Loading...
HomeMy WebLinkAbout0029 MARK LANE - Health 29 MARK LADE p � Hyannis. • --- � � A — 146 di 4 D �e B Town of Barnstable P# oF� Department of Regulatory Services „u;,,, BM ; Public Health Division DateKAM 200 Main Street,Hyannis MA 02601 Date Scheduled l U O Time Fee Pd. Soil Suitability Assessment for Se age 'sposal Performed By: Witnessed By: U, t'. J / LOCATION&GENERAL INFORMATION Location Address Owner's Name 'b c �� �j Ve_S-fe )-cl Kas L V dZnC1 S M Address 9A Plaik- L"1, 14YameNis J , Assessor's Map/Parcel: Engineer's Name LIVI-6 P.11}0 dL"- 14L NEW CONSTRUCTION REPAIR / Telephone# SO'k- a-1`t—-y 941 Land Use 2 l e n�a 1 Slopes(%) `J 9­0 m/o Surface Stones V o Distances from: Open Water Body 7 f 00 ft Possible Wet Area 71 o0 ft Drinking Water Well 7�SO ft Drainage Way 7 I 0 ft Property Line 7 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Parent material(geologic) l o I aCAal T L Depth to Bedrock �Z l00 Depth to Groundwater. Standing Water in Hole: 5 1 Weeping from Pit Face I A \ Estimated Seasonal High Groundwater .t71 t DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: , Depth Observed standing in obs.hole: ! - In, Depth to soil mottles: De'th to weeping from side of obs.hole: in. Groundwater Adjustment ©� ft. Index Well# IW'- Reading Date: 4 1- to Index Well level C Adj.factor 0 AdJ,Groundwater Level-&9I PERCOLATION TEST bete L Time.__ __. Observation —�- Hole# ° I u'-I Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ 0i oO _ Time(9"4") End Pre-soak D 3S ii Rate MinJlnch L�t `n I i^a'` 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:\SEPTIC\PERCFORM.DOC I DEEROBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) C) -3 tole 212 3- 15 6 C-M5L p 14 413 15-- 64 C M-c—Sari . 1 look �b°�oCx�avel 4 - 131 C-z C S,A l o ( *14 �5e1° 6f2-el DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C nsi en % -S I � 4 -C Ja",4 I b l(p ' O-i. Gr'Rvei 1 Go i C a- 13 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 May: Above 500 year flood boundary No_ Yes .1/_ Within 500 year boundary No Y Yes Within 100 year flood boundary No.:V Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervio s material exist in all areas observed throughout the area proposed for the soil absorption system? � . If not,what is the depth of naturally occurring pervious material? Certification I certify that on PJov 12—.Uo I(date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required train' g,expertise and experience described in 310 CMMR 15,017. Signature Date p Q:4SEpTIMERC17ORM.DOC T t 7 No. ;Wto ^ � C� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes fppfication for bisposal 6pstem Construction 'Vermit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) Complete System ❑Individual Components. Location Address or Lot No.o2 9 /�f/c�� G�/ai y y Owner G(Name, 'dtess,and Tel.No. � Assessor's Map/Parcel c�2 P 9 /01 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 7,7 S— —27j9P .7.7-07' Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date ���a=�� Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. TQ to-.v C� Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 BoardgfVealth. Signed4 Date Application Approved by '166AYADate Application Disapproved by Date for the following reasons �� �� r Permit No: Date Issued 7 ..,. �*.y.,.. Ywr� .y F "a,. i�a, a.;n......r.• ,¢: - ' �.... n._,,q,,; w 4 No. `' t Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yet ftpYitation for ]Disposal 6pstem Construction vermit Application for a Permit to Construct( ) Repair( ) Upgrade(, Abandon( ) . 6 Complete System ❑Individual Components Location Address or Lot No., 9 -W54400(- Z,, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 9 'oe ov Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. t.�//�'J G'�. se�l3�G�/�' 7,7 S'' G+7p� .��`iYOd /'�i.e�?d •� 17f✓ 7-T-7 Type of Building: ! Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) .�S'G� gpd Design flow provided ��O' gpd Plan Date Number of sheets Revision Date Title i Size of Septic Tank -000'r1''p qkx f• Type of S.A.S. `.'""C-r Description of Soil r °Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: J 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 o ealth_ "-- Signed � v�v/� Date �" �•'/cam Application Approved by !' �j Date Application Disapproved by Date v for the following reasons Permit No. ozU y ` d y 1 Date Issued 7— 1— f --------_---------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded Abandoned( )by �/iJ at o� �i4/.�'.rf `/li .�/�,L has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.Q0 10 —OD l dated -7' a~f V Installer �i �,,E'�p�!//�` Designer 6''41.04 /P/A✓T® #bedrooms Approved design flow "-5;,e0 gpd The issuance of tYIA s permit shall not be construed as a guarantee that the system will 2ctionnas designed. 1 �' ` X, Date "7 I b Inspector )t' }: ----- ---------- ---- - O� ------------ - --------- Fee---f�-------- No. 9d 10 —� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-i BARNSTABLE,MASSACHUSETTS Misposal Opstem Construttion permit Permission is hereby granted to Construct( ) Repair( ) Upgrade Abandon( ) System located at gyp'" .G-ow and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years.of the date of this permit. l Date � .Z-- ((� Approved by / � i Town' of Barustable Regulatory Services Thomas F.Geiler,Director MAR& Pnblk Health Division Thomas McKean,Director 200 Main Street, Dyann186 MA 02601 Office: 508-8624644 Fax: 508-790-6304 Date. �'�/� Sewage Permit#�p`�'_�c� Assessor's Map/Parcel. 