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HomeMy WebLinkAbout0064 HAMPSHIRE AVENUE - Health 64 HAMPSHIRE AVE. , HYANNIS A=291-137 4 I ° I o i r i I i r Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in comp uter: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitotlon for Disposal *pstrm Construction VPr it Application for a Permit to Construct( ) Repair(;Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. i64 oAVe,t l�qWi5 Owner's Name,Address,and Tel.No. Lan:' 5-2- "W-L Assessor's Map/Parcel `� yur_,J f cs) a Installer's Name Address,and Tel.No. SC*-koi�'S- �`��1� Designer's Name,Address,and Tel.No. S 0 1 S 5 S'nqw -02 61, Type of Building: Dwelling No.of Bedrooms Lot Size q.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided �� gpd Plan Date Number of sheets Revision Date Title ,� Size of Septic Tank =�CT,gzc�/��) Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) /�/�e'l�� ��y,4� Date last inspected: Agreement: w The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not t lace the system in operation until a Certificate of Compliance has been issued by this Board of Health. S' e I Date 16,14,00 Application Approved by Date Application Disapproved Date for the following reasons ��z- Permit No. �iOly�i 5,7v - -__-__ Date Issued L01z'i/?.�+6 No. /v' — 4 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered inkomputer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppYitation for Misposai 6pstrm Construction 3permit Application for a Permit to Construct_(.)_.-Repair( pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. (o4 I1VL 01 ek P*i �Owner's Name,Address,and Tel.No. 51bb L&TA,3Z- C►4NNle WIIFL Assessor's Map/Parcel ag Installer's Name Address,and Tel.No. SCrp-1,?5'S 4 y Designer's Name,Address,and Tel.No. sue_3\,y_off,q y QI \k> c- sr, i Sez 6 o IS ,eui ' As V_A 5 w, v e3 1�rpe of Building: Dwelling No.of Bedrooms Lot Size 6111sq.ft. Garbage Grinder( ) Other Type of Building �A/ _ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided � �� gpd Plan Date Number of sheets Revision Date Title � t Size of Septic Tank /1 // Type of S.A.S. Description of Soil -P Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: 4 The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with'the provisions of Title 5 of the Environmental Code and not tX lace the system in operation until aCertificate of � Compliance has been issued by this Board of Health. � S' e Date /�— v }-Application Approved by - Date 6 2> Application Disapproved 00' Date for the following reasons ` Permit No. Zo(y 3 To Date Issued /0j 'I t zo C THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE MASSACHUSETTS J Certifitate of Compliante THIS,IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(4-<' Upgraded( ) Abandoned( )by at rD ` - /^ v �Q� has been constructed in accordance i with the provisions of Title 5 and the for Disposal System Construction Permit No Z/S - 3q0 dated P P Y G 5 Installer ,r Designer #bedrooms t Approved design flow y� gpd The issuance o this permit shall not be construed as a guarantee that the system will font ri desig1. � Date Inspector \ `'11 ------------------------------------_------ ------- _=-- -----=--=----------�----------------------------- 3)15- 3' QQ No. U Fee l01-110 . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction 3prrmit Permission is hereby granted to Construct( ) Repair(11-K Upgrade( ) Abandon( ) System located at a�l j //` k u C and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date ��/Z9/ZO�y Approved by -— z Town of Barnstable °F r Regulatory Services ti Thomas F. Geiler, Director BARNSrABIZPublic Health Division 9q'Ar1639. a Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: k Sewage Permit# `:5'1 Assessor's Map/Parcel \ \, Installer& Designer Certification Form Designer: C0U6Hh00wZ Installer: �jX\\l rtwl It►�ce�a_ Address: 43 Tizi 1-W,LL ClK Address: '5 On VAZ _ UJ d�k WM 7(')1 or was issued a permit to install a (date) (install septic system at 64 Hampshire Ave based on a design drawn by (address) DhVID D . CC)UGNAUOWZ, dated kk\L VS (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component. of the septic system) but in accordance with State & Local R ations. Plan revision or certified as-built by designer to follow. Stripout(if req ' ected and the soils were found satisfactory. o� DAVID D COUGHANOWIR N (Installer's S� natu'�) No. 1093, S T�C��O �M� I-. � s4?VVT N (Designer's Signature) (Affix Designers Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAof[ice formsWesignercenification form.doc EXCERPT FROM BOARD OF HEALTH MEETING MINUTES ON 09/08/2015: I. Septic Variance: A. David Coughanowr, Eco-Tech, representing Federal National Mortgage Association, owner— 64 Hampshire Avenue, Hyannis, Map/Parcel 291-137, 13,614 square feet parcel, septic repair, setback variance requested. GRANTED WITH CONDITIONS: The Board granted the variances on the plan with the following conditions: 1) a monolithic tank is installed, 2) a monolithic pump chamber is installed, and 3) a four- bedroom deed restriction be recorded at the Barnstable County Registry of Deeds with an official copy of the deed restriction be supplied to the Public Health Division. .r TMf Town of Barnstable BAMSrABM MAS& ,� h. Regulatory. Services Department ''Tea►� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6,2007 Rev.4/7/15 DEADLINES TO REPAIR FAILED SYSTEMS An"x" marked in the ❑ is the failure criteria and associated repair deadline _ 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the.house due to an overloaded or clogged SAS or cesspool ONE 1 YEAR DEADLINE CRITERIA Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well o Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution).. TWO (2) YEAR DEADLINE CRITERIA o Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching pit with high liquid level, <12"below pit (per Town Code §360-9.1) Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments qM 5 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every, y Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information o Iz- 1 Inspector: V Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code . 