The URL can be used to link to this page

Home My WebLink About0078 PONTIAC STREET - Health 781 " R i`ar. Street.-, i Hyannis F/R q 269 190ETf;;"! ° _ = K 7f2 CR I 1 I }rf • a t a w � 1 1 r q w _ Q gNUNITEDST/1TES Return Receipt for International Mail POSTALSERVICEe (Registered,Insured,Recorded Delivery,Express Mail) Postmark of the office Administration TOWN OF B RNSTABLE q � 11 r recc eipt reeipt the �� des Postes des t 01 Timbre du Etats-Unis bureau d'Anrrique 2017 t1UNR 12 Pm P—im A ion ,\S _-�7,', r'avis yant Return by the The sender completes and indicates the address for the return of this receipt. quickest route (A remp/ir par I'expediteur,qui indiquera son adresse pour le renvoi du present avis.) (airlor surface Wame or Firm--(Norn o sociale) marl),a decouve...t ftT 7T4. 1 . .. �..: .(.":1!::Ilti.l.. ........................ and postage free, x l3 /� {� l r oie la r par Str6et and Number(Rue et go.) , la vole la plus � rapide(aerienne �—(?�- &A44 ou de surface), City,State,and ZIP+4(Localitie et code postal) a decouvert et en franchise de CU (/ port' U TED STATES OF AMERICA Etats-Unis d'Am6nque PS Form 2865, February 1997 . Avis de reception CN07 (Old C5) Item Description egistered Printed her Recorded Delivery Express (Nature de [Article(Envoi �Lettre)0 Matter ❑ ttutre)❑(Envoi i livraison 0 Mail Inter- ,1'envoi) recommande) (Impnme) attestde) national orn o, Insured Value Valeurdeclaree)Article Number o c Insured Parcel ( �j o a El avec valeur declaree) 1C�54T'?o ' �( OL's m Office of Mailing(Bureau de depot) Date of Posting(Date de depot) oa Addressee Name or Firm(Nom ou raison sociale du destinqtiire :An OA ¢�� CD o E Street and No.(Rue et ) �' Place an Country(Localite et pays) . B swine Th' receipt must be signed b)r(1)the addressee;or,(2)a person authorized to sign un r the regulaG its o1 the f s ark of the office of c o those regulations so provide,by the employee of the office of destination.This signed f vril be return a ust mail. destination(Timbre du g m bureau de destination) 15 i (Cat avis do8 itre signs par le destinataire ou par une personne y autorisee en vertu des eg ements du pays de destination,ou,si ces Nriglements fe comportent,par I'agent eb bureau de destination,et renvoye par le premier coumer dauectement i expedleul. mThe article mentioned above was duly delivered. Date (L'envoi mentions ci-dessus a ete dement livre.) d n Signature of Addressee gn ere Office of Destination Employee Signature of destinataire) (Signature de)'agent du bureau du destination) 8`. 01 PS Form 2865, February 1997 everse) J OD� 7 r .� ' Town ®f Barnstable Barnstable THE Tp As-Amrsica0v BARD OF HEALTHM ASS t 1 RA Bea 200 Main Street, Hyannis M.A 02601 , 9�A i639 ,gym M 2007. rEp AC a. Office: 508-862-4644 Wayne Miller,M.D. FAX 508-790-6304 Paul Canniff,D.M.D. . Junichi Sawayanagi CERTIFIED MAIL - Canada KA-LubL3Lnus March 1, 2012 Freerk R.'Jilderda,Trs. J CC Nominee 799 Glen Cairn Avenue Toronto, ON M6B-2A2 CANADA YOU FAILED TO APPEAR BEFORE THE BOARD AT THE HEARING ON Tuesday, February 14th, 2012 at 3pm in the Town Hall, 367. Main Street, Hearing Room, 2nd Floor, Hyannis, MA due to your failed septic system at 78 Pontiac Street, Hyannis, MA. You failed to respond either in person, by mail or by phone: ( On 2/14/2012, the Board of Health voted,to.inform you that the: The septic system has been in failure for three (3) years and it must be repaired within (60) days. The State Environmental Code Title V requires all failed septic systems to be repaired or replaced within two years. The Town of Barnstable Board-of Health has more stringent deadlines dependent upon the type of failure identified. In this case, the septic system has been in failure beyond the established deadline. (See attached copy of State Environmental Code). We have a copy of the recent inspection which passed on February 14, 2012. However, this does not overturn the earlier failed inspection. Also, the Town of Barnstable requires all rentals to be registered. You are hereby ordered to register the property as rental property within sixty (60) days. If these criteria are not met, further action will be taken and tenants would need to be removed. PER**ran ORDER OF THE BOARD OF HEALTH er, M.D. Enc: State Environmental Code Q:1WPF1LES178 Pontiac St Hy Feb 2012.doc ' Commonwealth of Massachusetts Title 5 official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February 14, 2012 required for y ry every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out i forms on the computer, use 1. '-Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name 189 Cammett Road Company Address Marstons Mills MA 02648 ream City/Town State Zip Code 508-428-1779 SI 12855 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of r Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority "jO February 14, 2012 Job# 12-22"" °:01 In ector's Signature Date ? 'u The system inspector shall submit a copy of this inspection report to the Approving Authority (BoWd of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. --This report only describes conditions at the time of inspection and under the conditions of use -at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. l5ins-11/10 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 1 of 17 I � Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February 14, 2012 required for y ry every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 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: Recommend pumping tank. Leaching chambers had 10" of standing water with no definite high stains and no evidence of surcharge. 13) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is required for y H annis MA 02601 February 14, 2012 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11/10 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 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February 14, 2012 required for y ry every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than _day flow t5ins•11/10 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 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is required for y H annis MA 02601 February14, 2012 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is required for y H annis MA 02601 February14, 2012 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. