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HomeMy WebLinkAbout0116 IYANNOUGH ROAD/RTE 28 - Health yto g16 Iann6u h Road Hyannis`, - j A =328 144 J s! I x I i i u • Town a�Barnstable: / 3 �� �. ' P ' Department of Regulatory—services Pu;Wc Health Division, Date i6Jy:- 200 Mam Street Hyannis'MA 02601 Date Scheduled / Time,. Fee Pd d� Soil-Suitability Assessment for �` Disposal G -C. .. Performed By •: Witnessed By: C // LOCATION& GENERAL)<NFORMATIQN. Loeadon Address 116 Owner's Name iA tNi-e(• Adds sa I� Assessor's Mapftrcel: G''( � Engineer's Name ja4.eC NEW CTION RBPAIR Tel hone# �G .7 y? CONS RU Land Use, C t�L , Slopes Surface Stones Distances:from: Open Water Body Z c�ft Possible Wet Area. 16� ft Drinking WaterWell Lre ft� Drainage Way ft .Property Line ft .Other` ft SKETCH:(street name,dimensions of lot,exact locations of testholes a perc tests;locate wetlands fn proximity toUles) rLd 6 -(geologic) _C_ V4-c)J C A Depth to Bedrock (,Parent material 1 is ,, r Depth t6 Groundwater. Standing Water in Hole: � Weeping ftm Pit Face�! -A= Esdmated Seasonal High Groundwater l 2 �--- DETERNIINATION FOR SEASONAL HIGH WATER TABLE Depth Observed standing in obs.hole: In, Depth to soil mottles: Depth to weeping from side of obs.hole: In, groundwater AdJustmen.t $. Index.Well:# Reading Date: Index Well level,, Adj.ihetoi Ac 1(3roufldwCteC'1evc1,.,,� PERCOLATION TEST Date Time. Observation Hole# Time at 9" .Start Pre-soak Time® ,�• �✓` Time(9";6') End Pre-soak Rate Wallach C Z ' Site Suitability Assessment: Site Passed_ �_ Site Failed: Additional Testing Needed(YM) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be.conducted within 100' of wetland,you must first'notify the. Barnstable Conservation Division at least one (1) week prior to beginning. Q:ISEPTICU'ERCFORM.DOC DEEP.OBSERVATIONHQLE IOG Hoye# Depth from Soil Horizon Soil Texture Soil=Color Soil Older Surface(in.) _. (USDA),;. •, (Mansell) Mottling 'Y(Structure,Stones;Boulders: ' .4-. a,V• (LS/. 77 Z l C Ntti S 2 : DEEP OBSERVATION HOLE TOG Dole# �' Depth'in Soil Horizon Soil Texture Soil Color Soil Other Surface(in) (USDA) (Mansell) Mottling (Structure,Stones;,Boulder$. 5 77 a_ - A SL : �ayCL- J ...... ram. r b t. a ' r 2- 7 - DEEP OBSERVATION HOLE LOG Hole# Depth'rfrom- Soil Horizon Soil Texture Soil.Color. Soil Other Surface.(ib.) (USDA) (Mubsell) Mottling (Structure,Stones,Boulders. DEEP OBSERVATION IOLE.LOG Hole# Deptl',from Soil Horizon Soil Texture Soil Color Soil Other Surfaee(ib.) - (USDA) (Munsell) Mottling (Structure,Stones,'Boulders. ....'..:.0 _ Flood Insurance Irate Man: _' ..°..` . e: Above 500 yeai,flood'bpundary °'No_ Yes . . Within SUl)'year tioundaiy No� Yea, Wtthin l00 year flood boundary No Yes Depth of NaturaUy Occurr==ma pervfous 1Vlate rial Does'at least four feet of naturally occurring pervious in Eerial exist inall areas observed`througkout2the;.' area proposed for the sotl absorption system? If not;what:is the depth of naturally occurring pervious atonal? Certtfi„carton �a p. I certify that-on ��� t dated I.have assed the soil evaluator examtnation approved by= the Department of Envtranmental Protection and that:,the above analysts was performed by me consistent uvith' th$regwred°uainin expertise and experience described in lU C1vIR 15017: Date Signature Q\SBVMM- BRCFORM.DOC f EXCERPT FROM BOH MEETING MINUTES 6/14/2011 B. Peter McEntee representing Bank of New York Mellon — 116 lyannough Road, Hyannis, Map/Parcel 328-144, 9,330 square feet lot, variances. Peter McEntee presented the plan. There is a lining which will run between the cellar wall and the SAS. It will run the length of the SAS. Upon a motion duly made by Dr. Canniff, seconded by Junichi Sawayanagi, the Board voted to approve with the following conditions: 1) A three-bedroom deed restriction will be properly recorded at the Barnstable County Registry of Deeds, and 2) a proper copy of the deed restriction will be supplied to the Barnstable Health Division. (Unanimously, voted in favor.) Bk 25564 P:025 0-35m688 1 ' DEED RESTRICTION HER S,Wayne Pacheco, of Hyannis, MA, is the owner of 6 lyan ugh Road, Hyannis, MA, and being shown as Lot 3A as shown on a plan of dentied evisior s of Lots 2 &3 in Hyannis (Barnstable) Mass. Property of William A. Korpela et Scale 1 in. =30 feet- Nov: 7, 1951. (Bearse & Kellogg—Civil Engineers)"which iuly recorded with the d plan is d Barnstable County Registry of Deeds in Plan Book 1, Page 141. HER CAS,Wayne Pacheco, as owner of said Lot have agreed with the Town of arnst le Board of Health to a restriction as toc the numberoobtaining bes in ng a disposal wow ms i cluded in any home built on said Lot as a pre- onstrucpon permit.in compliance with 310 CMR 15.000 State Environmental Code, itle V, inimum Requirements for the Subsurface Disposal of Sanitary Sewage d of Health, as apre-condition to granting a HERE�S,the Town of Barnstable Boar system in compliance with 310 CMR tiposal,Works Construction Permit for a septicy. Titre V Minimum Requirements for the Subsurface 15.000, Mate Environmental Code, • the ispos 'of Sanitary Sewage is requiring that the agreement �t Put on restrecriction o the umberrn the Qf bedrooms in any house constructed on s Barnstaple County Registry of Deeds by recording this document. NOW TOEREFORE,Wayne Pacheco, do hereby place the following restriction on their above r ferenced land in accordance with their agreements itthbthi di wn of Barnstable Board of Health which restriction shall run with the land an successors in titre: 1. 116 lyannough Road may have constructed upon it a house containing no more toan three (3) bedrooms. a rees that this shall be a permanent deed restriction affecting the Wayne Facheco g dwelling Hyannis, MA and bei located 3A in Plan Book 101 Page 141. �g i I i Page 1 ,I i j f - i or title, ' see deed recorded in the Barnstable County registry of Deeds Il � ok 25504, Page 98. day of 1 2011. U ecuted,as a sealed instrument this Y i - i'D wneds' n res I ` i I 1 COMMONWEALTH OF MASSACHUSETTS 1 i 2011 ss 7 f Date Then pefsonallY aPPea'ed the above named instrument and nown-tP me to be the persons who executed the following cknowl' ged the same to be their free act and deed,before me. i s c Rya Notary public i �= -">oaa��� = My commission expires: (date) ••.af zz gsO,YWEP 0Tq'i?y',p��� I 1 ' page 2 i j BARNSTABIE REGISTRY OF DEEDS 09/06/2011 09:07 5084775313 ENGINEERING WORKS PAGE 01 Town of Barnstable iRegulatory Services Thomas F. Geiler,Director Public Health Division s Thomas McKean,Director 200 Maim Street, Rys#nis,MA 9MI Mae: 5084862-" Fax: 508-790-6304 Date: ) Sewage Permit# Assessor's Map/Parcel r ) L l histafler&ftimer Certificafto Form DeBigner: ,. ? War C . Installer: i �,1►ri ( n ,address: 1 z. W. C-M a g �e 14 l2R#. Address: �•� �.s w t-r- A- d-Z-le y Cero' • J► X ;��dW-z, Ua �.