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 16.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluatio the Local Approving Authority 4-2-15 / C 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 • r Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ 'I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: 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): a t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is H required for every y annis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments cGM s 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Hyannis MA 02601 4-2-15 F required for every y 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 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 ® El or liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Hyannis MA 02601 4-2-15 required for every y page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of.the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official lrispectlon,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 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of ❑ ® this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 w • t5ins•3/13 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 ;M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No i Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)); Detail: Sump pump? ❑ Yes ® No Last date of occupancy: r ;a UnknownDate 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ® Single cesspool ® Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts T F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is H required for every y annis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1970's Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 48"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.): Good condition. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age:. years Is age confirmed by:a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•3/13 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 ,M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 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 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.): 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•3/13 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 ^M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grader 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 1. Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town 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.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts _ F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 1-10, ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: 1 ❑ 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.): Leach line and overflow cesspool have obvious signs of back-up with stain lines above inlet invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 2-Inline Depth—top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool 6x6 Materials of construction Block Indication of groundwater inflow ❑ Yes ® No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 I - Commonwealth of Massachusetts Title 5 Official ,Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GqM 64 Hampshire Ave System 2 of 2 - Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 6 ----- -- Sp e Y Z� � . o .. � � t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° M 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water s ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 16' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators installers- (attach documentation ® Accessed USGS database- explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at greater than 16'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Hampshire Ave System 2 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. CityrFown State Zip Code Date of Inspection 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Osposal System-Page 17 of 17 TOWN OF BARNSTABLEArr LOCATION SEWAGE# VILLAGE )A�4(, Mt> ASSESSOR'S MAP&PARCEL ti INSTALLER'S NAME&PHONE NO. Wt` )k]E}� 5 C)\'Alk SEPTIC TANK CAPACITY A606 LEACHING FACILITY:(type) size) $t�� NO'.OF BEDROOMS x eel ,ce OWNEI( 0t� PERMIT DATE: \6 2_ COMPLIANCE DATE:. l(k._N Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �j Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) lA Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY*yN\�j %A--\ � 1� a s d . o .® d TOY OF BbMSTABLE � sltss GE I.00l�'TiQid . ASSI�MOWS NW, LOTS—?IL SBIZC TANK CAPACITY (v C /S. Q CIENG CI T¢r tom) -- wio !vo.()FBEDR or s ��ruaF.�o�t}�ra�tER RER "£1�A 'E. t3RFI.f�,NC ?�►TTi<' r S�paravon Dastance Bet�rlesne N3axtu uanAd'ustcclGroondwaier Tabtetot eBottomofI.each ngFam ity l~ce� Pnvate stet_ up�IYe�l aand Iasaaa �clatgty w� exa5� on sats or watwi 2f;49 feet mf les h g f y) Feet Edge if V+I�t#and and I,eaclataig l"aca (if any wetlands exist' wathasa 3�;feet of.Ieaelurag-#a } Fee l~uritished oy S � �� f ? � n i f ISZ, b i `!i Town of Barnstable P _� 11i6 Department of Regulatory Services „tom Public Health Division Date 4 y P, 2o15 . teJ➢ 1 200 Main Street,Hyannis MA 02601 ' rfl►rAld h Date Scheduled `C� .� Time Fee Pd C . Soil Suitability Assessment for Sewage isposal. �-q t {� Performed•By:.�U1,.�\ �.J� Co oocj{)llG✓1 b'L#Lf6, ,• . wltnessea By: Location Address LOCATION.