3,� 'Installer&Des' er CeIg cation Form Designer: ��� � Installer: 0_14V. Address: 0. ;3i;� ,t-0I,, Address: was issued a pen-nit to install a (date) (installer), Septic system at n based on.a design drawn by (� ess +1�o dated 4 a (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. Y certify that the septic system referenced above was installed. with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required)was inspected and the soils were found satisfactory. , OF (Installer's Signature UNQA'I. PINTO CIVIL in No.46504 x (Designer's ignature) A � ti � ) PLEASE RETURN' T4 BARNSTA ALE PUrBLIC HE DIv][SIOIv. CERTCATE COMPL CE WILL NQT 4 ISSUED UriT H, BOTH 'HUS FORM ANIFID AS- BU ELT C"--AIiE RECEICYED =BY THE BARNSTABLE PUSI.YC H A,I,TH DIVI ION. Jk xau. 04f ice f0MMk esfgnerc=i1Cadon form.doc Z0/T0 39Vd 60Z5968809 60:CT 0Z0Z/80/L0 APPLICANT: V ADDRESS: 0q, Marc I..n• ann'► DESIGN FLOW: L�o gpd REVIEWED BY: DATE: N/A OK NO Le al boundaries denoted [310 CMR 15.220(4)(a)] Street, Lot,tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided 310 CMR 15.2204 t Plan proper scale?(1"=40'for plot plans, 1"=20'or fewer for components) [310 CMR 15.220(4)] Easements shown [310 CMR 15.220(4)(b)] System located totally on lot served [310 CMR 15.405(1)(a) for / u ades]- i not, a variance is required 310 CMR 15.412(4 ) Location of impervious surfaces (driveways,parking areas etc.) / [310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR 15.220(4)(c)] Location and dimensions of system components anMareas [310 CMR 15.220(4)(e)]S stem Calculations [310 CMR 15.220(4)(f)]dail flow se tic tank ea aci re wired and rovided)soil abso tion s stem (re uired and rovided whether s stem desi ' 'for arba e grinder North avow [310 CMR 15.220(4)( )] Existing and proposed contours [310 CMR 15.220(4)( )] Location and log of deep observation holes(existing grade el. on each test) [310 CMR 15.220(4)(h)] V Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h)and(i)] ✓ Location and date of percolation tests(performed at.proper / elevation?) [310 CMR 15.220(4)(i)] I/ Percolation test results match*loading rate?-[310 CMR 15.242] Certification statement hy Soil Evaluator 310 CMR 15.220(4)0)] Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310.CMR 15.220(4)(n)] Location of every water supply,public and private,.[310 CMR 15.220(4)(k)] Address Sheet l of 7 within 400 feet of the proposed system location in the case lof surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case / of private water supply wells V Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. [310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located [310 CMR / 15.220 4 (m) (if water line cross see 310 CMR 15.211 1) 1]) v Profile of system showing invert elevations of all system / components and the bottom of the SAS 3 10 CMR15.220(4)(o)] V Stamp of designer 310 CMR 15.220 l and 310 CMR 15.22 0(2) Stamp of Registered Land Surveyor(required if construction / activities within 5 ft. of lot line) [310 C1V1R 15.220(3)] Test Holes adequate(two in each of the primary and reserve / unless trenches as permitted in 310 CMR 15.102(2)or as / approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] v Test hole adequate to demonstrate four feet of suitable material? 310 CMR 15.103(4)] Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benchmark within 50-75'of system [310 CMR 15.220(4)( )] Materials specifications noted? [various sections of 310 CMR 15.0001 System components not> 36" deep(unless Local Upgrade jApproval or LUA requested) 310 CMR 15.405(l(b) Address Sheet 2 of 7 Size OM P10 CMR 15.223(1)] Inlet tee located ten inches below flow line 310 CMR 15.227(6)] Outlet tee 14"or 14"+ 5"per foot for increase ft depth [310 CMR / r(6)]tee with as baffle or a roved filter [310 CMR 15.227(4)]egarding installation on stable compacted base [310 CMR (1)] tion between inlet andoutlet tees (no less than liquid 310 CMR 15.22 7(2) Inlet/Outlet elevations at least 12" above high groundwater - (except as described 310 CMR 15.227(5))or permitted for upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater) - / middle access at least 8" (b 7/07) [310 CMR 15.22 8(2)] V Access to within 6 " of grade - one port for systems<I000gpd, / two forsystems>1000 d 310 CMR 15.228(2)] . All at-grade covers secured to unauthorized.access? [310 CMR / 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Duo anc calculation Required/Done 310 CMR 15.221(8)] H-20 Where appropriate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.211] Required when other than single-family dwelling or flow>1000 ! d [310 CMR 15.223(1)(b)] First compartment 200%daily flow; Second compartment 100% daily flow 310 CMR 15.224(2) and.(3)) "U"pipe through or over baffle, outlet of each compartment with / as baffle or approved filter[310 CMR 15.224(4)] V Address Sheet 3 of 7 I ' Located at least ten feet from any water line? [310 CMR 15.222(2)] Disposal piping at least 18"below water line (when water and sewer cross, see 310 CMR 15.211(1)[1]) Cleanouts re wired/ rovided ? [310 CMR_ 15.222(8)] Thrust blocks specified in force mains?310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable / [310 CMR 15.222(6)] V Proper pitch on all runs? (.005 within gravity-distributed trenches / and beds) r310 CMR 15.251(9)and 310 CMR 15.252(2)(c)] V Siphonproblem/ leachfield below pump chamber) Vda or vent manifold specified? orientation of discharge holes specified?(not smaller "not larger than 5/8") [310 CMR 15.251(8) and 310.252(2)(h)] s specified (310 CMR 15.251(5)specifies various pipe owed) rS Stable compacted base [310 CMR 15.22](2)and 310 CMR / 15.232(2)(a)] V Splash plate or baffle tee required on inlet/provided?(when pressure sewer to d-box or steep pitch of gravity sewer) [310 / CMR 15.323(3)(a)] V Riser if deeper than 9" [310 CMR 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] Minimum sum 6" [310 CMR15.232(3)(e)] Watertight cover if<2000gpd); waterproof manhole if>2000gpd / [310 CMR 15.232(3)(d)] Capacity(emergency storage above working=design flow)? [310 CMR 231(2)] rService tbacks [310 CMR 15.211 (same as septic tanks)] ht 20-in minium access manhole at least 20"MUST BE / DE [310 CMR 15.231(5)] omponents accessible (not too deep with piping, disconriects accessible) Alarm floats - alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6)and (8)] Stable Compacted Base [310 CMR 15.221(2)] Buoyancy calculations needed ?Provided? [3.10 CMR 15.221(8)] I Address Sheet 4 of 7 - Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR / Required separation togroundwater? 