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February 14, 2012 required for y every page. City/Town State Zip Code Date of Inspection D. System Information Description: I Number of current residents: Unknown 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: Currently Occupied. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts' W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February 14, 2012 required for y ry 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: Unknown Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-1 Ill 0 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is required for y H annis MA 02601 February14, 2012 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: Compliance date: 5/19/05 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1' Depth below grade: 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): 16" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5' long x 5.2'wide- 1000 gal. 6„ Sludge depth: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is required for y H annis MA 02601 February14, 2012 every page. Cityrrown 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 24" Scum thickness 4" 6" Distance from top of scum to top of outlet tee or baffle 91, 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.): Liquid level was found at bottom of outlet invert, tees were intact. tank has significant accumulated solids and should be pumped. Grease Trap (locate on site plan).- Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 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 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February 14, 2012 required for y ry every page. City[rown 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February 14, 2012 required for y ry 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 0" f 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 solids or high stains present, liquid level was at bottom of outlet pipe. 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-11/10 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 12 of 17 M Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February 14, 2012 required for y ry every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: Two 500 gal drywells. Elleaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Observed 10-11" of standing water with no definite high sidewall staining. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Y Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February required for y 14, 2012 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.): t 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.): l5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 I Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA_ 02601 _ February 14, 2012 required for -- State Zip Code Date of Inspection every page. Cityffown 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 t 5 50 34 . ;. 23 A1177M ater Service Pontiac Street I Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 0178 Pontiac Street Property Address Jilderada Owner Owner's Name information is Hyannis MA 02601 February 14, 2012 required for y ry 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: 15+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ® Accessed USGS database-explain: USGS topo map and town GIS. You must describe how you established the high ground water elevation: Town groundwater contour map shows water at el. 20 and topo map shows property at el. 40. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 & Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 78 Pontiac Street Property Address Jilderada Owner Owner's Name information is required for y H annis MA 02601 February 14, 2012 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file l5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES^2/14/12: A. Freerk Jilderda, owner— 78 Pontiac Street, Hyannis, failed septic. Mr. Jilderda lives in Canada and the Post Office shows he is in receipt of our registered letter. He has not contacted us to resolve the issue. He also needs to register his rental. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to have a-letter_sent stating (1) the septic has been in failure for three years and it must be repaired within 60 days, and (2) the owner must register the property as rental property within 60 days. If these criteria are not met, further action will be taken and tenants would need to be removed. (Unanimously, voted in favor.) I I � . a \ . ` Health Master Detail http://issql2/intranet/healthMaster/HealthMasterDetail.aspx?ID=269190 Logged In As: TOWN\Irlyrinj Health Master Detail Thursday,April L9 2012 F�a,—r-el Septic Pec Well I Fuel Tank 4 Parcel: 269-190 Location: 78 PONTIAC STREET,HYANNIS Owner:JILDERDA,FREERK R TRS Septic 1,5/19/2005 New Septic... Permit number:F2005212 Permit type:I Select type Complete system: F Septic tank size:F-1000 Type/Size of SAS:12-500 gallon chambers Installer:I select Installer D- Card on file: F I/A service type: FS—elect service Innovative/Alternative Technology type: Fselect IA type Variance date : F Abandon complete date 1� Abandon permit number: Repair deadline date F— Repair notification date Keyword: Comments: jold 97326 Pastore 3 BEDROOMS Delete Septic In'spection 4/1/2008 New Inspection... Number Inspection Date Inspector Result F4873 F4/1/2008 711 Paolini,Robert,Robert Paolini Septic Service F(Fail) 1,The following condition(s)are occurring: r- discharge or ponding of effluent to the surface of the ground pumping more than 4 times during the last year NOT due to clogged or obstructed pipe F backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool 170 static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool F any portion of the SAS,cesspool,or privy below high