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0107 OLD CRAIGVILLE ROAD - Health
1 U7 Old.Craigville Road .4, . Hyannis A= 248 - 114 I i TOWN OF BAR7NSTABLE LOCATION I67 ()1 Clic,��U Il . �C� SEWAGE# aQ1 �t. -3,q VILLAGE_��/G.rJ,-J 1 S ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. cLN—Vif0u"�tO lNg SEPTIC TANK CAPACITY x i g t►�c LEACHING FACILITY: e c (k� (type)�in r t,SL��� (size) 6 NO.OF BEDROOMS 3 OWNER Norzck PERMIT DATE: // — 1 / 2 COMPLIANCE DATE: / — 2 — Separation Distance Between the: n1t`ir.)C ��cou�YC�C�� Maximum Adjusted Groundwater Table toathe Bottom of Leaching Facility C&C Feet Private Water Supply Well and Leaching Facility(If any,wells exist on Vk 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 / �m L _ W � o 0 O ce �� � � � N ✓ � C,S' G. I � � G .S W � s. ..0 C,r ?� -- i � i t ` � � ' G1 � N C,J � � tip Qj .._.. .� �s \ W � s � s �� � C!' r , No. Fee "V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for *spo6a1 .pstrm CDnstruttion 3permit Application for a Permit to Construct( ) Repair(V�Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /(9 7 ®1 C��, ,.1 l Y 1 Owner's Name,Address,and Tel.No. Abaj Assessor's Map/Parcel ;Z L-I 6 I i L Installer's Name,Address,and Tel.No. VDesigner's Name,Address,and Tel.No. DovS)c5 R 13ir_, v 1:,-j L -i lr_ti W - ..., Type of Building: Dwelling No.of Bedrooms Lot Size 1 t,5-jy sq.ft. Garbage Grinder( ) Other Type of Building 1novs r No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '; gpd Design flow provided -3 gpd Plan Date lo 1-7 Number of sheets `2_ Revision Date Title Size of Septic Tank 46�- x5 f j All Type of S.A.S. �•j,'o d, t`(r i!S T s SjCT Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1.N 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 Bo of Health. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons n 0 Permit No. 9-o �` 3`� Date Issued f ., - - -- - - -- — - - -- ----------------------------------------------------------------------------------------- - No. a61 I ,mil Fee w THE COMMO,�,WEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS � �pfication for Sir bat *pstem Construction Permit 1 • 1 Application for a Permit to Construct( ) Repair(vy"Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /01 OI c) C va, i l 1 r Owner's Name,Address,and Tel.No. _ nbW c�lL A ssessor s M -<ap/Parcel L 4Cc_ , Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. I "i,,)s1C5 R i31�.,�,.j 5 jL .� Type of Building: Dwelling No.of Bedrooms 7 Lot Size 11 !pop sq.ft. Garbage Grinder( •) Other Type of Building Z_r No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) : !3 G gpd Design flow provided ��,</, }� gpd Plan Date /4') /?mod, Number of sheets 7--- Revision Date. Title m Size of Septic Tank y� /< Type of S.A.S. „d, �4•U.S . �I Description of Soil Nature of Repairs or Alterations Answer when applicable) I Date last inspected: I 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 i Compliance has been issued by this Board of Health. j Signed Date i f-^ Application Approved by ` Date 71_ Application Disapproved by Date for the following reasons ' / Permit No. og o I d 3 y Date Issued r 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 'Z)6 4 Z� at i pT i,-) rf r ;5�� Erg Ord E� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.d 0 J1- 3 L/ dated 1� Installer j a Q Designer #bedrooms -►, Approved design flow r gpd The issuance of this permit shall not be construed as a guarantee that the system will fun o as I sign Date 1 Inspector -------------------------- . _ -_-_----------_--------------- --_---- - ------. ------------ -------- No. ol) - 3 Fee /6V - _ _ - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(v� Upgrade( ) Abandon( ) System located at e2/41 �� _� ��, L r „4--lAl � 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. j Provided:Construction must be completed within three years of the date of this permit. Date Approved by hU^�LX 11/02/2012 14:17 5084775313 ENGINEERING WORKS PAGE 01 Town of Barnstable Regulatory Services Thomas F.Geiler,Director NAM Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-4304 Date: Sewage Permk#;2 A or's Map/Parcel Installer&DesiUer Certftgt ]Form Designvr: Inc . Installer: u9~ ✓r 4 vt Address: 1 z W, Crass C l cl 2d- _ Address: ' 0, T�c V, �a«z JAsl e M A- 6 Z& y Ct�k--c- +1 U, IMla C? on _-- 1 � V% was issued a permit to install a (date) (installery _ 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. 