310 CMR 15,,212)] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided?(system under driveway or >36"deep) [310 CMR 15.241] Inspection ports specified and within 3"final grade? [310 CMR / 15.240(13)] . Breakout requirements met?(No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] FY Chambers and Gal. in trench configuration supplied with inlet / every 20 ft. [310 CMR 15.253(6)] V Each structure with one inspection manhole(if>2000 gpd must be to grade) 310 CMR 15.253(2)] Aggregate 1'minimum-4'maximum. [310 CMR 15.253(1)(b)] 2'sidewall credit maximum [310 CMR 15.253(1)(a)] In bed configuration, inlet every 40 s . R. [310 CMR 15.253(6)] Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)] f 100 feet-maximum len h [310 CMR 15.251 1) a Minimum separation 2x effective depth or width whichever / eater(3x if reserve between trenches) [310 CMR 251 1)(d)] J Situated alon contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(l)[4] and Guidance Document] Nam minimum 2 distribution lines [310 CMR 15.252(2)(a)] Maximum separation between lines 6' 310 CM R15.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(c)] Aggregate depth below discharge pipes 6"minimum, 12" maximum. [310 CMR 15.252(2)(g)] Separation between beds 10'minimum. [310 CMR 15.252(2)(f)] I Bottom area used in calculations only 310 CMR 15.252(2)(i) Address Sheet 5 of 7 Pressure Dosed System ? Provided pump and piping calculations as required 310 CMR 15.220 4)(r)] Pressure dosing required on all systems.>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A / Remedial Use Approvals] V If used in gravelless system -make sure jet is directed as not to scour soil interface [Guidance Document] Inspections once per year(systems<2000 gpd) or quarterly (>2000 d)good to note on plan 310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)9 V Impervious barrier and/or retaining wall ?_f Guidance Document] Impervious barrier installation must be supervised by designer[310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer[310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? 310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2) and Guidance Document At least 5 ft. from impervious barrier to edge of SAS (1OR. recommended) [310 CMR 15.255 (2)(e)] Check DEP Approval letters for credits and design conditions If used with pressure dosing do not allow pressure discharge to our soil interface Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all V DEP Approval Conditions? Is there a note on the plan regarding tr e requirement for e etual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance / manual? Has applicant submitted a co y of a maintenance Are the variances listed on the plan ? [310 CMR 15.220 (4)( )] RLS Stamp necessary on plan if a component is within five feet of ro ert line [310 CMR 15.412(4)] New construction or increased flow proposed- [Refer to 310 CMR 15.414] Address Sheet 6 of 7 Is the system in a Designated Nitrogen Sensitive Area(Zone 11 for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? / [310 CMR 15.214(2)] V Are the nitrogen loads proposed in compliance? [310 CMR / 15.216(1)] �/ Pumping to septic tank? [310 CMR ]5.229 Shared Sys stem 310 CMR 15.290 F Address Sheet 7 of 7 -o posy IMMMUMMV PI7NEY 60WE5 � 02 4 A $ 05.320 0004606238 JUL16 2008 MAILED FROM ZIPCODE 02601 I 2150 0002 1041 9907MA a . LA —N-Cl- f N - 3 ya cz? � SYLVO29 029 4c 1 A4 c 02 Do/09/o8� � :. = UNABLE TO FORWARD/FOR RF=vZEW - NO FORW A➢ROINC5 ORDER ON FILE a RETURN TO POSTMASTER s=. OF ORIGINAL ADDRESSEE POReREVIEW ,1 � . . , i p • h 0 0 Do . I hioy G7 N I ■ Complete items 1,2,and 3.Also complete A. Signature m N w I item 4 if Restricted Delivery Is desired. ❑Agent Z a 1 ® Print your name and address on the reverse X ❑Addressee C1, V so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery � ` � M Attach this card to the back of the mailpiece, or on the front if space permits. n(� 00 I D. Is delivery address different from Item 1? ❑Yes 1 $y �9 1. Article Addressed to: t N [3o W If YES,enter delivery address below: No U. U.VIESZ� �-� �5 a L vas i S��ingn o o g r A•V-0t-A 1 3. Service i I 1ED,6rtified Mail ❑Express Mail { t0 Registered ❑Return Receipt for Merchandise {I ❑Insured Mail ❑C.O.D. 1 I 4. Restricted Delivery?(Extra Fee) ❑Yes Article Number _(rransfer from service label) 7006 215 2 0002 1041 9907 f t ) irn Receipt 102595-02-ra-1540 HI, 111111" I, s j *oFsHE rA Town of Barnstable Barnstable AS- Regulatory Services Department AmeiicaCfly • g Y p V BARNSTABLE, 9 6 9 ,��' Public Health-Division I , 4i'°jEa MAC A 200 Main Street, Hyannis MA 02601 -2007 I Office: 508-862-4644 Thomas i 'Geller Director '.FAX: 508-790-6304 Thomas A.,Wkean,CHO July 16, 2008 Jacques Sylvestre 29 Mark Lane Hyannis,MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410,091 S'TATF_SAN_ITA Y --NOTICE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at 29 Mark Lane, was inspected on July 15, 2008 by Jaime Cabot, 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 410.482- Smoke Detectors No Carbon Monoxide,(CO)Detectors were provided for'the.'bedrooms. -105 CMR 410.450..—Means of Egress. Observed rooms"being used as bedrooms within basement without proper second means of egress as,required by 780 CMR 3603.10.4.1 of .the Mass State Building Code. You are directed to correct the violations listed above within twenty=four (24) hours of your receipt of this notice by removing all beds from basement and ceasing and desisting from using any part of basement as sleeping quarters. You are ordered to remove entrance doors to basement rooms and open (2) two door way entrances to a minimum (5) five foot wide openings. 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-compfiance will result in a fine of$I00:00 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. 