�► ) r� {m was issued a permit to install a (date) (installer) septic system at�) d. based on a design drawn by dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 1.0' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State&Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required)wpam ted and the soils re found satisfactory. tH OF PE TIER T. er's Signature) NkENTEE CIVIL 9 .35109 ST� a\� ?(6 s Signature} (Affix Design PLEASK RETURN TO RaMSTABLE PUDUC HEALTH DIM I R LIANCE WI L �' BE LSSUED BATH IM FORM AND HITUX ARE RECEIVED BY THE BAMSTABLE PUBLIC TH DIMS O THAN YOU. gAo05ee tb�gwmcrgfiaabon xoradoc N Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd. Property Address Wayne Pacheco Owner Owner's Name — i 'afion is Hyannis ✓ MA 02601 3/22/2017 required for every page- Citylrown State Zip Code Date of Inspedion ., 41& 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. I°' Wtien filling ouforms A. General Information t on the computer, use only the tab 1 Inspector key to move your cursor-do not Paul Martin use the return Name of Inspector key Cape Cod Septic Services Cerny Name 350 Main St Company Address W.Yarmouth MA 02673 Cityrrown State Zip Code 608-775-2825 S15016 Telep w*Number License Number B. Certification 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 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 "t`ide 5(310 CMR 15.000).The system: Passes` ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the local Approving Authority - 3122M2017 nspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Auffxx ity(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. t5im•3113 Title 5 OWOW tnspecbw FOW%buda08 SMW Dispose System Page lot 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments; 116 lyannough Rd. Property Address Wayne Pacheco Owner Ownees Name t nfbffnafion is for Hyannis MA 02601 31=017 required- o d Cityrrown State Zip Code deft of inspection B. Certification (coot) 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: System in working condition. B) System CondWonally 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): t5kz•3113 TWO 5 OlGaal trispec M Fomx Subsurface Sewage Doposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form MW Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd. Property Address Wayne Pacheco Owner owners Name i"r°mt2fion is Hyannis MA 02601 3J22/2017 required for every page- Citylrown State zip Code Date of inspection B. Certification (coa) ❑ Pump Chamber pumps/alarms not operational.System will pass with Board of Health approval if pumpstalamis are repaired. B) System Conditionally Passes(cone): ❑ 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(witty 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(lXb)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 tFWM•3A3 TO 5 Of6d9d f Fame wmdwe Sege System•Page 3 d 17 CommonweaM of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd Property Address Wayne Pacheco Owner Owner's Name inforn Lion is Hyannis MA 02601 3/22f2017 requapage city/Town d for every � State zip code e of Impeciion �. B. Cerdficadon (corn.) 3. 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 wader 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. ElThe system has a septic tank and SAS and the SAS is within 50 feet of a primate 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 welr*. Method used to determine distance: This system passes if the well wafter analysis,performed at a DEP certified laboratory,for fecal eoliform bacteria indicates absent and the presence,of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other. D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® Static liquid level in the distribution box above outlet invert due to an overloaded or dogged SAS or cesspool % ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow tF=•3R3 T®e 5 MdW ItispeeGon Fart S bsuMm Savage Dbposd SyBYm-rage 4 of 17 Commonwealth of Massachusetias Title 5 Official Inspection Form Subsuriacs Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd Property Address Wayne Pacheco owner owners Name ' f0rt �" 'e Hyannis MA 02601 31=017 � Y Pap- cityrrmn Stale Zip Code Date of Inspection B. Certification (font.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to dogged 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 N the well water analysis,performed at a DEP certified laboratory,for fecal colifonm bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen le 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 Simon D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surfce drinking water supply 0 the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 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 ayes'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. t5irs,M3 Me 5 OM"Inspection Fomr Subusfaoe Sewage Disposal System•Page 5 of 17 k Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System.Foam-Not for Voluntary Assessments 116 Iyannough Rd Properly Address Wayne Pacheco owner ownees Name irdomlatim is Hyannis MA 02601 3/2?12017 required for every Pap- Cityrrown State 'Zip Code Date of Impedim C. Checklist Check if the following have been done.You must indicate"yes'or arid'as to each of the following: Yes No ® ❑ Pumping information was provided by the owner,occupant,or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of ❑ ® this inspection? ® ❑ Were as built plans of the system obtained and examined?