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HomeMy WebLinkAbout0234 GREENWOOD AVENUE - Health 234 Greenwood Ave Hyannis A=288-176 ' I ---------- _ - MET Town of Barnstable Barn ti Regulatory Services Department OftedcaC'j ' ,e�` - - - Public Health Division 200 Main Street, Hyannis MA 2 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7012-101.0-0000-2848 -0431 March 28, 2013 BRIAN HUGHES & KAREN MCGUIRE PO BOX 29 IMPORTANT NOTICE HYANNIS PORT, MA 02647 Map & Parcel: 288- 176 The Department of Public Works informed us that public sewer lines are now available in your neighborhood. According to our records, your property has a septic system. This letter directs you to connect your dwelling, at 234 Greenwood Ave, Hyannis,MA, to public sewer on or before 3/30/2015. The old septic system must be either removed or filled in due to future safety concerns. This may be done by the same contractor who connects you to the sewer. Septic Abandonment Permits ($ 25) are issued at the Public Health Division, 200 Main Street, Hyannis. Failure to comply with this Board of Health Order may result in a complaint against you, in a court of law. For additional information pertaining to the sewer connection, please see the reverse side of this page. PER ORDER OF T BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health Cc: Barbara Childs, WPC/Roger Parsons, Town Engineering,DPW Enc. QASEWER connectUtters Stewart Creek Sewer Connects\MAU ING L.etA Sewer 2Pgs Merged 3-28-13 Yr2015.doc ,r - • 4 Public Health Division March 28, 2013 ADDITIONAL INFORMATION AND REMINDERS FROM OTHER DIVISIONS: SAVINGS AVAILABLE/GRINDER PUMP: A reminder to those of you who need a grinder pump for your connection: Department of Public Works (DPW) sent you a letter in December 2012 stating the town, for a limited time of two ears l from y only the receipt of the DPW letter, would provide you with the pump at no charge. (This can save you thousands of dollars.) Please note: You must pay the installation cost through ygur own contractor. Please make your contractor aware of this, if interested. Also be aware: this is a shorter deadline than the Public Health Division's deadline on the reverse side of this page. SAVINGS AVAILABLE/PERMIT FEE: The Town offers a waiver of the residential sewer connection fee of $420.00 for those properties that connect within two years of the receipt of the DPW December 2012 letter. LOANS: For loan(s) available,please see the enclosed brochure, or see the town website: littp://www.town.barnstable.iiia.us/cdbg (under the "CDBG Programs", see "Sewer Connection Loan Program). For loan specific questions, you may contact Kathleen Girouard, Growth Management, at 508-86274702. CONTRACTORS: Information on Licensed Sewer Installers is available on our web site at www.town.barnstable.ma.us/Pub]leWorksTecii/sewerinstallers. Contractors, approved to perform sewer connection work in the Town of Barnstable must obtain and file a Sewer Connection Permit with DPW-Water Pollution Control Division, 617 Bearse's Way, Hyannis—contractors, please call Dave Anderson at (508) 790-6244. FOR ANY QUESTIONS /ASSISTANCE: Len Gobeil at the Town Manager's Office is available to provide you with direction you may need in reference to the Stewart Creek Sewer Connections. You may contact him at 508-862-4701. QASEWER connectTetters Stewart Creek Sewer COnnectAMAILING LetA Sewer 2Pgs Merged 3-28-13 Yr2015.doc Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is required for Hyannis Ma 02647 8/31/2009 every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information forms on the computer,use 1. Inspector: / only the tab key to move your Bernard Lynch cursor-do.not Name of Inspector use the return key. Ma Cape Code Home Inspection Co Company Name � PO Box 364 Company Address Milton Ma 02186 retr'" CityfTown State Zip Code (617)698-7763 SI 142 License Number B. Certification- I certify that I have personally inspected the sewage disposal system at this ad-crress'and MAI theme information reported below is true, accurate and complete as of the time of theanspection �T�le inRection was performed based on my training and experience in the proper function and raintenan of c# site sewage disposal systems. I am a DEP approved system inspector pursuantAb Section'I315.341gof Title 5(310 CMR 15.000).The system: w w f ® Passes ❑ Conditionally Passes ❑ Ails toy Ln ❑ Needs Further Evaluation by the Local Approving Authority _. 