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0041 HIRAMAR ROAD - Health
44-43 Hiramar Road + Hyannis A= 292-012 P�pFSHE Tp�� Barnstable y p� Town of Barnstable Barnst aarnstabl �. BARASS LE,M Board of Health m T MASS. � 16g9• °TF0 MPS 200 Main Street, Hyannis MA 02601 2007 Office: 508-862 4644 Wayne Miller,M.D. Paul Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi November 24, 2010 . Mr. Michael Pimentel JC Engineering, Inc. 2854 Cranberry Highway East Wareham, MA 02538 RE: 41 & 43 Hiramar Road, Hyannis MA A= 292-012 Dear Mr. Pimentel, You are granted conditional variances on behalf of your client, Household Finance Corporation, to construct a replacement sewage disposal system at 41 & { 43 Hiramar Road, Hyannis, Massachusetts. The variances granted ar e as follows: 310 CMR 15.405: To place 4.25 feet of soil cover over the top of the leaching facility, in lieu of the three (3) feet soil cover maximum allowed. 310 CMR 15.211: To place the soil absorption system up against the front property line, (zero feet away), in lieu of the ten (10) feet minimum ' setback required. 310 CMR 15.211: To place the soil absorption system 4.0' away from the side property line, in lieu of the ten (10) feet minimum setback required Section 360-1 Town of Barnstable Code: To install a septic tank 66.3 feet away from wetlands, in lieu of the 100 feet minimum setback required. These variances are granted with the following conditions: (1) Gas baffles shall be provided in the two compartment septic tank. The submitted revised plans, dated October 1, 2010, do not show a second baffle as required. Q:\WPFILES\PimentelHouseholdFinanceSepticVarHiramarRd2OlO.doc T (2) 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. (3) 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 three (3) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (4) The septic system shall be installed in substantial compliance with the revised engineered plans. (5) The professional engineer 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 revised engineered plans. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to its close proximity to wetlands. Sincerely yours, ayne iller, M.D. Chairman Q:\WPFILES\Pi mentelHouseholdFinanceSepticV arHiramarRd2010.doc Submtt by Emall: SINE DATE: S FEE: 9 BAEN6TABM 9. 1k Town of Barnstable REC. BY SCHED. DATE:\/7�vZ�JZ� Board of Health 200 Main Street, Hyannis MA 02601 � rr)ln� Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 JunichiSawayanagi , Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION Property Address: _41 & 43 Hiramar Road Hyannis, MA Assessor's Map and Parcel Number: _Map 292 Parcel 12 Size of Lot: 9 584 s.f. Wetlands Within 300 Ft. Yes _X_ Business Name: N/A No Subdivision Name: N/A APPLICANT'S NAME: _JC Engineering Inc Phone 508-273-0377 Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: Household Finance"Corporation II Name: Michael Pimentel, E I T (JC Engineering,Inc.) Address:_577 Lamont Road.Elmhurst,IL 60126 Address:2854 Cranberry Highway,East Wareham MA Phone: Phone: =508=273-0377 F-A , J 6ZE ` o O VARIANCE FROM REGULATION (List Reg.) REASON FOR VARIANCE (May attach if more space needed) C � G7 O _See attached Appendix A �, —n D C NATURE OF WORK House Addition 0 House Renovation❑ Repair of Failed Septic System 0 C� a a� Checklist to be completed by office staff-person receiving variance request application) n r Please submit copies in 4 separate completed sets. Four(4)copies of the completed variance request form _Four(4)copies of engineered plan submitted(e.g.septic system plans) Completed seven(7)page check]ist.confirm ing review of engineered septic system plan by submitting engineer or registered sanitarian Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. C:\\Users\\decollik\\AppData\\Local\\Microsoft\\Windows\\Temporary Internet Files\\Content.Outlook\\BAJ9P9B7\\VJ JC ENGINEERING, Inc. Civil & Environmental Engineering 2854 Cranberry Highway East Wareham, Massachusetts 02538 Ph. 508-273-0377—Fax 508-273-0367 APPENDIX A In accordance with 310 CMR 15.401 - 15.405 the following local upgrade gpDrovals are requested from 310 CMR 15.221 (7) for item 1. 310 CMR 15.211 for items 2 & 3• and 310 CMR 15.223(1) for item 4: (1.) A 1.0' waiver(3.0' - 4.0') for the maximum cover over the leaching facility. (2.) A 7.2' waiver(10.0' - 2.8') for the setback from the front property line to the leaching facility. (3.) A 10.0' waiver (10.0' - 0.0') for the setback from the side property line to the leaching facility. (4.) A waiver from providing a second tank in series with a minimum effective liquid capacity of 100% of the design flow of 440 gpd. UNITED STATESTLE#�1(� F� e&Pdid " Out F.. • Sender: Please print your name, address, and ZIP+4 in this box •� I JC Engineering, Inc. 2854 Cranberry Highway I East Wareham, MA 02538-1314 I SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A..,S' nature item 4 if Restricted Delivery is desired. ❑Agent X ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B: Received by(Printed Name) C. Date of Delivery I ■ Attach this card to the back of the mailpiece, or on the front if space permits. MCAm. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No VP l DER P � Mur`phy�Farilily Real•Estate Legacy LkV I c/o M{i�f "I Campbell 122 thRA 'nut Street 3. Se Type East76rrdgewater, MA 02333 Y Certified Mail 4❑Express Mail ❑Registered % ❑Return Receipt for Merchandise `--- ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes ------------ 2. ArticidNumber 7007 2680 ;0001. 8027 2804 A e �-Tf (transfer from servl I PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 1 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • JC Engineering, Inc. 2854 Cranberry Highway East Wareham, MA 02538-1314 SENDER: COMPLETE THIS SECTION COMPLETETHIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sig b item 4 If Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. R ived by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, K7 ►y � _ Do a- ,c � 12f Ib or on the front if space permits. "1 I 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes ' If YES,enter delivery address below: ❑No r Town of Barnstable 'Conservation Commission 200 Main Street Hyannis, MA02601 < 3. Sq&iceType d Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. ' 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number `' :s' 7'x 2 6 8 0; t (transfer from service/abeq�'' i= i - #► . 0 6 01 ;B'a 2 LIE 7 i i 2+7 B 1i € U PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • JC Engineering, Inc. 2854 Cranberry Highway East Wareham, MA 02538-1 3 . t : 11711IIi111 F'91�17.7�171il�ilt±'ilil�,l±if11±1±±117}I.311t1131i±�1 COMPLETE .N COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sign MU; item 4 If Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Nam) C. Date of Delivery- or on the front if space permits. 6 �, m" D. Is delivery address diffe.re�tfrom item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery addressress b olof w: ❑No George E. Marquit,Trustee': 41�E 19 � 3 t I 267 Falmouth Road Hyannis, MA 02601 ' 3. Si ice Type Certified Mail ❑Express--Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D., 4. Restricted Delivery?(Extra Fee)—, ❑Yes 2. Article Number ;i70pi7 26'8p 0-001'i. 8027 27741; gi p (Transfer from service label), '' 0 I-Z/ PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 i ,M t - - - --I JM�O-j L� CT 2-7 i } f I' f' k� � � i r� 4 1 + , 1 • I 1 • � � � 1 i •{ '. i r � � 1 1 � � 1 � i 1 � �• 1 I � 1 + r ,, 1 � � �� i { ,,. tf 1 1 1 ;� 1 ! I 1 1 � I 1 � I I 1• � f 1 �, • ' � � r I i � ! � f 4 � � � � e � ` I � � i � � �� � 1 �p r I, ✓ t la 1 �, `. 1 •�, P 1 1 ` i 4 �� ! � F r � j _ � � I; � � , , . 4 �I + , I 1 1 1 1 i I i � 1 1 , � 1 � { ' t, ' t 1 1 � ! F e 1 � 1 s 1�!' ' a ' i 1 4 i 1 f � 1 1 1 { � , { ' f r I 1 •�t / 1 r .._ z 1 1 1 i � 1 � � V { ' I f Capewide "3� " ENTERPRISES, LLC 41-43 Hiramar Road J.P. MACOMBER& SON Hyannis, Post Office Box 763 Centerville,MA 02632 To: Barnstable Board of Health From: Capewide Enterprises, LLC Date: October 6, 2010 Cost Analysis for 41-43 Hiramar Road, Hyannis to compare prices to install a7itle V septic system versus town sewer hook-up. Title V Septic System Installation Total cost.............. .........................$14,275.00 t - Connect to sewer via designing an extension to the existing sewer main (see attached letter) Estimate to complete work............... -: 0 0 C) ro p7 Phone: 508.428.4028 Fax: 508.428.3928 N'; rn, Rich@CapewideEnterprises.com Joao@CapewideEnterprises.coin www.CapewideEnterprises.com ,1 Town of Barnstable Department of Public Works 230 South Street, Hyannis MA 02601 MAS& $' www.engineering@town.barnstable.ma.us i65 Mark S. Ells , Director Office : 508— 862 - 4090 Fax : 508—862 -4711 September 17 , 2010 Capewide Enterprises Centerville, Mass 02632 Attn : Rich Capon Subject : Sewer tie-in for 41 & 43 Hiramar Road , Hyannis Dear Sirs ; The Town Engineer and I met this morning to discuss how the property at 41 & 43 Hiramar Road could tie-in to municipal sewer. The property owner will need to design and construct an extension to the existing sewer main from the Falmouth Road intersection. All costs associated with the design and construction will be born by the property owner. The construction would include the additional sewer main, a AirVac valve pit, and a service stub for any properties that the additional length of sewer main passes. The existing sewer main is part of a vacuum-assisted gravity system that serves that area of the Town. Therefore the design will need to be designed by, and stamped, a professional engineer. The vac-assisted gravity system has been assembled so that adjacent properties can share a common valve pit. The Town would require that the sewer main be extended to service the far end of the property. This will allow a valve pit to be installed for the adjacent property. The current AirVac system constructed for the Town was designed by the local office of Stearns & Wheler. Another source of information about AirVac systems would be to contact AirVac directly. The Town Engineer may have some information available relative to the original design and constrction of the current system. If you have any questions, or need additional information, please call Dave Anderson at 508 — 790 - 6244. Sincerely ; David J Anderson ; Construction Projects Inspector Town of Barnstable DPW - Admin & Tech Support qWhED STATES P STAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • JC Engineering, Inc. 2854 Cranberry Highway East Wareham, MA 02538-1314 o S ( "\ (}SS. I ili d"iffiIIIiSdii.11.11i 11211 SENDER: COMPLETE THIS SECTION COMPLETE THIS:SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signatu item 4 if Restricted Delivery is desired. ❑Agent X ■ Print your name and address on the reverse Addressee so that we can return the card to you. g d by P bt d Na e) C. Date of Delivery lls Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 19 ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No Jon E Stetlas . 2 Wilson Road I West Yarmouth, MA 02673 3. 8e7fce Type 13Ycertified Mail ❑Express Mail .5 ❑Registered ❑Return Receipt for Merchandise � ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes. 2. Article Number i 7 a D 2;6 a`o' 0 0 01 '8 D 2''7' 2 7 9 8 I i (transfer from service/ PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 Od-fit 0 tjdli F LETTER OF TRANSMITTAL JC Engineering Inc. Civil&Environmental Services 2854 Cranberry Highway €: Telephone: 508-273-0377 E. Wareham,MA 02538 Facsimile: 508-273-0367 TO: Town of Barnstable DATE: 10/05/10 JOB NO, 1845 Board of Health RE: Proposed Septic System Upgrade REV.1 200 Main Street 41 &43 Hiramar Road Hyannis,MA 02601 Hyannis,MA WE ARE SENDING YOU: X Enclosed — Under separate cover via X the following: Report Prints Brochures Shop Drawings Specifications Copy of Letter Change Order Forms Please find enclosed the following for your review and approval: 1.)four copies of a septic system design plan dated August 9, 2010 (last revised 10-1-10). THESE ARE TRANSMITTED as checked below: rNa _o —i X For Approval Resubmit Copies for Approval C' %-it o For Your Use —Approved as Noted Copies for Distribution 1 As Requested . Returned Approved as Submitted tv Returned For Review and Comment For Your Information 3 Cn S A s REMARKS Should you have any questions,please feel free to contact our office. W (V r r s rn COPY TO: File(1), Capewide(1) SIGNED: Wc6A61 Pim nt , E.I.T. ��� n r� ���� I Excerpt from Minutes—Board of Health September 2010 meeting �-41-43 Hiramar Road, Hyannis Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to Continue to the October 12, 2010 meeting at which time the cost of the two methods will be compared- conventional septic system verus a sewer system connection (vacuum pipe). Also, the Board does not approve the series of tanks and the plan must be modified to have a multi-compartment tank. k - J BATH BATH BED KITCHEN KITCHEN BED CLOSET w W CLOSET � w O CLOSET U U CLOSET LIVING LIVING BED BED #41 #43 EXISTING DWELLING FLOOR PLAN #41 & 43 H I RAMAR ROAD, HYAN N I S, MA NOT TO SCALE J capewnue ENTERPRISES, LLC 1 J.P. MACOMBER& SON Hyannis, MA Post Office Box 763 Centerville,MA 02632 To: Barnstable Board of Health From: Capewide Enterprises, LLC Date: October 6, 2010 Cost Analysis for 41-43 Hiramar Road, Hyannis to compare prices to install a Title V septic system versus town sewer hook-up: Title V Septic System Installation Total cost..........................................