1 certify that the septic system referenced above was installed with major changes (i.e. er than 10 lateral relocation of the SAS o �� r 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)w . ed and the soils were found satisfactory. J'A OF PETER T. installer's Signature) CIVILEE �Iw10.981Q�� 0 Designer's Signature) (Affix Desigtx ) PLEASE RETURN TO BARNSTABLE PUBI HEALTH DIVISION. CEItTMCATE OF CO'MIPLLANCE WILL NOT BE ISSUED UNTII. BOTH THIS FORM ANDAS- BUILT CARD AM D B $ THANK YOU. Q:office fannAdesigurcertificsfian fbm doc Town of Barna.ble r# Department of Regulatory Services Public HealthDivision. i o 3 Hate. ) 200 Main Street,Hyannis MA 02601 Date Scheduled_ // `l �J �1 Time F1 ee Pd. Soil Suitability Assessment for S e Disposal Performed.B : 2/�'� .G�� �2 y Witnessed By: Lv� LOCATION.& GENERAL INFORMATION Location Address )Q 7 le/ / vi j� Owner's Name , (/L /�(�`t✓f�cp ✓ 40 "K rj c-Y�1 Address /lea c1tL L( �r vY'�I lAssessor's Map/Parcel: S1 C n4 f Le Engineer's ame NEW CQNSTRUCTION REPAIR Telephone# 737--y-7 r.0 Land Use � � 4 Slopes(%) 1 —Z Surface Stones /V4f A-P- Distances from: Open Water Body 7 3 CC/ ft Possible Wet Area nl/,014 ft Drinking Water Well a 1`� ft Drainage Way N ft Property Line j 3+/-^' ft ,Other` ft SI{ETCH:(Street name,dimensions of lot,exact locations of test'holes&perc tests,locate wetlands fn proximity to holes) _n tN 0 L® Ci2A 1 C4-vr—(-� A9 C ;_ QyhAJaS� N t:- Parent material(geologic) Depth to Bedrock LA— z.L- D pth to Groundwater. Standing Water in Hole: Weeping from Pit FpCe a C> Estimir a ated 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 fr. Index Well.# Reading Date: Index Well levelr_:.�� Adj,(Actor Adj.Groundwater Level,mp PERCOLATION TEST Date- Thne Observation !� Hole# lam' Time at 9" Depth of Perc 36 Z'� G 416-,S Time at 6". Blatt Pre-soak Time® �t'>;1. /'S ° 15me(9"-6") End Pre-soak Rate MinJ1nch C�' 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:\SEPTICIPERCFORM.DOC A i 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) t.oy,Zs/� 26 M-C s SYlq DEEP OBSERVATION HOLE LOG Hole# Z- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Iviunsell) Mottling (Structure,Stones,Boulders. Consistency. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Cbnsisten6yGravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders. Consistency. Myln- t Flood Insurance Rate Map: f Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? �f es _— If not,what is the depth of naturally occurring pervious material? Certification I certify that on V (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 training,expertise and experience described in 310 CMR 15.017. Signature Date Q:GSBPTl0PERCFORM.DOC Town of Barnstable Barnstable pptNE T BOARD OF HEALTH A&Me`eaC'ly �( nA MASS,M S, 200 Main Street, Hyannis MA 02601 � ASS. Q �ArED MAt A�0 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi CERTIFIED MAIL# 7011 0470 0001 4525 7321 July 3,2012 Bank of America, NA 475 Crosspoint Parkway Getzville,NY 14068 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 107 Old Craigville Road, Hyannis,MA was last inspected on 12/8/2011, by Michael T. Bisienere, a certified septic inspector for the state of Massachussetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5(310 CMR 15.00) DUE TO THE FOLLOWING: • Backup of sewage into facility or system component due to overloaded or clooged 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 with 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 Second Ltr • Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\l07 Old Craiville Rd.,Hy,2nd Itr.doc SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signatu� t �� Rem 4 if Restricted Delivery is desired. rT// IN a9�t ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. Received by( fed Name) C. Dat of Dpery ■ Attach this card to the back of the mailpieoe, 2 or on the front if space permits. D. Is delivery address d'dten rrt from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑NQ , Bank of-America NA 475 Crosspoint Parkway 3. Service Type Getzville, NY 14068 o Certified Man o Express Mau ❑Registered ❑Return Receipt