& GENERAL FORMATION 64 rlq S ►fe � T- lit Owner's Name •l Address ���_ `l�ghhr S Assessor's Map/Parcel: t '-M / L-3 Engineer's Name ��j(r I CO v�Vl�?l�D�vY NEW CONSTRUCTION REPAIR Telephoned ®� Land Use•_ 2e rid g vj 1 r 101 6A ly Yt Slopes(96) ��© d -7 Surface Stones,, Flo )1�`p, Dletances m: Open Water Baly�g possible WeLArea r y - ft Drinking Water Well Lt/� ft Dralhage Way 30 • _R property Line _R Otherft Conw(jel f,'aki vrc5- ; rl formed q lcv-d ©, �)`'� �6 k�Q. � � ,� �rC SKETCH:(Street name,dimensions of lot,exact locations of test holes& l pore tests,locate wetlands in proximity, to holes) 70° U, GC TP-1 D I A Hk:_ wo-6-0 AMP S H i P, V Parent material(geologic) P teaIC4 a 1 Out W4 S j7 Now w �` Depth to Bed�•oeif Depth to Groundwater. Standing Water In Hole: `,One_ ' r Woeping fl'om PltPape Estimated Seasonal High Oroundwater t DETERM NATION FOR SEASONAL-ffiG A,TER TABLE Method Used: !t•',M o_ t�_�d t'USA Depth Observed standing in obs.hole: �O 4 E? _3 Z Ip, Depth to spit mottles..De th to weeping from side of bs.hole: Index Well It W 11! (}Reading Date;AU2.015, Index Well ltl' ©rnUndWater Adjustment fr l . Adj.tkCtar'�.Q.fst A4J.prvundwdter Level PERCOLATION TEST Data ' ► �rhnm t ObaervatIon Hole# Time at 9" Vk Depth of Pero _ Time at 6" �1 Start Pre-soak Time @ 0" Time(9"-6") End Pre-soak 2 Rote Min./htch , m i Site Suitability Assessment: Site Passed_ _ •Si te Palled: . Additional Testing Needed(Y/N) Original: Public Health Division Observtitlon Hole Data To Be Completed on Back— — ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)weep prior to beginning. Q:NS EPTIMPERCPORM.DOC DE EP OBSERVATION HOLE LOG I[ole# I Depth from Soil Horizon Soil Texture Sdil Color Soil• Other Stuface(in.) (USDA) (Munsell) Mottling (Stnucture,Stoner;Boulders. • ai a cy,%Orayell C ~�6 Cain h `Inp �rigble.- to DEEP OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil ; y Other Surface(in) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsiste. r�h q�317 w. n 10�R g tr � lP DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistanry, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Solt Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, r Conshitoncy. Flood Insurance_ Rate Map: Above 500 year flood boundary No_ Yes ., Within 500 year boundary No Yea ' 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 thrpughout the area proposed for the soil absorption system? �5 If not,what is the depth of naturally occurring pervious material? Certification I certify that on N• l (date)I have passed the soil av'aluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the requir �aini g, erti9e nd/�xperien a described in 10 CMR 15.017.? Date - Signature ' Q-.\9EPTiCtPBRCPORM.DOC ,t • 11KE Town of Barnstable Barn aicac" + BAMSCABLE. • �• MASS. $ Board of Health i639• pTEO a�A+� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi November 30, 2015 Mr. David Coughanowr, R.S. 155 George Ryder Road South Chatham, MA 02633 RE: 64 Hampshire Avenue, Hyannis, MA A=291-137 Dear Mr. Coughanowr, You are granted variances, on behalf of your client, Federal National Heritage Association, to construct a replacement onsite sewage disposal system at 64 Hampshire Road, Hyannis. The variances granted are as follows: Section 360-1 of the Town of Barnstable Code: To construct a soil absorption system and distribution box 80 feet away from a stormwater retention pond, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install a pump chamber system 50 feet away from a stormwater retention pond, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install a septic tank 42 feet away from a stormwater retention pond, in lieu of the minimum 100 feet separation distance required. The variances are granted with the following conditions: (1) No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. Q:\WPFILES\64 HampshireAve Hy DavidCoughanowr Sep2015.doc i v (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) A monolithic septic tank and monolithic pump chamber shall be installed. (4) The septic system shall be installed in strict accordance with the submitted plans dated August 14, 2015. (5) The designing registered sanitarian shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the submitted plans dated August 14, 2015. These variances are granted because physical constraints at the site severely restrict the location of the septic system components due to the small size of the lot and the location of the wetland adjacent to this property. The proposed new septic system appears to be designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sin c. ely your , Waynd Miller, M.D. Chairman Q:\AddressesOftenUsedBOHLetters\Coughanowr2Ol5.doc F �(t k1o) 9 ..OF1HE�p� /5/ ,DATE,: K��� '.:snxrvsrnst.e..� Y �a >aS q. T`o n 'o Bara9 td.ab e SCH}JD DATE: of HeAltb 200,1VIillI1 Sti- t, rQX; Ullicci St)S-t{ii2 rfGGl%( �f IVtiyte,i1:MlilLr,tii:f) I A-X: 5Uli 790'6301' Jtnticlit 5 nv iyanngl 1'liid>J Cannft ll.yLa. I V EO.RM LOCATION ,jj Property Addv(Ss: ;tom 1. rL �}N1 prj-t i L 4V E�1 U'L nsse'ssot's. iap anc3'Pa[c cl Numbei Stie„of["Or W00—ands VI!ilhui 300 I t Ycs Busii i s,Nanie,;' No,; Sutidlv,iston N7 . NTmc APPLICA T'S'N 1IV[E: Did the ow-ner of thc..prope'r[y authortzt ynu to represertt,,hi i..ar her? Yes!, n PROPERTY OWN'ER'S:NAIViE, CONTACT 1)E USON Name: 'FCPf`i� q� tai1�7. "�'t2{"'� ¢ �`SS Natne �.r�u4 ,Cp.UG'flr�woW 0 56 1 Phone: P,h6tye: VARIANCEIiROMRRGULA'11`ON(isrReg>} Rii1SON.F.ORVARIANGL(�t1y,3ttach;fnierctipaccnecdc;'i1) D ( (rID� rc'. 100 �etl�' c h. g v :lid �I 1'c-�<Q _1'7,a l' +tom M 6,10���'�-� C-0 NATURE-OT WO;RK 'Hoscnd'I IloeReatio Repair ofFaieScpS'ysten• Cheeli ist '�tU UL CO!)lrlL'te(�I)l�(ff1Gl'' 1jCl�J-1)L'1 SUM'8(IC'lVlllf.VCII'1((i1L'E`I'G'C�!(L',SI(Il)l1)1G'QIIUJIJ F&Ae,sribinit:caprec In 4 sep—anrte etiurnlelerl sets' _ -Four-(1)copies of[hc contplctr�i v In wee request farm (it)copies'ol=eitgiiteued p1a»subniiUed(c se itic s}stein plans) CComplctcd seven(7).pa-t.CI1CCl Htit C011h_ntllft�rL1 tC1\ill CII IIICUCd plan liy;suhlitiltiitg cngiijeq.