8/31/2009 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. b t5ins•09/08 Title 5 Official Inspection Form:Subsurface Aal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owners Name information is Hyannis Ma 02647 .8/31/2009 required for y every page. Cityrrown 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: 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): l5ins•09/0, Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is Hyannis Ma 02647 8/31/2009 required for y every page. Citylrown 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 or 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is Hyannis Ma 02647 8/31/2009 required for 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 El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form W Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is required for Hyannis Ma 02647 8/31/2009 every page. Cityrrown 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 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 10000 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 th El El 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is required for Hyannis Ma 02647 8/31/2009 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, orBoard 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): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 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 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is required for Hyannis Ma 02647 8/31/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes [] No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail 80GPD Sump pump? ❑ Yes ® No Last date of occupancy: currently.occupied 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 o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owners Name information is required for Hyannis Ma 02647 8/31/2009 every page. Cityfrown 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: pumpted on 4/1/2009 by Ace Cesspool Service 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): 1000 gal septic tank.,1000 gal pit t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is required for Hyannis Ma 02647 8/31/2009 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 11/23/1981 disposal permit and pencilled plan at BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1 ft-4in feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 2ft Tin 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: 90"x42"x60" Sludge depth: 0" see comments on bottom of page 10 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 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is H annis Ma 02647 8/31/2009 required for y every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 34" see comments below 0" see comments below Scum thickness Distance from top of scum to top of outlet tee or baffle 6" see comments below Distance from bottom of scum to bottom of outlet tee or baffle 18 see comments below measured How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee'or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Owner had tank pumped on 4/10/2009 by Ace Cesspool Service,inc.Title V was conducted on 8/31/2009,inlet tee and outlet baffle were in good condition no evidence of leakage 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 Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is required for Hyannis Ma 02647 8/31/2009 every page. City(rown 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hay_es Owner Owner's Name information is required for Hyannis Ma 02647 8/31/2009 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 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.): 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 H Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is Hyannis Ma 02647 8/31/2009 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: one ❑ leaching chambers nurnoor: ❑ 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.): 1000 gal leaching pit cover was opened the bottom of the pit is 8'-6" below the surface.,no signs of damp soil,hydraulic failure, normal grass above,no signs of ground water High ground water has been determined to be 13 feet from grass surface on top of the pit. see page 16 for furthur information.. 