$14,275.00 Connect to sewer via designing an extension-to the existing ,fir _r sewer main (see attached letter) ° Estimate to complete work......... . $62,365.00 • � 3a 3� N r �� Co Phone: 508.428.4028 N r; Fax: 508.428.3928 Rich@CapewideEnterprises.com Joao@CapewideEnterprises.coin www.CapewideEnterprises.com Town of Barnstable ° Department of Public Works uMM¢. 'g 230 South Street,Hyannis MA 02601 M'S' www.engineering@town.barnstable.ma.us s6�gti , Mark S. Ells , Director Office : 508—862 -4090 Fax : 508—862 - 4711 September 17 , 2010 Capewide Enterprises Centerville, Mass 02632 Attn : Rich Capon Subject : Sewer tie-in for 41 & 43 Hiramar Road , Hyannis Dear Sirs ; The Town Engineer and I met this morning to discuss how the property at 41 & 43 Hiramar Road could tie-in to municipal sewer. The property owner will need to design and construct an extension to the existing sewer main from the Falmouth Road intersection. All costs associated with the design and construction will be born by the property owner. The construction would include the additional sewer main, a AirVac valve pit, and a service stub for any properties that the additional length of sewer main passes. The existing sewer main is part of a vacuum-assisted gravity system that serves that area of the Town. Therefore the design will need to be designed by, and stamped, a professional engineer. The vac-assisted gravity system has been assembled so that adjacent properties can share a common valve pit. The Town would require that the sewer main be extended to service the far end of the property. This will allow a valve pit to be installed for the adjacent property. The current AirVac system constructed for the Town was designed by the local office of Stearns & Wheler. Another source of information about AirVac systems would be to contact AirVac directly. The Town Engineer may have some information available relative to the original design and constrction of the current system. I. If you have any questions; or need additional information, please call Dave Anderson at 508 — 790 - 6244. q k�Sincerely 1 a David 3 Anderson ; Construction Projects Inspector Town of Barnstable DPW - Admin & Tech Support r i Commonwealth of Massachusetts w Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any., way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, I use only the tab 1 Inspector: key to move your . - cursor-do not Ricky L. Wright key the return Name of Inspector T` y B & B Excavation, Inc. Company Name 14 Teaberry Lane Company Address Forestdale MA 02644 City/Town State Zip Code 508-477-0653 S14595 Telephone Number License Number B. Certification D 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: yr ❑ Passes ❑ Conditionally Passes ® Falls ❑ Needs Further Evaluation by the Local Approving Authority 6/18/10 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. t t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewag isposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 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): l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Li Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 41-43 Hiramar M Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *' This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t51ns•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 41-43 Hiramar M Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public.well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 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 El ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 0 °M 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 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 t 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 l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d N/A 9 ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09108 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 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system _ ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1998 Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer(locate on site plan): Depth below grade: 30"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.): At time of inspection building sewer was plugged solid with grease-advised owner's agent that this will need to be addressed Septic Tank (locate on site plan): Depth below grade: 18"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ® No Dimensions: 66"X 5"X 102" Sludge depth: 1' t5ins•09/08 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 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. Citylrown 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 26" Scum thickness 2' scum &grease Distance from top of scum to top of outlet tee or baffle scum over tee Distance from bottom of scum to bottom of outlet tee or baffle scum layer below tee How were dimensions determined? scour stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): At time of inspection septic tank appeared to be in good condition but needs to be pumped 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 um in p p g: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet Invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41-43 Hiramar 'M Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 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 2" 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.): Unable to locate d-box as drawings placed d-box under(3) large trees- inspected with camera Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 6 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At time of inspection we excavated down to leaching chambers-obvious ponding above and on the sides of the leaching chambers Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'M 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ' 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. Cltyrrown 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 i i i i 1 A g f i Al A2: 5 G 0- t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 page. Cityrrown 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: 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: inspection report on file ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 e Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 41-43 Hiramar Property Address HSBC Mortgage Services Owner Owner's Name information is required for every Hyannis MA 02601 6/18/10 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 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Town of Barnstable, MA Page 1 of 1 § 360-20 Criteria. The Board of Health may require the repair or replacement of an on-site sewage disposal system if any of the following apply: A. There is evidence of sewage flow to the surface of the ground. B. There is structural damage to the components of the system which prevent it from functioning as required. C. The bottom of the cesspool or leaching facility is less than four feet from the observed maximum groundwater elevation. D. The system was pumped more than two times in a ninety-day period (excluding maintenance pumping of grease traps). E. There.is evidence of breakout. F. There was sewage backup into the house because of a nonfunctioning leaching area. G. The edge of a leaching area is less than 100 feet from a well or less than 50 feet from a watercourse, as defined in 310 CMR 15.00: The State Environmental Code, Title 5: Minimum Requirements for the Subsurface Disposal of Sanitary Sewage. H. The standing liquid level in the leaching facility(ies) is at or above the invert pipe elevation. I. According to current local regulations, the system is not properly sized to accommodate a proposed change in use.or expansion of a building or dwelling. J. Any other condition deemed by the Board of Health to require maintenance as defined under 310 CMR 15.02 the State Environmental Code Title V, Section (19). http://www.ecode360.com/?custld=BA2043 ' 2/8/2010 TOWN OF BARNSTABLE LOCATION � ( ' ( 3 4%ir ,t Mer, SEWAGE# '70(0 q(&� VILLAGE G i ASSESSOR'S MAP&PARCEL a9A � - 1139_ INSTALLER'S OAME&PHONE NO. YU y6af-. SEPTIC TANK CAPACITY .k S©o 1t%0 LEACHING FACILITY.(type) Z o(size) NO.OF BEDROOMS �( OWNER ttJ k Q,, dr, r PERMIT DATE: 1 1-3 COMPLIANCE DATE: Zo l,, Separation Distance.Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility IVO(�Q17 feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) Ifeet Edge of Wetland and L,aching Facility(if any wetlands exist within 300 feet of leaching facility). feet FURNISHED BY ( `�-� wl of Uc v �� n c2aC W Z G G 3 S S G •K No. �,� ♦ 'I /�a /Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppricatiou for Mtopo!6ar *p6tem Cori.5tructiou Vermtt Application for a Permit to Construct( ) Repair V_ Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No."�l I Z W t-Y 3 jM11""p1L Owner's Name,Address,and Tel.No. Assessor's Map/Parcel -211 2- /'l Installer's Name,Address,and Tel.No.C4fAW,,4 �4�(/I��> Designer's Name,Address and Tel.No. J C PC 3 o X ?�r j Z 8SY � +/�-► l �ti►,,. r: \ T w Mom Type of Building: �+ Dwelling No.of Bedrooms Lot Size {�� sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ' Design Flow(min.required) 4,4o gpd Design flow provided L N*-4 gpd Plan Date 2010 Number of sheets ( Revision Date ^ O 1 ' 10 Title Size of Septic Tank 1 570 O Type of S.A.S. S"1 .�US x_ Description of Soil _Sex- �� �`G j .2-4`` Nature of Repairs or Alterations(Answer when applicable) VO et-0 I'vt . Date last inspected: 20l f. Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issuiy: y this Board o ealth. Sig Date /t ^ 3 Application Approved by Date 1119Moin Application Disapproved Date for the following reasons Permit No. ' Date Issued t y� � V t O�No. Fee ' THE'OMMONWEALTH OF MASSACHUSETTS Emered n computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye { Application for Moo!5ar *pgtem Con!Aruction Permit Application for a Permit to'Construct( ) Repair( Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components I Location Address or Lot No.C _ Owner's Name,Address,and Tel.No. ( i 2 i Assessor's Map/Parcel f J Installer's Name,Address,and Tel.No.� o N �Z. i` r)1 Designer's Name,Address and Tel.No. L Y �Le _-, h ,,�� .