(jrrc,gislered Sanitarian _ Four'-(J)colrics ot'labeled dnn�nsion II flurir plains sui'innhcd�(c�g= louse -I u15 or iesl.lur;in�kilcllcn ljliuts). St=ned Iettcr slattn thplalu lru �rl o�rncr autltnryreil pu 11)..re tr�5ult hmtlhu for thlti request ti. .. � I p-, Y � Y I Appli�iul uniicrstal}ds.tlt Il tltc ab ittcrs inust.be5wttttc(I hy,ccr',ttfi(d.titad at Ii asldcn days:prior to ie,, d ttt;al gtplicant s expense (fair 'rille- ` V,=tnd/or loe.tlseevage;regut iuon.�anances:.Unly) I iill nano suaintltcds(for grc Itic trap vari ii>cc nqucls only) V iriiu>ceraiucst Ippht:iuon fcccilllccteii.{nai fcc liic'hflguaril',,0dilicaiinn rcnc 4ah grcttsetrtp vaii;alut r i citti ds(s,tnit miner/lt5uc onlj^{; U itsid�chniri }trt im 'r�nctitlls[santc.(ili+nc dluu�eoniy{•'siitil van.UlceS tb fell it tallcd'se�tge.({ispoctl sytiii,inr_{tntly if fell c p:aieinit.tu tl c.; hiiiidmg pro}losedj, Varimtce regtiest s'ubmitt�d at lriisl I days:,pnor t5'nic.e.umg'tlate VAki-AI I E APPROVGL). 4Vayne,.Mlllcr chairiii ur NOT A1111R(;)WD Jtiiliclii,S nvtiyalittgi RI?ASON FOR DISAPP..ROVAI, 1';nil'J.CiinldITI,ON"11 C'\Us'ers\decoSY k\Aop6aca\Local\1•ticrosoi:c\4r=ndows\Temporary Incernet: F_3es\Content.:0utloo'.{\BAIJ§P9B7\VAR•IREQ.Doc r-iowna 6f Bamstable r 0 DepnrLinenL otneg111dory secvlces Public lIcalt tLC MAIM. ]�ill Dhdsion Da La nnI Tnnuc,� 1679• �a 7.OU Nlniu Slrnrl,liynnuln MA 02601 /f111�1A�h LI Dula snccllulcd Tl•nlo_ I� I oo 11,11. U ,Soil Suitability As'sess'inent %oj' Sei•vcr.g ispos'ccl 11 I II L, Pcrfarnmd•ny;�lrU�lb\ Cal i?v l'1C.rr)r,.F,; • }vllnayaetlny;,�`I�),:.�i�/; l/V '�-I-r,-__,_-L' lam. Larnllan Addrous LOCA`J'ION & GLNFI'lt&Tl uq O�!.T.ION r(vz/� �- ewj p 7 hI', re A-j owncr'n Name t Address I�(Cl rl S . A.sscssur's Mnp/Porech Lu'lucrr's Nnmc ) ;I C' t �t:r� 7 � �-r c oil:/blcwtr• NRIY COI`I5(7�'RUC �3. r'lUN RRPALR _� I'clrplionaif 5G>�� �j�`f C7 l bind Usa l—f�7rC y t%`T 1'-'l /f 'Z i ti 1 %I t Slopes('Ih) l(T� Surrnco Stones y_ h�LI Il C k Dlstanuch r,-unl: Upcn\Ynter Body �J $ fl t'osslble}ye(A.rcn -70 -`- n R Drinl;iug 1Ynlcr)Tell . )(-'�,� 1 {t Dn11VIngo Way C:0 Al rt Properly Line ([' fl 011lcr tl LL''1<E'I u'�II�i�C%YI l r••-I • - � 1 •.- r' 1' ' '7 1 11 '�.•I ,I!�': L�i ')L'r,Gl [.-..� -1-I f"I'ti fit_ C'�\!I h'l L ilI •r CI (ShtCt❑nlne,dinlenslons odor,exnet ioonllous urleal halos Sc pere teals,loente tvcllands(11 proximity, :o Mules) 1_ 't`' L Parcut rnnlcrial(gcolollic) 0lL Daplh lu Uuclruul; Dcp(h to Cruuudwnlcr. Suuuling Willer III flolc; V�i V`I�� 1 11 ocping 4'uln Pit Nnoe Ustlnmted Scnsonal High 011.111ndwaler DzJTMUV"N'-1"'.ION I'Olt SEAS ONAL-M G WATER TA.BLIP, Ivlclhod used: T-I", I,,,)farc'r i Dl:ptll 0hscrvcds1nnd(nl,hl ubs.hole: Dc III h,wcc Ihl III, Doplil In SUII 111011ION: III, ,l oulaldr.ufubs.h°lat III, 0ruundtwllurAdfuslluunt� Index\Yell i)I l Iv•-' Rcndln�Dula; l..•.. hulaa Plcll Icvel�?,rl( i1dJ,ILclur.�;L!1�: AIIJ.0rountivniterLavul,_ J.EI RCOA.,I�`�I.1O TEST Ullfo Ob.servnliull I Iola If ( �� - - - - - -- _ •- � _ 1'huonlrP� 11 r�� - - � _� _ napu,of rcln �,�-,�_ � • Tlmo nl 6" Shot Prc-soil'Tlluo(p Lud Pvc-sonic IlniaMiil./Juch. .�ll���( Sltc SIll.WI(IIIy Asnessincllt: SiloPnssril � 5ilc["\dell: AJd(liminl'res011g 1`Iccdcd(Y/i`I) t�•� • 0111;lnnl: Public Ilenllb Dlvlslan ' Observ«ilon ITole Dlth 1 t '0130 Compictod on Ducl(---- k`I'*Il I)(It-c011160n Lest is Lo uo couducLed�viLl)iz)7.OQ' }veLlBnt1 %ou 1 mu st First notify Lllc. ��111'll9itii)iL' CU)lfie;'}%14L1U11 Division lit leastU)!p ��[) }}'00i(i)rior to uc6i)).zzillg. clasel�i'Ic�PnRcroRM.Doi� - DLLP.0I3SEMUTION HOLE, LOG 7t-1010 ak I Depth from Suit I Idrizon Sall Texlure Shcl Color 8011• Other Surface(in.) (USDA) (Munscll) Marlling (Slnucture,Sloncs;ll0uldm. r`nnslslcnrv.%'CiritVcll C - I;IeC i L�''nl) S N Er _ 1 �• I n(� l•�jz �lNClyM �l�?i I(,'`l �> ��� 1.1 Loo DLrP ODSIJRVATZON HOLL LOG bole# Depth from Soil IlOrizmr SallTcxlure Soil Color Soll Olhar Surface(iu.) (USDA) (Nhmscll) Mottling (Stnteruro,Sloncs,bouldcm AP C lwl1' (alfn! -1l.(� 10 FLllJC-lJ�( it DLLP OBSSERVATION MOLL LO G i1olo# Depdt from Still lloriznn Soll'rexlurc Soil Color Poll Olhor Surface(In.) (USDA) (h4unacll) IvfoldIng (SlrUaturc,Stones,Moulders. r tcary.'YP DEE,P OB SL 0 v�k Dcpol from Soll Horizon Sall Twurc Soli Color doll Other Surface(In.) (U$DA) (Ivtunsell) Willing (Structura,S(oaes;llnultltn-S. ' - C' ns IcnnV.'fn Om�ll Flood Insin•nncc R(IW?Glop: Abnve 500 year flood boundary Ma— Yes Vlllhin 500 year homidnry Ma `(cs Pillion I00 year flood houndary No.-g— Yes 1� De tit of T liturnlly Orrnt•rintt PervinueMntnrinl Does ❑t It:ast four fcot of naturally OccutTing porvlouc nuilodul oxint in all m ctin obsorved throughout thu arcs proponed for tho soil absorption system'? ti125 _ If not,what is the depth of iullllrally occurring pervlous mut0rlall Ceilifirnilnn I ccrtily lhtrt on N• J (date)I lim pimmd the soil cvaluutor oxnminftbon approved by(hu Department ofP_nviioumuntat Protection and that the above analysis was performed by mr congistcnt whit the require -t�ailm g,' xllurtise and/uxpericnco descrilmd in }10 CNIR 15.017, Dail, ' �:��el>rlcrear_potthl.noc ' AsBuilt Page 1 of 1 LOCATION VILLAGE ASSESSOR'S NUP LOT DISTALLU S NAME PHONE NO.