groundwater elevation any portion of the cesspool within a Zone 1 to a public well F any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis Received Date Comments Evidence of solids carryover. - Leaching chambers were Delete Inspection up to inlet invert at time of inspection. - Sixty (60) day ltr sent 4/9/08 - FINAL ORDER ltr sent 1/25/09 - no indication repair was done as of 8/29/2011.jmf3/2012 septic inspection - passed. jmf3/07/2012 Will need new inspection (Title 5) 6-12 months from now.jmf Save Septic Changes Return to Lookup bVp iuepx? D=269|9O 4/19/2012 . � | ' �� Health Master Detail http://issgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=269190 Health-Master. Logged In As: TOWN\ftynnj Health Master Detail Thursday,Apid 192012 Aoplicabon Center Parcel Lookup Selection items Reports Parcel Septic I Perc Well Fuel Tank Parcel: 269-190 Location: 78 PONTIAC STREET,HYANNIS Owner:7ILDERDA,FREERK R TRS Septic changes have been saved. Septic 1,5/19/2005 New Septic.... Permit number: 12005212 Permit type: I Select type Complete system: F Issue date : 5/19/2005 Complete date: 5/20/2005 ".: Septic tank size: x1000 Type/Size of SAS: 2-500 gallon chambers i j Installer: I Select Installer Card on file: F I/A service type: Select service - Innovative/Alternative Technology type: Select IA type Variance date: r_ Abandon complete date: �- Abandon permit number: I � Repair deadline date : Repair notification date : Keyword: I Comments: old 97326 Pastore 3 BEDROOMS Delete Septic Inspection 4/1/2008 1 New Inspection... j Number Inspection Date Inspector Result j i 1 i 4873 4/1/2008 Paolini,Robert,Robert Paolini Septic Service - F(Fail) - { y'The following condition(s)are occurring: F discharge or ponding of effluent to the surface of the ground F pumping more than 4 times during the last year NOT due to clogged or obstructed pipe { I backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool {� Fv static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool {i F any portion of the SAS,cesspool,or privy below high groundwater elevation {i rF F any portion of the cesspool within a Zone 1 to a public well ! F any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis {+Received Date Comments Evidence of solids carryover.-Leaching chambers were up to inlet invert al ' Delete Inspection I ' Save Septic Changes I Return to Lookup I' http:Hissgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=269190 4/19/2012 - 0 - Town ®f Barnstable Barnstable �p THE l0 BOARD OF .HEALTH r1iCaC"� ' 9°'' MASS.8 z 200 Main Street, Hyannis MA 02601039. m �prfa Mat ale 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi CERTIFIED MAIL - Canada # PLA 5 i.2DL-5Lou5 March 1, 2012 Freerk R. Jilderda,Trs. CC Nominee 799 Glen Cairn Avenue Toronto, ON M613-2A2 CANADA YOU FAILED TO APPEAR BEFORE THE BOARD AT THE HEARING ON Tuesday, February 141h, 2012 at 3pm in the Town Hall, 367 Main Street, Hearing Room, 2"d Floor, Hyannis, MA due to your failed septic system at 78 Pontiac Street, Hyannis, MA. You failed to respond either in person, by mail or by phone. On 2/14/2012, the Board of Health voted-to..inform you that the: • The septic system has been,in failure for three (3) years and it must be repaired within (60)-days. The State Environmental Code Title V requires all failed septic systems to be repaired or replaced within-two years. The Town of Barnstable Board"of Health has more stringent deadlines dependent upon the type of failure identified. In this case, the septic system has been in failure beyond the established,deadline. (See attached copy of State Environmental Code). We have a copy of the recent inspection which passed on February 14, 2012. However, this does not overturn the earlier failed inspection. Also, the Town of Barnstable requires all rentals to be registered. • You are hereby ordered to register the property as rental property within sixty (60) days. If these criteria are not met, further action will be taken and tenants would need to be removed. PER ORDER OF THE BOARD OF HEALTH *'ran er, M.D. Enc: State Environmental Code Q:\WPFILES\78 Pontiac St Hy Feb 2012.doc 4� pU Barnstable Town of Barnstable N"MaBoard ®f Health h �. M �. . 1639. 10g '°rFn aw't" 200 Main Street, Hyannis MA 02601 2007 J Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Public and Environmental Health Program February 15,2012 Policies,Procedures, and Guidelines Septic:Systems Documen#ed asTaW to Protect Public Health and Safety and'the Environment b y a.DEP Approved System Inspector:Later:Documented to have a Passed nspection for the-Same.System:.Conducted.by a..DEP Approved.System'Inspeetor#;;2012 Oh,_ [Section 15.305 of the State Environmental Code, reads as follows'if a system is failing to protect public health, safety, welfare, or the environment as sel forth in 310 CMR 15.303(1)or 15.304(1), the owner or operator shall upgrade the system within two years of discovery unless:(a)a shorter period of time is set by the local Approving Authority or the Department based upon the existence of an imminent health hazard;or(b)the continued use of the system is permitted by the local Approving Authority in accordance with the provisions of an enforceable schedule for upgrade. The Town of Barnstable Board of Health will consider permitting the continued use of a septic system which has been documented to "fail" to protect public health, safety, and the environment but later documented to "pass" an inspection by an approved System Inspector conducted in accordance with 310 - CMR 15.302 and local Health Regulations. To-consider such an extension, the applicant is required to provide the Board two passing inspection reports conducted by two independent or separate DEP certified inspectors. The two independent passing inspections shall be conducted at least six months to one year apart. The following procedure shall be followed for consideration by the Board to grant an extension or to overturn a failed septic system inspection report: 1. The applicant shall submit four copies of the failed and passed inspection reports to the Health Division Office (200 Main Street Hyannis Ma) at least thirty days before the established deadline to repair the failed system. These documents will be forwarded to the Board members for review prior toand during the next regularly scheduled public meeting. . [NOTE:At properties used for seasonal use, inspections should be conducted during periods of heavy usage] 2. During the public meeting,the Board will determine whether or not the application would qualify for an extension. The Board.will also determine whether or not to require or recommend another septic system inspection which shall be conducted six to twelve months after the first passing inspection. The Board may require the additional inspection(s) to be conducted during a specific time period(i.e. during summer months)at seasonal properties. 