for MerchayfMV ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑ 2. Article Number 7 011 0470 0001 4525 7321 ffimnsfer from service labeo Ps Form 3811,February 2004 Domestic Return Receipt to2595-02-M-1540 I I UNITED STATES POSTAL SERVICE First-Class Mail I Postage&Fees Paid USPS N Permit No.G-10 I 1 ° Sender: Please print your name, address, and ZIP+4 in this box • I I I I Town of Barnstable I Public Health Division 200 Main Streety Hyannis, MA 02601 I I I I ttJJ ii J! tt jjjj III { i III jj Jj ii iF�l3IIIIIIIIIIIIIIiIIIIIIIlIIliltIIIIIIIIIIIIIIfIfIIII IIIIjIi Postal M (Domestic m N Ln OFFICPAL USLn Postage $ Z\S o26�j rl Certified Fee O Posbnerk O Retum Receipt Fee O (Endorsemerd Retred) Restrtatad Delta Fee r%- (Endorsemerd Requlred) =11 C,Q� O ToW Postage&Fees $ u rl rq Bank of America NA 475 Crosspoint Parkway Getzville, NY 14068 Certified Mail Provides: a Amailing receipt a A unique identifier for your mailpiece it: A record of delivery kept by the Postal Service for two years Important Reminders: { - a Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. a Certified Mail is notavailable for any class of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. a 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 mailpiece'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®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. 'f 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 f' Town of Barnstable Barnstable P�'°f TNF Tp�y BOARD OF HEALTH ;edcaCity B' ,MASS. O 200 Main Street, Hyannis MA 02601 039. �pIFD MAt 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi CERTIFIED MAIL # 7011 0470 0001 4525 7321 July 3,2012 Bank of America,NA 475 Crosspoint Parkway Getzville,NY 14068 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 107 Old Craigville Road, Hyannis,MA was last inspected on 12/5/2011;by Michael T. Bisienere, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 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 with 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 Ltr 1 Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\107 Old Craiville Rd.Hy.2nd ltr.doc Am •. • Ln ru u7 ru i Postage $ gyp,0260, Certified Fee 0 Postmark '0 Return Receipt Fee v C3 (Endorsement Required) gam' Restricted Delivery Feet ` (Endorsement Required) `` Y Q 0 Total Postage&Fees $ rl i o C3 Carole A. Morris ' c/o Bank of America,NA 475 Crosspoint Parkway Getzville,NY 14068 Certified Mail Provides: o 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: o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail Is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. a 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 mailpiece Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is required. o 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". o 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 3600,August 2006(Reverse)PSN 7530-02-000-9047 r lot , ® Complete items 1,2,and 3.Also complete 7Sgnatu7m ���� item 4 if Restricted Delivery is desired. ent R Print your name and address on the reverse • ❑ ssee so that we can return the card to you. B. Received by(Pri �(y��I 5ia elive`ry 0 Attach this card to the back of the mailpiece, V�l'"''r or on`the front if space permits. " <. D. Is delivery address different from item 17 ❑Yes` f 1. Article'Addressed to: If YES,enter delivery address below: ❑ No 775 'e A. Morris r Li Bank of America,NA �Crosspoint Parkway ; :r M ille,NY 14068 Getzw s. se ice Type �- Certed Mail ❑Express Mail r ❑Registered ❑Return.Receipt for.Merchandise ❑ Insured Mail 11C.O.D. 4. Restricted Deliverj/1(Extra:Fee) -❑yp 2. Article Number 7�11 047� 00�1 4525 7253C� (Transfer from service label) M PS Form 381.1,February 2004 Domestic Return Receipt' 102595-02-M-1540 I UNITED STATES POSTAL SERVICE First-Class Mai{ Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name,address, and ZIP+4 in this box • I I I I i Town of Barnstable Public Health Division I 200 Main Streety Hyannis, MA 02601 I t�lilitil}�31�i{j{Y55iik1�fli3ll�flt11}31ti�tllii}i�liifilflii i I' i i Town of Barnstable Barnstable �p THE T ti�P��ys BOARD OF HEALTH e"aCity 9 BARN STABLE, 200 Main Street, Hyannis MA 02601 m Qj t6gq. �0 A tFD M 7 MA't 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M. Junichi