� l'2 Type of Building- G Dwelling No.of Bedrooms Lot Size( SRO sq. ft. Garbage Grinder Other Type of Building t N o PQ l No.of Persons Showers( ) Cafeteria( ) " Other Fixtures Design Flow(min.required) Ll"A 9 gpd Design flow provided � t-(� � gpd Plan Date e,/ , _ j�] Number of sheets ( Revision Date 1 0 t " 1 kD Title ` Size of Septic Tank ( 0 p Type of S.A.S. I Description of Soil s n( �� ( r l G� '2�{{c 1 i ps 4 _ t Nature of Re airs r.Alterations Arisv'aei4he'n"a plic bfe)�t1k:,) v r? T YLA-- 1 , Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Sign Date 7 Application Approved by / Date1. o t() f' v r t Application Disapproved by: Date\, f for the following reasons } Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE;,.MASSACHUSETTS �ertif irate of Compliance THIS IS TO CERTIFY,that.'Ibe On-site Sewage Disposal System Constructed ( ) Repaired Upgraded ( ) Abandoned( )by (L D , at ,ice >2 ( t^ has been c `nstructe Wccdance with the provisions of Title 5 and the,for'Disposal System Construction Permit No. dated Installer , „� Q ¢� (�� c p C t \C Designer #bedrooms �— �� Approved design flow gpd r. A The issuance of this ermrt shall not be construed as a guarantee that the system w 'IMI ncti�jon/a�s de igned. Date ,5 In�spector ! l" �' Ni. �' / / Y r'c fl Fee _ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC EALTH DIVISION =BARNSTABLE, MASSACHUSETTS liooml A*paem Cowaructiou termit Permission is hereby granted to Construct ( ) Repair (� ) Upgrade ( ) Abandon ( ) System located at1 L( � 1 ,�,tln„n �j and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Con tructionjutist be completed within three years of the date of this Date I �IAOI Approved by Doc: 17153s784 11-19-2010 1 :53 QARNSTABLE LAND COURT REGISTRY DECLARATION OF RESTRICTIVE COVENANT Know all men by these presents, that Household Finance Corporation 11, being the owner of certain real property located in Hyannis, Barnstable County, Commonwealth of Massachusetts, being known and designated: Description of Land The land,together with the buildings thereon, situated in Barnstable (Hyannis),County of Barnstable, in the Commonwealth of Massachusetts,further H described as follows: Lot 28 Plan 17786-C(Sheet 2)All of said boundaries are w determined by the Court to be located as shown on Subdivision Plan 17786-C (Sheet 2)dated May 1, 1954, drawn by Bearse&Kellogg, Civil Engineers, and fled in the Land Registration Office at Boston, a copy of which is filed in Barnstable County Registry of Deedss in'Land Registration Book 120, Page 43 with Certificate of Title No. 16503 and said land is shown thereon as Lot 28. Household Finance Corporation II, as the owner of said and upon the arequest of the Town of Barnstable Board of Health hereby agrees to impose a restriction as to the number of bedrooms which can be included in any home bunt the property described herein, a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental a Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitar y d m Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to z granting a disposal works construction permit for a septic system in compliance � with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing .. the issuance of a building permit for the construction of a single family home on a this property, is requiring that the agreement for the restriction on the number of a bedrooms In any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, ¢ NOW, THEREFORE, Household Finance Corporation II does hereby impose the following restriction on this above-reference land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction C shall run with the land and be binding upon all successors in title: 1. 41-43 Hiramar Rd., Hyannis, MA may have constructed upon the lot a house containing no more than four(4) bedrooms. Household Finance Corporation II agrees that this shall be a permanent deed restriction affecting the property located at 41-43 Hiramar Rd., Hyannis, MA and being shown on the plan recorded in Land Registration Book 120, Page 43 with Certificate of Title No. 16503. For Title of Household Finance Corporation II see the following deed: Land Court Certificate of Title No. 191426. WITNESS,the execution hereof under seal this day of November, 2010 Househo Finance Corporation II y: Witness: iywml Ramirez �I.Ortega � _ Secret.an; Its: Asst. Vice President AsSL Vice press STATE OF CALIFORNIA Los Angeles County November 2010 On )l--10 l y before me personally appeared —2-3 of Household Finance Corporation, 11 ,who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that helshelthey executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument .the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument I certify under PENALTY OF PERJURY under the laws of the State of California, that the foregoing paragraph is true and correct. WITNESS my hand and official seal My Commission Expires: -a y 13 Notary Public 711MI FLOAES Commission # 1832925 . ram•. Notary Public-California z z %} 4 Y &bvJ►` Los Angeles County n My Comm.Expi:es Jan 2Q,2013 BARNSTABLE REGISTRY OF DEEDS. pp THE Tp� Town of Barnstable Barnstable Board of Health "N-""'m'°'M" * BARNSTABLE, MASS. 200 Main Street,Hyannis MA 02601 039. 1� A�FD MAI A 2007 m OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. BOARD OF HEALTH MEETING MINUTES Tuesday, October 12, 2010 at 3:00 PM Town Hall, Hearing Room 367 Main Street, Hyannis, MA I. Variance— Septic (Cont.): GRANTED Michael Pimentel, JC Engineering, representing Household Finance WITH Corporation II, owner - 41 & 43 Hiramar Road, duplex, Hyannis, CONDITIONS Map/Parcel 292-012, 0.22 acre lot, several variances request, report of cost estimates in comparison to cost of sewer connection. Sewer hookup would be approximately $62,000 versus $14,000 for a septic repair of the tank itself. The owner would bear the cost of the connection which will allow three houses to hook up. The revised plan presented had a single tank. MA DEP confirmed this is allowed because the previous system was a single tank and the property is not increasing its flow rate. The Board voted to approve the revised plan dated October 17and with the following conditions: 1) pending a final staff review of the revin, 2) a four- bedroom deed restriction be recorded at the Registry of Deed ) a proper of the deed restriction is submitted to the Public Health Division. II. Variance — Septic (New): GRANTED Sarah Ojala, Down Cape Engineering, representing Janice Schade, WITH owner— 265 Fifth Avenue, Hyannis, Map/Parcel 245-037, 0.83 acre CONDITIONS parcel, requesting several variances. The Board voted to approve the plan with the following conditions: 1) four bedroom deed restriction, and 2) a proper copy of the deed restriction is submitted to the Public Health Division. III. Modification of Comprehensive Permit for Living Independently Forever, Inc — Chapter 4013: DISCUSSED Review plan to the Zoning Board for owner, Living Independently Forever, Inc. - 550 Lincoln Road Extension, Map/Parcel 272-025, existing affordable housing development "Life at Hyannis", currently 16 units. The modification seeks to permit a fifth two-story multi- Page 1 of 3 BOH 10/12/10 11/30/2010 11:29 FAX 5084283928 CAPEWIDE Q 001/001 Town of Barnstable Regulatory Services 4. Thoinas F. Geiler,Director �'} �► t Public Health Division ibti9 Thomas McKean,Director 200 Main Street, Hyannl§, MA 02601 Office 508.962-4644 F'ax; 508 Date: it "l��- Sewage PermiO _ Assessor's Map/Parcel Installer& Designer Certification 4arm. Designer: Ste_ t��e�<�'�`� , T�� Installer: Caecwicie. nF�r�riszS Address: 2V5 i Crefnbe� w ..�.. Address: ©�C74a 0 77 II � On _ C t 2 Zcxt� ..., _ e. - tom—was issued a permit to ins.uall u i�t { �ti l C(i septic System at_ c� based on a designdrawnby (�dclress)� ---- �C dated 8,9-16 itu:.2 104Y10..) designer)---- -•_ _._ . ._ ._,. I certify that the septic system referenced above was installed stlbstan.ljally according to the design, which may include minor approved changes such as lateral relocation of the distribution box arid/or septic tank. Stripout (if required) was inspected and the soH.> were found satisfactory. —, 1 certify, that the septic system referenced above was installed with major clianges greaser than 10' lateral rcicx;ation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& I.ocal Regulation:;. Plan revi51013 Or certified as-built by designer to fbi;ow, Stripout (if required) s ectec and this soi l•� were found satisfactory. fNOF _ f Q� HURCMILI ..._.� .y. ..�_ r Y JR. t leas Sign urej MI. 41E.tl 8 signer S Si na ut _ .. .. b (A ix Dc, gn 1-lCre} P AS RETURN TO E PUBLIC HEAL I ' SI N. ,It'TIFICA14" QE O PLIANC , WILL NOT BE ISSUED UDML AQT11 THIS FORM ANDAS- BUILT CARD ARE RFCEIV D BY THE B. TABLE LULIC HEAI,T I DIVISIQN. THANK.YOUA q laff'n a fomtskdOigmmettif maUun t'or,».cne To 'Cl 1-J920 £ZZ 809 DN1833NIDNaOr Wkzl Z0; .0t 0T.OZ-02-AON Town of BArnstable. P#_� y Department-of Regulatory Services i „gt•� i ' ' Public Healfh Division Date 7 v 200 Main Street.Hyannis MA 02601 EED MA'Ih t 20 i U j p Fee Pd (2 Date Scheduled =Time — Foil Suitability Assessment for Sewage isposar Performed By: C C"AOtA C cm iU'L w E r ,C��4 witnessed Br i • LOCATION&GENERAL INFORMATION ress . Owners Name Location Add r CVS e�ncld, `lun aiC'L Car •� --, I Y3 �;M tir Address 5-7�Lavwc � �`� , E�v►���✓5�, 60(2�a �Olnn;s �C E� c1neP��vt C. • Assessor's Map/P4t'cel: r��2� 0 t z Engineer's Name ` / � 68- 2�3-037'7 NBW CONMUt�`170N REPAIR y Telephone# Laud Use t e'X C25i d err♦ ( dt,a l�- Slopes(%) ' 1" 2 Surface stones , Distances from: ripen Water Body ft Possible Wee Area >10 O;ft Drinking Water Well �"l A ft prainage Way ft Property Lin 7 t ft Other 5 SKETCH:($treet name6 dimensiods'of lot.exact locations of tact holes&perc tests,locate wetlands in proxitnity to holes) i i Parent material(F010gic) aukUA"g Depth to Bedrock l26 `-- front Face '7 t 20` �jS Depth to Groundwater. Standing Water in Holey "55 Weeping Estimated Seasonal 11 jigh Groundwater 1 Z o V S D TER TION FOR SEASO"L IRGH WATER TABLE Method Used: o VeGF ObS�IrR I 7 (2 0 in, Depth Qb�mved standing;in obs.hole: 7 6 Z 0 iD. Depth to soli tn0Wes: 7in. Groundwater At�Jueltneot Depth loiweeping from side of obs.hole: , _ Adj.{Actor ' Adj.ftundwale LeVal..•,�, Index Well# - Reading Date: "' index Well level PERCOLATION TESL' Observation _ Tiale at 9" _._.,...._.• -...----- Hole# ' 2N- `.12 — . , Time at 6" �— .••—•----- . Depth of Pere _ 0 Z An 'lime(9"•6") — ----- Start Pre-soak Time 0 0" - sAn End Pre-soak LZ Rate MtnJlnchAj e5 Site Failed t Additional Testing Needed(YIN) Site Suitability Ass�sment: Site Passed OrigiaaL,Public Hel<lth Division Observation Hole Data To Be Completed on Back ***If percola ion.test is to be conducted within 100' of wetland,you mast first notify the Barnstable C ' ervation Division at least one(1)wedk prior to beginning. DEEP OBSERVATION HOLE LOG Hole# i Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling .(Structure,Stones,Boulders. onsis encL%Gravel t2-2.4 6 L S 2N- 120 G GS 2. DEEP OBSERVATION HOLE LOG Hole# 2- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. el Fill t2.;21 1 LS 15Yr L-c,l 2y-t20 G cS 2.516/6 r i DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistego. Oravell DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones.Boulders. Consistency, Flood Insurance Rate May: Above 500 year flood boundary No_ Yes Within 500 year boundary No✓ Yes Within 100 year flood boundary No '� Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist.in all areas observed throughout the area proposed for the soil absorption system? _er If not,what is the depth of naturally occurring pervious material? Certification ' I certify that on f0`Z 7"R 7 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me.consistent with they required training,expertise ano experie described in 3.10 CMR 15.017. Signature Date o-=i-nCWERC1'0RM.DOC �. COMMOMVEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 41 -43 Hiramar Road ��� Hyannis /� Owner's Name: Kris Daignault ` K5 Owner's Address: _87 Bushnell Street I MA Date of Inspection: 5 -J" O Cam' Y �j �a �5 Name of inspector:(please print) Ili 11 jam F.