4PERORDER O THE BOARD OF HEALTH as A. McKean, R.S., CT Director of Public Health Town of Barnstable �l FORM30 CHIW HOBBS&WARREN rm THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH S14 e>L E_ �-- CITY/TOWN w ��AVZN DEPARTMENT ADORES TELEPHONE Z L� Address 2 MAXL4. L.4yE A*9IS Occupant_ AC Vis s�i Lvisr Floor Apartment No. "� No. of Occupants C.N. sy-r�,�„� v AL No.of Habitable Rooms I I No.Sleeping Rooms �_ �siclrsKA nta ��� 1 No.dwelling or rooming units No.Stories Name and address of owner_,o�G�Q��E.t--�_. I ti�S 2 1M41AL LAND S PA- 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.: O B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: I,ILA tv SS Chimney: BASEMENT Gen.Sanitation: "0 2 ad ,[ �Iv /� � Dampness: 2 G, SO 'd . O 4-1 OAT Stairs: ! ti LNt�Nl . Lighting: 5 1,V goQ A,1 S ¢-2M iT T STRUCTURE INT. Hall,Stairway: ,ra.0 otdty '( b S if jef I C_ Obst'n.: Hall, Floor,Wall,Ceiling: I .STA-riC Hall Lighting: r— DIE. Ps f l N f:L_0w Hall Windows: Z-4 Elf to IL D HEATING Chimneys: Central Y ❑ N Equip. Repair N0 co 0 if'f d r_-Z G 9 TYPE: Stacks, Flues,Vents: FOX. a /lq .,t y yg % PLUMBING: Supply Line: ❑ MS ❑ ST Waste Line:IP H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 11220 Fusin , Grnd.: . AMP: Gen. Corid. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry. Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 pia 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: eq �G Egress Dual and Obst'n: A S 2 ! GK p General Building Posted A, 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 INSPEC ION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES PERJURY ' f , INSPECTOR TITLE F� Ea C.,-T,/'� �^'$ �,,� DATE rL0 TIME �G'�O O 41 p P.M. A.M. THE NEXT SCHEDULED REINSPECTION �� A.M. F SHF T°�� Town of Barnstable Barnstable AlAmericaChy Regulatory Services Department BARNS-TABLE, D d ""S& Public Health Division j a639, ,� M a 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO July 16, 2008 Jacques Sylvestre 29 Mark Lane Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at 29 Mark Lane, was inspected on July 15, 2008 by Jaime Cabot, 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 410.4827 Smoke Detectors No Carbon Monoxide (CO) Detectors were provided for the bedrooms. 105 CMR 410.450—Means of Egress. Observed rooms being used as bedrooms within basement without proper second means of egress as required by 780 CMR 3603.10.4.1of the Mass State Building Code. You are directed to correct the violations listed above within twenty four (24) hours of your receipt of this notice by removing all beds from basement and ceasing and desisting from using any part of basement as sleeping quarters. You are ordered to remove entrance doors to basement rooms and open (2) two door way entrances to a minimum (5) five foot wide openings. 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 Citizen Web Request Pagel of 3 Fi Citizen Request Management Internal Use Request ID: 21961 Created: 7/7/2008 12:07:23 PM Cabot, Jaime i Status: Assigned To Staff Assigned To: Health Office 1 Anonymous: Yes Category: Chapter 170 : Housing Overcrowding E.C. Date: 7/21/2008 Created By: Couto, Melissa Citations: Health Office Time Worked: 6.00 Response Time: 9.00 Requestor Details: Email: Request Location: 29 MARK LANE Hyannis, Ma 02601 Parcel Number: Map: 289 Block: 146 Lot: 000 Request: CALLER STATED THAT THE OWNERS OF THE PROPERTY ARE RENTING OUT THEIR FINISHED BASEMENT TO APPROXIMATELY 5 PEOPLE. RENTAL IS UNREGISTERED. HE SAID THAT THERE IS A COUPLE WITH A BABY AND 3-4 GIRLS ALSO RENTING FOR THE SUMMER. Request Work History: Entered on 7/8/2008 4:26:29 PM by Cabot, Jaime JAC spoke to a visitor at the house and left a business card, and requested that the owner cal the Health department. Entered on 7/11/2008 8:53:49 AM by Cabot, Jaime Jacques Sylvestre called BOH. JAC returned call no answer. Entered on 7/15/2008 8:12:36 AM http://issgl2/intemalwrs/WRequestPrint.aspx?ID=21961 8/13/2008 Citizen Web Request Page 2 of 3 by Cabot, Jaime JAC spoke to Mr. Jacques set up an appointment for 10:00 On 7/15/08 Entered on 7/15/2008 1:14:41 PM by Cabot, Jaime JAC inspected property with home owner and all residents being on site. Completed Housing inspection report and checked files for building and septic permits. Internal Note History: System entry on 7/7/2008 12:07:24 PM: Assigned to Cabot, Jaime System entry on 7/8/2008 4:26:35 PM: Estimated completion changed from 7/9/2008 to 7/11/2008 Entered on 7/11/2008 8:53:49 AM by Cabot, Jaime Jacques 508-534-9640 Entered on 7/15/2008 1:19:50 PM by Cabot, Jaime 7/15/08 inspection noted the following: No CO detectors for bedrooms, house has 4 bedroom upstairs and has 2 finished rooms/ bedrooms (no second egress), a sitting area a bathroom and < "kitchen" in the basement. The owners daughter and an infant child were staying in one room an 3 women were staying in the other room. System entry on 7/16/2008 8:29:05 AM: Estimated completion changed from 7/11/2008 to 7/14/2008 Entered on 7/18/2008 8:27:45 AM by Cabot, Jaime JAC issued Board of Health Order Letter to cease and desist sleeping in basement. Owner ma! no longer be able to rent to more than one person, due to over crowding violations. System entry on 7/18/2008 8:28:50 AM: Estimated completion changed from 7/14/2008 to 7/21/2008 System entry on 7/23/2008 8:36:16 AM: Request Closed by cabotj System entry on 8/13/2008 3:33:34 PM: Request Reopened by cabotj http://issgl2/intemalwrs/WRequestPrint.aspx?ID=21961 8/13/2008 Citizen Web Request Page 3 of 3 Entered on 8/13/2008 4:02:53 PM by Cabot, Jaime Mr. Jacques called to say that he has just recieved Certified letteron 8/12/08. System entry on 8/13/2008 4:05:31 PM: -Please Review- email sent to Giangregorio, Robin http://issgl2/intemalwrs/WRequestPrint.asl x?ID=21961 8/13/2008 i I -5 17 1 s r q of jHKE r� 'own of Barnstable Barnstable Regulatory Services Department AFAmeecaC j • BARWrABLE. • t 63� ,��' Public Health Division A�E°MA+� 200 Main Street, Hyannis MA 02601 2007 m Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO July 16, 2008 Jacques Sylvestre 29 Mark Lane Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned b you located at 29 Mark Lane was inspected YY � p on July 15, 2008 by Jaime Cabot, 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 410.482- Smoke Detectors No Carbon Monoxide (CO)Detectors were provided for the bedrooms. 