�_ SEMC TANK,CAPACITY LEACHING FAC' iTY:(ram) t s S ot� 4 (sim)�zx NO,GFBEDROOMS $UtLMR OR MAR. Ps;RMF£DATE: -' COMPLf�L'�CE DATE: Sepat don Distanee Bdwcen ft: maximum AdjusWGroundwater Table to the Bottom of LexhingFadlity Fee -Private Water Supply$Tell andLeaching Facility (If any walls exist OR site'or within 2m feet of let MU0 freility) ` Edge of Wedand and Leaching Faclk(If any wetlands exist ' witialn 300 feet of leaching fac��itp) r Fees Furnished by �•G �J1 1 I ✓lJ�l,f 1 � f / http://issgl2/intranet/propdata/prebuilt.aspx?mappar=291137&seq=1 9/1/2015 Z c � 's P o � Q '3�51C)ICt COZ 0 � n i LIJ k , G FF � F + <AG� 5 ' G Doc- 1 r 281 F 153 10-28-20 15 12:27 f BARNSTABLE LAND COURT REGISTRY �!tl CX1 DEED RESTRICTION Federal National Mortgage Association a/k/a Fannie Mae, organized and existing under the laws of the United States of America, P.O. Box 650043, Dallas, TX 75265-0043 the undersigned owners of 64 Hampshire Avenue, Hyannis, MA 02601, by deed recorded in the Barnstable Registry District as Document No.1,234,840, noted on Certificate of Title No. 201958, being Lot 32 on Plan 14034-A, hereby covenant with the Board of Health for said Town of Barnstable that only four rooms at the premises shall be used as bedrooms. No other finished space other that the four existing bedrooms shall be used as a bedroom. The covenant contained herein and agreed upon by the Owner, shall be binding upon the property and upon the Owners, their heirs, successors and assigns. This covenant shall be recorded in the Barnstable County Registry of Deeds. Each Owner, in every instrument conveying title to the premises, shall specifically reference this Covenant and the place of recording. The Board of Health or its appointed agent shall have the right to enter said premises, with reasonable notice to the owner, to inspect and confirm compliance with this restriction. Z i I ' - I 1 Witness our hand.and seals this2Iday of Oc4al e, , 2015. Federal N ' nal Mortgage Association By: -— Rot er Ur Ing— Ass't Vice President Fannie PA se COMMONWEALTH OF MASSACHUSETTS Barnstable, ss: On this z'7 day of 06 Qe , 2015, before me, the undersigned notary public, personally :appeared I?V er '9-f'/Vig being the �. V R of Federal National Mortgage Association a/k/a Fannie Mae, proved to me through satisfactory evidence of identification, which was�L50 noun r\ to.be the persons whose names are.signed on the preceding or attached document, and acknowledged to me that they signed it voluntarily for its stated purpose and who swore or affirmed to me that the contents of the document are truthful and accurate to the best of their knowledge and belief o� i i Notary. Public My Commission Expires: j i BEUNDA L NELSON } ':. MY COMMISSION EXPIRES j 'o'lapd tic;' Jemmy 7,2019 f I I f ®RE�O.ISTRY Q COUNTY DS A TRUE COPY,ATTEST I <5-r•Nu— -Z' BARNSTABLE REGISTRY OF DEEDS :-Enj ... John F. Meade, Register A: �• Town of Barnstable Barnstable!mod Regulatory Services Department " 9. Public Health Division s63 �1� � m 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A:McKean,CHO CERTIFIED MAIL#7014 1200 0001 0358 3810 April 9, 2015 David Holt Today Real Estate 1533 Falmouth Road/Rte 28 Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 RE: system lof 2 The septic system located at 64 Hampshire Ave,Hyannis,MA was inspected on 4/2/2015 by Sean Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails"under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Structural Integrity Issues. You are ordered to repair or replace the septic system within sixty (60) days from the date of this notification by removing garbage disposal. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH i �eaneS., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Evl\64 Hampshire Ave Hy 2015.doc I Town of Barnstable r r s BARNSTA1314 rFo 9 A,�� Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/7/15 DEADLINES TO REPAIR FAILED SYSTEMS An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis.(This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching pit with high liquid level, <12" below pit(per Town Code §360-9.1) OTHER. -�^✓� urn In PT_ �SUQS Repair deadline: r ,1 Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc ssachusetts Commonwealth of Ma Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Z A. General Information _ 1. Inspector: �—� Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evalu the Local Approving Authority 1 4-2-15 l I pector's Signature Date I�7 "III 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. q, ,off �r c�u �� �,��6 �y t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments c�M 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: 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. r ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i� f - Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): f ❑ 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 5 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 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 h day flow t5ins.3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form !^ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No El ® 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 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ El Area 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4M s 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes 0 No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 �. Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ® Single cesspool ® Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts = W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (coat.) Approximate age of all components, date installed (if known) and source of information: 1970's Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 24"feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 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 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.): Grease Trap (locate on site plan): Depth below grade: feet Material of construction: a ❑ 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 e t i Commonwealth of Massachusetts m W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts w Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is c required for every Hyannis MA 02601 4-2-15 page. City/Town 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 N/A 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.