Sawauanagi -� i 4 CERTIFIED MAIL# 7011 0470.0001 4525 6874 May 24,2012 Carole A. Morris c/o Bank of America,NA 475 Crosspoint Parkway Getzville,NY 14068 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 107 Old Craigville Road, Hyannis, MA was last inspected on 12/8/2011, by Michael T. Bisienere, a certified septic inspector for the state of Massachussetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 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. On January 5"'2012 you were ordered to repair or replace the septic system within sixty(60) days from the date you receive notification. However,the system was not replaced as of this date (May,2012). You are again ordered to replace the failed system within thirty (30) days. Failure to repair/replace the septic system with the deadline period will result in future enforcement action PER ORDER OF THE B ARD OF HEALTH T omas McKean, R.S. CHO Agent of the Board of Health Second Ltr Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\107 Old Craiville Rd.,Hy,2nd Itr.doc CEr p i . •. • .•. Ln Ul rll OFFICIAL UST trl Postage $ is r_1 Certified Fee O Postmark d O d Return Receipt Fee (Endorsement Required) �Hff ere4 2012 p Restricted Detivery Fee (Endorsement Required) 0 �PS Total Postage&Fees r—1 -- — o ,Carole A. Morris-Estate of �Cgt 'c/o.Bank'of America,NA I .475 Cros's hint Parkway Getzville,NY 14068 Certified Mail Provides: o A mailing receipt t a A unique identifier for your mailmlp o A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mails or Priority Mail®. c Certified Mail is notavallable for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. a 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 mailpiece"Return Receipt Requested'.To receive a fee waiver for a duplicate return receipt,a USPSO postmark on your Certified Mail receipt is required. o 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° n 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 I i ER:-COMPLETE • 'j COMPLETE,THIS SECTION,ON DEL ■ Complete items 1,2,and 3.Also complete A. Signatu item 4 if Restricted Delivery is desired. X f Agent ■ Print your name and address on the reverse Addressee so that we can return the card to you. B:Rece me °' ate f Delivery a Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter,delivery address below: ❑ No I Carole,,* orris-Estate of c/o Ba%WiNof America;NA '475 Crd�point Parkway 14068 3. Service Type GetzvilTe,NY ❑Certified Mail ❑Express Mail ❑ Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7011 0470 0001 4525 5549 (Transfer from service/abeq 7 r1( I .PS Form 3811,February,2004 Domestic Return Receipto25so2-Mrt¢ao ! 1 i is S k UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No.-G-10 I ° Sender: Please print your name,address, and ZIP+4 in this box • i Town of Barnstable Public Health Division 200 Main Street I Hyannis, MA 02601 I � � I I I lll, I11,lM 0.1111,1il11 Ellie 1i111,t11,1iA,,,ol,ht Town of Barnstable Barnstable OF THE Tp� kaltd Regulatory Services Department er'caM 4 nARNSTABLE, 9 MASS. Am te39. ��� Public Health Division reo 2007 M a 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7011 0470 0001 4525 5549 January 5 2012 Carole A. Morris c/o.Bank of America, NA d 475 Crosspoint Parkway Getzville, MY 14068 i ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 107 Old Craigville Road,Hyannis, MA, was last inspected on 12/8/2011, by Michael T. Bisienere, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Fails" under the guidelines of the 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 with the deadline period will result in future enforcement action. ORDER-OF T E BOARD OF HEALTH C . j. omas c n, R.S.S. Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures\Town of Barnstable.doc I I ` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 107 Old Craigville Road Property Address Bank of America/ Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information forms on the . I computer,use .1. Inspector: only the tab key to move your Michael T. Bisienere cursor-do not Name of Inspector use the return key. A&K Septic Systems Plus Company Name Q 565 Carriage Shop Rd. Ilk 10 Company Address East Falmouth MA 02536-' Cityrrown State Zip Code 508 540-6706 S13938 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.]am a DEP approved system inspector pursuant to"Section 15.340 OC Title 5 (310 CMR 15.000).The system: 0 Passes ❑ Conditionally Passes ® Failsa - - ❑ Needs Further Evaluation by the Local Approving Authority .. r 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 10,000gpd 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. f t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 ' Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments wM 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D I 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 i Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): i t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 f ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form = Not for Voluntary Assessments ,^M 107 Old Craigville Road. Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for H annis MA 02601 12/05/2011 y every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system'required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if - - --the-system-is-faiiing-to-protect-public-health,, safety-or-the-environment------ -- ---------- - 1: System will pass unless Board of Health determines in accordance with 310 CMR 151303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is Hyannis MA 02601 12/05/2011 required for y every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of.Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has aseptic 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: t Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑' ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool - Static liquid level in the distribution box above outlet.invert due to an overloaded ❑ ® or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/day flow t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary.Assessments ,M 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(§). 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 feet of a tributary to a surface drinking_.water supply____ ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, .or.answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You.must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, 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. ® El approximation 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): Number of bedrooms(actual): 3 ` DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): t5ins:69/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 II Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 107 Old Craigville Road Property Address Bank of America/ Estate-Carole A. Morris Owner Owner's Name information is Y required for Hyannis MA 02601 12/05/2011 every page. City/Town State Zip Code Date of Inspection D. System Information Description: System consists of 1000 Gallon Septic Tank Overflow Cesspoot and SAS 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 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Sept.-2009 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,., Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? El Yes ❑ No Non-'sanitary Waste discharged to the Title 5 system? ❑ Yes..❑ No- -Water meter readings, if available: .t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 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) f _ __ ❑_ ,__`. Innovative/Alternative tech nol-og_y__Attach_a_co.p_y_-of_th.e-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): Septic Tank-Overflow Cesspool.and SAS 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 wM 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 4 feet Material of construction: ®_cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 4 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Septic Tank was found to be leaking. r If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No 1000 Gallon ST Dimensions: Sludge depth: t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 f . ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 2' 1„ Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? 