- Robinson Sr. - CompanyNamc: William E. Robinson Septic Service Mailing Address: P O Box 1089 cr; r- Centerville. MA Telephone Number: ( 5081 775-8776 CERTIFICATION STATEMENT I certify that 1 have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the lime 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 7toSetion 15.340 of Title 5(310 CA1R 15.000). The system: ses Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: �/�� l 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. Notes and Comments "This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. e r� Title 5 Inspection Form 6/15/2000 page 1 C i J Page 2 of I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 41 -43 Hiramar Road Hyannis Owner: Kris Daianault Dale of inspection: 5 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ` 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. if"not determined"please explain. The septic tank is metal and over 20 years old" or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exftltration or tank failure is imminent_System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. •A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or Idgh static water level in the distribution box due to broken or obstructed pipes)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstt-ctcd pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: L C S Page 3 of I 1 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 41 —4 3 Hiramar Road Hyannis Owner: Kri _ Dai gnault Date of Inspection: S'—S—_O Further Evaluation is Required by the Board or Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is fat ing 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 yssem 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 Z. S stem will fail unless the Board of Health(and Public Water Supplier,if any)determines that the syste 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 s rface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ,. — The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well'• Method used to determine distance •'This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: VYL 3 t Page 4 of I I OFFICIAL INSPECTION F0101—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 41 -43 Hiramar Road Hyannis Owner: Kris Daignault Dale of Inspection: "G D. System Failure Criteria applicable to all systems: Yo must indicate"yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ Liquid depth in cesspool is less than 6"below invert or available volume is less than Vs day flow _ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _ Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100.feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less titan 100 feet but greater than 50 feet front a private%%attr supply well with no acceptable water quality analysis. (This system passes if tine well water analysis, performed at a DEI certified laboratory,for coliform bacteria and volatile organic compounds indicates that(Ice Hell is free from pollution from (fiat facility and (lie presence of ammonia nitrogen and nitrate nitrogen is equal to or less than S ppm, provided ilia( no other failure cri,(cria are triggered.A copy of the analysis must be attached to this form.] Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: T be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 d. Y u must indicate either"yes"or"no"to each of the following: (11 a following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of,a surface drinking water supply _ the system is within 200 feet of a tributary to a stniace drinking water supply _ the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—1WPA)or a mapped Zone 11 of a public water supply well If u have answered"yes"to any question in Section E Lice system is considered a significant threat,or answered "ye "in Section D above the large system has failed.The(m-na or operator of imy large system considered a sign in threat under Section E or failed tender Section D shall upgrade the system in accordance with 310 CMR 15.3 4.The system owner should contact the appropriate regional office of the Depattment. 4 Page 5 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 41 -43 Hiramar Road Hyannis Owner: Kris Dai nault Date of Inspection: S— — p _ 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 7 Has the system received normal flows in the previous two week period? Z✓ 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) Z— 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 battles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum 7 _ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no Existing information. For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)(310 CMR 15.302(3)(b)J 5 Pagc 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 41 —43 Hiramar Road Hyannis Owner: Kris Daignau t Date of Inspection: S —,5-0 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):. Number of bedrooms(actual): L/ DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): L v Number of current residents: S' Does residence have a garbage grinder(yes or no): Alo Is laundry on a separate sewage system(yes or no):&o [if yes separate inspection required) Laundry system inspected(yes or no):di b Seasonal use:(yes or no): Iv o �¢41 • 2 0 0 5—51 7 5 0 r Water meter readings,if available(last 2 years usage(gpd)): , #4 3, 2 0 0 5—4 0, 5 00 Sump pump(yes or no): ,-i v 2 0 n---3-0, 7 5 0 2 0 0 4—5 0 , 2 5 0 Last date of occupancy: S 5-6 4, COMMERC U/INDUSTRIAL Type of estab shment: Design flow ased on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap resent(yes or no):_ Industrial aste holding tank present(yes or no):_ Non-sani waste discharged to the Title 5 system(yes or no):_ Water me er readings,if available: Last dat of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: ti Was system pumped as partdf the inspection(yes or no): If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: F7't_*ate TYPf�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/Altcmative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval —Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at"the site(yes or no): �J 6 I'agc 7 of OFFICIAL INSPECTION FOINI-NOT FOR VOLUNTARY ASSESSIIIENZ'S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORAI PAIa C SYSTEM INFORMATION(continued) Tropert)•Address: 41 —43 Hiramar Road Hyannis Owner: Kris. Daignau Date of BUILDING/gurac: (locate on site plan) Dcptl,belowMalerialsofion: castiron _40 PVC other(explaut). Distance fro[ water supply well or suction lulc: Comments(on condition ofjuu,ts,venting,cvidcncc of Icakagc, ctc): SEPTIC TANK: Y (locate on site plan) Dcpth below grade: i Material of construction:_✓concrete metal fiberglass pol)culylene _othcr(explain) _ — If tank is metal list age: Is age confinned-by a Certifrcale of Compliance Oyes or nu):_(attach a copy of certificate) Dimensions: a !✓ " JG L Sludge depth: Distance from lop of sludge to buttons of outicl Icc or battle: l $ r Scum thickness: 6")2 " Distance from top of scum to 101)of outlet Ice or baflle: 2— Distance Gorn bottom of scum 10 bouon,of utlet Ice or bailie: low sere dimensions dcicrinincd: d Comments(Oil pumping reconunendatiuns, inlet and outlet tee or bailie condition, structural intef;rity,liquid levels as related to oullct invert,cvidcncc of Icakagc,etc.): /�A 4-- iz GIIEASE T I':_(locale on site plan) Depth below adc:_ Material of a nsiruetion:_concrete metal fiberglass polyethylene _oilier ry (captain): Dimensions _ Scum Ihic css: Distance fr 111 top of scum to lop of oullct tee or ba(lle:Distance ont bottom of scum to button,of oullct tcc or ba_ilie: Datc of I sl pumping: Cortunc is(on pumping rceonuncndatiuns, inlet and outlet Icc or battle eonditi0:1, S11Uctulal 11)1cgrlty, liquid ICvcls as rclal d to oullct invert,cvidcncc of Icakagc, ctc.): 7 'age 8 of I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSUIffACE SELVAGE DISPOSAL SYSTEM INSPECTION FOR01 PART C SYSTEM INFOMIATION(continued) Property Address: 41 —43 Hiramar Road Hyannis Owner: _Kris Daignault Date of lospcclloo: S S—G C TIGHT or HOLDIN ANK:_(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of constru lion: _concrete_u►etal_fiberglass�rolyethylene other(explain): DimensioY Capacity: allons Design Fl gallons/Jay Alann pres or no): Alarm levAlann in working order ()•cs or no): Datc of laing: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:Zor resent must be opcncJ)(locatc on site plan) Depth of liquid level above outlet invert: (� Conunents(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 CHANIB It:_(locate on site plan) Pumps in wor g order(yes or no):— Alarms in wo ing order(yes or no): _ CUrttlrtents( otc condition of pump chamber,condition of pumps and ahpuitcnan(cs,ctc.). page 9ofII OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 —43 Hiramar Road Hyannis Owner: Kris Daicinault Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: ype _ caching pits,number: T _ leaching chambers,number: leaching galleries;number: leaching trenches,number, length: leaching Gelds,number,dimensions: overflow cesspool,number: irutovative/a item ative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): t v S Ta 1?o CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and c nriguration: Depth— ;find to inlet invert: Depth of sol ds layer: Depth of sc m layer: Dimensio of cesspool: Materials f construction: Indicatio of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): jDeptofsolids: (locate on site plan) of construction: s: (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): ------------------------------ Page 10 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SEWAGE DISPOSAL SYSTEM I SUBSURFACENSPECTION FORM PART C , SYSTEM INFORMATION(continued) Property Address: 41 —43 Hiramar Road Hyannis Owner: Kris Dai nault Date of Inspection: 5 s SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. sI 13 4�IL 0--lil GtJ/tt-14 f�g fi3 - l VV 10 Page I of 11 OFFICIAL INSPECTION FORM—.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 -43 Hiramar Road Hyannis Owner. Kris Daignau t Date of inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water / �l feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how round u o stablished the high you g g water elevation: / A_ J a b 11 -\ COMMONWEALTH OF NLASSACHUSETTS r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL, INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: Owner's Name: Owner's Address. Date of Inspection: A-la,4 d no Co / Name of Inspectg.-:-{ ease prin� tiM-iA9 Company Name• , ,q N y Mailing Address: [ '? �! ILIA �� z Telephone Number: CERTIFICATION STATEMENT 1 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 rq training and experience in the proper function and maintenance of on site sewage disposal syrstems. I am a DEP, approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). Th"e'system. Passes . Conditionally Passes Z rr: �[ eeds Further Evaluation by the Local Approving ,uthority ils Inspector's Signature: _��"�" Date: c 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 10,00.0 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments . 7U� � e�he ��' 'z`&aeel ****This report only describes conditions at the time of inspection,and under the conditions of use at that time. This inspection does not address how the.system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page l L Page 2.of 11 OFFICIAL.INSPECTION FO RM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: T 4—9�3 ke r 2b " . .Owner: , Date of In pection: Inspection'Summary: Check A,B,C,D'or E./ALWAYS comp lete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described-in 310 GMR 15.303 or in.i 10 CMR*15.304 exist. Any failure criteria.not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair; as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N;ND)in the for the following statements, if"not determined','please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or.tank failure.is imminent:System will pass inspection if the existing tank is replaced with a.complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation.of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain.- .The system required pumping more than'4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with.approval of the Board of Health); broken pipe(s)are replaced obstruction is removed ND explain: - Page 3 of 11 OFFICIAL INSPECTION FORM -.:NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIONFORM PART A CERTIFICATION (continued) Property Address: t_ A14 Owner• Date of pection: 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_un.less.Board-of Health determines in accordance with 310(MR 15.303(1)(b) that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any).determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of surface water supply or tributary to a surface water supply. _ The system has a septic rank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from,a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and.volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3., Other: 3 r Page 4 of 11 OFFICIAL.INSPECTION FORM—..NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: �' V0 Owner: >: Date of In ectionc (�/;, D. System Failure Criteria applicable to all systems: Y PP y You must'indicate"yes"or"no"to each of the following for all inspections: Yes No A . 