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. CityTrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: 1-6x6 ❑ 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.): Overflow cesspool was empty at inspection with stain line at 20" below inlet invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 2-Inline Depth—top of liquid to inlet invert N/A Depth of solids.layer N/A Depth of scum layer N/A Dimensions of cesspool 6x6 Materials of construction Block Indication of groundwater inflow ❑ Yes ® No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 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.): Cesspools had structural integrety problems causing safety hazards. 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M s 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately B r r 6 r ° . � — ULI n t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 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: 16' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at greater than 16'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 a. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 64 Hampshire Ave System 1 of 2 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 4-2-15 page. City/Town State Zip Code Date of Inspection 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 I t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 oF�,F r Town of Barnstable O Department of Health, Safety, and Environmental Services 9�^ �� i6gq. Public Health Division Qj ♦0 �FDN1°YA P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health June 13, 2000 Deborah LeeGigante David Lankin Swift P.O. Box 577 Marstons Mills, MA 02648 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE, ARTICLE 51 The property owned by you located at 64 Hampshire Avenue, Hyannis, was inspected on June 2, 2000 by Glen Harrington, R.S. Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code H, Minimum Standards of Fitness for Human Habitation were observed: 410.480: No locks were present between basement apartment and upstairs apartment. 410.481: Dwelling was not posted with owners name, address and phone number. 410.482: Smoke detector in hallway to bedrooms was inoperable. 410.601: Article 51, Section 4-5.1: Rubbish pick-up not provided (paid for) by owner. You are directed to correct violations of 410.482 within twenty-four (24) hours of receipt of this notice by installing smoke detectors. You are also directed to correct the remaining above listed violations within seven (7) days of receipt of this notice. I , You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF TH BOARD OF HEALTH Thomas A. McKean Director of Public Health enc. Inspection report l�lo o,-�.Li L e-e. �°�✓ccy�-� NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE H, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 6 y {-�"S ti^4 0-"ol , was inspected on 1v,,k- Z , 2000 by Glen Harrington, R.S. Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code H, Minimum Standards of Fitness for Human Habitation were observed: n/o <a cGc_i JOT ( /VIC, q10 m 4670 i° q10 , Y 8 / ��iNeC(c c, j � f pC1 � w� Oz�" v►w 1 ll w -k3 b.Q_t&VV014 > d, You are directed to correct violations of vwithin twenty-four (24) h urs of receipt of this notice. Y/0. �}�ZCSw►�a� 0.e;kt, ,� You are also directed to correct the remaining above listed violations within seven (7) days of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health FORM30 CH&W/ Hosss_gtWnRaEN'" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH wJ*4 za CITY/TOWN = Y-t, a DEPARTMENT 'o ADDRESS GSM yvey`0 �,f�.,�� / TELEPHONE Address G his, �� Occupant- t5� Floor_A artment No. No.of Occupants—/ _ No.of Habitable Rooms 9-1 No.Sleeping Rooms _ No. dwelling or rooming units No. Stories_/ p Name and address of owner ��-�`� _f�- pi ��� � Remarks Reg. Vio. YARD Out Bld s.: Fences: i -t/ n7 Garbage and Rubbish ✓O:,s ty h C 4- 1 /0-W kRti 10 � Containers: 3 W Drainage' Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ N Equip. Repair TYPE: 1� Stacks, Flues,Vents: PLUMBING: Sup2ly Line: wa-4, ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s)M ELECTRICAL Panels, Meters,Cir.: ❑ 110 11220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to Outlets Walls I Ceils. Wind. Doors Floors Locks 9 Kitchen /!dw 10 Bathroom 64 Pantryoleo Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten. as Oil, Elect.: / ° cf fs,A Stacks, Flues Vents,Safeties: k Kitchen Facilities Sink Stove Crk.e_ Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted ,r tA4 &. YR Locks on Doors: Ale b ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE 'f� OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTI F PERJUR " INSPECTO ' TITLE DATE / TIME 3�v A.M. THE NEXT SCHEDULED REINSPECTION )v ye.CQ,� '��.� P.M. rr +��yi�7r*, 3{Nagxr2na+gik'pia" +Ffr+ 'tier'A"xgsq"i1�+v`S !*b'���&{�06ra � j�`" +� ki:ii�'f�lT .:t �f .n .�.,r,,• .� c. C., V 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the heaith, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.0.00. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. .I r' v Health Complaints 02-Jun-00 Time: 8:40:00 PM Date: 6/2/00 Complaint Number: 2386 Referred To: GLEN HARRINGTON Taken By: GLEN HARRINGTON Complaint Type: CHAPTER II HOUSING Article X Detail: Business Name: Number: 64 Street: HAMPSHIRE AVE. Village: HYANNIS Assessors Map-Parcel: 7ia f Complaint Description: THERE IS NO HOT WATER. CAN'T GET A HOLD OF THE OWNER BUT SHE HAS THE OWNER'S ATTORNEY'S NUMBER=617-720- 1940. SHE LIVES IN A HOUSE WITH 2 UNITS. SHE DOES NOT PAY UTILITIES. OWNER SERVED HER NOTICE TO QUIT BECAUSE OWNER LOST HER JOB AND NEEDS TO MOVE BACK IN TO HOUSE. OWNER IS Actions Taken/Results: Investigation Date: Investigation Time: � I 0000 62B De t LOT 32 .3 317AAT9:59BORAH LEE to I s 101 SWIFT,DAVID LARKIN P 0 BOX 577 YeWAD an MARSTONS MILLS MA UZb on-nonn-oon IGANTE,DEBORAH 000019500 E AVENUE FoRM30 C W,J HQBBS6 WARREN tm THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN o DEPARTMENT ADDRESS y(n 6 TELEPHONE Address A124 Occupant_t1 c, 2ew,' il, _ Floor___A artment No.