105 CMR 410.450—Means of Egress. Observed rooms being used as bedrooms within basement without proper second means of egress as required by 780 CMR 3603.10.4.1of the Mass State Building Code. You are directed to correct the violations listed above within twenty four (24) hours of your receipt of this notice by removing all beds from basement and ceasing and desisting from using any part of basement as sleeping quarters.You are ordered to remove entrance doors to base a 2) two door way entrances to a minimum (5) five foot wide o 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 I�,at� �ti��� �z�2ti�� �_ O Ir M Postage $ 4�C� 0 Certified Fee ru x ostrtiarl2o08 p Return Receipt Fee Here p (Endorsement Required) iC3 Restricted Delivery Fee (Endorsement Required) o USpS ram.-{ Total Postage&Fees fU Set o � treat, pt o.; Z M or PO Box-No.-- qi City,State Z/P+4 �-� A"A r-AA o2Co i Certified Mail Provides: e A mailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: e Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. o Certified Mail is not available for any class of international mail. c NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse maiipiece"Return Receipt Requested".To re:eive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery" a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 FORM30 C&,_ HOBBs&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS rBOARD OF HEALTH CITY/TOWN F �1L�Al.'T N _ a DEPARTMENT �A-/ Ag uIS OAA ADDRESS `'M Sv0 eW C'of ) a6 Z— y TELEPHONE Address 2 -�- �-4H� W1,yA41A1S Occupan �AC lets � LVcvriff Floor 'T� Apartment No. No.of Occupants Gy. No.of Habitable Rooms L l No.Sleeping Rooms 19 �isc,,a�n hCt �00,l�� No.dwelling or rooming units — No.Stories Name and address of owner:_4GQvF, ��.V�S C R t 2 1M0.4. LA W F 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 Gutters, Drains: Walls: Foundation: N it S. Chimney: BASEMENT Gen.Sanitation: "iq 2 g //V /Q Dampness: 2 V 0 ,O,g io Stairs: / n. yM Q.r.a Lighting: O A11 S 41 PoRM i1-r STRUCTURE INT. Hall,Stairway: A-h Itdty l ?I e— Obst'n.: 4•N Hall, Floor,Wall,Ceiling: 1 e- .SZO'79 C,4 MiT Hall Lighting: r OL P11 cte.AJ �rLOw Hall Windows: 1t�C C D HEATING Chimneys: Central Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: Fox X to. Aa 0 o,7 14 %8 y PLUMBING: Supply Line: ❑ MS ❑ ST Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusin ,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 L Bedroom 3 Bedroom 4 f"O 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: F Egress Dual and Obst'n: General Building Posted ¢ i �, 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 INSPEC ION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES PERJ7/21Y INSPECTORTITLE Ea L`fy� 1^r8 DATE 20 TIME �6�'O O P.M. 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 lisfnc. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fal within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violadon(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to wl-om 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 gEs. (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). I 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 trial 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 concitions (1) Lack of a kitchen sink of sufficient size aid 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 prctective 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 tie health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. I� I ' TOWN OF BARNSTABLE �. L.00AT-io SEWAGE # VILLAGE -Ft ✓V�J ASSESSOR'S MAP & LOT Z? l INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: ( pe) (size) LCOD (lei NO.OF BEDROOMS 111 llJ BUILDER OR OWNER Ndq A o OUJl� PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) I I Feet h Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility)` Feet Furnished by eavc (� A GA h AAZ(OLP A92-9 L as . 3 ZclU' T COMMONWEAL'ITI OF EXECUTIVE OFFICE Or ENV�-RGN1\4E-NT'-AL AFFAIRS DEPARTMENT OF ENVIRONMEN`IA , PROTE - w C :VED d .q Nov 2 7 2002 c sTABLE '��M 5y0v TOWH�OF DEPT. TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VLLUT''s.AR Y A.SSF,SSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM � 44- PART A CERTIFICATION MAP Property Address: 29 MARK LANE HYANNIS, 11'IA 02601 2�-q t L PARCEL Owner's Name: TOLCHINSKY LOT ' Owner's Address: 29 MARK LANE HYANNIS, MA 326;1;1 Date of Inspection: 10/31/02 co?v Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS Mailing Address: P.O. BOX 2119 TEATICKET, NIA..02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I ani a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes _ CojdaPasses _ Ne Evaluation by the Local Approving;A.U:::irity Fa Inspector's Signature: __.�. I at-1; 10/31 022 The system inspector shall su of this inspection report to the Approving Authority(Board ofl lealth or DEP)within 30 days of completing this inthe system is a shared system or l;.is 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 DEI'. 