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 closQed SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ Liquid depth in cesspool is less.than 6 below invert or available volume is less than /2.day flow _ Required pumping more than 4 times in.the last year NOT due to clogged or obstructed pipe(s).Number / of times pumped _ U 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. V Any portion of a cesspool or privy is less than 100 feet but greater than.50 feet.from.a private water supply well with no.acceptable water quality analysis.,[This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the,well is free from pollution from that.facilityand 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..musf be attached to this form.] \I - / J(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15303,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 10,0Kgpd to 15,000 gPd You must indicate either"yes or"no"to each of the following: (The following criteria apply to,large systems in addition to the criteria.above) yes no the system is within 400 feet of a.surface drinking water supply the system is within 200 feet.of a tributary to a surface drinking water supply _ - the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—I WPA)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. Page 5 of l 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B . CHECKL�IS�T� Property Address: Owner: 7 Date of Tn ection: Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No Pumping: m inforation was:provided by the owner,occupant, or Board of Health / i�! 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) v _ Was the facility or dwelling inspected for signs of sewage back up v 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: Yes o i ,, 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 I5.302(3)(b)] 5 Page 6 of 11. OFFICIAL INSPECTION FORM-NOT FOR1 VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART.C SYSTEM INFORMATIOl`d' Property Address: aeIMClr o i ^ Owner: u H Date of In ection: (p FLOW CONDITIONS RESIDENTIAL" Number of bedrooms(design):- Number of bedrooms(actual).: DESIGN flow based on 310.CM 15.203 (for example: 11.0 gpd x#of bedrooms): Number of current residents: Does.residence have a garbage grinder(yes or no): ; �• a - r Is laundry on a separate sewage system(y s or no)- f if yes separate inspection required] Laundry system inspected(ye .or no)f Seasonal use: (yes or no): i Water meter readings, if av alable(last 2 years usage(gpd)): ���O:t"©/ Sump pump (yes or no):/ Last date of occupancy: COMMERCIAL/INDUSTRIAL.%�/Q Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): . Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: `�%�- � Was system pumped as part of the i spectioh( es or no): If yes, volume-pumped: . gallons-=.How was quantity pumped determined?- Reason for pumping: T�YOF SYSTEM V Septic'iank, distribution box, soil absorption system _Single cesspool Overflow cesspool _Privy _Shared system (yes or no)(if yes, attach.previous inspection records, if any) _In.novative/Alternative technology.Attach a copy of the,current operation and maintenance contract(to be obtained from system owner) Tight tank Attach a copy of the DEP approval Other'(describe): pp oximate age of all c. .ponents, date installed(if know ) and so ce of inforrt�aei Were sewage odors.detected when arriving at the site(yes or no): 6 Page 7 of]'1 7. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM.INFORMATION(continued) a Property Address: Owner: �C Date of I6 pection: BUILDING SEWER(locate on site plan) u Depth below grade: Materials of construction:_cast iron 40 PVC_other(explain): Distance from.private water supply well or suction line: Comments (on condition of joints, venting, evidence of leakage, etc.): - �- SEPTIC TANK:_(locate on site plan) Depth below grade: Zoncrete Material of construction: . _metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ Is age confumed.by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 'Lp Scum thickness: I®%� r/ Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to botto outlet tee or baffle: e � How were dimensions determined: Comments(on pumping recommendations, i let and outlet tee or baffle condition,structural integrity, liquid levels a related to outlet invert evi nce of leakage, etc.): A G' GREASE TRAP/b (locate on site plan)' + . Depth below grade: Material of construction:_concrete_metal fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): L 7 Page 8 of 11 OFFICIAL.INSPECTION FORM .NOT FOR.YOLUNTARY ASSESSM ENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION(continued) l Property Address: - �/ p ©" a Owner: pt.. Date of it9pectiom.7A � �(� 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/day Alarm present(yes_ or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.):; DISTRIBUTION BOX: if resent must be opened)(locate on site plan) ( P . 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 akage into or out of box, etc.), k PUMP CHAMBER/)&(locate on site plan). Pumps in working order(yes or no): , Alarms in working order(yes or no):'' Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): 3 - Pate 9 of 11 ' OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner T Date of spection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) If SAS not located explain why: r _ Type leaching pits,number:_ aching chambers,number: leaching galleries,number: leaching,trenches,number, length: leaching fields,number, dimensions: - overflow cesspool,number: innovative/alternative system Type/name of technology: Comments (note condition of soil,,signs of hydraulic failure,level of ponding,-damp soil, condition of vegetation, etc,): D Y.. _ i i CESSPOOL (cesspool must be pumped as part of inspection)(locate on site plan) � I Number and configuration: Depth'—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: I Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): . Comments (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): i PRIVY(locate on site plan) Materials of constriction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic.failure, level of ponding, condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART-C SYSTEM INFORMATION(continued) Property Address Owner Date of I ectlon: ' SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters-the building. f LryG 10 i Page 1 l of 1 I ' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of I ection:' SITE EXAM Slope Surface water Check cellar Shallow wells Estimated.depth to ground water ,` feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of health-explain: Checked with.local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: LOX. 0 kl p �, 11 Permit-Number: Date: Completed by: v�, HIGH GROUND-WATER LEVEL COMPUTATION Site Location: l L� /�/ �'/� fzl/ Lot No. Owner: Ip Address: �i`� �l p 4e1 4Jk4/l5x i Contractor: Address: �JiG17 �r Va- STEP 1 Measure depth to water table f to nearest 1/10 ft. .......................... . .Date �J / I month/day/year STEP 2 Using Water-Level:Range Zone and;Index:Well Map locate site and determine: OAp.propriate index well................................ ..�� . OWater-level range zone ........................... . . i STEP 3. Using monthly report "Current Water Resources.Conditions" determine current`depth to i water level.for index well .......:................... month/Year i i STEP 4 Using Table of Water-level Adjustments j for index well (STEP 2A'), current depth to:Water level for iridex wela (STEP 3), and.water-level zone (STEP 2B) determine Water-level adjustment ..................... ............................................. i STEP 5. Estimate depth to high water by subtracting.the water level adjustment(STEP'4). 'from measured depth to water level'atsite:(STEP 1.) q ...... ......................... . . ... Figure 13.-Reproducible computation form. 15 i f s \J Town of Barnstable FTME 1p� ° o Regulatory Services STAB Thomas F. Geiler, Director BMW9�A 69. ••� Public Health Division lFD MA'S a Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 July 31, 2006 Mr. Kris Diagnault 87 Bushnell Street Dorchester,MA 02124-4921 SECOND NOTICE ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located 41-43 Hiramar Road, Hyannis, MA,was last - inspected on March 191h 2006 by,Robert J Bartlett, a certified septic inspector for the State of Massachusetts. The inspection of your septicsystem showed that your system had "Failed"under the •guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Septic tank pumping recommended 10" of scum and 18" of sludge at the time of inspection. You have 60 days from the date of the of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. TABLE HE TH DEPARTMENT .r Thomas A ,McKean R.S:, C.H.O. Agent of the Board of Health • ra L Town of Barnstable - Op tHE rp� P� o Regulatory Services MSTABLE Thomas F. Geiler, Director y MASS. �A i619. ,m� Public Health Division TFD A1A�A Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 23, 2006 Mr. Kris Diagnault 87 Bushnell Street Dorchester, MA 02124-4921 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located 41-43 Miramar Road, Hyannis, MA, was last inspected on March 19th 2006,by, Robert J. Bartlett, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system has "Fails" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Septic tank pumping recommended Puddling above stone at time of inspection You have 2 years from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. BARNSTABLE HEALT DEPARTMENT Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health 4 r , Town of Barnstable F THE 1p� o Regulatory Services sniuvsrnsi a Thomas F. Geiler, Director 9wp 1639. •�� Public Health Division TFD MA'S a Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 23, 2006 Mr. Kris Diagnault 87 Bushnell Street Dorchester, MA 02124-4921 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located 41-43 Miramar Road, Hyannis, MA,was last inspected on March 191h 2006,by, Robert J. Bartlett, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system has "Fails"under the guidelines of 1995 TITLE 5,(310 CMR 15.00) due to the following: Septic tank pumping recommended Puddling above stone at time of inspection You have 2 years from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. BARNSTABLE HEALT DEPARTMENT Thomas A. McKean, R.S., C.H.O. Agent of,the Board of Health I � C Town of Barnstable OF'THE 1p� o Regulatory Services sS1AB Thomas F. Geiler, Director 9$ . ••�A Public Health Division ATFO MA'S ! Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 July 31, 2006 Mr. Kris Diagnault 87 Bushnell Street Dorchester,MA 02124-4921 SECOND NOTICE ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5 The septic system owned by you located 41-43 Hiramar Road, Hyannis, MA,was last inspected on March 19' 2006 by,Robert J Bartlett, a certified septic inspector for the State of Massachusetts. The inspection of your septic system showed that your system had"Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: Septic tank pumping recommended 10" of scum and 18" of sludge at the time of inspection. You have 60 days from the date of the of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. TABLE HE TH DEPARTMENT Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health First-Class Mail UNITED STATES POSTAL SERVIC A Fees Paid USPS 0 Permit No.G_'1"0- 0 Print yournamb,`address, and ZIP Code in this box 0 Public Health Division Town of Bamstable R 0.BOX 534 IiYannlk Massachusetts 02601 SENDER: I also wish to receive the o ■Complete items 1 and/or 2 for additional services. e► ■Complete items 3,4a,and 4b. following services(for an 1 H ■Print your name and address on the reverse of this form so that we can retum this extra fee): f card to you. ., d ■Attach this form to the front of the mailpiece,oron the back if space does not 1. ❑ Addressee's Address . permit. d ■Write"Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery U) ■The Return Receipt will show to whom the article was delivered and the date r c delivered. Consult postmaster for fee. C I a 3.Article Addressed to: 4a.Article Number d 7 7 E 4b.Service Type 1 u Ir. Howard Wi nner ❑ Registered Certified ¢ .B.O.Box 434 °' I W L ❑ Express Mail ❑ Insured H IW Harwichpo-rt , M_� 02646 , I ❑ Return Receipt for Merchandise ❑ COD a7.Date of Delivery 3 Iz I p 5.Received By: (Print Name) 8..Addressee's Address(Only if requested I W and fee is paid) t 6.Signat re: ( ddressee or Agent) H I PS For"'3811, Decemberi1994 3 4 Domestic Return Receipt Z . 