3. Immediately after the third inspection is conducted(six to twelve months later)the applicant shall provide the Health Division four copies of the third septic system inspection report, regardless of whether it's a passed or failed result. The Health Division will forward the documents to the Board members for review prior to and during the next scheduled public Board of Health meeting. At that meeting; the Board will determine whether or not the application would qualify for any additional extensions and/or determine whether or not two passing inspection reports would overturn the failing inspection originally submitted. • Wayne Miller,M.D. Junichi Sawayanagi Paul Canniff,DMD C:1Documents and Settingslmckeant\Desktop\FailedSepticSystemsWithPassingReports.doe ED USPS.com®-Track&Confirm https:Htools.usps.com/go/TrackConfirinAction.action t_J English Customer Service USPS Mobile Register)Sign In ` T_ Search USPS.com or Track Packages USPSA lvi Quick Tools Ship a Package Send Mail Manage Your Mail Shop Business Solutions Track & Confirm GET EMAIL UPDATES PRINT DETAILS YOUR LABEL NUMBER SERVICE - STATUS OF YOUR ITEM DATE E TIME LOCATION FEATURES RA56520636OUS First-Class Mail Delivered March 06,2012,1:37 pm CANADA Registered Mail" International Return Receipt Attempted Delivery- March 06,2012,10:34 am CANADA Item being held, addressee being notified Attempted Delivery- - March 06,2012,8:14 am CANADA Item being held, addressee being notified - r Addressee not available March 06,2012,7:25 am CANADA -Addressee advised to pick up the item - Arrival at Post Office March 06,2012,7:18 am CANADA Customs clearance March 05,2012,2:41 pm CANADA • processing complete - - Customs Clearance March 05,2012,2:35 pm CANADA Processed Through Sort March 05.2012,2:35 pm CANADA - Facility _ - Processed Through Sort March 04,2012,8:10 am ISC NEW YORK NY - Facility (USPS) Arrived at Sort Facility March 04,2012�8:09 am ISC NEW YORK NY (USPS) Dispatched to Sort March 02,2012,5:40 pm HYANNIS,MA 02601 Facility Acceptance March 02,2012,2:52 pm - HYANNIS,MA 02601 Check on Another Item What's your label(or receipt)number? Find LEGAL ON USPS.COM ON ABOUT.USPS.COM OTHER USPS SITES - Privacy Policy> Governrnenl Services) About USPS Homer Business Customer Gateway 1 Terms of Use> Buy Stamps&Shop r Newsroom I Postal Inspectors, FOIA r Print a Labef,with Postage I- Mail Service Updates> Inspector General I No FEAR Act EEO Data, Customer Service r Forms&Publications Postal Explorer e - Site Index: Careers> Copyright£@)2012 USPS.All Rights Reserved E https:Htools.usps.com/go/TrackConfirmAction.action 3/13/2012 Town of Barnstable ' �OF� T°tyti Barnstable P Board of Health - AlAnedcaCly IIAFLNSPABLE, ` s- o' MAS' 200 Main Street, Hyannis MA 02601 i6gq. ♦� �ATED MA't a' 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi BOARD OF HEALTH MEETING RESULTS Tuesday, February 14, 2012 at 3:00 PM Town Hall, Hearing Room, 2ND Floor 367 Main Street, Hyannis, MA I. Hearings — Housing / Septic (Cont): A. Lili Seely, owner—33 Candlewick Lane, Hyannis, housing and septic issue (continued from Dec 2011). Lili said today she had installed the smoke detectors, CO2 detector and had the two door locks installed. The Board voted to continue to the April 10, 2012 meeting to follow up and see that all the housing violations have been fixed and the septic permit has been pulled. B. Kenneth Carey, owner— 439 (a.k.a. 441) South Main Street, Centerville, 3.units, housing violations (continued from Dec 2011). Kenneth Carey explained that the additional replacement of the porch has added a large cost. His goal will be to have all,work completed by April, if possible. The Board voted to continue to the April 10, 2012 meeting to see whether the septic inspection and the three units' repairs have been completed. II. Hearings — Septic: A. Bonnie Cooper, owner- 131 Skating Rink Road, Hyannis, failed septic. Bonnie has taken out a septic loan with the County and is working with B&B for the septic installation. B&B has made an appointment for the perc tests. The Board voted to continue to the April 10, 2012 meeting. B. Freerk Jilderda, owner— 78 Pontiac Street, Hyannis, failed septic. Mr Jilderda dives in Canada and has not contacted us to resolve the issue. Page I of 2 BOH 2/14/12 N The Board voted to have a letter sent stating (1) the septic has been in failure for 'three years and it must be repaired within 60 days, and (2) the owner must register the property as rental property within 60 days. If these criteria are not met, further `action will be taken and tenants would need to be removed. III. Hearing — Connect to Sewer: 30 Thornton Drive- Business Condos, Barnstable Owners: A. William and Rita Amaral 1 Unit Map/Parcel 296-008-OOA B. Richard Fleming 2 Units Map/Parcel 296-008-OOB & OOC C. Bert Mosher 1 Unit Map/Parcel 296-008-OOD D. Michael Michnay 2 Units Map/Parcel 296-008-OOE & OOF Issues that exist: The building was originally set up as a condo trust. One of the owners has moved out of town and is headed into foreclosure. Mr. Fleming's attorney had advised him not to hook up as he would become liable for the whole building. David Anderson, DPW, requires having all owners fill