ✓ Teaching chambers,number: 1 -500 Qal. leach chamber-•2'x 13'x 16.5'(per as built card) leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovativelalternative system' Typetname of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): The chamber was located but not dug up.. There were no sim offailure in the D-box. The bottom to grade was approximately 5'. CESSPOOLS: None (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: - r Depth of scum layer: r Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 74 Frost Lane. Hyannis, AM Owner: Barbara Knapp Date of Inspection: October 9, 2001 Map:289 Parcel. 157 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. -g,Ik NCAC� �a Al- �1a ' A-3 _ (D 0 . (o 33" 3a . (a Aq ' (�y - 39. 10 Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - SYSTEM INFORMATION (continued) Property Address: 74 Frost Lane , Hyannis, AM Owner: Barbara Knapp Date of Inspection: October 9, 2001 SITE EXAM Slope Surface water Check cellar - Shallow wells Estimated depth to ground water 25' +/- feet (Adjusted High Ground Water Level is 21.1') Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic 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: The bottom of the leach chamber to grade was approximately 5. Using the Barnstable topographic map and the Cape Cod Commission water contours map, the maps were showing approximately 25'+1-to ground water. Using the Cape Cod Commission Technical Bulletin, the high ground water adiustment for this site(MI W 29, Zone C, 8101)was 3.9'. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. a. .. _ _ ..G ,. �. � � - � .. � ,. � � �� - � - .. � _ 1 - `�' - � � � � �, � c� �- � � � � _,, cam. 3 � �-- �. � � �' n �. mac► TOWN OF BARNSTABLE C' LOCATION `� -%aSo� G SEWAGE # � � VILLAGE ASSESSOR'S MAP & -2 f INSTALLER'S NAME&PHONE NO. -T SEPTIC TANK CAPACITY LEACHING FACILITY: (type) C�/ 4r4cLC"ize) NO.OF BEDROOMS LTILD OR OWNER 1zF c' PERMITDATE. « COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table.to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ------------- -91 Q' 47 - � ;� r PyoFTME ro�� TOWN OF BARNSTABLE OFFICE OF DAINSTABL Rasa. i BOARD OF HEALTH � r � 039. `gym p MAX 367 MAIN STREET k' HYANNIS, MASS.02601 July 20, 1998 Tim Pearson Markwood Corporation 110 Breed's Hill Road Hyannis, MA 02601 RE: 74 Frost Lane, Hyannis Dear Mr. Pearson You are granted a variance from the Board of Health"330" Regulation in order to construct an onsite sewage disposal system at 74 Frost Lane, Hyannis. The variance is granted with the following conditions: (1) The septic system must be installed in strict accordance with the submitted plans.. (2) The dwelling shall be,,connected to-town,water., (3) No more than two bedrooms are authorized.`.Dens, study rooms, finished basements, sleeping lofts, and similar type rooms are considered bedrooms according to DER A floor plan showing a maximum of two (2)bedrooms shall be submitted to the Public Health Division office. (4) The two (2) bedroom maximum restriction shall be recorded on the deed. It is the opinion of the Board that the installation of one additional septic system which complies with Title 5, the State Environmental Code, in this area should not significantly alter the quality of the