348 6S9 797 Receipt for y Certified Mail No Insurance Coverage Provided �.e Do not use for International Mail ISee Reverse) Sent to T �/J _ erg . „ ( u t Street VNoe, y3 y 2 P.0We a.Ind ZI C e G�� 1)r4 62 E 0 Postage ` CO) c Certified Fee _ 12 Special Delivery Fee C a fUUr`ict'e'd D'€iivgrr�Fee' !R"etti'rrn R"ec,V,'IW SFio"v IK6 to Whom&Date Delivered Return Receipt Showing to Whom, Date,and Addressee's Address TOTAL Postage ^7 ��7 &Fees G Postmark or Date RETURN R&601 UESTE UJ STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, I,f CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). kv 1�.If you want this receipt postmarked,stick the gummed stub to the right of the return address le the receipt attached and present the article at a post office service window or hand it to j K.,Y iya,r-rural carrier(no extra charge). IS2xIf you do not want this receipt postmarked,stick the gummed stub to the right of the return Cl) address of the article,date,detach and retain the receipt,and mail the article. rn C) 31 yf you want a return receipt,write the certified mail number and your name and address on a 2 fidrn receipt card,Form 3811,and attach it to the front of the article by means of the gummed 0 Of if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT UESTED adjacent to the number. C I ff you want delivery restricted to the addressee,or to an authorized agent of the addressee, �[ enrorse RESTRICTED DELIVERY on the front of the article. E L t. o 54 nter fees for the services requested in the appropriate spaces on the front of this receipt.If tL return receipt is requested,check the applicable blocks in item I of Form 3811. a 6. Saxe this receipt and.pipsp,!,-0-if you make inquiry. 105603-93•B-0218 t 1 Town of Barnstable Department of Health, Safety, and Environmental Services BAMSTABM Public Health Division �F0tA0�A P.O. Box 534, Hyannis MA 02601 Office: 508-790-6265 Thomas A McKean,RS,CHO FAX: 508-790-6304 Director of Public Health November 9, 1998 Mr.Howard Winer P.O.Box 434 Harwichport,MA 02646 NOTICE TO ABATE VIOLATIONS OF 310 CMR: 15.00 THE STATE ENVIRONMENTAL CODE TITLE V: MINIMUM REOUIREMENTS FOR THE SUBSURFACE DISPOSAL OF SANITARY SEWAGE,AND 105 CMR 410.00 STATE SANITARY CODE H-MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION. The property owned by you located at 41/43 Hiromara Rd. ,Hyannis, and listed as Parcel 012 on Assessor's Map 292 was inspected on November 6,1998 by Glen Harrington,Health Inspector for the Town of Barnstable,because of a complaint. The following violation of 310 CMR 15.00,the State Environmental Code,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage and 105 CMR 410.00 State Sanitary Code H-Minimum Standards of Fitness for Human Habitation was observed: REGULATION 310 CMR 15.02(207)AND 105 CMR 410.300: Overflowing sewage onto the ground. This violation is a serious public health hazard. 1) You are directed to hire a licensed septage hauler to pump the overflowing cesspool within twenty- four(24)hours of receipt of this letter. 2) You are also directed to keep the on-site sewage disposal system pumped as many times as necessary to keep from overflowing onto the ground. 3) You are further directed to contact and hire a licensed Disposal Works Installer within seven(7) days of receipt of this letter in order to repair this system or connect to town sewer. r You may request a hearing before the Board of Health if written petition requesting same is received within seven(7) days after the date the order is served. Non-compliance could result in a fine of up to$500.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE B ARD OF HEALTH as A. McKean Director of Public Health Town of Barnstable Q/winner.doc.-K.S. fi NOTICE TO ABATE VIOLATIONS OF 310 CMRt 15.00 THE STATE ENVIRONMENTAL CODE TITLE V: MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND 105 CMR 410.00 STATE SANITARY CODE II - MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION. The property owned by you located at listed as Parcel on Assessor's Ma , was inspected on hAftieltP , 19918, by 6 2.S ,. Health Inspector for the Town of Barnstable because, of a complaint. The following violations of 310 CUR 15.00, the State Environmental Code, Minimum Requirements for the iNbsurface Disposal of Sanitary Sewage and 105 CMR 410.00 State Sanitary Code II - Minimum Standards of Fitness for Human Habitation were observed: REGULATION 310 CMR 15.02 (207) AND 105 CMR 410.3001 Overflowing sewage onto the ground. This violation is a serious public health hazard. 1) You are directed to hire a licensed septage hauler to pump the overflowing cesspool within twenty-four (24) hours of receipt of this letter. 2) You are also directed to keep" the on-site sewage disposal system pumped as many times as necessary to keep from overflowing onto the ground. 3) You are further directed to contact and hire a licensed Disposal Works Installer within seven (7) days of receipt of this letter in order to repair the system. " You may request a hearing before the Board of Health if written petition requesting same is received within seven (7) days after the date the order is served. Non-compliance could result in a fine `of up to $500.00. Each 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 J Health Complaints 09-Nov-98 Time: 4:00:00 PM Date: 11/5/98 Complaint Number: 1618 Referred To: JEROME DUNNING Taken By: K>S. Complaint Type: TITLE V SEWAGE Article X Detail: UNSANITARY CONDITIONS Business Name: Duplex Number: 43 Street: Hiromara Rd. Village: HYANNIS Assessors Map_Parcel: Complaint Description: Back up sewage in the appartment. The landlord is Howard Warner Realty- Canton. Actions Taken/Results: GH- I spoke with occupants of 43 Hiramar Rd. and Dorothea at 41 Hiramar Rd. Occupant of #43 said cesspools were in rear of property by fence. Grass clippings were being thrown on top of breakout. Two pictures taken. Black moist soil, leaves and pooled effluent were observed. Occupant of#43 said cesspools were pumped 1 mopnth ago. I called Howard Winer, owner/landlord and told him to have someone to pump within the hour. I told Dorothea to call if noone showed up. On Monday 9 Nov 98, Rodger Roberts stated that he pumped system that Friday afternoon. Investigation Date: 11/6/98 Investigation Time: 2:40:00 PM 1 y TOWN OF BARNSTABLE LOCATION SEWAGE # / " 'T.13 2f VILLAGE � ASSESSOR'S MAP & LOT al .0 1'1 INSTALLER'S NAME&PHONE NO.H �.�!iC . �0 6 SEPTIC TANK CAPACITY r . LEACHING FACIi..TI'Y: (type)' (size) t t NO.OF BEDROOMS .__ # `< BUILDER OR OWNER_��C�a,r►tiR-/ <: .,. 1 .� _ s , PERMITDATE: /.17- `K i COMPLIANCE DATE: Separation Distance Between the: k Adjusted Groundwater Table to the Bottom Feet Maximum d us edof Leaching Facility Jg Y Private Water Supply Well and Leaching Facility".',any wells exist-" �-on site or within 200 feet of leaching facility) Feet Edge of Wetland and.Leaching Facility(If any weilanas exist within 300 feet of leaching facility) Feet Furnished by t ® O v wy qk v O . An R � � • `�=� 'r,I��"/� ,/� .,r� �ir�1���-��`'°'U `".� r° No. --73 r Y 'i�K���►"'�j� E2' ee �J THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PA Z PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pplication for ]Dig otal *pgtem Construction Verna L�tt9t1 Application for a Permit to Construc �air( )Upade'hO Abandon( ) Complete System O Individual Components \_ Location Address or Lot No. �? , r �—%Nci� e Owner's Name,Address and Tel. o. _ _ y '_ .4}� Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. . 6 Type of Building: Dwelling No.of Bedrooms _ Lot Size sq. ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( Other Fixtures Design Flow LN O gallons per day. Calculated daily flow �i � gallons. �g N Plan Date Number of sheets Revision Date Title Size of Septic Tank �� 1 Type of S.A.S. i .�il"W carves -��/✓� ��`J ' Description of Soil 's j4a� "Wr Nature of Repairs or Alter S.A tions(Answer when applicable) // 15-0 /c_�q�` � - 1 i .� i') N l�. Ir�� l�`I✓ S J%�/E-�l� ✓i�P i''t� LYr `� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to 21!acmhe system in operation until a Certifi- cate of Compliance has beenyseue�� ealth. pp�� Signed Date �� 17`?b Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS f�� BARNSTABLE, MASSACHUSETTS r�A15:-. Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded Abandoned( )by W 4 ICc- t 1 C at � i has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. q,#- 7R dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector 1"66C56"- TSw�K►4 `n� rt ��t `t�,►�, t Fee THE COMMONWEALTH OF MAISACHUSETTS Entered in computer: Yes PUBLIC'HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z . 4 ZppYicatiott for Mtgpogal *pgtem Congtruction Vertntt `� Application for a Permit to Construe Repair,(., )Up ade A)Abandon( ) [Y*GOmplete System ❑Individual Components �r - ' Lo Location Address or t No.` j r ray Owner's Name,Address d Tel. o. a,? ' rvST' w Assessor's Map/Parcel Installer's Name,Address,and Tel.No. .'Desig�%s�Name,Address and Tel.No. "'a0 ►a� l v Type of Building: Dwelling 'No.of Bedrooms Lot Size sq. ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria Other FixturesCfq / Design Flow Yq0 gallons per day. alcula[ed daily flow gallons. t.4� Plan'Date Number of sheets* ;ti A Revision Date �^ Title . Y-t bum k e of S.A.S. i Size of Septic Tank 5.tfU; r Type yp Description of Soil. Nature of Re airs or Alterationsb(Anser when applicable) lA-S%121�1 ow ,�Vy� �� 1-► � cyr iti KI It -Tye4i _S tf`Sio�vcj. Sv/�o ttf Date last inspected: , Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the_Enxironmental Code and not to place-the system in operation until,a Certifi- cate of Compliance has bS�ssn`e-Tby tfiis B d- ealth. Signed Date Application Approved by Date " Application Disapproved for the following reasons Permit No. Date Issued --------------------------------------- �,� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded Abandoned( )by fit" at V � L/3 /"c</ l / `y!, has been constructed in accordance •with the provisions of Title 5 and the for Disposal System Construction Permit No. W,5'7 r1 dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector _ ___ No. _)3c-----A c f�Yy —�� 1�---- --Feed THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lwioogal .4w tem. C rm onstruction 3permit Permission is hereby granted to Construct( e air i grade(i' )Abandon- System located at ` �� •t'�"�`". r / and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construc •on must be completed within three years of the date of this e Date: / Approved by y 10/9/97 1 a NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems OnIk. 3. CERTIFICATION OF SKETCH AND APPLICATION FOR A ' DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT , ENGINEERED PLANS) t ; E ,_hereby certify that the application for disposal works �. tj F construction permit signed by me dated �t "��'� g i ,-concernin the ML meets all of the w property located at. i i r rx following criteria: # N • There are no wetlands located within 100 feet of the proposed leaching facility l There are no private wells within-150 feet of the proposed septic system �' j':: i�• There is no increase in flow and/or,change in use proposed There are no variances requested or needed. If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the ;.. ��.�.- proposed leaching facility will 1142 be located less than fourteen(14) feet above the maximum adjusted } � groundwater table elevation. , T_. ..! . Please comple"te the fo'liowing: ra A)Top of Ground Elevation(according to the Engineering Division G.I.S.map) r B)Observed Groundwater Table Elevation(according to Health Division well map) {e'. t> 3 SIGNED LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER f 9 4 ley - •• ?. � -'[At tach n sk' '—ptan of the proposed 3ystern:Also if the licensed installer pbsesses a certified plot plan, ,th, plan should be submitted]: I, a Z - - w 07 ; .Y" ;q:AeatWkilder.art r pad r;YwUa . . �.,R p'• 4u,u - „*r-r-SN.+FH�4a1?Woae"�:.. •..x .'s,....3rwp.�. .Iwm�t -�`ra� ,\ �� ` ....� � I r �\, t � - b �, �t .> r. �` � �_ �' � ° � o � � ' .�, _ - ,r - L � -.. T � _ � ..._ - r � '-�.. 4 f 1 !