out a questionnaire prior to connection to sewer. Information on questionnaire includes chemicals used in units and whether the units have floor drains. The owners confirmed that units A-D do not have floor drains. It is unknown whether units E&F do. It is unknown how many septic systems are at the location. Action: The Health Division will send a letter to Michael Michnay requesting the questionnaire be filled out within 30 days. The septic installer Sean Enright will find out how many septic systems are there. Tom McKean will meet with Dave Anderson, DPW to see how we can move forward and Dr. Miller will check with the Town Attorney on any possible issues. Continued to the April 10, 2012 Board meeting. IV. Innovative / Alternative (I/A) System (Cont.) Stephen Wilson, Baxter Nye Engineering, representing David Brito, P&S Agreement with owners — 31 and 43 Church Hill Road, Centerville, . Map/Parcel 207-138 and 207-139, total two lots is 32,045 square feet, three variances, MicroFAST system, (continued from Jan 2012)-revised plans. Dr. Miller said one of the criteria to granting the I/A is that a regular Title V system could be installed on the property but the I/A is desired for it's additional benefits. The Board voted to continue to the March 13, 2012 Board meeting to allow time to determine from Zoning whether the property is officially one lot or two, and to allow Mr. Wilson time to make adjustments in his plan. V. Variances — Septic (New): �r Y Page 2 of 2 BOH 2/14/12 � a Town of Barnstable h ppSNE tOly� Barnstable P� Board of Health AlAr„e;caCRY i TIARN.s-TABLE, 9~�MAC m 200 Main Street, Hyannis MA 02601 i639' PTE0 MAC A' 2007 Office: 508-862-4644 _ Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi BOARD OF HEALTH MEETING AGENDA Tuesday, February 14, 2012 at 3:00 PM Town Hall, Hearing Room, 2ND Floor 367 Main Street, Hyannis, MA I. Hearings --Housing / Septic (Cont): A. Lili Seely, owner— 33 Candlewick Lane, Hyannis,housing and septic issue (continued from Dec 2011). B. Kenneth Carey, owner— 439 (a.k.a. 441) South Main Street, Centerville, 3 units, housing violations (continued from Dec 2011). If. Hearings — Septic: A. Bonnie Cooper, owner— 131 Skating Rink Road, Hyannis, failed septic. I B. Freerk Jilderda, owner= 78 Pontiac Street, Hyannis, failed septic. III. Hearinq — Connect to Sewer: 30 Thornton Drive- Business Condos, Barnstable Owners: A. William and Rita Amaral 1 Unit Map/Parcel 296-008-OOA B. Richard Fleming 2 Units Map/Parcel 296-008-OOB & OOC C. Bert Mosher 1 Unit Map/Parcel 296-008-OOD D. Michael Michnay 2 Units Map/Parcel 296-008-OOE & OOF IV. Innovative / Alternative (I/A) System (Cont.) Stephen Wilson, Baxter Nye Engineering, representing David Brito, P&S Agreement with owners — 31 and 43 Church Hill Road, Centerville, Map/Parcel 207-138 and 207-139, total two lots is 32,045 square feet, three variances, MicroFAST system, (continued from Jan 2012)-revised plans. Page 1 of 2 BOH 2/14/12 A. Bonnie Cooper, owner— 131 Skating Rink Road, Hyannis, failed septic. Freerk Jilderda, owner- 78 Pontiac Street, Hyannis, failed septic. l W y III. Hearing — Connect to Sewer: Condos,30 Thornton Drive- Business.Co , Barnstable Owners: A. William and Rita Amaral 1 Unit Map/Parcel 296-008-OOA B. Richard Fleming 2 Units Map/Parcel 296-008-OOB & OOC C. Bert Mosher 1 Unit' Map/Parcel 296-008-OOD D.' Michael Michnay 2 Units Map/Parcel 296-008-OOE & OOF IV. Innovative / Alternative (I/A) System (Cont.) Stephen Wilson, Baxter. Nye Engineering, representing David Brito, P&S Agreement with owners - 31 and 43 Church Hill Road, Centerville, Map/Parcel 207-138 and 207-139, total two lots is 32,045 square feet, three variances, MicroFAST system, (continued from Jan 2012)-revised plans. r i Page 1 of 2 BOH 2/14/12 ` POSTPONED TO FUTURE DATE C. Ban on Pharmacy I obacco Sales. Awaiting Draft Regulation n Page 2 of 2 BOH 2/14/12 Town of Barnstable Barnstable Regulatory Services Department Aid-AmdiCaCft� i IIARNSTABLE, ASS. Public Health Division 200 Main Street; Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL - Canadian f}3 GJ`w� �70 u S December 28, 2011 Freerk R Jilderda TRS CC Nominee 799 Glen Cairn Avenue Toronto ON M6B-2A2 YOU ARE SCHEDULED TO APPEAR BEFORE THE BOARD on Tuesday, February 141h , 2012 at 3 pm in the Town Hall, Hearing Room, 2nd Floor 367 Main Street, Hyannis, MA due to your failure to repair or replace the failed septic system at 78 Pontiac Street,Hyannis,MA The State Environmental Code Title V Requires all failed septic systems to be repaired or replaced within two years. The Town of Barnstable Board of Health has more stringent deadlines dependent upon the type of failure identified. In this case, the septic system has been in failure beyond the established deadline. You will be given the opportunity to testify, present witnesses, documentary evidence, and other official information regarding this case. PER ORDER OF THE BOARD OF HEALTH Wayne Miller, M.D. " Chairman y. QASEPTIC\Letters Septic Inspection Failures\78 Pontiac St.,Hy..doc ' USPS.com® -,T aQk,,& Confirm https:Htools.usps.com/go/TrackConfirmAction.action English Customer Service USPS Mobile. Register I Sign In � - r USIPS,;-;,,.e.,,+ f Search USPS.,.;om or Track Pack2gr:.s Ovick Tools Shim a Pnrkt:ne Sc:;nii A:inii Manage YOUr IVlail Shan Business Solutions Track & Confirm ... PRINT OETAILS - YOUR l ABFL NWAILEi? $Eh VICF. SI'ARIS OF YOUR I'Ckl- DATE TIME LOCATIO,+ FEATURES RASi,.52Ufi17pU5 First-Class Mail Delivered January 11,2012,.1:31 pm CANADA Registered Mail" International " Return Receipt Attempted Delivery- January 11,2012,•12:15 pm CANADA Item being held, addressee being notified Attempted Delivery- January 11,2012,8:54 am CANADA _ Item being held, addressee being notified Addressee not available January 10,2012,8:40 am CANADA -Addressee advised to - pick up the item - Arrival at Post Office January 10,2012,7:51 am CANADA Customs clearance January 09,2012,9:49 am CANADA processing complete Customs Clearance January 09,2012,9:08 am CANADA Processed Through Sort January 09,2012,9:08 am CANADA Facility Processed Through Sort January 06,2012,10:38 am ISC NEW,YORK NY Facility (USPS) . Arrived at Sort-Facility January 06,2012,10:30 am ISC NEW YORK NY (USPS) Dispatched to Sort January 04,2012,6:45 pm HYANNIS,MA 02601 Facility Acceptance - January 04.2012,4:35 pm HYANNIS,MA 62601 Check on Another Item What's your label(or receipt)number? - Find LEGAL ON USPS.COM ON ABOUT.USPS.COM OTHER USPS SITES i'r:vaC,Polx:y+ i;uv)nnu=ni 5.