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.): System shows signs of Hydraulic Failure Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 ' Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 107 Old Craigville Road Property Address Bank of America/ Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•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 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert N/A Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: —----- t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is Y required for Hyannis MA 02601 12/05/2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: one ❑ leaching fields number, dimensions: ® overflow cesspool number: one ❑ 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.): System shows signs 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 __ s___ - -_---..-_------ -�-- Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow El Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every 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.): Cesspool overflow show signs of hydraulic failure 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•09108 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 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate Where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately CA) Chu e`t �A9 >>e� � tl v. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 "s Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal -g posal System Form Not for Voluntary Assessments ;M 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: Undetermined failed system 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 El 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 �• Commonwealth of Massachusetts • Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 107 Old Craigville Road Property Address Bank of America/Estate-Carole A. Morris Owner Owner's Name information is required for Hyannis MA 02601 12/05/2011 every 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-09/08 z Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 h i try ray Town of Barnstable Barnstable � °� BOARD OF HEALTH ;edcaCft 4 n"R�ssaLE'm 039. 200 Main Street, Hyannis MA 02601 I o MAC 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi CERTIFIED MAIL# 7011 0470 0001 4525 7321 July 3,2012 Bank of America,NA 475 Crosspoint Parkway Getzville,NY 14068 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 107 Old Craigville Road, Hyannis,MA was last inspected on 12/5/2011;by Michael T. Bisienere, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 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 with 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 Ltr 1 Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\107 Old Craiville Rd.Hy.2nd ltr.doc Ma M CO .M Ul � � Postage $ �Q� 0 r CeMed Fee E3 Return Receipt Fee Here O (Endorsement Required) Restricted Delivery Fee M (Endorsement Required) �SPS 0 Total Postage&Fees r$ i rl,- o Carole A. Morris c/o-Bank of America, NA 475 Crosspoint Parkway 1 Getzville,NY 14068 Certified Mail Provides: l a A mailing receipt a A unique identifier for your mailpiece a A record of delivery kept by the Restal Service for two years Important Reminders: a Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. a Certified Mail is not available for any class of international mail. a 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 mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSO postmark on your Certified Mail receipt is required. o 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 3600,August 2006(Reverse)PSN 7530-02-000-9047 qr ■ Complete items 1,2,and 3.Also complete 7SSIgnature. item 4 if Restricted Delivery is desired. L :Agent ® Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Rec r��rr��m r(D 1F Delive(y ■ Attach this card to the back of the mailpiece, .V�� or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No Carole A. Morris c/oBank-of America, NA x. 4�.