„ � Z 203 IW10- 1 99 63 US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail See reverse Se to be ice,State,&ZIP Code Postage Certified Fee Special Delivery Fee Restricted Delivery Fee uO rn Return Receipt Showing to Whom&Date Delivered Q Return Receipt Showing to Whom, Q Date,&Addressee's Address 0 TOTAL Postage&Fees M Postmark or Date LL to •�' �' CL Stick postage stamps to article to cover First-Class postage,certified mall fee,and charges for any selected optional services(See front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached, and present the article at a post office service window or hand it to your rural carrier(no extra charge). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the a�i return address of the article,date,detach,and retain the receipt,and mail the article. 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by"means of the rn gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article it RETURN RECEIPT REQUESTED adjacent to the number. Q 4. If you want delivery restricted to the addressee, or to an authorized agent of the C addressee,endorse RESTRICTED DELIVERY on the front of the article. GGo ch 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make an inquiry. 102595-97-B-0145 FTHElpk, 'Town of Barnstable 0 Department of Health, Safety, and Environmental Services BABNSTABM 0 9. Public Health Division P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health August 28, 1998 Howard Winer A. Tr. P.O. Box 434 Harwichport, MA 02646 NOTICE TO ABATE VIOLATIONS OF 310 CMR: 15.00 THE STATE ENVIRONMENTAL CODE TITLE V: MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF SANITARY SEWAGE, AND 105 CMR 410.00 STATE SANITARY CODE II - MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION. The property owned by you located at 41 Hiramar Road. Hyannis, listed as Parcel 292 on Assessor's Map 012 was inspected on August 26, 1998 by Jerome Dunning, Health Inspector for the Town of Barnstable, because of a complaint. The following violation of 310 CMR 15.00, the State Environmental Code, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage and 105 CMR 410.00 State Sanitary Code Il-Minimum Standards of Fitness for Human Habitation was observed: REGULATION 310 CMR 15.02 (207)AND 105 CMR 410.300: Overflowing sewage onto the ground. This violation is a serious public health hazard. 1) You are directed to hire a licensed septage hauler to pump the overflowing cesspool within twenty-four(24) hours of receipt of this letter. 2) You are also directed to keep the on-site sewage disposal system pumped as many times as necessary to keep from overflowing onto the ground. 3) You are further directed to contact and hire a licensed Disposal Works Installer within seven (7) days of receipt of this letter in order to repair this system or connect to town sewer. You may request a hearing before the Board of Health if written petition requesting same is received within seven (7) days after the date the order is served. Non-compliance could result in a fine of up to $500.00. Each day's failure to comply with an order shall constitute a separate violation. O TH BOARD OF HEALTH 47asA. McKean Director of Public Health r Po y3L NOTICE TO ABATE VIOLATIONS OF 310 CMR: 15.00 THE STATE ENVIRONMENTAL CODE TITLE V• MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND 105 CMR 410.00 4STATE SANITARY CODE II - MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION. The property owned by you located at !d ( listed as Parcel *,),.9& on Assessor's Map oij , was ".inspected on }� g,., 1998'1 by �^ ( `13� , Health Inspector for the Town of Barnstable because of a complaint. The following violations of 310 CMR 15.00, the State Environmental Code, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage and 105 CMR 410.00 State Sanitary Code II - Minimum Standards of Fitness for Human Habitation were observed: REGULATION 310 CMR 15.02 (207) AND 105 CMR 410.300: Overflowing sewage onto the ground. This violation is a serious public health hazard. 1) You are directed to hire a licensed septage hauler to pump the overflowing cesspool within twenty-four (24) hours of receipt of this letter. 2) You , are also directed to keep the on-site - sewage disposal system pumped as many times as necessary to keep from overflowing onto the ground. 3) You are further directed to contact and hire a licensed Disposal Works Installer within seven (7) days of receipt of this letter in order to repair the system. You may request a hearing before the Board of Health if written petition requesting same is received within seven (7) days after the date the order is served. Non-compliance could result in a fine of up to $500.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE HOARD OF HEALTH Thomas A. McKean Director of Public Health TOP OF FOUNDATION = 43.9'± NOTE: PROVIDE EXTENSION RISER FINISH GRADE OVER D-BOX= 41 .2'± 4"SCHEDULE 40 PVC MIN. SLOPE 1 % PROPOSED PVC VENT //�� R F.G. OVER BIODIFFUSERS= L�1 ,Q - L�2,161 G E N E Rf"1L 1 V OT E S �- SEPTIC TANK SHALL BE WITH COVER OVER INLET, SLOPE @ 2% MIN. 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WATERPROOF AND WATERTIGHT. OUTLET&COMPARTMENT INSPECTION PORT WITH METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISHED GRADE , WALL TO WITHIN 6"OF F.G. ACCESS BOX TO WITHIN f- @ FOUNDATION = 42.5''} F.G. OVER TANK EL.= 42.0 ± max REMOVABLE WATER-TIGHT COVER OVER 3"OF F.G. (ONE PER ROW) CODE AND ANY APPLICABLE LOCAL RULES. RISER TO WITHIN 6"OF FINISHED GRADE . _ _ .__. _ __ -_ _ _ _ 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE PROP. 4" 20"MIN. ACCESS COVER - --- -------- SCH.40 PVC (TYPICAL FOR 3) 9"MIN. I DESIGN ENGINEER. 36"MAX. 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL EXIS1 -� 36"MAX. SE5 1" MAX. TOP OF SAS/B.O. = 37.91' SYSTEM UNLESS OTHERWISE NOTED. PIPE PROPOSED 4" 5"DIA. OUTLET(S) 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN " " 2" DROP MIN. " SCHEDULE 40 PVC MIN.SLOPE @ 1% 6 -3-3 DROP MAX. 3 9 3" 9" PROVIDE WATERTIGHT FELEVATION = 37.91 FOR A DISTANCE OF 15 AROUND THE PERIMETER OF THE SAS. UNLESS A a•scrl.ao MIN.SLOPEQ0.50% L=76'± JOINTS(TYP.) 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF ------------ -- - -------- � 4"PVC IN FROM � 1.33' " THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 14" 14" _73$.75' SEPTIC TANK 4" PVC OUT TO 39.1 ± 0.90, (TYP.) 10.75"(T�'P) 16 LEACHING FACILITY I 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. I j 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 38.92' LIQUID LEVEL OUTLET TEE 37.77' MIN. 6" 37.60' 37.48' 36.58' (laid flat) 2.875'(34.5")--I 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK COMPARTMENT (TYP.) FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS WALL 6" CRUSHED STONE . NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH GAS BAFFLE OVER MECHANICALLY (TYP.) 5'MIN. 48 HRS DETENTION) (24 HRS DETENTION 14.375' AND DESIGN ENGINEER. ( ) COMPACTED BASE REQ'D 12.4'TO FND. 2/3 1/3 25.0' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 42.00'ESTABLISHED 6"CRUSHED STONE 5 OUTLET DISTRIBUTION BOX (TYP.) ON TOP OF A HYDRANT BONNET BOLT AS SHOWN ON PLAN. OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= < 31 .50' * BIODIFFUSERS (END VIEW) 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION tqgrm COMPACTED BASE BASE. FIRST TWO FEET OF OUTLET THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT PROPOSED 1500 GALLON TWO 2 COMPARTMENT SEPTIC TANK PIPES TO BE LAID LEVEL. 25 - BIODIFFUSERS (PROFILE) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES LENGTH 10'-6" WIDTH 5'-81' DEPTH 5'-8" DIMENSIONS PER CROSS SECTION VIEW ( ) (BY ADVANCED DRAINAGE SYSTEMS, INC.) * EL. 27.0'± PER BARNSTABLE 1992 GOUNDWATER CONTOURS MAP TO THE DESIGN ENGINEER. `CONTRACTOR TO VERIFY EXISTING WIGGIN PRECAST CORP. p �-+ L } �j ELEVATIONS PRIOR TO ANY WORK F. SEPTIC TANK PROFILE POCASSET,MA D I S T R I B U T I O N BOX DETAIL 25 ARC 36HC ( 361 6 B D 1 H-20 BIODIFFUSERS 10 ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOT TO SCALE 508-564-677s NO' '..,r ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING -� _____ ____ - _,____ _. _____._ I ___ _____ -_. _ T -DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM • EST P APPROPRIATE AUTHORITY. NOTES: �o _ 1f - l PERC NO. 12994 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS /�0'. • • J ' - I INSPECTOR: David W. Stanton, R.S. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP - i THEY SHALL_WITHSTAND H-20 LOADING. EDGE OF EACH SEPTIC SYSTEM COMPONENT. Benchmark o 32") EVALUATOR: Michael Pimentel, E.I.T. Hydrant Bonnet Bolt U.P.77 C.S.E.APPROVAL DATE: Oct. 27, 1999 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. Elev. =42.00' ` O 4 DATE: July 20, 2010 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION � � Approx. M.S.L. � 0 � ! TEST PIT#: 1 MATERIAL 1N AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. OF THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY 4 , •` ,� REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, WITH TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER c� 1 1 $ a� ! • ELEV TOP= 41.50' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH O n • ELEV WATER= <31.50' TEST PIT DATA. 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN / ZONE 2 SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. PERC RATE _ <2 min./inch CM 16. PROPOSED PROJECT IS LOCATED WITHIN: ,Z. PROPOSED DISTRIBTION BOX U DEPTH OF PERC= 24"-42" ASSESSOR'S MAP 292 PARCEL 12 1 CO ,XX 1 TEXTURAL CLASS: 1 OWNER OF RECORD: HOUSEHOLD FINANCE CORPORATION II PROP. PVC VENT PIPE; EXACT LOCATION PER OWNER �X p • ADDRESS: 577 LAMONT ROAD MAP 292 rX'y` I Z PARCEL 13 - 41 Q LOCUS I " ELMHURST, IL 60126 o_ ! 0 41.50 11 0rL• J FEMA FLOOD ZONE C ON TOWN SEWER NGE X�X41 a ,• Fill ( ) �FEj�-X X cj • • I 12" 40.50' COMMUNITY PANEL# 250001 0005 C p� 3 _j • �! Loamy Sand SHRUB \ n O • '� I B 10Yr 5/8 17. DEED REFERENCE: LAND COURT CERTIFICATE 191426 1 v I (10-20%gravel) °45'27"W OI -� ` 1 �� 24" 39.50' 18. PLAN REFERENCE: LAND COURT PLAN NO. 17786-C S7 �0 p0' 10.0 s Perc _ PROPOSED TOTAL 25 ARC 36HC (#3616BD) H-20 BIODIFFUSERS IN A FIELD CONFIGURATION 42" 38.00' 19' ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. SHRUB Q� £ 20. THIS PLAN IS TO BE USED ONLY FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT PROPOSED 1500 GALLON TWO / - 42� \ I ASSUME ANY LIABILITY FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. COMPARTMENT H-10 SEPTIC TANK �K f g�1 WA 1 I PROPOSED INSPECTION PORT WITH C Coarse Sand 21. IN ACCORDANCE WITH 310 CMR 15.401 -15.405, THE FOLLOWING LOCAL UPGRADE \ ` ACCESS BOX TO GRADE (TYP OF 5) r" 2.5Y 6/6 APPROVALS ARE REQUESTED FROM 310 CMR 15.221 (7)FOR ITEM 1; 310 CMR 15.211 FOR \ a d I o ITEMS 2&3;AND 310 CMR 15.223(1)FOR ITEM 4: oil c #43 0 ' N £ ' (loose) (1.) A 1.25'WAIVER(3.0'-4.25') FOR THE MAXIMUM COVER OVER THE LEACHING FACILITY. EXISTING ° , I (2.) A 10.0-WAIVER(10.0--0.0') FOR THE SETBACK FROM THE FRONT PROPERTY LINE TO THE 2-BEDROOM SHRUB t j " LEACHING FACILITY. MAP 292 DWELLING y 1� \ PARCEL 12 / � TOF - 43.9'± � � 1 (3.) A 4.0'WAIVER(10.0'-6.0') FOR THE SETBACK FROM THE SIDE PROPERTY LINE TO THE 1� LEACHING FACILITY. (ON SLAB) 14LOCUS PLAN 9,584 S.F.± 124� o e 22. THE FOLLOWING LOCAL VARIANCE IS REQUESTED FROM ARTICLE 1,SECTION 360-1: 170 / 0 24"TREE v w �. SCALE: 1"= 1000' 1.)A 33.7'(100-66.3')VARIANCE FOR THE SETBACK FROM THE PROPOSED SEPTIC TANK TO N\ 120" 31.50' THE WETLANDS. u3� `� 5 w-w-- No Mottling, Standing or Weeping Observed - ` £ � TEST PIT DATA �� � _ 1 .. DESIGN DATA LEGEND Z � \ GAS O, , , PERC NO. 12994 �•�'O� \ GPIs � NUMBER OF BEDROOMS (DESIGN) 4 (i.e.2 UNITS @ 2 BEDS EACH =4) INSPECTOR: David W.Stanton, R.S. \�> \ 97,0 g�T W P�K , DESIGN FLOW 110 GAUDAY/BEDROOM i EVALUATOR. Michael Pimentel, E.I.T. 50x0 EXISTING SPOT GRADE \ I o �' 011, `z j 42 EXIST. 5 INFILTRATORS(SIZE TOTAL DESIGN FLOW 440 GAUDAY C.S.E.APPROVAL DATE: Oct. 27, 1999 _ _ _ _ _ _ \ \\ C/O o #41 S ; UNKNOWN)TO BE ABANDONED DESIGN FLOW X 200 % = 880 GAUDAY 50 EXISTING CONTOUR \ \\ \ EXISTING CP �T j 1 DATE: July 20, 2010 2-BEDROOM o 0 50 PROPOSED CONTOUR o TEST PIT#: 2 DWELLING 1 m \ \ TOF =43.9'± M SEPTIC TANK ELEV TOP= 41.50' ❑/H/W EXISTING OVERHEAD UTILITIES \ \ (ON SLAB) LANDSCAPE , A G 1500 ELEV WATER= <31.50' I USE PROPOSED GALLON 2-COMPARTMENT TANK W W- EXISTING WATER LINE �061 \ \ \ 0 1 2 COMPARTMENT 1: PERC RATE _ DESIGN FLOW x 200% (i.e.48 hrs detention) = 880 GAUDAY GAS EXISTING GAS LINE \ O ' 1 \ DESIGN CAPACITY = 2/3 x 1500 GAL = 1000 GAUDAY DEPTH OF PERC = - - TEXTURAL CLASS: 1 � TEST PIT LOCATION \ \ �►�. 