-;niter>s: PJ:Ioui USr=51-Icn:e• Fu::Iness Ct!siunlx Graleve:Iy• . Te FGy Suwips 8 Shop, Na—room; F'nsi;al.ln=_(s'.f,IGrS: _Ip•I F, t � 1.MhF! i Go:: fl dca'Ltl-..,,: hlo FEAT?Art LE(:Dal: . - Cusb::nlr:!r c;iervi•::r;; ."rim N Puuli..""Vo s, n. Pr„i�1 E:;plor;r https:Htools.usps.com/go/TrackConfirmAction.action 2/8/2012 � - Town of Barnstable Barnstable y�s�ram, ✓ Regulatory Services Department "Amedcacay Public Health Division A� �a 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO 08/07/09 Patricia DeOliveira Manuol Ozano Neto 78 Pontiac-St--- Hyannis, MA 02601 FINAL ORDER ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at, 78 Pontiac Street, Hyannis, MA was last inspected on 4/1/2008,by Robert Paolini, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: "Static liquid level in the distribution box above the outlet invert due to overloaded or clogged SAS" The deadline for repair has past. We, The Department of the Board of Health, have not been informed that you have taken any steps to bring your failed system into compliance. Therefore, you are ordered to repair or replace the septic system within 60 days from the date you receive this'notification. You may request a hearing before the Board of Health, a written petition requesting a hearing on the matter, within seven (7) days after the day this order was received. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BO OF HEALTH Thomas McKean,R.S., CHO Agent of the Board of Health t4� .�A � �'� '.. n�;� � -per• �'`m` ® ,. � .. g,..-. �y r-�'• ems_ � ti��yj� ��j 1.. � �, l-3 Pi� k`�`3 ��n P1 C L !,�ii, L L f S a Ln Postage $ y f!" r3 Certified Fee fU � ' vk{err I C3 Return Receipt Fee p (EndorsementRequlred) 1= Restricted Delivery Fee (Endorsement Required) i 4y m rd Total Postage&Fees OF - - r: • . Sheet,Apt.No.; -- - I .. ;t �✓'�, r3 or PO Box No. -`T-_ - �. City,State,ZIP+4 07-601 MEOW 7 COMPLETE •N COMPLETE THIS SECTIONON ■ Complete Items l.9.and 3lAlso complete A. Signature i Item 4 If ResMcted Delniery is desired ❑Agent ■ Print your name'and address on the reverse X ❑Addressee I so that we CSrI m—tu-im the'Card to you. B. Received by(Printed Name) C.Date of Delivery I ■ Attach this card to the back of the mdIIplece, I or on the front If space permits .. D.Is delivery address different from item 17 ❑Yes 11. Article Addressed to If YES,enter delivery address below: ❑No 1Ua L��OII J�iTa ' 1 Y� 3. se ceType l/ . i 04 OZfo I Certfffed Mall ❑Express Mail I r ❑Registered ❑Return Receipt for Merchandise , i i f •,�� f ' � =rt ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?pft Fee) ❑Yes i 2. Article Number I (r}ansfer ffom seMriaby I 7008 1830 0002 0500 8 819 1 I PS Form 3811,iFetiru `2004 � f 68—?i - R etum Revel t 1025 . � - p 2-M 1540. • , � •gym,,,. .. ,..._._ .^xu• — - "„`°wti Town of Barnstable o �� Public Health Division �,%e,Per • BARNST�ABLE.• ' t 200 Main Street Hyannis,MA 02601 • I r ,d 7 +y°PFTNEY 6417u•ES . ° otj046os23s $ ®5 54 y MAILED FROM Zip CODE 02601 7008 1830 0002 0500 8819 ��,£'POSp� n ZO Q., ® • �QDMOVEO�Q�IV21ra ' PrTNF.YS A�FMP ESN ._ 02 1.A $ 00.000 UAt`'�A•f°m8f°° QNOSI-Aiu,-6 -NOTKN�ESs I r 0004606238 AUG11 2009 i �+ No NCHS ORF� 1yN MAILED FROM ZIPCODE 02601 L/ Ol SOON TRFfT NSEO Dare A Np7-O P/I NTMeFR \ ORf SS��N BCE OR�oR o one W4RD fS'GF.;i�l��q�j,'� tys312. ��"�li??ilil?iittl�lElF1!'14l1111�33�!?��llf3ii�ililliil?tlii?� i r F F ` le Town of Barnstable Barn — -.A SMSc lip; Regulatory Services Department j micas f + BARNSCABLC p "` Public Health Division 200 Main Street,Hyannis MA 02601 2007 Office: 508-8624644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO April 9, 2008 Patricia DeOliveira 78 Pontiac Street Hyannis, MA 02601 ORDER TO COMPLY'WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 78 Pontiac Street, Hyannis MA was last inspected on April 1, 2008,by Robert Paolini, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: } • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within One (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health CERTIFIED MAIL# 7006 2150 0002 1038 7152 4. l Q:\SEPTIC\Letters Septic Inspection Failures\78 Pontiac Street.doc I Town of Barnstable I ®-QV POD Public Health Division 200 Main Street I • z i I e � PIYPJEY OWES Hyannis,MA 02601 i • 02 1 A 05.21 j I c 0004606238 APR 11 2008 I f MAILED FROM Zip CODE 02601 7006 2150 0002 1038 7152 j t7•.n'yy'' 67 � � C—� s��i3s�'PO ey C1� SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY �• !• �• t' +• .,t; i ti. �3 s i�i I ! 'FS 1 i l.4 { `! 1 tJ�¢..•��.`%•L��#� •�t`.S'!.L �31??4?i�?�Etleiit? t?1?�1?'st?�?-s??tii��9!??i�l???11??1?� 34ei ■ Complete items 1,2,and&Also complete % signature ; I Item 4 if Restricted Delivery is desired. ❑Agent 0 Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery.r ■ Attach this card to the back of the mailpiece, 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 j �►€� � � i(ti�.Q• QZ-C�[7 t- 3.,Service Type s ®Certified Mall 13 Express Mail Registered M Return Receipt for Merchandise , 13 Insured Mail .❑C.O.D. s 4.. Restricted Delivery?(Extra Fee) p Yes } 2 Article Number r 7 0 0 6 215 0 0002 1038 7152 (Transfer from iI. •3, , PSrForm 3811 February 2004 ' '`i []omestic'Retum Receipt 102595-02-M-1s4o i k ,. ', 1-• " 1 �i t ii - t t It:�is;:t]ii:j{ii i si. tSB'��51�"�4-�� _{�'S.G :tEiil? 