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 Forth:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts 4 - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is Hyannis Ma 02647 8/31/2009 required for y 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 Commonwealth of Massachusetts Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is Hyannis Ma 02647 8/31/2009 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: (hand-sketch in the area below ❑ drawing attached separately Tv F it 1 9 c�eA•+v O V T� / v 1 ,7 1 b 111 449krA9A 2 3 1 /-- r . y•s PVC �� T'o H = / 7 ` At "'A ro = .i 1000 GAL N T 'C D� / P rr D = 33 6 GR I''tA/ vvood �Vt� t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts o- Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 234 Greenwood Ave Property Address James R Hayes Owner Owner's Name information is Hyannis Ma 02647 8/31/2009 required for y 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. 13feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: See ANR plan dated 10/3/1986 prepared for Arthur Pacheco regarding lot 5a and lot 5b . 234 Greenwood Ave aka lot 4 ,which is also on said ANR plan shows approx edge of wetlands on lot 4 ,that edge ,which is approx 140 feet from the leaching pit on 234 Greenwood Ave and by measurement appeaes to indicate the high ground water elevation is 13'below the surface over said leaching pit.. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 234 Greenwood Ave Property Address James R Hayes Owner Owners Name information is Hyannis Ma 02647 8/31/2009 required for State Zip Code Date of Inspection every page. Cityfrown E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 b . % 0/V e r - IS 71 � � ���-; � � �. � � �. � �� � Q �. 2. � ` ,� � � i e `' � � � � ` �. Q ��, c �, ` r �! � 1 =�� c� ` e r- �\ _._- J r ND.81. f-3-- - Fps.....$..5.00....... THE COMMONWEALTH OF MASSACHUSETTS ,yam BOAR® OF HEALTH ....--" --...._....7own.---..--.OF................BAnMfable............................................... Appliration for EIiipnii al Works Tnntitrnrtion amit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: .234 Greenwood Ave. Hyannis, MA _02601 _... _. ........ -•-•-•........................................................................•-... Location-Address or Lot No. Alice Godin P.O. Box0 � Hyanni�ort,� MA „ ,•._,__,.- •.....................__...-----....--•-----•---•--•------•----------.........-------•-...._..._ ................... Owner Address a A & B Cesspool_ Service 128 Bishops Terrace, Hyannis, MA 02601 ---------------•. .........---------------- Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.... ......................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................. No. of persons......1.................... Showers ( ) — Cafeteria ( ) a Other fixtures Q - ------------------••-----••------•-----•-.-•-----'------------------------- - -- ..... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----_------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water..................... G%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a .................................................. ••------------------------------------ •----------- --- •-••........ -------------------------- ---------------- ODescription of Soil..Sand----......--•--------------------------•---.........-•------------------------------------•--------•---------------•--•-----------------------•------.--•--- x w -----------•-------------------------------•--•-••------•-----.....--•--------------••---••-••--•------•--•--•---•--------------------------------------------------•-•---•--•-----------•---•--.....--- UNature of Repairs or Alterations—Answer when applicable....installation.-of--a-1.,000-- llon-septic-_tank, and :a 1,000 gallon pre-cast; stone packed leach-•Pit •overflow_______________ ............................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TMI TI. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha been isj th ar f health. Sign •--•--•----••6J ( �'.•_------.1 LVQ 1�2181. Application Approved By.......... �./ ... • .•. . j -•-•----•-------1Date •-- Date Application Disapproved for the following reasons:................................................••••---•----•--------•-•----------------•-••-•---••---......_._ --------------------------------•-------------._...._..--•----------•------------._...•...-•--------••---'--•------=....................................................-.......................... e Dat Permit No. 81 - Issued 11/23/ Dat Date r NO.01-....� 3 t FEB..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................T.Wn..........OF...............Bad"Ili't-3••b1e--------------.-..-.------_-.---.--.-----..----. ApplirFatiou for Disposal Works Totutrur#iun runtit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: ......234..Gre,:nw_aod...A.W...,..-1 teals,.. .....02601. ..................................•------------.......------------•-----.......................... Location-Address or Lot No. ...... ime.C.ndin................. .. ....