-5;cross oint Parkway P y I * 3. Service Type Getzville, NY 14068 ❑certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number I l 17 01'1 0 4,7 0 i 0 0 0'1 �14 5 2 5 6874 (Transfer from service labeo _ PS Form 3811,February 2004 Domestic Return3Recepf' 102595-02-M-1om C. 4 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 ' Sender; Please print your name, address, and ZIP+4 in this box • Town of Barnstable Public Health Division 200 Main Streety Hyannis, MA 02601 THE own of Barnstable Barnstable P�_p TQ�y ' ' BOARD•O]F HEALTH IIB AmeeieaC" 9°" ASS. a 200 Main Street, Hyannis MA 02601 m i6T9• ��� ArFO MAt a, 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M. , Junichi Sawauanagi CERTIFIED MAIL# 7011 0470 0001 4525 6874 May 24, 2012 Carole,A. Morris C/o Bank of America,NA 475 Crosspoint Parkway Getzville,NY 14068 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 107 Old Craigville Road, Hyannis, MA was last inspected on 12/8/2011, by Michael T. Bisienere, a certified septic inspector for the state of Massachussetts. The inspection of the septic system showed that the system "Fails"under the guidelines of the 1995 TITLE 5(3 10 CMR 15,00) DUE TO THE FOLLOWING: o Backup of sewage into facility or system component due to overloaded or clogged SAS. On January 51h 2012 you were ordered to repair or replace the septic system within sixty (60) days from the date you receive notification. However, the system was not replaced as of this date (May,2012). You are again ordered to replace the failed system within thirty (30) days.. Failure to repair/replace the septic system with the deadline period will result in future enforcement action PER ORDER OF THE B ARD OF HEALTH T omas McKean, R.S. CHO Agent of the Board of Health Second Ltr Q:\SEPTIC\L.etters Septic Inspection Failures or Future Eval\107 Old Craiville Rd.,Hy,2nd Itr.doc LEGEND as 88 __ EXISTING CONTQUR N S7, o` S o Wa X 100.98 EXISTING SPOT GRADE ® ;. MglP aD —W EXISTING WATER SERVICE Street N ST �cc c c —G EXISTING GAS SERVICE P'^e H.KL - OVERHEAD WIRES Linda �� moov" ® TEST PIT L a BENCHMARK 2a `\ LOCUS Carlotta Ave DMA; ce QG• �� a � � o 16 Z d 0Wq %y Q N 47'43'35" E LOCUS MAP 101,11 stockade fenceNOT TO SCALE INSPECTION 101,06 100.0 101,78 ----- .\102,17 ;4 PURT—, TP_1 GENERAL NOTES: �'G5' 100,9 62.5' P-2 VENT 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. EXISTING LEACH PIT 10 o I___� �POP�SED�S_.A S_� � ___1_0 �2 TO BE PUMPED & FILLED ` �L6S 2• ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS W SAND AND ABANDONED OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE EXISTING SEPTIC TANK LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: o1,11 -Tim (TO REMAIN) -310 CMR 15.405(1)(b): BENCHMARK SET )00,75 t 66 TOP OF TANK, EL.=99.07 1) to 6'vmax. cover.t S.A.S. shallmbe cover and uvetedt, for up �_��� 101,06 �„i INV.(OUT)=9774f 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR GREEN PAINT ON CONC/BLOCK R. EL.= 101.73 (Assumed Datum) BP1' DOSINSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 10,1 73 DECK 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING Z FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN \ � '.. ENGINEER BEFORE CONSTRUCTION CONTINUES. N 10�\l7 101,50 O N } 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. N O \� o cj I 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF N THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF rn EXISTING o crs HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. SPLIT LEVEL 101, 6 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. / rrl �\ HOUSE(#107) 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.. Al T.O.F.=102.3f(fro nt) 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS / g AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE T.O.F.=105.5f(bock) DIRECTED BY THE APPROVING AUTHORITIES. //99,40 I X 10. IT SHALL BE THE RESPONSIBILITY. OF THE CONTRACTOR TO VERIFY O10 , 9 101.58 10 ,4g X 10L3 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING 1 101,36 GS i. CONSTRUCTION. (LOT 22) 11. INERE THE ARQEAIBENEATH ANDTOR FFORS5ALL ONRALLOVE SIDESLOFNTHEABLAESSOILS AND .�. _ v APN 248-114 t OF REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). Mq 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE 11,500S.F.f P��� SSq� INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. 1 o PETER T. ✓ 13. THIS PLAN IS TO BE USED FOR SEPTIC'SYSTEM PURPOSES ONLY AND O' 10,00 I - NOT CONSIDERED TO BE A PROPERTY LINE SURVEY. P 100,11 100.00 McENTEE ` CIVIL 14. USAGE OF THE EXISTING SEPTIC TANK IS SUBJECT TO THE APPROVAL 99,43 SIDEWALK N 47'43'35" E -J 101 15 No. 35109 OF THE BOARD OF HEALTH. 