4tt5iti:.i4Eiib1� 1i-1.'s'.i1ii •• i UNITED STATES POSTAL SERVICE First-Class Mail Postag USPSe&Fees Paid Permit No.G-10 • Sender. Please print your name, address, and ZIP¢4 in this box • -------------- r % Town.of Barnstable i Health Division 200 Main Street Hyannis,MA 02601 I Town of Barnstable Health Inspector oFtHe t Office Hours ti Regulatory Services 8:30—9:30 * Thomas F.Geiler,Director 1:00—2:00 * anRxsrnaLE, 9� 1639 ,off Public Health Division AlFD ,ts Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE 1. General Information: Size of Property: OD's Address: 79 Map 2--6q Parcel Name: &i at'(A ao Phone#: 77 1 7- 76 Y . 2a. How many bedrooms exist at your property now? v 2b. Are you planning to add_any bedrooms? If yes, how many? 2c. How many bedrooms total are proposed at this property (including the amnesty unit)?s 2d. Please include a copy of the floor plans for the entire property showing the existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or VO If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is SID or OUTSIDE a Zone of Contribution o public supply wells? 5. Is the dwelling connected to an ONSITE WELL or to PUeLICWAER? 6. Is a disposalJa. " ks construction permit on file? YES or NO r- 'a. IKes,howy bedrooms were approved according to this permit? Bedrooms. T . W=any bg permits obtained for construction of additional bedrooms? YES or NO :. Is RMQre an eered septic system plan on file at the Health Division? YES or NO i� ;g. HaShe septi system been inspected by a DEP certified inspector within the last two years? YES or NO . ='- -- ------ ------------------------ ---------------------------- --------------------- ------------- T w C= FOR OFFICE USE ONLY V. The Public Health Division has no objection to bedrooms at this property. Special Conditions: Signed: Date: Q;/health/wpfiles/amnestyapp 30.0' 30.0' .._._.... -----------.._..._...__...............------------ --- , I i 12.0' Patio 12.0' Deck 38.0' Q pp i 38.0' lC�NA^ B&h Brl Bath Din. Lndry. BR c c Area Kitchen wd. 28.0' 26.0' 28.0' stp. N C I c LTV 1 A16 N Living s JV �, BR Room c c 24.0' 14.0' 2.0' 14.0' 2.0' 4.0' BASEMENT FIRST FLOOR Comments: Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments G M 78 Pontiac Rd Property Address u , Patricia D Oliviera 1j1 3 Owner Owner's Name information is'required for Hyannis Ma. 02601 4/1/2008 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC Company Name rab P.O.Box 763 Company Address Centerville Ma. 02632 rerum City/Town State Zip Code (508)428-4028 S14454 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 16.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Ev luation by the Local Approving Authority Cr 4/1/2008 Inspector's Signature Date ru The system inspector shall submit a copy of this inspection report to the Approv ng Auth`ority(Board .of Health or DEP)within 30 days of completing this inspection. If the system is e shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 78 Pontiac Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's Name information is required for Hyannis Ma. 02601 4/1/2008 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 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: Water level in Leaching Chambers were up to invert at time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon,completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval/of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed 78 Pontiac Rd.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface.Sewage Disposal System Form - Not for Voluntary Assessments M 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's Name information is required for Hyannis Ma. 02601 4/1/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: - C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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. 78 Pontiac Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 , Commonwealth of Massachusetts j W 'Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's Name information is Hyannis Ma. 02601 4/1/2008 required for y every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: - Yes No ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters El ® due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 78 Pontiac Rd.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's Name information is required for Hyannis Ma. 02601 4/1/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet.but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the"system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. ti 78 Pontiac Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 9° 78 Pontiac Rd. �M Property Address Patricia D Oliviera Owner Owner's Name information is required for Hyannis Ma. 02601 4/1/2008 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. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 78 Pontiac Rd.•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 l Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 47M 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's Name information is required for Hyannis Ma. 02601 4/1/2008 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example 110 gpd x#of bedrooms): 330 Number of current residents: unknown Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2006:131,000 g ( y g (gpd)): 2007:178,000 Sump pump? ❑ Yes H No, Last date of occupancy: 4/1/2008Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other.