'I'hc original should be sent to the system owner and copies sent to the buyer, if applicable,and the all authority. Notes and Comments SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING NOW AND THEN EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ****This report only describes conditions at the time of inspections and under (lie coliditious of use at (hat lime.This inspection does not address how the system will perform in the future under the same or different conditions of use. Tiflr, 5 InCnPrtinn rnrm rill sr,nno I t Page 2 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 29 MARK LANE HYANNIS,MA 02601 Owner: TOLCHINSKV Date of Inspection: 10/31/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING NOW AND THEN EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined" please explain. n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed ND explain: n/a Page 3 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 29 MARK LANE HYANNIS,MA 02601 Owner: TOLCHINSKY Date of Inspection: 10/31/02 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(I)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance n/a "This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: n/a Page 4 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 29 MARK LANE,HYANNIS,MA 02601 Owner: TOLCHINSKY Date of Inspection: 10/31/02 D. System Failure Criteria applicable to all systems: You trust indicate"yes"or"no"to each of the following for alLinspections: Yes No _ X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped TWO YEARS BY OWNER. _ X Any portion of the SAS,cesspool or privy is below high ground water elevation. _ X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. _ X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet frorn a private water supply well with no acceptable water quality analysis. IThis system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] (Yes/No)The system fails. I have determined that one or more of tl:e 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. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—1 WPA)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 "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMIt 15.304. The system owner should contact the appropriate regional office of the Department. a Page 5 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 29 MARK_ LANE HYANNIS,MA 02601 Owner: TOLCHINSKY Date of Inspection: 10/31/02 Check if the following have been done.You must indicate "yes" or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection '? X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up`' X _ Was the site inspected for signs of break out'? X _ Were all system components,excluding the SAS, located on site'? X _ 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'? X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems'? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no X _ Existing information. For example,a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 5 Page 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 29 MARK LANE HYANNIS, MA 02601 Owner: TOLCHINSKY Date of Inspection: 10/31/02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: I Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use:(yes or no): NO Water meter readings, if available(last 2 years usage(gpd)):-n/a- 0"2 1®(—1 10o QAWIC,w Sump pump(yes or no): NO v Last date of occupancy: n/a �1 COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sg fit,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: TWO YEARS BY OWNER Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1972 13Y OWN Ell Were sewage odors detected when arriving at the site(yes or no): NO Page 7 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 29 MARK LANE HYANNIS, MA 02601 Owner: TOLCHINSKY Date of Inspection: 10/31/02 BUILDING SEWER(locate on site plan) Depth below grade: 12" Materials of construction:_cast iron _40 PVC Xother(explain): 20 PVC Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 6" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000 GALLONS" Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 4" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 14" How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. GREASE TRAP:_(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a 7 • Page 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 29 MARK LANE HYANNIS,MA 02601 Owner: TOLCHINSKY Date of Inspection: 10/31/02 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:_(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: n/a Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box,etc.): NO D-BOX PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a R Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 29 MARK LANE HYANNIS,MA 02601 Owner: TOLCHINSKY Date of Inspection: 10/31/02 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a ,i/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.SYSTEM SHOWS NO SIGNS OF FAILURE. PIT HAD 4' OF LIQUID IN IT AT TIME OF INSPECTION. PIT HAS 6" OF LEACHING LEFT IN IT. BOTTOM IS AT 7'6". CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil, signs of hydraulic failure, level of ponding;condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a 4 Page 10 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 29 MARK LANE HYANNIS,MA 02601 Owner: TOLCHINSKY Date of Inspection: 10/31/02 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. CO-) AA Zb' Iki 2.(i 10 2-Cj Ll i in Page 1 1 of 1 I ;OFFICIAL INSPECTION FORM-.NOT-FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPr,,cTION FORM` PART C. SYSTEM INFORMATION(continued) Property Address: 29 MARK LANE.HYANNIS, MA 02601 Owner: TOLCHINSKY Date of Inspection: 10/31/02 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record - If checked, date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: HAND AUGER- 12+FT. 11 � //Q✓1 r 5 or S-�Frs �N�i;n �� � r � �� �� � �----� � --� .- __._-, ._—, �D,�._.._ �a°� �� r�� � a �, � f �s� � ©o Citizen Web Request Page 1 of 2 P r a Y III I 5L\'SfAll �} Citizen Request Management - Internal Use b'.� I ♦ `ht.