(if they were not available note as N/A ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components,excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered,opened,and the interior of the tank inspect for the condition of the baffles or bees, 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. El ® Determined in the field(if any of the failure criteria rued to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 110x3= DESIGN flow based on 310 CMR 15.203(fo example: 110 gpd x#of bedrooms): 330gpd 15M•3N3 Title 5 otfiaef kWection Fo m: -Page 6 of 17 CommonweaHh of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd. Ply Address Wayne Pacheco Owner owners Name WlIbmultion is required for every Hyannis MA 02601 3/M017 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: Unkown Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection information in this report) ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ® No 2015=203gpd Water meter readings,if available(last 2 years usage(gpd)): 2016=33gpd Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Current Date CommerciaUlndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): GaO=per day&M Basis of design flow(seats/persons".ft.,etc.): Grease trap presets? ❑ 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: ffibn-3M3 Tille 5 Official tsPecbon fay Suta+faoe Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd Property Address Wayne Pacheco owner Owner's Name itffonnation is Hyannis MA 02601 3J2?J2017 �� every page- City/Town state zip Code Date of IWO45M D. System Information (cunt.) Last date of occupancy/use: EMM Other(describe below): General Information Pumping Records: Source of information: No Records Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gam How was quantity pumped determined? Reason for pumping: Type of System: Septic tank,distribution box,soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy El Shared system(yes or na)(if yes,attach previous inspection records,if any) ❑ Innovative/Attemative 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): tsars-3i13 TWOS Offwiat tnsperJion Fonm stowfaos Sew D4osd&pioem-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 Iyannough Rd. Pmperty Address Wayne Pacheco Owner Owner's Name infoffnafim fortes H emyyannis MA 02601 3/2?J2017 State Zip Code Date Of lwpec�ion page. City/Town D. System Information (cont.) Approximate age of all components,date installed(if known)and source of information: 2011 Per BOH records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 22" Depth below grade: feet Material of construction: ❑cast iron ®40 PVC ❑other(explain): +10' Distance from private water supply well or suction line: feet Comments(on condition of joints,venting,evidence of leakage,etc.): Line checked with sewer camera and was found to be clean, properly pitched with no sign of root intrusion. .Septic Tank(locate on site plan): 12" Depth below grade: feet Material of construction: ®concrete ❑metal ❑fiberglass ❑polyethylene ❑other(explain) If tank is metal,list age: y m Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No 1000t;a1 Dimensions: 8-10n Sludge depth: t5irn•W TWO 5 Otfcid kMeman Faun:Sui wtwe •Pie 9 d 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd. Property Address Wayne Pacheco owner Owner's Name information is Hyannis MA 02601 31=017 required for every State zip code e of Irrspedion Pa p- System Information (cont.) Septic Tank(cont) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Estimated How were dimensions determined? Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 1000Gal H-10 tank in good structural condition. PVC flees in place.Tank at nominal operating level. Covers 12"below grade.Tank scheduled to be serves 3/28/2017 Grease Trap(locate on site plan): Depth below grade: teat 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: tie t5kn•3H3 -rde 5 OMCW kapeCWn FOM&"NNW Rate n•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessmerrts 1161yannough Rd.Pmpefty Address Wayne Pacheco owner Owner's Name �"fo" alim is MA 02601 3122iL017 pap-required for every gown State ZipCode tote of Inspection D. System Information (coat.) 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 Bolding 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: gallcm Per day Alarm present ❑ Yes ❑ No Alarm level: Mann in working order: ❑ Yes ❑ No Date of last pumping: Dace Comments(condition of alarm and float switches,etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No - t5ins•3/13 Title 5 Offidal hVeebw Form Subsurface Sewage Disposes System ge'Pa 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form. Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd Property Address Wayne Pacheco Owner Owners Name required for is Hyannis AAA 02601 3C12/2017 required for every Cityrro State Zip Code Date of hgxKdm D. System Information (cost.) Distribution Box(if present must be opened)(lode on site plan): Depth of liquid level above outlet invert (r 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.): H-10 DB-3 with 1 line in and 3 lines out in good condition. Box is dean and level with minimal solids carryover.Outlet inverts equal No sign of overloading or hydraulic failure.Cover 2'below grade. Pump Chamber(locate on site plan): Pumps in working order. ❑ Yes ❑ No* Alarms in working order. ❑ Yes ❑ No* Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): *If pumps or alarms are not in working order,system is a conditional pass. Soll Absorption System(SAS)(locate on site plan,excavation not required): If SAS not located,explain why: Skis-313 - '. Title 6 Olfi�trispe Foroc Sbaaface S map Disposal SW=-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd property Address Wayne Pacheco Owner Owner's Name 'efbffnation required re Hyannis MA 02601 31=017 required for every Par- Cityrrown state Zip Code Date of Impedim D. System Information (corn.) Type: Q leaching Pits number 36 ® leaching chambers numberInc ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number. ❑ innovative/attemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): Arc 36 HC-1-120 chambers in a 8.5x31.2'field.Chambers found dry at time of inspection with soil dean No sign of overloading or hydraulic failure. 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 tsxis•3n3 ride 5 orfiam ksvemon Form:&N urfaoe sewage Disposal system'Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd. Property Aoddress Wayne Pacheco Owner Owner's Name irrfO fb 1 Hyannis MA 02601 3)=017 on is required or every page- citylrown State Zip Code Data of ftped D. System Information (corn.) Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Privy(lode 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-3113 Title 5 Official Inspection Fomr Sulmsfaoe Sewage Disposal System.Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd. Property Address Wayne Pacheco Owner Owneirs Name infomudirequired � Hyannis - MA 02601 3/22/2017 page. Cityrrown State Zip code Date of kgnd on D. System Information (corn.) 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 t5ins•3M 3 Title 5 Official lrepe0on Form:Subswfaoe Sewage Disposal System•Page 15 of 17 I - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd. Properly Address Wayne Pacheco owner Owner's Name ird0rm tion is required Hyannis MA 02601 3/22/2017 for Cityrrown Stdo Zip Code Date of inspection D. System Information (corn.) Site Exam: ® Check slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water. +10' 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: 2011 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Test hole data per plan on file at BOH. Max bottom of leaching is V. Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ft-3H3 - Title 5 Oradd l Famc S490afaee S-"e Dsposel System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 116 lyannough Rd. Property/arm Wayne Pacheco owner Ownees Name irdbrmation is requaed for every Hyannis MA 02601 31=017 per. Citylfown State Zip Code Date of tnspedion E. Report Completeness Checklist ® Inspection Summary.A, B. C, D,or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 OtSdal k pec"Form:SOMOSOO Sewage Disposal System-Page 17 of 17 . 4 1 TOWN OF A/fl NSLABLE 1 LOCAIION _ ygmpot _SEWAGE# aml-241 VIIIAGE au�1W5 ASSESSORS MAP&PARCEL IN MUER'S NAM&PHONE NO. A bfoarj Ux sEP=TAWCAFAcrrY �ff5 IEACHMFAMAY.(t F) Arr x Nc-MW ($be) NO OF BEDROOMS 3 OWNER �C(7 PERMITDAA1E �/�/l� CONMIANCEDAME l Seps�aeIiis000eB�ffie - - M A*ftdGUM.ONT"faft Boom dlza&nFwft - Pri�W��y�en�ai�MosF+�aus(r��..easamcoo y i smarwi�m200�8�flraei�g5pi�y) rcd Bdg "cdmdmdLe dmgftcft(ffmpwcft&a6atwidffi 3W fid o£1 %MQY) Feet . Ftwamu)BY peA�4' 3-11 3-1� 4- t8 y— 6 F S-23 S--U 3 G M K � 9 AbO$� Town of Barnstable Barnstable Regulatory Services Department e' C j BABNSPABLE. Public Health Division m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7008 3230 0002 5178 2373 March 30, 2011 Mr& Mrs William T. Mullay 4000 Horizon, WY.-Suite 100 Irving, Texas 75063 . ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located 116 Iyanough Road/RTE 28, Hyannis,MA was last inspected on 1/07/2011, by Raymond Dumas, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Liquid depth in cesspool is less than 67 below invert or available volume is less than day flow You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE ARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures\1-I SAMPLE 60 Day Deadline.doc Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information IVI� on the computer, use only the tab 1. Inspector: key to move your cursor-do not Ricky L. Wright use the return Name of Inspector key. B & B Excavation, Inc. rab Company Name 14 Teaberry Lane Company Address Sandwich MA 02563 Cltyrrown State Zip Code 508-477=0653 S14595 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance ofon site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 ofD Title 5(310 CMR 15.000).The system: CD - ❑ Passes ❑ Conditionally Passes ® Fails F �'1 ❑ Needs Further Evaluation by the Local Approving Authority 3/10/11 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage DisposalSystem•Page I 1 of 17 1 A Commonwealth of Massachusetts Title 5 Official Inspection Form. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. Citylrown 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): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 4 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): El 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. City[Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D). System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ E 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 t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts = Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 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 ❑ ❑ 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 y g cant threat under Section E or Palled 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 M r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments '4M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. CitylTown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System_Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms (actual): 3 DESIGN flow-based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms). 330 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 _ 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 n/a 9 ( Y 9 (gPd))� Detail: Recommend hooking laundry to septic system at time of repairs Sump pump? ❑ Yes ® No Last date of occupancy: a year ago Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) . Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 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: approx. 25 years Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 15"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: f e0 t Comments (on condition of joints, venting, evidence of leakage, etc.): At time of inspection building sewer appeared to be in good shape no signs of leakage or blockage Septic Tank(locate on site plan): 6, Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: , years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No � Dimensions: 5.2x5.2x8.6 Sludge depth: 2° t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. CityfTown 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 31" Scum thickness 4" Distance from top of scum to top of outlet tee or baffle scum was below invert due to leaking tank Distance from bottom of scum to bottom of outlet tee or baffle 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 tank appeared to be deteriorating water level was 3.5 feet below invert,also signs of solids over the invert at on time due to hydraulic faliure. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 i Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y 116 lyanough Road GSM Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 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 = Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): At time of inspection d-box appeared to be deteriorating and in poor shape signs of leakage as well. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 III Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching 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.): At time of inspection leaching appeared to be dry however staining and signs of solids carryover above invert. 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 = u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page.• Cityrrown 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 , 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. Cityrrown 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 A G� de S O U 0 _ y A A3 A4 = 24' B2= 18 ' 30'6 '` t5ins•09l08 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 . 116 lyanough Road Property Address First Horizon Home Loans Owner Owner's Name information is required for every Hyannis Ma 02601 3/10/11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: >10 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 c Commonwealth of Massachusetts w W Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 116 lyanough Road Property Address First Horizon Home Loans Owner Owners Name information is required for every Hyannis Ma 02601 3/10/11 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist E Inspection Summary: A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems)completed E System Information—Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BARNSTABLE LOCATION SEWAGE# qQI I— 2! CVILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. A birow,) SEPTIC TANK CAPACITY l�IC�s trig. LEACHING FACILITY: (type) A It Sr, H C--/20 (size) ; 2 NO.OF BEDROOMS 3 OWNER PERMIT DATE: '7190& COMPLIANCE DATE: L6 l Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �sFr: ^ v fi Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Doi_ VV--n) 0 i � a es� � I No. J ` ' I s Fee ( V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftpliCatlon for disposal *pstem Construttion permit Application for a Permit to Construct( ) Repair(✓Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.j/,/ L y,4 1JA)00C9)4 ��v Owner's Name,Address,and Tel.No. Assessor's Map/Parcel �L - lelA ;D6 Cy e'o Installer's Name,Address,and Tel.No. Designer's Name.Address,and Tel.No. yias A '�3i�u:nyJ-NC SCE$-zk�0 7/S""7 €Ny�a��<:� ttti<,1Cg Type of Building: Dwelling No.of Bedrooms Lot Size 9 $`,30 sq.ft. Garbage Grinder( ) Other Type of Building ko,_),�Lo No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 30 gpd Design flow provided gpd Plan Date ��ti])/ Number of sheets Revision Date. Title Size of Septic Tank rx.5, ,.v Type of S.A.S. Arc 3 G N C Description of Soil Nature of Repairs or Alterations(Answer when applicable) UuSkaA New 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. Signed ce Date 7,loob Application Approved by c Date 7—,LU—C/ Application Disapproved by Q Date for the following reasons Permit No. (90` ;,- f Date Issued j •'j t +. �� :r�.•d:,•P No. O f t 9 != c 1 Fee /(k) THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 21pplicatlon for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(&,/Upgrade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No.//(/ _T Y,4/d A)00 C9 q /_�C) Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 3� /c/s/ RGCAO rQ Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. C).wS1c.s /•1 �013.1/00_7/S'7 le-S Type of Building: Dwelling No.of Bedrooms 3 Lot Size 9130 sq.ft. Garbage Grinder( ) Other Type of Building h0 JSP ..No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 36 gpd Design flow provided 3 32-,S gpd Plan Date H /I Number of sheets 2 ',,Revision Date Title Size of Septic Tank 1_ X15f OeV 5 Type of S.A.S. A fC I G H C b Description of Soil '^ q: Nature of Repairs or Alterations(Answer when applicable) 1 sS c 1, New S. Q.S Date last inspected: Agreement: fl 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. d`- fi�rr"" � Signed (9 Date 7,4 O f/ • { Application Approved by c v JWZuq PL 5 Date Application Disapproved by Q Date for the following reasons Permit No. C Cr ^` + Date Issued 7 %1 C7 ` - - --.• - - - .: - ----- ------ •----- - -- - --•-- - - - - -- -- ---- -- - ---- - ---- - - - --- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (tertificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(`) Upgraded( ) Abandoned( )by O.Cj�G �Cl fG• N C at 1 I G =L yA 0N©0S has been constructed in accordance toll-a��l with the provisions of Title 5 and the for Disposal System Construction Permit No. dated - Installer Designer si^Jre.tIds lJoi�[$ #bedrooms 3 Approved design flow 35 a.S" gpd The issuance of this permit shall not be construed as a guarantee that the system will function as des- ned u Jj Date 7/4 O I J Inspector �✓ 1 I�-' --------- --------- - - ------=--._ No. a�6�f� � _ Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstrm Construction hermit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at //G .T 1,4 NeJ C9 on O t S and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constru-/c'tiion mu t be completed within three years of the date of this permit. Oka Date rt C)' / Approved by lGG��� Town of Barnstable P# / 3 Department of Regulatory Services Public Health.Division Date sbsq �� 200:Main Street,-Hyannis MA 02601 Date Scheduled CT� /� r Time Fee Pd. �. •1, Soil Suitability Assessment for S • e Disposal Performed;By:j e- f c i^e�- -�-C� Witnessed By: LOCATION& GENERAL INFORMATION Location Address a H v\OW Ft Owners Name 1�e(. �1-16 y, � � � � 4 ��r`t ' •.�P 4 v�tn Address Assessor's Map/Parcel: 3 l c r Engineer's NameCfG NEW CONSTRUCTION __Telephone.# 5Cj,?—7`3i 7 4 7,ec.� Land,Use. C t`,-JQl A-y CJt , Slopes(9'oj Zi�� Surface Stones N�•� Distances from: Open Water Body ft Possible Wet Area. ft Drinking Water Well ��J� ft ti. r Drainage Way �/ �' ft Property Line i -� ft .other` ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) c'^,A. — YJ S /2.Q,f f Parent material(geologic) cLy4•t).S-R S Depth to Bedrock Depth to Oroundwater. Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: __ _._In, Depth to soil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. ` Index Well.# Reading Date: Index WeII level— Adj thetor, 9 Adj.Orouttdwater Level PERCOLATION TEST bate, Time..._ Observation Hole# Time at 9" Depth of Penc � �+ 24- `b Time at 6" .Start Pre-soak Time @ `� Q� Time(9"-611) End Pre-soak Rate MinJlnch. CZ Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division _ Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be.conducted.within 100' of wetland,you must first`notify the Barnstable Conservation Division at least one (1)week prior to beginning. Q:\SEPTIMERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders: Consistency. Gravel) M--C'S 1 g%fos -7,S" g. ;tea -- • cz„ 'g Z DEEP OBSERVATION HOLE LOG Hole# zz Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. _ Consistency,% ?✓2 --2 2 C. (;S 1 d 1 �'r�(o fv 1'�g lQi J b h Z c S -sWLd f , di S -�� DEEP OBSERVATION HOLE LOG _ Hole# Depth from Soil Horizon Soil Texture Soil Color Soil* Other' Surface(in.) ' (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. Gravel) .DEEP-OBSERVATION HOLE.LOG- Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,.Stones,Boulders. Consistency, Flood Insurance Rate Man: Above 500 year flood boundary No Yes _-- Within500'year boundary No-1 Yes Within 100 year flood boundary No ,. Yes Death of Naturally Occurring Pervious Material Does at least four feet.of naturally occurring pervious m•terial exist in all areas observed throughout the area proposed•foi the soil absorption system? 'e If not,what is the depth of naturally occurring pervious aterial? Certification _ . �_ ... I certify,that on - �\ ��*,04 s (date)"I have passed the soil evaluator examination approv=.with Department of Environmental Proteehon and that theabove analysis was performed by me .} the required tranin expertise and experience described in 310 CMR_15.017. WA Date Signature' I i Q:\SEvnMERCFORM.DOC FORM30 s&W HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H CITY TOWN OtOARTMENT ADDRESS G,f,y Soy`0 h 7PHONE a Address Y Occupant Floor Apartment No. No.of Occupants No.of Habitable Rooms No.Sleeping Rooms No. dwelling or rooming units No.Stories Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof r7 v Gutters, Drains: 14 Walls: 0 5C Foundation: (n�Q • Chimney: / BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: ` DWELLING UNIT Ventil. Lgtnq Outlets Walls Ceils. kVind.nDoors Floors Locks Kitchen /0 Bathroom 0 Pantry Den Living Room Bedroom(1), Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect..- Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove. Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPOR NED AND CERTIFIED UNDER THE PAINS AND PENALTIEUQERJU INSPECTOR _ TITLE e � DATE TIME { �� A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. Certified Mail#7009 2820 0003 3168 1411 Town of Barnstable 0 Regulatory Services AA:RN$TA.IR4 yMAS& Thomas F. Geiler, Director s63q. Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 5, 2010 William Mullaly 23 New Haven Avenue p Marstons Mills, MA 02648 FINAL NOTICE NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 116 Iyannough Road was re-inspected on March 4, 2010 by Timothy B. O'Connell, R.S. Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.500—Owner's Responsibility to Maintain to Structural Elements. The storm door to the front door was observed to be held together with duct tape. It was also observed that sliding glass door has been replaced with a conventional door. This was ordered on September 21, 2009 with a previous order letter. However, door has not been trimmed and the sheet rock has not been finished (i.e paint) so that it can be cleaned easily. 105 CMR 410.351 (B): Owner's Installation and Maintenance Responsibilities. The dishwasher that wa4 o be repaired or replaced by an order letter dated September 21, 2009 has been removed but has not been replaced. It was also observed that owner installed clothes dryer is not functioning as intended to. You are directed to correct the violations listed above within twenty-one (21) days of your receipt of this notice; by replacing or repairing storm door so that it excludes wind, rain and is weather proof; repairing or replacing dishwasher; repairing or replacing clothes dryer; by finishing trim and sheet rock around newly installed kitchen door. QAOrder letters\Housing violations\Rental ordinance\1 16 lyannough rd 11.doc You may request,a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable QAOrder letters\Housing violations\Rental ordinance\l 16 lyannough rd II.doc SHE Tp�� Town of Barnstable Barnstable Regulatory Services Department AMmedcaCky > BARN ABLE, + D 6 . ,0� Public Health Division 4�ATf° +a 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7008 3230 0002 5178 2350 March 16, 2011 First Horizon Home Loans 29 Bassett Lane Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located 116 Iyannough Road, Hyannis MA was last inspected on 2/07/2011,by Ricky L. Wright, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future Menforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures\1-1 SAMPLE 60 Day Deadline.doc /A °p SHF 1°� Town of Barnstable Barnstable A%APv _ ti Regulatory Services Department aC ft IIARNS'rABLE, +039. ,�� Public Health Division m�p�fD +a 200 Main Street, Hyannis MA 02601 2007 e Office: 508-862-4644 Thomas F.Geilei,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7008 3230 0002 5178 2350 March 16, 2011 First Horizon Home Loans 29 Bassett Lane Hyannis, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located 116 Iyannough Road,Hyannis MA was last inspected on 2/07/2011, by Ricky L. Wright, a certified septic inspector for the State of Massachusetts: The inspection of the septic system showed that the system"Failed"under the guidelines of 1995 TITLE 5 (310 CMR.15.00) due to the following: • Backup of sewage into facility or system component due to overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures\]-1 SAMPLE 60 Day Deadline.doc FORM30 ,I W HOBBSB WARRENIM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H CITY OWN N. ri ADDRESS ff (� TE PHONE Address V Y-- — _.