—_ _ No. of Occupants_ No. of Habitable Rooms _No. Sleeping Rooms_—?7n-- No. dwelling or rooming units__ No.Stories O. kk Name and address of owner p t b ci t_ 6 ;� '�It _ ��S�� y/ x Remarks Reg. Via YARD Out Bld s.: Fences: jG(,(-v os Garbage and Rubbish ✓ S h o Ow & ,Qti C//t7 (�If Containers: 3 Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen..Sanitation.- Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: O bst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING ) Chimneys: Central b4 Y ❑ N E ui . Repair TYPE: �'M Stacks, Flues,Vents: PLUMBING: Su I Line: IOU,- wa4jz -- ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT „ Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks W41 Kitchen APJ _ /V 5Tz_ Bathroom .,/3 Pantryrv .. Den Living Room Bedroom(1) Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten. Gas Oil, Elect.: K. S /OL° f G,.Q c Q�14 10d Stacks, Flues Vents,Safeties: K Kitchen Facilities Sink Stove S 14 11 yr L.— Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches,or Other: Egress , Dual,and Obstih: - �- - - •r Y- e T _ General Buildin Posted / ltiof J*J I01, -w,W OLktt4) ,NA4-J Cj,ff "k- Locks on Doors: AA0 •cU JU b d ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE ISrA CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIE OF PERJUR U11_ INSPECTOVV /49 TITLE A. DATE Z/ � TIME 3�Uv THE NEXT SCHEDULED REINSPECTION 10 �e cel ' -I o I o/-dL A.M. P.M. /2 AA . c Y 1 4 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the heaith, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos.dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0) shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. S' ��F ETti Town of Barnstable aextvsrnai.E, Department of Health, Safety, and Environmental Services "'"� i639. Public Health Division 9qj . ,0g' ArfD1A0sA P.O. Box 534, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health RECORD OF VERBAL COMMUNICATION S/.-0 671, a,! av,` h j - r Z e i / L S4. 7.S Gam'. �C�!w� f�.c•fe S 1,� Lai 6�c UV Jv P� . S G_. Items J Co C j', ra 'A14 0,"� w Li A o at, Z 1c►�11 o CTV Q- fit fr y12 0-V-eC L I rN Cvull - t wed -S M �N,�di oy+ a4l l h.tl-CG g' alo✓� �.�i LDS Z t �- o, a.dedw ecttj - Z- Z- Gt r�rt,,� . �S ��� G►I�h-d' �J taw?�-�_ Gwi��� verbcomm.doc �oFIME l ti Town of Barnstable snx�srnB Department of Health, Safety, and Environmental Services 1639. Public Health Division ♦0 AlfD1iADsA P.O. Box 534, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health 6 l� sha-0 / ' RECORD OF VERBAL COMMUNICATION Svc xZs� t� ?��v��� G�=/� coat I �f��r'c, ��-cz,�,�� t�►�t.�G,� r�P (cL/,q to 0A,,/� ,� �044,1z r�, `1 a�r/lei (a _b LeV( Ott+ l.Vl4 (`va t ky �6 T 16-C, `/ Z. S r s� " 6X/c,10C " ( .I a /0a i k"�f,+� dy CCPK�e Over 6�/v �C�q— �tid ��,rCA t/z GP 0�OILJ� �" ie-'� d rr` _ ({U CGS 14 - ly y;� -- verbcomm.doc THIS PLAN IS INTENDED SOLELY FOR INSTALLATION OF THE SEPTIC SYSTEM 8 DEPICTED ON IT. FOR ANY OTHER CHANGES TO THE PROPERTY INCLUDING NOTES® TWo S oko rt 2 PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS, OWNER FALMOUTH k SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. , INSTALLER MAY MOVE VENT PIPE TO A^DIFFERENT LOCATION. ROAD J 36 35 J� - 100.62 ft. 34 33 32 .31 �P Q -- -- TREE REMOVAL AT INSTALLERS DISCRETION . . so .ALL UNSUITABLE SOILS ARE TO BE REMOVED DOWN TO THE G C HORIZON !CLEAN MEDIUM SAND), AND REPLACED WITH o SILT . , a �c� LOCUS NOT I PROPOSED SOIL POET BARS/ER CLEAN MED IUM SAND PER TITLE- 5 i ABSORPTION ►► ft I �r NPMPyA�E ,n�N SSA 0 ^' I LE SYSTEM o I L�CC�L�NID toy F SEPTIC COMPONENTS IS < -SEE DETAIL 9P V SOIL 1 MINIMAL -� i ON BACK REMOVAL 1 „ 1 O O HYANNIS. MA P a # �• - � 1500 GAL �. PROPOSED 24 n SEPTIC TANK GRADING ' AREA ❑ o ® HEp o 1uoNourH►C L O C U S M. A P #Es /,� 5 I000 GAL • ti ? PUMP CHAMBER WATER LINE4 W �0 t F ft . MONOLITHIC OAS LINE 36 80 f -5_�4 ft , o L�LEVATIONIS OVERHEAD .• LEACH NTI WIRE CESSPOOL O ELEVATIONS SPECIFIED ARE INVERT ELEVATIONS (BOTTOM•• OF P1 P PE) EXPRESSED IN DECIMAL FEET 1 LPi • t I �^: � DISTRIBUTION BOX OO SEWER LINE OUT - EXISTING 29.5 . 1 , LEAN 1 SEWER LINE OUT - EXISTING 31.0 Q A OUT o TEST PIT FL OOI� PLAN : CHERRY '�• I SEPTIC TANK T 30.00 SEPTIC TANK OUT 29.75 - PUMP CHAMBER IN 2.9.58 4 1 PUMP CHAMBER.OUT 29.33 ELTH BED o D-BOX IN 34.30 Roots D-BOX OUT 34.I3 I cn THIS PLAN WAS APPROVED BY 36 '" w LEACHING SYSTEM IN 34.00 THE .BARNSTABLE. CONSERVATION -f BOTTOM OF LEACHING 32.00 BATH KITCHEN Q�� ;. .+ COMMISSION AT A HEARING E V 1 . n� v, 1 ON OCTOBER 13• 2015 LIVING FAMILY _ 1 0 R OO O i'IVu 1 d � � Z BED BED ROOM ROOM �. . I ROOM ROOM � /�W[�C�[��NN�: VARIANCES REQUESTED TOP ® MINI®nM m BAR1360-1 UPPER. LEVEL G EL o 37•114 '� LOCATION T ION LOCAL RC PONE �., LOCATION OF SEPTIC COMPONENTS WITH , I s RESPECT TO WATER BODIES GARAGE 100 ft SETBACK REQUIRED THE FOLLOWING VARIANCES ARE REQUESTED: R 1 pp I� I 1 80 ft TO DISTRIBUTION BOX & LEACHING GALLERY p T BED BATH I LOT 07L / I t 1 50 ft. TO PUMP CHAMBER M Roots AREA 13614 sf o • 1 . 42 ft. TO SEPTIC TANK L/ FAMILY PLAY T ROOM LAND COURT PLAN 14034—A \�N OF MASS jN OF MASS ROOM ROOM 36 ASSR MAP 291 PCL 137 / \ \ DAVID OyGv, DAVID / THIS IS A D. i 30 . . u COUGHANOWR v; u COJGHANOWR N LOWER LEVEL _=- COLO R No. 1093 No. 461 __ -- 34 �00.00 f t 33 r 32,. 31 PLAN G E��. 9PPR 35 T USE COLOR PLAN ONLY. 1 SOS O� (SILT BARRiER EDGE OF PAVEMENT FOR INSTALLATION CONSTRUCTION DETAIL Mn �" PSHIREI V�EU V V FULL DETAIL IS BESTU1SHA M . VIEWED IN DOUBLE � ., FULL COLOR STAKE-------,, SEWAGE DISPOSAL SALES STAPLE FAeR c GARB R PILAN SYSTEM PLANTO ; T A DEED RESTRI TION -TO SERVE EXISTING DWELLING STAKE A OWED � � A LIMITING THE DWELLING'S FEDERAL NATIONAL v SjpgLE GIS DgT�V� _ BEDROOM CAPACITY TO FOUR �'`, SCALE: I in .20 ft MORTGAGE ASSN. k cI f� ELEVATION _::\ 20 40 SHALL.BE RECORDED AT •• } THE.BAANSTABLE COUNTY. OWNER(S) OF RECORD V 0.:. 