groundwater. This variance is granted because the Board is of the opinion that, although the proposed septic system does not strictly meet the nitrogen.loading requirements in 310 CMR 15.214, the applicant has achieved maximum feasible compliance because the use of an alternative-.type system-with nitrogen removal would exceed ten percent of the estimated real estate value. pearsonI In addition, this site is in an"area of concern" as defined in the Town of Barnstable Wastewater facilities plan and other alternatives are being explored for wastewater disposal in this area in the future. Therefore, the Board of Health is of the opinion that you have achieved maximum feasible compliance. Sincerely yours, t'l l, _ Susan G. Rra , R.S. Chairman Board of Health Town of Barnstable SGR/bcs cc: Arne Ojala T. Geiler pearsonl THE T TOWN OF BARNSTABLE 6�Q ♦� OFFICE OF : 9ARN9TAZL BOARD OF HEALTH 7 NAM p� s639. 0 367 MAIN STREET 'e0 MAY k. HYANNIS, MASS.02601 July 20, 1998 Tim Pearson Markwood Corporation 110 Breed's Hill Road Hyannis, MA 02601 RE: 74 Frost Lane, Hyannis Dear Mr. Pearson You are granted a variance from the Board of Health"330" Regulation in order to construct an onsite sewage disposal system at 74 Frost Lane, Hyannis. The variance is granted with the following conditions: (1) The septic system must be installed in strict accordance with the submitted plans. (2) The dwelling shall be connected to town water. (3) No more than two bedrooms are authorized. Dens, study rooms, finished basements, sleeping lofts, and similar type rooms are considered bedrooms according to DER A floor plan showing a maximum of two (2) bedrooms shall be submitted to the Public Health Division office. (4) The two (2) bedroom maximum restriction shall be recorded on the deed. It is the opinion of the Board that the installation of one additional septic system which complies with Title 5, the State Environmental Code, in this area should not significantly alter the quality of the groundwater. This variance is granted because the Board is of the opinion that, although the proposed septic system does not strictly meet the nitrogen loading requirements in 310 CMR 15,214, the applicant has achieved maximum feasible compliance because the use of an alternative-type system with nitrogen removal would exceed ten percent of the estimated real estate value. pearsonl In addition, this site is in an"area of concern" as defined in the Town of Barnstable Wastewater facilities planvand other alternatives are being explored for wastewater disposal in this area in the future. Therefore, the Board of Health is of the opinion that you have achieved maximum feasible compliance. Sincerely yours, Susan G. Rra , R.S. Chairman Board of Health Town of Barnstable SGR/bcs cc: Arne Ojala T. Geiler pearsonl TOWN OF BARNSTABLE LOCATION / / Pro sT L,,Qe,4- SEWAGE # 1 c S6 :,VI:fiAGE• ��t/,Innl S ASSESSOR'S MAP & LOT a'P ' INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY l s� LEACHING FACILITY: (type) �' S(� �Cl�• (size) 1W, A NO.OF BEDROOMS oL— f� �/ (� a�X !3 x �o•t BUILDER OR OWNER �bA�/a 14OD PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leachingfacility) -�— Feet Furnished by "1�/1�'��c.�IO .!