__—Occupant Floor Apartment No. _No.of Occupants No. of Habitable Rooms_ _---- No.Sleeping Rooms No.dwelling or rooming units.___ __No.Stories Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: In ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to Outlets Wall i Ceils. ind. Doors Floors Locks Kitchen Bathroom t 0 Pantry Den Livina Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice,Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See ver) "THIS INSPECTION REPOR NED AND CERTIFIED UNDER THE PAINS AND PENALTIES ERJU 5 INSPECTOR _ TITLE DATE TIME c 5 ----- A.M. THE NEXT SCHEDULED REINSPECTION P.M. M. � _ - 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health,or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore,is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(6)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the.electrical facilities required by,105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by, 105 CMR 410.254; (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to.provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents,cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or-safety and well,-being of an occupant upon the failure of the owner to remedy'said condifion within the time so ordered by the Board of Health. i ..;.,;,�.,,y„v.,T,.wa�'%..'^`.-.v---...•+....,.`•�'n..tn;r`r.•..--..a'.r`t+..w.-,.•.+..,r""'^m,.w-+w•.•`.+�.�.. r ..+- r........n.. w-•+.n..rv..n.e.YceMr-+i2.[i:*"i...vti..rrr.v^'1n^'R.r•�/!:•r.r..''`r..C'j7r• '-^��.:'..�.�i��'•r•- ''=F", FORM 30 C&W HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HE pLTH CITY DEPARTMENT , • °in• SVOy`mW ADDRESS t TE PHONE Address ' C t Occupant_ Floor Apartme t No. No. of Occupants No. of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units_ No-Sftt ri'et, s Name and address of owner �,,.c.••. _ 4Remarks„ Reg. Vio. YARD Out Bld s.: Fences: ' Garbage and Rubbish ` Containers: -. Drainage l Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: -f- _ Dual Egress:and Obst,n.: ❑,B E] F: ❑ M Doors,Windows: �. ,w C rffN Roof /k Gutters, Drains: `° Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness; Stairs: Li htin STRUCTURE INT. Hall,Stairway: - Obst'n.: * Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: _._Central ❑ Y . ❑.N _,_ Equip.,_Re. air__•=!- .�..--. : - +'TYPE Stacks, Flues,Vents: PLUMBING: Su ply Line: I ❑ MS ❑ ST ❑ P Waste Line: ,✓' H.W.Tanks Safety and Vent(s) y ELECTRICAL Panels, Meters,Cir.: _ ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: ,, 1 DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom ' Pantry3 Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 . Bedroom 4 Hot Water Facil. kSu .Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties`. Kitchen Facilities Sink — /W IX- Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Y A LIM 15 "j ' Wash Basin,Shower or Tub: _c Infestation-- ' ~Rats Mice,-Roaches-or-,Other:s� p,Vt� - _ ._ ____i i_.. - .'�.. 141 , � 12 Egress Dual and Obst'n: , 1 J 2 '-- - - " General Building Posted A fW Locks on Doors: (17 ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) ",THIS INSPECTION REPORT S SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR TITLE (� t (A.M. DATE � -1 1� TIME A.M. THE NEXT SCHEDULED REINSPECTION l P.M. .� wl 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s)pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold,to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G)• Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352,^ so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N). Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: . (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. . (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents,cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and,well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. _ TOWN OF BARNSTABLE OCATION / c�Qrrtro u r �Q .� �� SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (si NO.OF BEDROOMS �r I OWNER PERMIT DATE: IANCE DATE: Separation Distance Between the: t® Maximum Adjusted Groundwater Table to the ottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY ri EXIT 7 LEGEND RT.6 TOWN OF BARNSTABLE RT. 6 �E —— 98 —— EXISTING CONTOUR BARNSTABLE WATER 3 v x 100.98 EXISTING SPOT GRADE 93.93 PARCEL. ID: 328-142-001 �y Z —W EXISTING WATER SERVICE c —e.H W. EXISTING OVERHEAD WIRES TEST PIT oJ� > 0 BENCHMARK ® 88 90 WETLAND FLAG J ?g R� WETLAND SYMBOL tb + 90.26 co tb LOCUS R j v 1F Q 94,79 o� Lewis Bay ( x 9b II /1rIF 14 YANNO GH ROAD TOINI ES ER GS PARCEL ID: 328-143 i \. LOCUS MAP `'� j ( l\ x 90.92 j 89 39'+ ViA NOT TO SCALE �� � 95,16`� � 88.�5 b � \ \ Ben ch m ark No. 2 i �O GRA VEL N 6g ss S o' 40RDERING OUTSIDE COR./BOTT. STEP 94. 4869 ��' �� CA OUTSIDE VEGETATED EL.=99.08 {Assumed datum) ; ��\ DRIVEWAY \\ 0 8987 ' WETLAND > 5.69 ` t- O ` \ •. � V102 Zq x 975 (LOT 3A) 88.90`�. ' 99X0� 95\,20 APN 32,8-144�\ 7�-N/F KORPELA, T01 I TAIMI ESTER x 9,330 S.�t � WT ��FC, 114 IYANNOUGH ROPD �o 87.'9\5 PARCEL ID: 328-147 b I '96.89 97.81 60 . \ � 3"k .,) 1) x 96,82 � x 95. x V1, x 90 0� 88,72 COO) .5 96 INSTALL A 40 MIL POLY LINER I ,07 y'q� + DECK X'96.0,b ! `� BETWEEN HOUSE ANb S.A.S. I +' i o C TOP OF LINER, EL.=95l,0 i �CS � BM2 .EXISTING l ! 1 BOTT. OF LINER, EL.=92.5 I �`99-08 HOUSE(#116) x 9/6,6 ; 3 x 91,65 0 � T.O.F.' 99.3f1 97.02 1 la o � \� i �� T.O.F.=99.3f� �GS ^ 1011,56 98.76 1 7,82 ! x 97.94 TP-1 x< \78 I i �R�� S Jr,T� 8,37 � rP 'r.q` -- Ben chm ark No. 1 I85 5' VEN 12"�� i ' 94.56 OUTSIDE COR. OF BULKHEAD A.I.QQ•D3 99,19 9S .. `\ EL.=97.82(Assumed datum) I i S i + 6/0 126?'„ 96.�Q PI / Y -� �__ \ EXISTING SEPTIC TANK +r '� % ��`J\ (TO REMAIN) I i ` TOP OF TANK, EL.=96.46 I { INV. OUT=95.13t VERIFY � i '•' b^ EXlS71NG LEACH PIT �� TO BE PUMPED, FILLED WITH SAND AND ABANDONED �� Z WORK LIMIT/SILT FENSE x 99.62 �p rn N/F IVES, DAVID U ' 102 IYANNOUGH ROAD CBDH f d OQ ,` PARCEL ID: 328-152 10 \\ \ (9 C H f n d J ` �Q N/F KORPELA TOINI TAIMI ESTER 114 IYANNOUGH ROAD DECK I ROOF O PARCEL ID: 328-145 9'x18' � KITCHEN 5'x8' 8'x12' KNEEWALL (STG.) BATH DINING RM ' ENTRY �P�\c� Of MAssq�y BED 1BED2 PETER T. ('� RM RM McENTEE 9'x12` /�� CIVIL BED LIVING' 1/O RM LIVING ROOF No. 35109 RM KNE ALL (STG.) t- Vv_ �DqF R£G S E��� `� ENTRY O-9 S�( H��� FIRST FLOOR SECOND FLOOR OWNER OF RECORD O U ' FAKo KIEAO% BANK ONEWYM N PROPOSED SEPTIC SYSTEM UPGRADE PLAN f/k/a/ THE BANK OF NEW Y 116 IYANNOUGH ROAD, HYANNIS, MA 4000 HORIZON WAY--SUITE 100 IRVING, TX 75063 Prepared for: Bank of NY Mellon, 4000 Horizon Way, Suite 100, Irving, TX 75063 FLOOD ZONE DESIGNATIONS FROM WETLAND DELINEATION Engineering by: SCALE DRAWN JOB. NO. VACCARO Inc. P.T.M. COMMUNITY PANEL NO.250001 0005 C Environmental Consulting Engineering Works, c 1°°=20' 139-11 Revised August 19, 1985 P.O. Box 955 DATE Sandwich, MA 02563 12 West Crossfield Road, Forestdale, MA 02644 CHECKED SHEET NO. j� Site lies within Zone C (508) 888-5855 (508) 477-5313 5/4/11 P.T.M. 1 Of 2 f • a{ NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL.94.8 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. INSTALL RISERS & COVERS OVER INLET & INSTALL INSPECTION PORT OVER END UNIT CHARCOAL OR OUTLET AND SET TO 6" OF FINISH GRADE INSTALL RISER & WATERTIGHT CONVENTIONAL VENT T.O.F. COVER SET TO 6" OF GRADE (CONNECT ALL LINES) EXISTING F.G. 97.0 to EL: 999.0(MAX.) F.G. EL.=97.0t � F.G. EL: 98.0t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. L = 23' L = 6( ) INSPECTION r ® S=1% (MIN) ® S=1% (MIN.) PORT 4"SCH40 PVC 4"SCH40 PVC 1 6" i� 70"I " 6 1 4" 11.75" TO EXISTING 48" LIQUID INVERT LEVEL ADD I i GAS BAFFLE ' INV.=94.67 PROPOSED INV.=94.50 (3 ROWS OF 6 UNITS AT 5.0'/UNIT) + 1.2' (1 COUPLER) = 31.2' INV.=95.13 Q BMX EXISTING INV.=94.40 SOIL ABSORPTION SYSTEM (PROFILE) EXISTING SEPTIC TANK DESIGN CRITERIA SEPTIC SYSTEM PROFILE ESTABLISH VEGETATIVE COVER BACKFILL WITH CLEAN NATIVE OR NUMBER OF BEDROOMS: 3 BEDROOMS N.T.S. PERC SAND TO TOP OF CHAMBERS SOIL TEXTURAL CLASS: CLASS I r DESIGN PERCOLATION RATE: <2 MIN/IN BREAKOUT=TOP DAILY FLOW=DESIGN FLOW: 330 G.P.D. TOP ELEV.=94.83 GARBAGE GRINDER: NO INV. ELEV.=94.40 C LEACHING AREA REQUIRED: (330) = 445.9 S.F. BOTTOM ELEV.=93.50 .74 L:!__83' EXISTING SEPTIC TANK: 1000 GALLON CAPACITY 5' MIN. ABOVE BOTTOM OF PROPOSED D-BOX:: 1 INLET, 3 OUTLET (MINIMUM), H-10 RATED T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH=8.5' USE 3 ROWS OF 6-ADS Arc 36HC UNITS + 1 COUPLER PER EXISTING SUITABLE ROW WITH NO SEPARATION BETWEEN EACH ROW & NO STONE NO G.W., EL=87.9 = MATERIAL BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF UNIT) USE 3 ROWS OF 6-ADS Arc 36HC UNITS + 1 COUPLER PER (Arc 36HC Units) 18 UNITS x 5.0 LF x 4.80 SF/LF = 432.0 SF ROW WITH NO SEPARATION BETWEEN EACH ROW & NO STONE (COUPLERS) 3 COUPLES x 1.2' x 4.80 SF/LF = 17.3 SF TYPICAL SECTION TOTAL AREA = 449.3 SF DESIGN FLOW PROVIDED: 0.74(449.3 S.F.) = 332.5 G.P.D. 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS, PRIOR TO INSTALLATION, SOIL LOG 2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE ON A MECHANICALLY COMPACTED SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN DATE: APRIL 26, 2011 (REF#13,257) 310 CMR 15.221(2). SOIL EVALUATOR: PETER McENTEE (SE#1542) 3) INSTALL INLET & OUTLET TEES AS REQUIRED. WITNESS: DESMARAIS R.S.HEALTH 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE HEALTH AGENT ELEv. TP-1 DEPTH ELEv. TP-2 DEPTH AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 98.9 A 0 99.0 A 0" SANDY LOAM SANDY LOAM 10YR 4/2 10YR 4/2 T _.�_� _ _ _ ... --- ---SANDY LOAM SANDY LOAM 96.2 10YR 5/8 10YR 5/8 C 1 C 1 32.. 96 3 32„ M-C SAND PERC M-C SAND 10YR 5/6 10YR 5/6 48"/54" 17.46" COBBLES & COBBLES & BOULDERS BOULDERS -�{I��� 93.1 C2 70" 93.0 C2 72" M-C SAND M-C SAND 7.5YR 5/8 7.5YR 5/8 16" COBBLES & COBBLES & 12.37" BOULDERS BOULDERS 92.1 C3 82" 92.0 C3 84" 10.38" MED. SAND MED. SAND INVERT DOME END 2.5Y 7/3 2.5Y 7/3 HEIGHT 87.9 132" 88.0 132" POST END PERC RATE <2 MIN/IN. ("C" HORIZONS) C33.75" NO GROUNDWATER ENCOUNTERED NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. GENERAL NOTES: 11111111 4640 TRUEMAN BLVD 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL LoPme HILLIARD, OHIO 43026 BOARD OF HEALTH AND THE DESIGN ENGINEER. ADVANCED DRNNAGE SYSTEMS,INC. Arc 36HC SIDE PORT COUPLER 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 63.25" OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE J� LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: -310 CMR 15.405(1)(a)&(b): 1) A 5' variance, S.A.S. to property line (front), for a 5' setback. 2) A 5' variance, S.A.S. to property line (side), for a 5' setback. 3) A 14' variance, S.A.S. to cellar, for a 6' setback. 34.5" 4) A 2' variance to the 3' maximum cover requirement, for 5' of max. cover. S.A.S. shall be H-20 and vented. -LOCAL REGULATION Chapter 360. Article 1 - Setback Requirements IF 5) A 3' variance, S.A.S. to Wetland, for a 97' setback. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TOP VIEW TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. 60" 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING END CAP END CAP FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN FRONT VIEW SIDE VIEW ENGINEER BEFORE CONSTRUCTION CONTINUES. END CAP 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM. REAR/TOP VIEW fl- 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT SIDE VIEW THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY M M mia HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 4640 4640 TRUEMAN BLVD 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. HILLIARD, OHIO 43026 Are 36HC DETAIL �d 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS ADVANCED DRAINAGE SYSTEMS,INC. AGREED UPON BYOWNER AND CONTRACTOR OR AS OTHERWISE PROPOSED SEPTIC SYSTEM UPGRADE PLAN DIRECTED BY THEE APPROVING AUTHORITIES. 10. IT SHALL BE THE RESPONSIBILITY THE.CONTRACTOR TO VERIFY 116 IYANNOUGH ROAD HYANNIS MA THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING > >CONSTRUCTION. f 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS Prepared for: Bank of NY Mellon, 4000 Horizon Way, Suite 100, Irving, TX 75063 IN,THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND ' REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). Engineering by: SCALE DRAWN JOB. NO. 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE Engineering Works Inc. NTS P.T.M. 139-11 INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. .. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. ` IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. (508) 477-5313 5/4/11 P.T.M. - 2 of 2 c Y ,