4 yN� I COMPARTMENT 2: DESIGN FLOW x 100%(i.e. 24 hrs detention) = 440 GAUDAY _- Q m Q PROPOSED 1,500 GAL. 2-COMPARTMENT SEPTIC TANK N n DESIGN CAPACITY = 1/3 x 1500 GAL = 500 GAUDAY Go 0 00 !mXISTfNG 1,500 GALLON SEPTi `m N t,, / p 0" 41.50' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE 4 o TANK TO BE ABANDONED (i.e. \ \ ¢ Fill rn I PUMPED, BOTTOM OPENED/ ��� / `�� INSTALL 25 ARC 36HC (#3616BD) BIODIFFUSERS (H-20) 12" 40.50' PROPOSED DISTRIBUTION BOX RUPTURED AND FILLED w/CLEAN / \ N\ \ ,.E pyK �,, 1 SAND)PER 310 CMR 15.354-' \ \ s 12°29�� B�� I B Loamy 10Yr 5/8 Sand O \ \ 10 N- 331. / SYSTEM CAPACITY (10-20%gravel) 0 PROPOSED ARC 36HC (#3616BD)BIODIFFUSER(H-20) 6 \ kS (TOTAL L.F. OF BIO'S&COUPLINGS)(4.8 SF/LF)(0.74 GPD/SQ.FT.)=GPD 24" 39.50' \ 0`b (125 o EXIST. DISTRIBUTION , �p�M1 \ BOX TO BE ABANDONED )(4.8 SF/LF)(0.74 GAUSQ.FT.)= 444.0 GAL. LEACHING/DAY 1 10-01-10 MCP JLC Added 2-comp.tank; redesign sas 4 REV. DATE BY APP'D. SCRIPTION S TOTALS: DEPROPOSED SEPTIC SYSTEM UPGRADE \ TOTAL NUMBER OF BIODIFFUSERS: 25 !►TOTAL NUMBER OF COUPLINGS: 0 C Coarse Sand "> ' J,I`"S`tic PREPARED FOR: �00 _'" N TOTAL LEACHING AREA: 600.0 2.5Y 6/6 CAPEWIDE ENTERPRISES �� .�� HC 3 �, TOTAL LEACHING CAPACITY: 444.0 (loose) JOHN L. �`� CHUR HILL SJR- K ISOLATED �i� \ \ \ P� Hc_ #43 - aao WETLAND G�/- \ \� ` �° PARCEL 138 c N „� \ h EXISTING '� T ,- LOCATED AT '(jso�° DWELLING 5) NOTE: 41 & 43 HIRAMAR ROAD ' SWING-TIES SCALE: 1"=20 � 2) TOF = 43.9'± (6 EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE HYANNIS, MA 02601 DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER HG1 HC-2 HC-3 HC-4 �,' - _ -- DESCRIPTION E3 1) "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO SCALE: 1 INCH - 10 FT. DATE: AUGUST 9, 2010 ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003(LAST 120" 31.50' 0 5 �0 20 ao FEET SEPTIC COVER IN (1) 36.8' 30.9' -- - MODIFIED JUNE 3, 2010 . TRANSMITTAL NUMBER=W000052. �� No Mottling, Standing or Weeping Observed _----- _--�._-�_------------... � PREPARED BY: SEPTIC COVER OUT(2) 44.3' 24.3' - -- � -_ _ - __ _ -____. I _ _..�__-- z� '�� EXISTING BIODIFFUSER CORNER(3) -- - 10.8' 65.3' 2-BEDROOM RESERVED FOR BOARD OF HEALTH USE ° JOHN L JC ENGINEERING, INC. DWELLING CHURCH LL JR. I BIODIFFUSER CORNER(4) -- -- 24.T 69.0' TOF = 43.9'± N C 807 2854 CRANBERRY HIGHWAY HC-4 ���, - EAST WAREHAM, MA 02538 s 508.273.0377 S ��� BIODIFFUSER CORNER(5) -- -- 32.1' 46.5' �'T _ - SCALE: 1"= 10' BIODIFFUSER CORNER(6) -- -- 23.2' 40.8' Drawn By: MCP Designed By:MCP I Checked By:JLC JOB No.1845 TOP OF FOUNDATION = 43.9'± NOTE: PROVIDE EXTENSION RISER FINISH GRADE OVER D-BOX= 41 .2'± 4"SCHEDULE 40 PkC MIN. SLOPE 1 % PROPOSED PVC VENT F.G. OVER BIODIFFUSERS= 41 .0' - 42,16' SEPTIC TANK SHALL BE WITH COVER OVER INLET, SLOPE @ 2% MIN. 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WATERPROOF AND WATERTIGHT. OUTLET&COMPARTMENT INSPECTION PORT WITH METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISHED GRADE WALL TO WITHIN 6"OF F.G. ACCESS BOX TO WITHIN CODE AND ANY APPLICABLE LOCAL RULES. f_ @FOUNDATION = 42.5'± F.G. OVER TANK EL.= 42.0 ± max REMOVABLE WATER-TIGHT COVER OVER 3"OF F.G. (ONE PER ROW) 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE RISER TO WITHIN 6"OF FINISHED GRADE __.__-.._ __._____._._. 1 DESIGN ENGINEER. PROP. 4" 20" MIN. ACCESS COVER 9"MIN. } li SCH.40 PVC (TYPICAL FOR 3) 36"MAX° I 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL -i-- 36"MAX. SEE 51''MAX. TOP OF SAS/B.O. = 37.91' SYSTEM UNLESS OTHERWISE NOTED. PROPOSED 4" 5"DIA. OUTLET(S) 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 2" DROP MIN. SCHEDULE 40 PVC PROVIDE WATERTIGHT ELEVATION = 37.91' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A MIN.SLOPE 1% 6" 3" 3" DROP MAX. 3" 9" 3" 9" _ 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 4'SCH.40 MIN.SLOPE @ OS09G L=76'± JOINTS (TYP.) - - -------- 1.33' THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 0 4" PVC IN FROM 16" 14" 14" 3$.75' SEPTIC TANK O 4" PVC OUT TO i 0�, (TYP.) 10.75"(NP) l 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. LEACHING FACILITY + 1 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 38.92' LIQUID LEVEL c 1 12" 6" , 37.48' 3f .58' laid flat) 2.875'(34.5")_- 7• LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK �tA, COMPARTMENT OUTLET TEE 37.77 MIN. 37.60 5.0 ��°�' WALL 6" CRUSHEDSTONE � (TYP.) FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH GAS BAFFLE OVER MECHANICALLY (TYP.) 5 MIN. 14.375 REQ'D AND DESIGN ENGINEER. (48 HRS DETENTION) (24 HRS DETENTION) COMPACTED BASE 25 0' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 42.00' ESTABLISHED 12.4'TO FND. 2/3 1/3 6" CRUSHED STONE 5 OUTLET DISTRIBUTION BOX (TYP.) ON TOP OF A HYDRANT BONNET BOLT AS SHOWN ON PLAN. OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= < 31 .50' * BIODIFFUSERS (END VIEW) 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION COMPACTED BASE BASE. FIRST TWO FEET OF OUTLET THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT PROPOSED 1500 GALLON TWO (2) COMPARTMENT SEPTIC TANK PIPES TO BE LAID LEVEL. 25 - BIODIFFUSERS (PROFILE) 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES * EL. 27.0't PER BARNSTABLE 1992 GOUNDWATER CONTOURS MAP CROSS SECTION VIEW (BY ADVANCED DRAINAGE SYSTEMS, INC.) TO THE DESIGN ENGINEER. LENGTH 10'-6" WIDTH 5'-8" DEPTH 5'-8" DIMENSIONS PER WIGGIN PRECAST CORP. �'" G, r "` '-r- '�' •-' - � "> _ �' - " '� - --- � �-' 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. POCASSPR MA 2� - 1•J .� i 1 1 K3, NOT TO SCALE Ii-2-0 b I U U I Ir I' Lj.`J' Iv I-0,,°.) t POCA 4 6776 NOT TO SCALE CALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING NOT TO SCALE _ __ _1._________ __.__._______ _______._________ REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM - APPROPRIATE AUTHORITY. PERC NO. 12994 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS NOTES: Y - • y • INSPECTOR: David W.Stanton, R.S. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP I o 2 EVALUATOR: Michael Pimentel, E.I.T. THEY SHALL WITHSTAND H-20 LOADING. EDGE OF EACH SEPTIC SYSTEM COMPONENT. Benchmark C.S.E. APPROVAL DATE: Oct. 27, 1999 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. Hydrant Bonnet Bolt U.P.#40/7 i O � ` DATE: July 20, 2010 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE Elev. =42.00' i MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION Approx. M.S.L. 1 Q 0 � TEST PIT#: 1 OF THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, 1 WITH TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER IL 0 „ ELEV WATER <31.50' 41.50' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). ' ELEV TOP= AND LOCAL BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH O� I • 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN I � = TEST PIT DATA. ZONE 2� SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. PERC RATE _ <2 min./inch / o 16. PROPOSED PROJECT IS LOCATED WITHIN: x PROPOSED DISTRIBTION BOX U DEPTH OF PERC = 24"-42" ASSESSOR'S MAP 292 PARCEL 12 X • © TEXTURAL CLASS: 1 OWNER OF RECORD: HOUSEHOLD FINANCE CORPORATION II PROP. PVC VENT PIPE; EXACT ,X 1 •- ;,�- I � ADDRESS: 577 LAMONT ROAD LOCATION PER OWNER .X X" 1 O ,X Z I ELMHURST, IL 60126 MAP 292 41 0 g LOCUS 0" 41.50' FEMA FLOOD ZONE C PARCEL 13 Fill (ON TOWN SEWER) FEN�X X-X` X�4� o m � u . •� 12" Loam Sand 40.50' COMMUNITY PANEL# 250001 0005 C O J ' B 10Yr 5/8 17. DEED REFERENCE: LAND COURT CERTIFICATE 191426 (10-20%gravel) 21 24" _d 39.50' 18. PLAN REFERENCE: LAND COURT PLAN NO. 17786-C 045' Perc 7 _ S7 TO.00 / 10 0' 1 PROPOSED TOTAL 25 ARC 36HC (#36166D) H-20 • 42" 38.00' 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. BIODIFFUSERS IN A FIELD CONFIGURATION 20 ASSUME ANY LIABILITY FOR SEPTIC SYSTEM UPGRADE. JC OTHER THAN ITS INTENDED ENGINEERING WILL NOT PROPOSED 1500 GALLON TWO A2� ) '� � r COMPARTMENT H-10 SEPTIC TANKS �� gt�'WP`K 1 I PROPOSED INSPECTION PORT WI-'H C Coarse Sand 21. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE ACCESS Box TO GRADE (TYP OF F� .. _ ... � �G' 2.5Y 6/6 APPROVALS ARE REQUESTED FROM 310 CMR 15.221 (7) FOR ITEM 1; 310 CMR 15.211 FOR � - �, ' 4 ITEMS 2 &3; AND 310 CFAR 15.223(1) FOR ITEM 4: / 3 A° (loose) (1.) A 1.25'WAIVER (3.0'-4.25') FOR THE MAXIMUM COVER OVER THE LEACHING FACILITY. (2.) A 10.0'WAIVER(10.0' 0.0') FOR THE SETBACK FROM THE FRONT PROPERTY LINE TO THE 5 A��9 ate/ 2 BEISTING DROOM ' 1 LEACHING FACILITY. 2 (10.0' -6.0') FOR THE SETBACK FROM THE SIDE PROPERTY LINE TO THE MAP 29 DWELLING LEACHINGAGILITY PARCEL 12 / TOF = 43.9'± 1 1 � LOCUS PLAN �\ 22. THE FOLLOWING LOCAL VARIANCE IS REQUESTED FROM ARTICLE 1, SECTION 360-1: 4'0,584 S F + / (ON SLAB) o 1 12U" 31.�U' fI IL WETLANDS. - 1. A 33.7' (100-66.3')VARIANCE FOR THE SETBACK FROM THE PROPOSED SEPTIC TANK TO 2. o \ �O SCALE: 1" = 1000' - \ \ \ Q _ �v Thu v�� No Mottling, Standing or Weeping Observed \� /p0 z e, PERC NO. 12994 \�`,L \ O /-L� Now \ NUMBER OF BEDROOMS (DESIGN) 4 (i.e. 2 UNITS @ 2 BEDS EACH =4) INSPECTOR: David W. Stanton, R.S. W LK DESIGN FLOW 110 GAUDAY/BEDROOM EVALUATOR: Michael Pimentel, E.I.T. 50x0 EXISTING SPOT GRADE \�'j A4 , TOTAL DESIGN FLOW 440 GAUDAY • Oct. 27, 1999 C.S.E. APPROVAL DATE._ - - - 50 - - - EXISTING CONTOUR \ \ \ \ 1 C/O _ #41 S� DESIGN FLOW X 200 % = 880 GAUDAY EXISTING I m DATE: July 20, 2010 50 PROPOSED CONTOUR \ 2 BEDROOM `� TEST PIT#: 2 DWELLING R` ------ EXISTING OVERHEAD UTILITIES SEPTIC TANK ELEV TOP= 41.50' \ \ \ TOF = 43.9'± - \ (ON SLAB) p L I 1500 ELEV WATER- <31.50' USE PROPOSED GALLON 2-COMPARTMENT TANK - - - . ------ ,,- --- EXISTING WATER LINE COMPARTMENT 1: PERC RATE DESIGN FLOW x 200% (i.e.48 hrs detention) = 880 GAUDAY GAS EXISTING GAS LINE DESIGN CAPACITY = 2/3 x 1500 GAL = 1000 GAUDAY DEPTH OF PERC = \ \ •tJ� \ I TEXTURAL CLASS: 1 � TEST PIT LOCATION \ \ 1 \� \ �`� \r� V I \ COMPARTMENT 2: ° _ _ PROPOSED 1 500 GAL. 2-COMPARTMENT SEPTIC TANK DESIGN FLOW x 100 /° (i.e. 24 hrs detention) 440 GAUDAY O m O . \ \ U) DESIGN CAPACITY = 1/3 x 1500 GAL = 500 GAUDAY ,3j 0" 41.50' PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE \ OD Fill 31 m " P�K, / INSTALL 25 ARC 36HC (#3616BD) BIODIFFUSERS (H-20) 12" Loamy sand 40.50 PROPOSED DISTRIBUTION BOX \ \ \ E �N eCn r B 10Yr 5/8 \ 1 \ \ N�20293 p 6� I SYSTEM CAPACITY (10-20% gravel) 39.50' 0 PROPOSED ARC 36HC (#3616BD) BIODIFFUSER (H-20) � \ \ \ \ \ o �� �633A (TOTAL L.F. OF BIO'S&COUPLINGS)(4.8 SF/LF)(0.74 GPD/SQ.FT.)=GPD 24" \ \ \ \ \ I� �,o \ (125')(4.8 SF/LF)(0.74 GAUSQ.FT.)= 444.0 GAL. LEACHING/DAY 1 10-01-10 MCP JLC Added 2-comp. tank; redesign sas REV. DATE BY APP'D. DESCRIPTION TOTALS: PROPOSED SEPTIC SYSTEM UPGRADE so Gyp TOTAL NUMBER OF BIODIFFUSERS: 25 ��►I<1.A1 TOTAL NUMBER OF COUPLINGS: 0 C Coarse Sand \�� PREPARED FOR: �0 \ \ \�ti TOTAL LEACHING AREA: 600.0 2.5Y 6/6 `Ly \ \ \�s \ O0 HC-3 TOTAL LEACHING CAPACITY: 444.0 (loose) JOHN L.j ' Y CAPEWIDE ENTERPRISES MAP 292 ` o Z CHu CHILL JR. ISOLATED �i� �� �� s� HC- #43 , , 4bU66 PARCEL 138 EXISTING '1 T LOCATED AT WETLAND ��-� \ 00 , oo`'�0 2-BEDROON ��`' " DWELLING 5 NOTE: ., 41 & 43 H I RAMAR ROAD \ SWING-TIES SCALE: 1" =20' 2) TOF =43.9'± (6 EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE HYANNIS, MA 02601 DEPARTMENT OF ENVIRONMENTAL PR OTECTION APPROV AL LETTER DESCRIPTION HC-1 HC-2 HC-3 HC-4 4a 1) "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO SCALE: 1 INCH = 10 FT. DATE: AUGUST 9, 2010 ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3, 2003 (LAST 120" 31.50' 0 5 10 20 40 FEET SEPTIC COVER IN (1) 36.8' 30.9' - -- MODIFIED JUNE 3, 2010). TRANSMITTAL NUMBER=W000052. ys ' No Mottling, Standing or Weeping Observed SEPTIC COVER OUT(2) 44.3' 24.3' -- - #41 :4 PREPARED BY: EXlSiING RESERVED FOR BOARD OF HEALTH USE / . JR N I jR JC ENGINEERING, INC. BIODIFFUSER CORNER(3) - - 10.8' 65.3' DWEL INGOOM �( , r Fiu cl L , ,:. 4 _ __ 24.r s9.o' TOF - 13.9'± r,o 41 2854 CRANBERRY HIGHWAY BIODIFFUSER CORNER O Hc-4 =�., EAST WAREHAM, MA 02538 BIODIFFUSER CORNER(5) - - 32.1' 46.5' HC-1 508.273.0377 SITE PLAN BIODIFFUSER CORNER(6) - - 23.2' 40.8' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No. 1845 SCALE: 1"= 10'