`r J Request ID: 21961 Created: 7/7/2008 12:07:23 PM Status: Assigned To Staff Assigned To: Cabot, Jaime Health Office Anonymous: Yes Category: Chapter 170 : Housing Overcrowding E.C. Date: 7/11/2008 Created By: Couto, Melissa Citations: Health Office Time Worked: 2.75 Response Time: 9.00 Requestor Details: Email: Request Location: 29 MARK LANE Hyannis, Ma 02601 Parcel Number: Map: 289 Block: 146 Lot: 000 Request: CALLER STATED THAT THE OWNERS OF THE PROPERTY ARE RENTING OUT THEIR FINISHED BASEMENT TO APPROXIMATELY 5 PEOPLE. RENTAL IS UNREGISTERED. HE SAID THAT THERE IS A COUPLE WITH A BABY AND 3-4 GIRLS ALSO RENTING FOR THE SUMMER. Request Work History: Entered on 7/8/2008 4:26:29 PM by Cabot, Jaime JAC spoke to a visitor at the house and left a business card, and requested that the owner cal the Health department. Entered on 7/11/2008 8:53:49 AM by Cabot, Jaime Jacques Sylvestre called BOH. JAC returned call no answer. Entered on 7/15/2008 8:12:36 AM http://issgl2/intemalwrs/WRequestPrint.aspx?ID=21961 7/15/2008 TOWN OF BARNSTABLE LOCATION C� 9 �/lt6r" e�`' SEWAGE# 0,00100 ®'7®/ VILLAGE � ASSESSOR'S MAP&PARCELc2 oQ'9 -- INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 'V/0 LEACHING FACILITY:(type) (size) NO.OF BEDROOMS / OWNER J. PERMIT DATE: .7 "® COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted'Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on / site or within 200 feet of leaching facility) ✓ Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY ^� k tl a � 0 � o - o D W �O V 4d � Citizen Web Request Page 2 of 2 by Cabot, Jaime JAC spoke to Mr. Jacques set up an appointment for 10:00 On 7/15/08 Entered on 7/15/2008 1:14:41 PM by Cabot, Jaime JAC inspected property with home owner and all residents being on site. Completed Housing inspection report and checked files for building and septic permits. Internal Note History: System entry on 7/7/2008 12:07:24 PM: Assigned to Cabot, Jaime System entry on 7/8/2008 4:26:35 PM: Estimated completion changed from 7/9/2008 to 7/11/2008 Entered on 7/11/2008 8:53:49 AM by Cabot, Jaime Jacques 508-534-9640 Entered on 7/15/2008 1:19:50 PM by Cabot, Jaime 7/15/08 inspection noted the following: No CO detectors for bedrooms, house has 4 bedroom upstairs and has 2 finished rooms/ bedrooms (no second egress), a sitting area a bathroom and < "kitchen" in the basement. The owners daughter and an infant child were staying in one room an 3 women were staying in the other room. http://issgl2/intemalwrs/WRequestPrint.aspx?ID=21961 7/15/2008 Town of Barnstable �oF��Tati -� o� Regulatory Services BA.RNS'CABLE. Thomas F. Geiler, Director 9 MASS. i639. Public Health Division pjED MA'I A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 July 15 2008 Attn: Hyannis Fire Health.Inspector Jaime A. Cabot conducted an inspection in response to a complaint. In accordance with the State Sanitary Code, 105 CMR 410.482, the Health Department is required to notify the Fire Department if there is a smoke detector violation, or possible smoke detector violation. The following property had possible smoke detector(and\or CO detector) violation(s): 29 Mark Lane,Assessors Map-Parcel: (289-146) - No Carbon Monoxide (CO) detectors provided for the bedrooms. h Jal A. Cabot, Health Inspector I Q:\Order letters\Housing violations\Rental ordinanceUire ViolationsTIRE TEMPLATE.doc TOP OFF DATION 24"diameter concrete covers EL=50.8 raised to within 6"of fimsh grade Hyannis, (or as noted) Inspection Port and cap with magnetic marking tape to i+nthin 3"of grade 0, 5.0' 5.0' 5.0' )-; S.0 MA EL=23.5 t fL=24.5t EL=24.5-26.0(max) T West A4ain St j Cv I olln house SAS Ter 18"Minimum D I °� Cover for H-20 N �� LOCUS + Rated � � s 2/.9_ 20.8 f� gted�n Rd co in Vent Inspection Ports(see Note#4) v �o ,s 20.40 O N Pro osed PVC Tee,� 19,50 PLAN VIEW. Ardor Way P Gas Baffle.anima SCALE: 1 " = 10' 5.-4 '- Congest Run TWENTY SEVEN(27)AD5 ARC 36 7. (36162502)UN1T5/N BED DO-6 CONFIGURATION IN THREE(3)ROW5 LL=14.5+Adjusted High Groundwater+ V A RI A N C E 5 RE Q U E 5 T E D /500 GALLON (H-20 Rated) OF N/NE(9)UNIT5 EACH EL=J 4./-+Observed Groundwater -r- U m SEPTIC TANK D-LJDX LL��� C/ /�1/VILJ�/\� EL=/2.4+Bottom of Test Hole VARIANCES REQUESTED FROM 3 10 CMR 15.000 AND TOWN OF 51 T E LO C U 5 H-20 Rated SANDWICH LOCAL UPGRADE APPROVALS: N FLOW P RO I LE 3 10 CMR 1 5.22 1 (7)General Construction Requirements for All System NOT TO SCALE HIGH GROUNDWATER LEVEL CALCULATIONS: Components: NOT TO SCA-E 1.)SAS > 3G"Below Grade: Depth To Water Table(4120110): 9.3'(EL=14.1±) G2" Held 2G"Variance Requested 1 .) Deed Book I G7 I G, Page 32 Appropriate Index Well: MIW-29 g 2.) Assessor's Map 269, Parcel 14G Water Leve nge Zone: C(3-4') hJ e� Ih , ( ���� r,A�rGC gjf�Q S �f'� Current Depth To Water Level For Index Well (03/05): G.0' ` Water er CO N STI�U CTi O N NOTESproperty Is In a Zone II of a Public Water Level Adjustment: 0.4' Water Supply /.)ALL WORK5HALL CONFORM TO 7HE5TATEENVIRONMENTAL CODE, TITLE5 Estimated Depth To High Water: 8.9' (EL= 14.5±) 4.) Flood Zone: C (3 10 CMR l 5.000):STANDARD REQUIREMENTS FOR THE SlT/NG, CONSTRUCT/ON, 5.) Vertical Datum Shown Is Assumed 1NSPECTON, UPGRADE; AND EXPAN5101V OF ON-5/TE SEWAGE TREATMENT AND Parcel 145 DISPOSAL 5Y5TEM5 AND FOR THE TRANSPORT AND 015P05AL OF SEPTA Of AND Town Water THE LOCAL BOARD OF HEALTH REGULATIONS. 2.) ANY5EPT/C SYSTEM COMPONENT INSTALLED!N A LOCAT/ON WHERE THERE 15 Vacant Land 89 49 F°""I>' Parcel I Fen I POTENTIAL FOR VEHICLES OR HEAVYEQUIPMENT TO PA55 OVER lTSHALL BE / DE5/GNTD TO WITHSTAND AN H-20 LOAD/NG !F UNDER AN IMPERVIOUS SURFACE O / e / / / LEGEND SYSTEM SHALL BE VENTED TO THE ATMO5PHERE _lip , EXISTING SPOT GRADE 3.) TO MINIMIZE UNEVEN SETTL/NG, ALL SYSTEM COMPONENTS SHALL BE IA15TALLED O / ;, ,;/ ' 96x3 PROPOSED SPOT GRADE ON A STABLE MECHANICALL Y- COMPACTED BASE ON SIX INCHES OF CRUSHED - - 18.1'STONE I O'min EX15tmg DrlveWay" vH EXISTING CONTOUR �. / , F3ath 0 / Garage � o PROPOSED CONTOUR 4.)COVERS OVER THE/NLTTAND OUTLET TEES OF THE5EPTIC TANK, THE Batt, j ozi w WATER SERVICE LINE DISTRIBUTION BOX, AND THE 501L ABSORPTION SYSTEM SHALL BE RAISED TO E U WITHIN 6"OF FINAL GRADE LEACHING FIELDS, TRENCHES, AND OTHER SOIL 22.. OVERHEAD UTILITY LINES ABSORPRONSYSTEMSWITHOUTACCE55MANHOLES5HALLHAVEATLEASTONE Pro osed5A.5 4a U UNDERGROUND UTILITY LINES 0)INSPECTION