99 45 SIDEWALK \�„__—► �3` A £�/SZE�c�p `� 15. THE ENGINEER IS NOT RESPONSIBLE FOR ANY UNDOCUMENTED SEPTIC SYSTEM COMPONENTS NOT SHOWN ON THIS PLAN. 99,06 99,55 99,79 edge of Pavemen 100,67 P�F S A LNG PROPOSED SEPTIC SYSTEM UPGRADE PLAN kj ��1� OLD C_R,4ICVILL�' �OA.aO w� 107 OLD CRAIGVILLE ROAD, HYANNIS, MA -- — — — — OWNER OF RECORD Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 BANK OF AMERICA, NA Engineering by: SCALE DRAWN JOB. N0. %NOWAK, GREGORY W & LOMBARDY, KATHLEEN Engineering Works, Inc. 1"=20' P.T.M. 257-12 152 EVANS STREET 1.2 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. OSTERVILLE, MA 02655 (508) 477-5313 10/17/12 P.T.M. 1 of 2 i' r_ s NOTE: TO PREVENT BREAKOUT, THE PROPOSED SPIKE SET A FINISH GRADE SHALL NOT.BE < EL.=97.3 FOR A DISTANCE OF 15' AROUND THE -- WPO_62.5' PERIMETER OF THE S.A.S. I__------ [S.A�S__1___I___L__ SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S>' INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL 2 INSPECTION PORTS (MINIMUM) T.O.F. OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE 1 CHARCOAL ,j EXISTING FIG EL =101.1 t F.G. EL.=100.9t F.G. EL.=1102.3(MAX.) VENT w n MAINTAIN 2% GRADE (MIN.) OVER S.A.S. DECK p L = 32' L = 8'(MAX.) INSPECTION PORT ® S=1% (MIN.) p S=1% (MIN.) a (1-MINIMUM) 4"SCH40 PVC 4"SCH40 PVC nta" s 1INVERT EXISTINGEXISTING48" LIQUID SPLIT LEVEL LEVEL GAs�eAFFLE INV.=97.17 PROPOSED INV.=97.00 1 ROW OF 10 UNITS AT 6.25'/UNIT = 62.5' HOUSE07 INV.=97.74E A-BOX INV.=96.94 F / (# • EXISTING 4 OUTLETS (MIN.) SOIL ABSORPTION SYSTEM (PROFILE) T.0.F.=102.3E(front) EXISTING SEPTIC TAN I I T.O.F.=105.5t(back) ESTABLISH VEGETATIVE COVER it BACKFILL WITH CLEAN NATIVE OR PERC SAND TO TOP OF CHAMBERS LAYOUT NOTES: BREAKOUT EL.=TOP EL. S.A.S. 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE TOP ELEV.=97.33 INVERTS, PRIOR TO INSTALLATION. INV. ELEV.=96.94 75" 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.=96.00 IIImIIIII119II 1 GRADE ON A MECHANICALLY COMPACTED SIX 11 INCH CRUSHED STONE BASE, AS SPECIFIED 5' MIN. ABOVE BOTTOM OF 2.83' IN 310 CMR 15.221(2). T.P. EXCAVATION OR G.W. I 3) INSTALL INLET & OUTLET TEES AS REQUIRED. EXISTING SUITABLE 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE BOTTOM OF TP, EL=91.3 = MATERIAL AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 1 ROW OF 10 - 16" (H-20) 76"� ADS BIODIFFUSER UNITS � PROFILE WITH NO SEPARATION BETWEEN EACH ROW & NO STONE SEPTIC SYSTEM PROFILE TYPICAL I`SECTION N.LS N.T.S. 16" j 11 DESIGN CRITERIA SOIL LOG i--34" DATE: OCTOBER 15, 2012 (REF#13,762 SECTION END CAP NUMBER OF BEDROOMS: 3 BEDROOMS SOIL EVALUATOR: PETER McENTEE PE(SE�1542) WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT 6�� HIGH CAPACITY (H-20�BIODIFFUSER UNIT SOIL TEXTURAL CLASS: CLASS I � ELEV. TP-1 DEPTH ELEV. N TP-2 DEPTH MODEL 16" HICAP UNITS MUST BE STAMPED H-20 DESIGN PERCOLATION RATE: <2 MIN./INCH 0" t 0" 101.4 A 101.3 :,.A LENGTH 76" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT DAILY FLOW: 330 GPD SANDY LOAM SANDY LOAM TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY DESIGN FLOW: 330 GPD 100 9 tOYR 4/2 6" 100.8 I 10YR 4/2 6 EFFECTIVE LENGTH 75 DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. GARBAGE GRINDER: NO B g SIDE WALL HEIGHT 11.2" SANDY LOAM II SANDY LOAM OVERALL HEIGHT 16" EXISTING SEPTIC TANK: 1000 GALLON CAPACITY (VERIFY) 10YR 5/8 1 10YR 5/8 OVERALL WIDTH 34" 4640 TRUEMAN BLVD (IF 1000 GALLON AND FOUND TO BE UNSOUND, REPLACE WITH NEW 1500 GALLON TANK) 99.4 24" 99.3 24" 13.6 CF ® HILLIARD, OHIO 43026 pff4z PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLET (MIN.) C C 36"/48" CAPACITY (101.7 GAL) ADVANCED DRAINAGE SYSTEMS, INC. LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF PERC .74 GPD/SF MED. SAND 1; MED. SAND PROPOSED -SEPTIC SYSTEM UPGRADE PLAN SOIL ABSORPTION SYSTEM 2.5Y 6/6 2.5Y 6/6 107 OLD CRAIGVILLE ROAD, HYANNIS, MA USE ADS 16"HC BIODIFUSSER UNITS IN STONELESS TRENCH CONFIGURATION Prepared for: D.A. Brown, Inc., P.O. Box 145, Centerville, MA 02632 Engineering by: (GENERAL USE APPROVAL FOR 7.88 SF/LF IN TRENCH CONFIGURATION) I SCALE DRAWN JOB. NO. 1 TRENCH WITH 10 UNITS © 6.25' PER UNIT = 62.5' 91.4 120" 91.3 ' 120" NTS P.T.M. 257-12 62.5' x 7.88 SF/LF = 492.5 SF PERC RATE <2 MIN/IN. RI("C" HORIZON) Engineering Works, Inc. NO GROUNDWATER ENCOUNTERED 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET N0. DESIGN FLOW PROVIDED: 0.74 GPD/SF(492.5 SF) = 364.5 GPD G (508) 477-5313 10/17/12 P.T.M. 2 Of 2 • J