---•-----------...---------•------.... p.e-0.,. P oX SQ r M a i o �..FsA--...--------................... • Owner A ress ------A ... ewpool_._Sar im--------------------------------------- 128.. �...mA....a6m..... Installer �ddress UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms___2......................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.....1,..................... Showers ( ) — Cafeteria ( ) P4Other fixtures ------------------------•----------------............................ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity_....._.....gallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by.......................................................................... Date.................................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •-•-•-•--•-•--•-----•-----••••--......--••••-•-•••.......•••-•••.....-••--•.......-••-•----------•---•--•.....................••-...........-••...-----•••--- 0 Description of Soil__Sand------------------------------------•--------. V W -----------------------------------------------•--------------•---------•-------------............................................................................................................... U Nature of Repairs or Alterations—Answer when applicable_..Jnst,-}-latgpm-.af•& 1 -0QO 11042 Sept i�---tank, .....and..a._.1,QDIl..ga1117n..pre---cast,---s-tone..Paeked-- -.--------•----------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT?.E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance hasbeen issued by the ard_�f health. Sign a �??j�.. = = ` W ....---•-Z D�2,3//21---- Application Approved By.......... . , •' �" ----------------------• .................11/23f 81•--- Date Application Disapproved for the following reasons------------------•-------•------•-----------------..._....----•----------------•----------.........•••••...--._ ............................-............................................................................................................................................................................. Date Permit No.............. ...................................... Issued...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................T.awn...........OF.....Ba=etatae..................................................... (9rdifirtate of TuntpliFanre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X ) by.....A.A... __C ss�s�al__�Sexsri�ce.�...128..A3sYaops- exa^a.cer l yea s,.g"A-----02601-----------------------------------•.--- Installer at_234•.Cx7c 1a>"to .Ax��r H,Yannis,•-MA----D2601------..Ala.ce--&adin--------------------•-----------•-•-•----------••------------------- has been installed in accordance with the provisions of TI T L✓ 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No._81:t_.z_-�_`1................... dated........... --._•_-_.---•••--- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEK,,VVILL FUKjZTION SATISFACTORY. DATE..................II/FD`, I..... =............................... Inspector..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH FSl-�9 ..................... &atestable............---.....---......................... Disposal Works Tnnstrt uan ernttt rr Permission is`hereby granted........A••&..R..C'essp040,, r.V.j l ...................... ...................................................... to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at No......... z �eeen�rnod.Axa.,_..Hyax�nia, MA 426©1 - Algae Gfld r Street r -q as shown on the application for Disposal Works Construction Permit No.__81::........... Dated_:^___•4 ........... Boar ea th DATE.....11/2 ................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS f 0 C� a H O M E S } T _ _ bluhomes.com 130 TURNER STREET STE 610 1 WALTHAM MA 02453 1 T:617.275.2333 f 200 PINE STREET 8TH FL I SAN FRANCISCO CA 94104 I T:415.525.0809 P 100 N.FOURTH AVENUE I ANN ARBOR MI 48104 1 T:617.275.2333 I. 11 � This document is intended for the singular view of the party to which Blu " Homes has presented it.Any copying,dlsinbubon,or otherv/ise sharing of the text,images,or data therin expressed ofthi document is a violation of . LI 0 the terms to which said party has implicitly agreed upon by accepting this document. ' I GARAGE ®ALL RIGHTS RESERVED CONSULTANTS t ` R A202 - I - — -- -- i PFS Corporation - -- NortheastRegion.II - LI , L ', 1. OUTDOOR A401 I _ I A402. APPROVED 2 - ' ' ;_LINE OF FLOOR OVERHANG _ 2 - -- ------- -- -- -- ---- - alup 3 - -----= { i ;omR I I �9_�TE I _ '_____rr_{tt____ _____ I i _ ,1 pp 11 _ _----------- — P51 1 I N —_ 1" N^ -' Y�O�I3 h ---- - -'— - --- - I- —Z77 M APProval limited to Factory Built Portion LAUD3 IENTRY 2x6 WALL WITH '< CLOSET 1r c KITCHEN 4 URRIN12" -`° 13'-4112.. .4'-11" 3'-111/2'. 