PORT CONSISTING OF PERFORATED 4'PVC PIPE PLACED Living B,jrr„ Bdr"I (See Detail) 20rrytn Patio i GAS SERVICE LINE Bdrm / VERTICALLY TO THE BOTTOM OF THE SOIL AD50KPT/ON SYSTEM WITH A CAP, TIED > ° TOP Of BANK WITH MAGNET/C MARKING TAPE, ACCESSIDLE TO WITHIN 3"OF FINAL GRADE First Floor Second F EDGE OF CLEARING loor • ' r 5.)PIPING SHALL CONSIST OF 4"SCHEDULE 40 PVC OR EQUIVALENT. PIPE SHALL Ewstinq Sepbc Tank and : d tb `-'- FENCE BE LAID ON MIN/MUM CONTINUOUS GRADE OF NOT LESS THAN 2%FROM THE Leach Pit to be Abandoned 0 b TEST HOLE LOCATION BUILDING TO THE SEPTIC TANK, AND NOT LE55 THAN 1967 OTHERWISE. (See Note R 19) % m ELOOI� PLAN Existing 4 pr 5T SEPTIC TANK 6.)D/5TRIOUTIONL/NES FOR THE501LAB5ORPTIONSYSTEM5HALLBE4" r edroom DwettlncS I n DB DISTRIBUTION BOX DIAMETER SCHEDULE 40 PVC(OR EQUIVALENT)LAID AT 0.005 FT/FT. UNLESS NOT TO SCALE 1 5, �l IL _ 1 1.0' op of Foundation (p SAS 501L AB50KPTI ON SYSTEM OTHERW/SEN07ED. LIIIE55HALL BE CAPPED A T ENO OR A5 NOTED. Parcel 132 10'min �20 0, ST 10'min EL=24.4± Reserve RESERVED FOR FUTURE USE 7.)LlNE5 FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIR5T TWO(2) Town Water -� TP-2 DB (min) FEET BEFORE PITCHING TO THE50/L ABSORPTION SYSTEM. DISTRIBUTION BOX I CERTIFY THAT I AM CURRENTLY APPROVED BY THE SHALL BE WATER TESTED TO ASSURE EVEN DISTRIBUTION. DEPARTMENT OF ENVIRONMENTAL PROTECTION PURSUANT TO 23 3 10 CMR 15.017 TO CONDUCT 501L EVALUATIONS AND THAT w w w 8J GROUT TO BE U5E0 AT ALL POINTS WHERE PIPE5 ENTER OR LEAVEALL THE ABOVE ANALY515 HAS BEEN PERFORMED BY ME w CONCRETE5TRUCTURE5 IN ORDER TO PROVIDE WATERT16HT5EAL. CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND T) • k EXPERIENCE DESCRIBED IN 310 CMR 15.017. 1 FURTHER 1p 5.)HEAVYEQUIPMENTSHALL NOTBEALLOWED TO OPERATE OVER THEL/MNT5 OF CERTIFY THAT THE RESULTS OF MY 501L EVALUATION AS O ' Existing IINDA J. Ln THESEWAGEDI5PO.5AL FIELD DURING THECOUR5EOFCON5TRUCRONOFTHE INDICATED ON THE ATTACHED 501L EVALUATION FORM, ARE Driveway PINTO .� SYSTEM. ACCURATE AND IN ACCORDANCE WITH 310 CMR 15.100 O Lot 2 CIVIL THROUGH 15.107 z No.46504 l0.)1N ACCORDANCE WITH 310 CMR 15.221, ALL SYSTEM COMPONENTS 5HALL 1 0,2 1 1 S.F.± K = 5 0.33' pa BE MARKED W/TH MAGNETIC MARKING TAPE , L = 1 0.04' '�� GL S T ER ��4r I I.) THERE ARE NO KNOWN WELLS WITHIN 150'OF THE PROPOSED SOIL ` ,{. 1 Fence 1 0 3 9 4' AD50RPT/ON SYSTEM. �i,+,/�, ° v Linde J. Pinto, certflied Soil Evaluator S 86 19'30 W 12)FROM THE DATE OF THE/NSTALLAT/ON OF THE SOIL ABSORPTION SYSTEM Parcel 147 UNTIL RECEIPT OF THE CERTIFICATE OF COMPLIANCE THE PERIMETER SHALL BE Town Water Survey Mork bp. STAKED AND FLAGGED TO PREVENT USE OF THE AREA THAT MAYCAU5E DAMAGE - - - TO THE SYSTEM. BENCHMARK A & Af Land Services Corner Concrete Bulkhead /3.) THE DES/GNERW/LLNOT BERESPONS/BLEFORTHESY5TEMASDES/GNE TEST HOLE LOGS 618 Mein Street D EL=23.0 (As5umed Datum) SITE PLAN South Yarmouth, MA 0,2664 UNLESS CON5TRUCTED A5 SHOWN ON PLAN. ANYCHANGE5 5HALL BEAPPROVED Parcel 038 - __ IN WRITING BY THE DESIGNER. Town Water Ph. (508) 737-1777 Email anmlend®comeast net Test Hole#I (EL=23.4±) SCALE: I " = 20' I4.) THE BOARD OF HEALTH REQUIRES INSPECTION OFALL CONSTRUCTION BYAN AGENT OF THE BOARD OF HEALTH AND THE DESIGNER. THE DESIGNER 5HALL Depth Layer 5cil Class Sod Color Comments CERTIFY IN WRITING THAT THESEWAGT DI5P05AL SYSTEM WAS INSTALLED 1N Prepared for: ACCORDANCE WITH THE TERMS OF THE PERMIT AND THEAPPROVED PLANS. 46 0"-3" A Fm m e-Medw Sandy Loam I OYR 212 P HDURS ADVANCE NOTICE 15 REQUESTED. 15" B Fine-Medium Sandy Loam I OYR 4/3 1 @ SYSTEM DES 1 G N CALCULATIONS JacUe5 S a Y 5"-GG" Cl Medium-Coarse Sand I OYR 4/G 50%Gravel - Perc 52" Ivestre 15.)CONTRACTOR 51-IALL BERE5PON51BLEFOR DETERMlN//VG THELOCAT/ON OF GG"-132" C2 Coarse Sand I OYR 4/G 30%Gravel-GW @ 1 1 2" 29 mark Ln., hyanrn5, MA ALL UNDERGROUND AND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OFANY SEWAGE DE516N FLOW REQUIRED.•4 BEDROOM DWELLING Qa WORK. 7H/5 INCLUDES, BUT 15 NOT LIMITED TO, REQUESTS TO 0165AFE ANY 110 GPD/BEDROOM=440 GPD REQUIRED P r0 o5e d Se wa e D 1 s 0531 5 5 to m PRIVATE UT/L/TYCOMPAN/TS, AND THT LOCAL WATER DEPARTMENT. Test g p y Test Hole#2 (EL=23.3±) INSPECTION NOTE: 29 mark Ln., Hyann15, MA, 16.)CONTRACTOR SHALL VERIFY THAT ALL WA5TTL1NE5 ARE CONNECTED BY WATTR SEWAGE RATION FLOW PROVIDED: Y'NINE(9)UNITS EACH. SEVEN(27)ADS UNITS/N BED TEST/NG WITHIN THE DWELLING PRIOR TO INSTALLATION OFANY5EPTIC Depth Layer Sod Class Sod Color Comments CONE/GURAT/ON!N THREE(3)ROWS OF PRIOR TO FINAL IN5PECTION BY THE ENGINEER,5Y5TEM COMPONENTS. NEEDS TO BE COMPLETE INCLUDING BUILDUP FOR COVERS. Prepared by: z 0"-4" A fine-Medium Sandy Loam I OYR 211 Vt=j(440/0.74)/(4.8 FT /FT)/5.0 LFJ =24.7ADS UNITS 17.)CONTRACTOR SHALL VERIFYEX15T1N6 INVERT ELEVATIONS PRIOR TO 4"-13" B fine-Medium Sandy Loam I OYR 4/G REQUIRED(27 PROVIDED) /N5TALLATION OFANY.5EPT/C SYSTEM COMPONENTS. 13"-GO" Cl Medwm-Coarse Sand I OYR 5/G 50%Gravel GO"-1 32" C2 Coarse Sand I OYR 7/2 Loose 480 GPD PROVIDED>440 GPD REQUIRED 16.)INSTRUMENT SURVEY CONDUCTED FOR PROPOSED WORK ONLY. 51TE PLAN �I SEPTIC TANK CAPACITY RTQU/RED: 440 GPD X 200% =880 GPD REQUIRED " I l►� SHALL NOT BE USED FOR 5TAKING, OR ANY OTHER PURPOSES. 5EPT/C TANK CAPAC/TYPROV/DED: /500 GALLON 5EPT/C TANK(MIN/MUM ALLOWED) DATE OF TESTING: 04/20/10 I9.)EXISTING 5EPTIC COMPONENTS TO DER,-MOVER. ANY CONTAM/NATED SO/L 501L EVALUATOR: LINDA J. PINTO, P.E., C5N ENGINEERING A 6ARBA6E015P03AL 15 NOT PERMITTTD W/TH TH/5 DESIGN FLOW O 20 40 GO " SHALL BE REMOVED FOR A DISTANCE OF FIVE(5)FEET LATTRALLYFROM THT SOIL BOARD OF HEALTH AGENT: DAVID STANTON, BARNSTABLE HEALTH DEPARTMENT P.O.Box 2030 Phone:(508)274-7347 AB50RP7_10N SYSTEM AND REPLACED WITH CLEAN SAND. AREA TO BE COMPACTED PERCOLATION RATE: LF-55 THAN 2 MIN/INCH IN "C" LAYERS Teaticket,MA 02536 Fax:(508)548-5478 TO MINIMIZE SETTLING. now SCALE 1"=20' C:\C5N\RR-MarkOD5-RR-Mark.dw6j Date: 0412GI10 Scale: As Shown 1 By: LJP Check: MTA Project No. C57N0084