• �Or� L d O r6 O _ i � � " tee l TOWN OF BARNSTABLE .LOCATION e SEWAGE # U r � vn.LAGE 1/ , jL ASSESSOR'S MAP& -2 INSTALLER'S NAME&PHONE NO. OZ. . Xe r j;, C44 SEPTIC TANK CAPACFfY - LEACHING FACELl1 Y: (type) 1 .tom ,-./ t«cL0"ize) 2 X 13 NO.OF BEDROOMS ;a UII, OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by w N �. C✓ pv ' No. L �� :. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH � — O F APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( 1 Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System ❑Individual Components `7Il `cose -4, / Location Owner's Name 29! / is-T ye a+^ -- iI Map/Parcel# 7 C.s Lot# L Telephone# staller': e(� signer's Name' ddress r�/ Address ((� d- �r Telephone# Telephone# Type of Building: P"4 ✓e-- Lot Size /�, 3 Ste/ Sq.feet Dwelling—No.of Bedrooms. Z Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min. required) gpd Calculated design flow L gpd Design flow provided 2 3 gpd Plan: Date do - I/ Number of sheets Revision D to —/14 Title /y z �-SE�vlr, — ��-A. �,�= �7` �T �s,✓t Description of Soil(s) (.c Soil Evaluator Form No. // Name of Soil Evaluator Date of Evaluation to DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned grees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and fu r s not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date Inspections FORM t - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 r✓� y ! N6.��!/'� � THE.COMMONWEALTH OF MASSACHUSETTS FEE B O A R'D O F , EE A LTH 1- t O F APPLICATION FOR DISPOSAL SYSTEM`rCONSTRUCTION PERMIT k � Application for a Permit to Construct ( Repair ( ) Upgrade O Abandon ( ) ❑Complete System Individual Components j _ Location Owner's Name `7' Map/Parcel# 77r7J '. rLot# Telephone# /� ,/ tallcr's c Vn signer's Na ddre ( P ,�/Wddress KI s Telephone# Telephone# Type of Building: Lot Size ��, 3��� Sq.feet , Dwelling No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min...required) gpd tc alculated design flow 2 L-o gpd Design flow provided 2 3 gpd Plan: Date !> - )j = --Number of sheets Revision Date -�1 4 Title .>>> r'"SE �v^ /©��4.�� �E� -77` ST ✓ 4- Description of Soil.(s)'� l�� / Soil Evaluator Form No. J �/ Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS_OR-A-LTERATIONS a z"".•u The undersigned grees to install the above described Individual Sewage Disposal System in accordance with"the povis�ons of { - TITLE 5 and furth a rees not to place the system in operation until a Certificate of Compliance has been issued by the Boairdof Health. Signed Date >" Inspections r FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No.� a` � THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) [Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed(1r),Repaired( ),Upgraded( ) Abandoned( ) 4 .�by: o .P�/ .� f., at has been installed in accordance ith the provisions of 310 C�-MJR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated . Approved Design Flow (gpd) Installer Designer: , Inspector / D 'te The issuance of this certificate shall not be construed as a guarantee that the system will function as de sgned. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 -^ �- --- -- -- --- —._—.-- - ------ ----- --_ - -_------ _- ---- -----4 No. �� THE COMMONWEALTH OF MASSACHUSETTS FEE /D0,111� i� /tr,�' L...•BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby rante o,Construct,-( 4)'Repair ( ) Upgrade ( ).Abandon (. ) an individual sewage disposal system at J J1 as described in the application tion for Disposal System Construction Permit No. «� 7 dated PP P Y n_ Provided: Construction sh 11 be,completed within three years of the date of this permitifi. .11-local conditions must be met. Date ��-,1�. �l Board of Health ,47 FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM PUBLISHERS- BOSTON 0 9A 04 : 51P Jeffer-y Johnson 508-775-6029 P. 01 QUITCLAIM DEED ROBERT N. LEVIN and RICHARD J. LEVIN, both c/o 25 Walnut Street, Wellesley, MA 02181 for consideration paid of TWENTY--TWO THOUSAND AND NO/100 ($22, 000 . 00) DOLLARS hereby grant to MARKWOOD CORPORATION, a duly organized Massachusetts corporation with a principal place of business at 110 Breed' s Hill Road, Hyannis, MA 02601 WITH QUITCLAIM COVENANTS the land in the Town of Barnstable (Hyannis) , Barnstable County, Commonwealth of Massachusetts, bounded and described as follows : A certain parcel of land with all the buildings and improvements thereon, situated on Frost Lane, in the Town of Barnstable (Hyannis) , Barnstable County, Commonwealth of Massachusetts, laid out and delineated as Lot No . 2 (two) , Block 5, on that plan of land entitled "Subdivision of Blocks 4, 5 & 6 at 'Whip-O-Will Glen' Hyannis, Mass . Property of Miles & Elizabeth Frost Sydney March 3 , 1984 E.D. Kellogg Civil Eng' r Osterville" , which plan is recorded in the Registry of Deeds for the County of Barnstable in Plan Book 183 at Page 21 . Meaning and intending to convey and hereby conveying a portion of that tract of land conveyed to Arabelle F. Frost, Executrix Executrix Deed dated August 24, , by an 1949, and recorded in said Registry Of Deeds in Book 729 at Page 338 , to which reference may be had for a more particular description. The premises are conveyed subject to a Decision by the Town of Barnstable Board of Health dated July 20, 1998 which states inter alia. " (3) No more than two bedrooms are authorized. Dens, study rooms, finished basements, sleeping lofts, and similar type rooms are considered bedrooms according to DEP. A floor plan showing a maximum of two n(2) bedrooms shall be submitted to the Public Health Division office. ,, 04-9s3 •04`: 52P Jeffery Johnson 508-775-6029 P.01 For our title see deed to us dated November 6, 1989 reoorded in the Barnstable County Registry of Deeds .in Book 6973 , Page 173 . Witness our hands and seals this ost- `f day of w, 1998 . Robert N. Levin Richard J.- Levi • COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, SS. ( , 1998 Then personally appeared the above--named Richard J. Levin and acknowledged the foregoing instrument to be hi free act and deed, before me of is J�� tj^ct D'V co ion expires: COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, SS. - r -f Then personally appeared the above-named Robert N. Levin and - acknowledged the foregoing instrument to be his e act and deed, before me Ot Pub y I Z6crs,� M C i5 expires: lcvinric.drA TOWN OF BARNSTABLE t� LOCATION l �rp sT '�/� SEWAGE# VILLAGE uy/Q 415 ASSESSOR'S MAP&PARCEL INSTALLER'S NAME'&PHONE NO. SEPTIC TANK CAPACITY SW LEACHING FACILITY:(type) CAAA,�t,C (size) oZ X 13 X «•S NO.OF BEDROOMS OWNER Ho 11 AA 2 PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) �-� Feet FURNISHED BY.LnS*yT_1Bn y . FDr 4 ;Ttor% a . O Y SEPTIC PROFILE TEST HOLE LOGS -- --- - -- -- ACCESS COVER TO WITHIN 6' OF FIN. GRADE (NOT TO SCALE) AccEss COVER (WATER 1GHT) To ENGINEER:�L I - _W HIN 6• OF FIN. GRADE vr-1 s t•:( MINIMUM .75' OF COVER OVER PRECAST2X SLOPE REQUIRED OVER SYSTEM WITNESS: - - --- D I T_- of r,t DATE: 'kAI I I RUN PIPE EVE'- , 7' DOUBLE NASHED PEAS?ONE I --- -- — I 3 C> - I --FOR FIRST 2' -- - 3' MAX. PERC. RATE PROPOSED GALLON SEPTIC �� ,, _T �— \ T 'I (� -- _-_ !'; � �\ 3 CLASS _�- --- _ SOILS P� TANK (H -_10 ) I' GAS t�pr, _-- - -- - ----_ 1 �- 1 �a`r I - - ---- --- --- - 2-ZsLo; - � ooQO � ooa �L i % SLOPE) 6- CRUSHED STONE OR MECY+ANICAL Q Q Q Q E-1 Q Q C7 Q I ELEV. ELEV. JK COMPACTION. (15.221 [2]) -. 2' Q Q O O E-1 0 Lam- 0" E_ _� I 0" - -- Q DEPTH OF FLOW _� �_ X SLOPE) TEE SIZES: 3/4" TO 1 1;2" DOUBLE WASHED STONE: F I INLET DEPTH = eY� -- Z- --`7 -Io Y< - -! OUTLET DEPTH s �- L LOCATION MAP SCALE 1 - LEACHING _ _ FOUNDATION- - ! - - SEPTIC TANK - - ' -- - — D' BOX - --- -- - FACILITY _ — ASSESSORS MAP 7 PARCEL i 57 S ZONING DISTRICT: 1.=6 r•4 . YARD SETBACKS: ___ -f FRONT = SIDE I REAR = �� PLAN REF. - r �•t ',, a- �� FLOOD ZONE: iv A r�.� ,. Z C ►/II A�� I 1-7 A i Imo'( NOTES_ f 1 f U SEPTIC DESIGN_ (GARBAGE DISPOSER Is � �w2r� ) 1 . DATUM IS h�F `��:_ _ _ __' i!'__ I-,`tp r► 6�Jd DESIGN FLOW: BEDROOMS (_�GPD) 2. MUNICIPAL WATER f GP SI(;TJ FLC�! !� ; r. E 3. MINIMUM PIPE PITCH TO BE 1 /8 PER FOOT. USE A -- D DE .� { SEPTIC TANK: i:i% GPD ( j' ) = --- _ 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H-_ L --' 5. PIPE JOINTS TO BE MADE WATERTIGHT. USE A `& V GALLON SEPTIC TANK LEACHING 6. CONSTRUCTION DETAILS TO 8E IN ACCORDANCE WITH MASS. _ ENVIRONMENTAL CODE TITLE V. ;�, j , r -2-- ,,.) ? 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE SIDES: ---- USED FOR LOT LINE STAKING. BOTTOM. - -�=� �-- � - 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. TOTAL: ! S.F. '? GPO 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED A� 5o0 �, ,« ti,y,�• �:r_ii.Gl•t�EI"•�P FROM BOARD OF HEALTH. o a - ' a -�att. r[! _ -_ �'Ir y"1�`i ! �' 10, CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE �NUfa f LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. ILI LEGEND I C_�� ll �` ' / LDrit.. �rlr►rt�1� i — Sl TE AND SEWAGE PLAN 7100.0 , PROPOSED SPOT ELEVATION OF- - --- - - --^---- ---_ � 100x0 EXISTING SPOT ELEVATION -------�----+-`�� IN THE TOWN OF: 1001 _-0 PROPOSED CONTOUR ) !F 3 - - 100 - - EXISTING CONTOUR PREPARED FOR: ✓'j �/ L Iki ,/vf� ?�ti- �. 4� �irl �J,�PP�,~�- ��/F ►% b-fit-/% �- �.t�r w+� I' 1 1^ ` 1 hv! t J ►�T[� F h dh !h t01r r po a�r I Ta vI t► � 1 �1QyJ� l,c) 0 'Lc� {{ c7 a J ►vl�rd h t� f u(L • R- P b�- rI' 1 M BOARD OF HEALTH 1 ----- -- - - -- SCALE: =.� DATE: APPROVED DATE - -- -- - -7- t a r��ia p I,,y�. IN1 ,►�1 FG�k71h'� �r� ���'� �- D +� i �r IZ��{l ,� I ' r~'�r'-'� t.► ' ,r ��tY.O- �S.005 �0�N«;,-� ,0►-1 soe -,i ec down cape engineering, inc. �`Aa OF , `�N of M � A Ro`' ARNE CIVIL ENGINEERS an H. 5�p,.A,,i4,�.t►)Ir 6 �i'+ }�f,14.1'.