3,�-4.. 2,-5 3/7F1012 G+ I 11. 8,. 51/2" o < �(I w A3B2 S33 I N =-- _ - - N MCGUIRE-HUGHES Residence to D c 234 AVE. O 02601 —!_� I OF 3 inl 4 �3'-53/4' I1'-9" 9'-11" 2 I AZD3 234GRHYANN GREENWOODENWO MAVE. w I LINE OF FLAT CEILING -- CEILING _ _LINE OF FLAT _ p __ ___ !FIXED SIDE 2x6 WALL WITH FURRING _ _ _ _FIXED SIDE_ !� rn I -�7ALI- ---- -�--- - -J�6'-,12' FOLDING SIDE "1� ! "— FOLDING SIDE j i I - CLIENT CONTACT: KAREN MCGUIRE p 0(D w I WOOD BURNING FIREPLACE — m i PROJECT DESIGNER/PROJECT REVIEWER: MH/ MR PORCH 0 REVISION DATE DESCRIPTION F I I � BY BLU BE9R00 1 I DINING LIVING I s ve ! 3/11/2013 3 20/2013 STATE SUBMITTAL ,x Z34 I 3/28/2013 PROCUREMENT 4/05/2013 STATE RESUBMITTAL 35-7 12" I m 1 V-11 12" - ...\ — I� L-p - zmee f-- zouv c zouL 2 LINE OF ROOF OVERHANG I , 48'-4"OUTSIDE OF STEEL TO OUTSIDE OF STEEL Lot 0 LA NOTES:. - 2 h O SCREEN PORCH,OUTDOOR SHOWER,GARAGE,EXTERIOR DECK,RAIL AND STEPS ✓J TO GRADE AS REQUIRED TO BE SUPPLIED AND INSTALLED BY SITE CONTRACTOR, IMPORTANT:DECK IS TO BE SUPPORTED INDEPENDENTLY OF BLU UNIT. - i�GUTTER AND DOWNSPOUT TO BE SUPPLIED,DETAILED,AND INSTALLED BY BLU J PRE-BUILT STAIR TO BE SUPPLIED AND INSTALLED BY BLU DRAWING TITLESTAIR AND RAIL TO LOWER LEVEL TO BE SUPPLIED,DETAILED,AND �. O SITE CONTRACTOR.DESIGN ASSUMES 10"TREAD AND 7 114"RISER.SITE BY ENTRY.LEVEL PLAN ' O FIREPLACE,FLUE 8 CHASE TO BE SUPPLIED AND INSTALLED BY BLU. - ©DATA PLATE 8 LABEL UNDER KITCHEN SINK SCALE AT 22xa4: 1/4"=1'-0" REFER TO WINDOW AND DOOR SCHEDULE ON PAGE A510 BLU MODULE: r TE WINDOW WITH TEMPERED GLASS EVOLUTION 48/LEFT DWINDOW MEETS MINIMUM EGRESS REQUIREMENTS: >24"CLEAR OPENING HEIGHT >26'CLEAR OPENING WIDTH " 15.7 SO FT CLEAR OPENING AREA 04-SILL HEIGHT LOCAL INSPECTION'INDICATES AREA OF PROJECT THAT IS NOT PART OF THE BLU PROJECT MoouLE: SHEET NUMBER: HOMES PACKAGE AND REQUIRES INSPECTION/APPROVAL BY LOCAL BUILDING - OFFICIAL,IT IS THE RESPONSIBILITY OF THE SITE CONTRACTOR TO SCHEDULE ENTRY LEVEL PLAN THESE INSPECTIONS. P kip, H O M E S bluhomes.com - _ .. 130 TURNER STREET STE 610 1 WANCISC MA02453 1 T:617.275,2333 15.62.080 200 PINE STREET 8TH FL I SAN FRANCISCO CA 94104 I T:415.625.0809 q,� 100 N.FOURTH AVENUE I ANN ARBOR MI 48104 1 T:617.275.2333 . f - #° "•i to which Blu This document is intended for the singular view of the Party. Homes has presented It Any copying,distribution,or otherwise sharing of 'the text,images,or data thenn ezpressed.ofthTs document is a violation of the terms to whkh saitl parry has implicitly agreed upon by acceptrng Nis- - j document C GALL RIGHTS RESERVED I CONSULTANTS s I PFS Corporation n2o2 { - �---- ' -'---------- - Northeast Region --- --- APPROVE® 12 i ` 3 ' 14 5 :I H Raup-3 �- _ ________ LINE OF ROOF OVERHANG Z34 -----------' Z34 ___-� 4/8/13 — ____________ 234' -----___ _j ____ Z34. 2 Approval limited to _ Factory Built Portion - m.q HALLWAY Az4 1 BEDROOM 2 — — -- ! O I Oza STUDY MCGUIRE-HUGHES Residence I CLOSET 3 CLOSET 2 234 GREENWOOD AVE. ,eo.L lu HYANNISPORT,MA 02601. 1 y O - "� A302 CVVO 11'-111/2' 8-01/4' - -4 12'-2" 3'-53/4" 2'-412" 9'-7" R� �-' o j II � E 2 A203 CLIENT CONTACT KAREN MCGUIRE-1 H R PROJECT DESIGNER/ MH/ M - _.--._1_(— -��_.— .-_- -- — __—_ L —:I .TE TD SIGNDATE RDRDESCRIPTION --4ZC04�=-- __ __ ___ fVv39L __ ___ __ TE-•C08" ___ _ C08. _ 3 .B CT REVIEWER: Ir I E PROJECT \ r O LINE OF ROOF OVERHANG _.� 3/11/2013 L r TE 1 3/20/2013 STATE SUBMITTAL Y I // IA4o3, I 3/28/2013 PROCUREMENT w 4/05/2013 STATE RESUBMITTAL t I , i -i. NOTES: Oi PRE-BUILT STAIR TO BE SUPPLIED AND INSTALLED BY BLU O'GUTTER AND DOWNSPOUT TO BE SUPPLIED,DETAILED.AND INSTALLED BY BLU I ° O FIREPLACE CHASE AND FLUE TO BE INSTALLED AND FINISHED BY BLU ACCORDING TO MANUFACTURER'S INSTRUCTION DRAWING TITLE: n -+rga, s O LABEL UNDER BATHROOM SINK UPPER LEVEL PLAN , 1 REFER TO WINDOW AND DOOR SCHEDULE ON PAGE A510 WINDOW WITH TEMPERED GLASS SCALE AT.32%34: 1/4"=1'-0" f TE WINDOW MEETS MINIMUM EGRESS REQUIREMENTS: {lll E 24'CLEAR OPENING HEIGHT BLU MODULE: O'20'CLEAR OPENING WIDTH >5.7 SO FT CLEAR OPENING AREA -44"SILL HEIGHT EVOLUTION 48 if LOCAL INSPECTION'INDICATES AREA OF PROJECT THAT IS NOT PART OF THE BLU LI HOMES PACKAGE AND REQUIRES INSPECTION/APPROVAL BY LOCAL BUILDING OFFICIAL.IT IS THE RESPONSIBILITY OF THE SITE CONTRACTOR TO SCHEDULE #R' THESE INSPECTIONS. 1; t• ,�PROJECT MODULE SHEET NUMBER: 50 i UPPER LEVEL PLAN �j 8 .