2 O REGISTRY OF DEEDS. q' �' 64 HAMPSHIRE AVENUE • s: �SpOT�NONCpE� :� O.. 10 eo 20 _ . .. 155 G Ryder Rd 5 I IYANNIS.. MA ' # 3 PROPERTY ADDRESS PRINT ON 111 x 17 in PAPER Chothom. MA 0263 - - - - --- FOR PF,-OPER SCALE DavidcouC�Hotmoil.corn DATE. AUGUST 14. 2015 508 364-0894 Pc.1/2 �oe� ETE-3926 DATE: JUNE 4. 2015 SSUL TEST LOG PERC# 14718 1000 GALLON PUMP CHAMBER * 8L .AMORr T`OO NISI SOIL EVALUATOR: DAVID D. COUGHANOWR. ASE 0461 1 00 IMALLM M O N O L I T HIS DIMENSIONS AND DETAIL FOR TP ICA PERMIT NEEDED ��Q T E�Mu] o o �� WITNESSED BY: DAVID STANTON. HEALTH DEPT. SEP T1 W YAW NK a ► 3 n + G5A3 NOT am �• ►- ' ! NO GROUNDWATER ENCOUNTERED BUOYANCY TO TEST PIT 1 PERC AT.54 in - 2 MIN/INCH IN C SOILS USE SHOREY PRECAST STLITHO BUOYANCY H-lO MONOLITHIC CALCS SCALE ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER A/ �� DRYWELL INCHES HORIZON TEXTURE (MUNSELL) MOTTLES A L 33.5 f t SEASONAL HIGH UNIT 35.80 SEASONAL HIGH r i' GROUNDWATER = 26.86 0 CD 0-8 Ap SANDY LOAM 10 YR 3/3 NONE FRIABLE 0 c GROUNDWATER = 26.86 r PUMP CHAMBER = 25.00 33.47 8-28 Bw LOAMY SAND 10 YR 5/8 NONE FRIABLE BOTTOM OF e � cow 28-132 C MEDIUM SAND 10 YR 5/4 NONE LOOSE BOTTOM OF - DEPTH OF WATER LO^ w Ln 24.80 SEPTIC TANK = 25.42 ® DISPLACED = 1.86 NO GROUNDWATER ENCOUNTERED DEPTH OF WATER EXTERIOR DIMENSIONS OF TEST . PIT 2 2 MINIINCN IN C SOILS DISPLACED = 1.44 UNIT= 8.25 ft x 5.42 ft t�' m ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER - EXTERIOR DIMENSIONS OF 8.25 x 5.42 x 1.86 = 83.17 cu it 8 ft._,3 !n 5.{ _ STONE INCHES HORIZON TEXTURE (MUNSELL) MOTTLES UNIT= 10.17 ft x 6.08 ft I 83.17 cu ft x 7.48 = 622.1 gal - 35.85 0-8 Ap SANDY LOAM 10 YR 3/3 NONE FRIABLE 10.17 x 6.08 x l44 IS 0 622.1 x 8 lb/ go/ = 4977 * USE SHOREY PRECAST 4 ft 8.5 ft 8.5 ft 8.5 ft 4 ft PUMP CHAMBER WEIGHS 9200* ST-1000 H-10 33.3E 8-30 Bw LOAMY SAND 10 YR 5/8 NONE FRIABLE = 89.04 cv ft U) PUMP CHAMBER WILL NOT FLOAT MONOLITHIC - - - 30-132 C MEDIUM SAND 10 YR 5/4 NONE LOOSE 89.04 cu ft x 7.48 11 24.85 = 667 go/ 70 TANK TO BE CERTIFIED WATERPROOF ALL ELECTRICAL CONNECTIONS 500 GALLON DRYWELL F & WATERTIGHT BY MANUFACTURER TO BE MADE OUTSIDE CHAMBER 667 x 8 /b/ go/ = 5336# t�2 �� DIMENSIONS.& DETAIL INSTALL ONE INSPECTION Dh1(I r1 h n rt�n r1 n nn �jn O 1t n \ CONTROL PANEL TO CONSIST E- AUDIBLE AND VISUAL ALARM ON t1=71�`J(IUII{(`(�J{IVVI\YVVII I(tv(J� � IILI7►(`[J�IIIV"11111LI� � 11UI U IIIJ\VII]`tiJ[ SEPTIC TANK WEIGHS 11833# �'� '� t� INDEPENDANT CIRCUIT AND TO BE-LOCATED OUTSIDE DWELLING. RISER TO WITHIN THREE SEPTIC TANK WILL NOT FLOAT b USE I&CHES INDICATE FINAL LOCA LOCATION USE BARNES SE411 PUMP 0.4 HP.' 115 V; 1750 RPM H-)O DESIGN FLOW: 4 BEDROOMS X 110 GPD = 440 GPD ON as-aulL r SEPTIC TANK: 440 OPD X 2 DAYS = 880 GALLONS PASSING 1-1/2 in SOLIDS UNIT INLET INSTALL NEW 1500.GALLON SEPTIC TANK.. . OUTLET- PROVIDE 1/4 in INSTALL OUI_CK COVER WEEPHOLE TO DISCONNECT TO s O 33 INSTALL 1000 GALLON PUMP CHAMBER COVER COVER T as 0� DRAIN 1 A in PIPE AFTER COUPLER GRADE 0 t� f21STRIBUTION BOX: INSTALL UNIT DEPICTED.BELOW. IN DROPFLOW LINE PUMP 'CYCLE INTO RISER- pq�aapo 00�00 ,OIL ABSORBTION SYSTEM: FROM TO (�on.poo po 00 THE LONG TERM ACCEPTANCE RATE FOR A CLASS ONE - D-BOX SOIL WITH A PERCOLATION RATE BELOW b MINUTES BUILDING )O !n inU D BOX i STORAGE 500 GALLONS PER INCH = 0.74 GALLONS PER DAY. PER .SQUARE FOOT. FROM WEEP /02 in 48 in SEPTIC ALARM ON 24 In HOLE THE 33.5 ft x 12.5 ft x 2 ft LEACHING GALLERY LIQUID GAS TANK CHECK CROSS SECTION VIEW DEPICTED BELOW CAN LEACH: LEVEL BAFFLE PUMP ON 17.2T In VALVE INSTALL AN APPROVED OEOTEXTILE BOTTOM AREA = (33.5 x 12.5) 418.7E sq. ft. FABRIC OVER STONE _\ SIDEWALL AREA - +1 = 184 s ft: PUMP OFF 12 In TOTAL AREA 602.75 sq. ft 6 in STONE BASE FLOW CAPACITY = 0.74 x. 602.75 .446.03 gal/day SEPARATION BETWEEN INLET & OUTLET TEES NO LESS THAN LIQUID DEPTH 28 9N ►n TO LEFFE INSTALL A 33.5 ft x 12.5 ft x 2 ft GALLERY AS CONFIGURED DOSING = 110 GAL/CYCLE = 4 CYCLES/DAY 1n 1-1/2 1n ORAVg VEo ~u?In ORAVQ BELOW. FLOW CAPACITY= 446.03 gal/doy WHICH EXCEEDS CROSS SECTION VIEW STORAGE 500 GALLONS 440 OPD REQUIRED THE 440 gal/dog REQUIRED FOR A FOUR BEDROOM DESIGN. CROSS SECTION VIEW 46 58 �6 in 50 in ALL STONE TO BE DOUBLE WASHED AND FREE OF IRONS. DUST AND FINES /N PLACE / LLII OBSERVED GIN NONE AT 24.80 VENT INDEX WELL A1W-230 TOP OF FOUNDATION RAISE COVERS TO WITHIN ALL PIPE TO BE SCH. 40 PVC - ZONE D EL 37.14 + 6 in OF FINAL GRADE AND TO PITCH AT. 1/8 In/ft MIN PIPE READING DATE JUNE 2015 33.0Q 36.00 READING 22.06 ADJUSTMENT 2.06 ®-BOX 3 ADJUSTED OW BELOW 26.86 31.00 MAX -INSTALLER TO OBTAIN 34.7E DISPOSAL WORKS PERMIT 30.E TEE N BEFORE STARTING WORK. ������� REFER TO DETAIL BOX 34.30 INSTALLER TO VERIFY LOCATIONS �oa o. 000 PRECAST oop��o 1 29.E ��®® ��LhIL®NJ °4°°7�°cb�o�o,�� °o o�° �o°�� O OF ALL UNDERGROUND UTILITIES P�®�®��® 34.13o o�f- % D R Y W E LL o°oo°o �000, BEFORE EXCAVATING FOR SYSTEM. EXISTING SEPTOC TANK 129.75 1000 GALLON Tin oo o�oo oo. 25:42 STONE 3].O REFER TO DETAIL BOX PUMP CHAAAI3Ef� 29.33 BASE SOILS ABSORPTION �, T -ALLREQUIR REQUIREMENTS OF MASSACHUSETTS MEET TITLE H5 SEPTIC IMM EXISTING _ CODE (310 CMR .15). 25.00 L34.00 mm REFER TO � 6 in STONE BASE 129,58 �����uW o E -ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION 30.00 6 in" STONE BASE 5-12 ft DETAIL BOX OF LOW FLOW FIXTURES & APPLIANCES. AND PERIODIC 2.5 ft 3 S f t PUMPING OF THE SEPTIC TANK. 32.00 ADJUSTED SEASONAL 10 .37 f t HIGH GROUNDWATER _ 26.86 lei -SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. SEWAGE DISPOSAL SYSTEM PLAN 64 HAMPSHIRE AVENUE HYANNIS. MA AUGUST 14. 201E ETE-392 PG 7/2