-t►'�►Ot-I CIVI y N Z. P�� 090 a� v �N► v7 �rK-CG ark LAND SURVEYORS No Ps s 0,2.ep A. • ,�-��• I 939 main st. yarmouth, ma 02675 '`F,ss�� E JQ JOB# =i - �� OJ P.L.S. DATA "77«- >�:. '� ,, - 'M ,via •� ,�.. 1. i':, .x ;jti�`'.r .. - .'. - x ♦ Y`. , a ....f _...J!M xl.. . iN iq, 1..t •./. ♦ rv. n hX ,J i. .,, .., .. +r:lr f, y�[ �', l : ,y y. A`,i' >!J'. �y� ra P ' SEPTIC PROFILE TEST HOLE LOGS I T.O.F. AT EL. ACCESS COVER TO WITHIN 6' OF FIN. GRADE (NOT TO SCALD I ACCESS COVER (WATERTIGHT) TO IN 6• OF FIN.. GRADE ENGINEER: ✓ (/SA t-�. h G ZS,Q MINIMUM .75' OF COVER OVER PRECAST, 2% SLOPE REQUIRED OVER SYSTEM —2 WITNESS: •� OJT�! ! cyl ' 1 RUN PIPE LEVEL 2' DOUBLE WASHED PEASTONE DATE: - I 1 ` � j ♦n z i4L—1 FOR FIRST 2' PROPOSED PERC. RATE1 � --- 3' MAX. "� SOILS P#GALLON sEPTIc , 05 -_--� 3 CLASS --.� `� 34 TANK (H— 10 ) GAS l �. 7f BAFFLE z, ,�-1 ZL'--' C� O 0 O C� 0 a O I; ✓s --J _ -- YXSLOPE QQOC7 a C� QQC7 �4 ( ) 6' CRUSHED STONE OR MEC!iANICAL , i Q Q Q Q Q Q Q Q (� ` �y COMPACTION. (15.221 [2]) � � 1 � ELEV. ELEV. 2 oaoo Q QOQQ�-- - !as 4 �1 .3 o" 4 , 9. i h,�r / �w� DEPTH OF FLOW = � ( �o X SLOPE) ( X SLOPE) ____ J � — — TEE SIZES: 3/4" TO 1 1/2" DOUBLE WASHED STONE INLET DEPTH = I� � � ``%• �°Y� +,ry 1..�7 to " oLJT'.ET DEPTH = -AIL_ e � LOCATION MAP SCALE 1 r ' LEACHING � I � 5 �2 �) �' � �` 4`a � t FOUNDATION— 1 � -- SEPTIC TANK L '' D' BOX FACILITY r— ASSESSORS MAP Y PARCEL ! 5-7 ZONING DISTRICT: /L6 YARD SETBACKS: -"1-I FRONT = G SIDE = REAR = I r L PLAN REF. - FLOOD ZONE: (� ►'��' / NOTES: P SEf'I!C DESIGN: (GA.R. -'E DISPOSER Is_ A� E_ L ) 1 . JAT�_'M IS __ �1 0 _ ' '< 'YVA-I ER ISDt rLOW BEDROOMS GPD) . y ! Y PIPE PITCH TO BE 1/8" PER FOOT. C rANh r'PD _ 4. DESIGN _OAUINi� FOR ALL r' iLCrS! ^�I i i U i't P.aSHO r _ y� s 1 ' - 5. P! E JOINTS TO BE MADE WATERTIGHT. ti h y USE -1 :_;--: GALLON SEPTIC TANK -- 6. CONSTRUCTION DETAILS TO BE IN ACCORCANCE WITH MASS. 0� L_EACHiNG_ ENVIRONMENTAL CODE TITLE V. S, { Iz v>�j v ) 3 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE clv DES: -----�--- USED FOR LOT LINE STAKING. Ire 5 I L i�J �I I BOTTOM: ---- 8. P,PE FOR SEPTIC SYSTEM TO SOH. 40-4" PVC. �S 1 r'� o j 10TAL: N � '_ S.F. %- ?_GPO 9. COMPONENTS NOT TO BE BACKF!LLED OR CONCEALED WITHOUT �� E t — INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED /% 1 ,�� 1 Soot/ . 1 b-Nl3�Q- • 1- �= �t�-� r FROM BOARD OF HEALTH. 5.3 10. CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE v2 �' LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR / TO COMMENCEMENT OF WORK. .� 5'C, � LEGEND SITE AND SEWAGE PLAN 100_9_] PROPOSED SPOT ELEVATION OF 1 C 1y ,l 100x0 EXISTING SPOT ELEVATION IN THE TOWN OF: ti �i' i Oo o-_ ----a PROPOSED CONTOUR ; �i C�'�F r�r''411-� F' Eta►-1�� o -- — 100 — — EXISTING CONTOUR PREPARED FOR: 0012 O.' 1. 61��� 0 �10 ►��-�h t `t t�(i- v >v wt t j BOARD OF HEALTH n , APPROVED DATE MA SCALE: � DATE: .-t v iI✓ i n�l,�j�A c4e�,I h -f, t.-I a�-4 off a0e--W2--,s�, r= xn 3w-oeao p'1 � f({ ✓^+Y7i(i� 'lJ.00�j C��`f,1 -i1110� tGj'�� p h,,Ak f `'�� �O1F1C�R+ 1d1.1 1'Jt.t�.h ! t q 4 {� �lH Of Mq down cape engineering, inc. o��� ARNE �y �� tt1 0F CIVIL ENGINEERS y �?�12� a P '�' �► .a t o�I 90 0.26348' o vk LAND SURVEYORS i ER�`� Z (�(j �1, w lt-4Gt P2.012CI�rE O O r� t LAND SJQ �F9E�IST � JOB# �`� - p �� °' z� �T� 939 main st. yarmouth, ma 02675 ARNE H. 0.1 . S. DATE