(describe): 78 Pontiac Rd. 03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's.Name information is required for H annis Ma. 02601 4/1/2008 y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ` ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection-of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: Leaching installed in 2005 Were sewage odors detected when arriving at the site? ❑ Yes ® No 78 Pontiac Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts, W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's Name information is Hyannis Ma. 02601 4/1/2008 required for y every page. City/Town State Zip Code Date of Inspection D. System Information (cent.) Building Sewer(locate on site plan): ../ Depth below grade: 14"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 20'+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): t Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank (locate on site plan): Depth below grade: - 15"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: � years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No ------------------------------------------------------------------------------------------------------------------------- Dimensions: 1000 Gallon 6" Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle 26" ` 81 Scum.thickness Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 8" How were dimensions determined? Measured 78 Pontiac Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 , Commonwealth of Massachusetts W Title 5. Official Inspection Form Subsurface Sewage Disposal System'Form- Not for Voluntary Assessments GSM 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's Name information is Hyannis Ma. 02601 4/1/2008 required for y 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.): Pump septic tank every 2 years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears to be structurally sound. 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 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): 78 Pontiac Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° 78 Pontiac Rd. M Property Address Patricia D Oliviera Owner Owner's Name information is Hyannis Ma. 02601 4/1/2008 required for y ' every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) 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 Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert Yes . 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.): Box is Ievel.Box has one outlet lateral.Evidence of solids carryover.No evidence of leakage into or out of box. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 78 Pontiac Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's.Name information is Hyannis Ma. '02601 4/1/2008 required for y every page. City/Town State Zip Code Date of Inspection, D. System Information (cont.) 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: Type: ❑ leaching pits number: ® leaching chambers number: 2-500 LC ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): Damp soil.Leaching chambers were up to inlet.invert at time of inspection. 78 Pontiac Rd.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r �M 78 Pontiac Rd. Property Address Patricia D Oliviera Owner Owner's Name information is required for Hyannis Ma. 02601 4/1/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool 1 Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): r 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.): 78 Pontiac Rd.•OWN Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Map Page 1 of 2 Town of-Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size Zoom Out ]A. �' J In � ✓5 1 _ 1 -- 1 01 ------------- 1 1 1 \ 1 h 4 1 3 y � T , ly � 1 .&� 1 y �� ,�✓ a 0 20 Feet 11.0 Set Scale 1" = 20 I Aerial Photos rn—rinhf 9nnF_9nn7 T—in of P—nefohlo AAA All rinhfc roc—, http://www.town.bamstable.ma.u§/arcims/appgeoapp/map.aspx?propertyID=269190&mapp... 4/1/2008 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 78 Pontiac Rd. Property Address Patricia D Oliviera , Owner Owner's Name information is required for Hyannis 'Ma. 02601 4/1/2008 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: Bottom of LC 15" 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: 2005 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: As-Built Card ❑ Checked with local excavators, installers- (attach documentation). ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-000-01 Plate#2.Annual ranges of grounwater elevations. 78 Pontiac Rd.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 l Town of Barnstable OF 1HE Tp� ' yP� ti� Regulatory Services BARNSTABM ; Thomas F. Geiler, Director v$ 3 6.3 ,�g . ATE Public Health _Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-8624644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and interpretations contained within this report. In addition,by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the "Disposal Work Construction Permit". If you should have any questions regarding this report, please contact the certified Septic System Inspector who conducted the inspection. -- _ �p- TOWN OF�STABLE LOCATION fir/ ?yA-T-Jfg _ s SEWAGE # 0Y �— VELLAGE fy"rA^,64-5 ASSESSOR'S MAP &LOT.a 104/fy INSTALLER'S NAME&PHONE NO. ' ' - '� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) ' f0� C 114*-w (size) / 3•d'� •� NO.OF BEDROOMS } s BUILDER OR OWNER lY PERMITDATE: ��`i 'd'� COMPLIANCE DATE: '� �'®V 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 v 'I k r No. 5 ct— Fee 4HE COMMONWEALTH OF MASikHUSETTS Entered in computer: /es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplication for �Digogaf *pgtetn Cotvwuction Permit Application for a Permit to Construct C\'RepaigN )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7t� p�}T`j, G� -`-9� ,,lv Owner's Name,Address and Tel.No. 57—ru&/, Olwe Assessor's Map/Parcel _ & 1190 , Installer's Name,Address,and Tel.No. pq S-r 09? Designer's Name Address and Tel No. P o S� �q 1� W, �n.0Ss F t6Z_0 rZ.0 �sr rD zs Ivia ra7ZZ1s°r01X7ZZ X601. Type of Building: Dwelling No.of Bedrooms Lot Size /4 Z3 Z-sq.ft. Garbage Grinder( ) Other Type of Building j�,C)7NNo.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow IS 1 0 gallons. Plan Date '5—/N :b� Number of sheets 'Z_ Revision Date Title Size of Septic Tank (;;f t%-nfj& i0 0 0 Type of S.A.S. � :SOO QkAmRFZ✓ t Description of Soil C', 9 . y M GD S Nature of Repairs or Alterations(Answer when applicable) j,)Eoj Lr;;;,4c.+4 Fly Z 56d qt t S'Tov,sr, 0-., ,A tom. Y f3TS 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 J:iqe 5 of the n ntal Code and not to place the system in operation until a Certifi- cate of Compliance has been iss b 's d of th. Sign Date O(- Application Approved by Date Jr" 5 Application Disapproved for a following reasons Permit No. !a CC) 5 J '�l Date Issued `l s No. (iCh ✓ d"> .. . __.. t� Fee AL Entered in computer: COMM6NWEALTH,OF MASSACHUSETTS es PUBLIC HEALTH DIVISION - TOWN-OF BARNSTABLE., MASSACHUSETTS r, Zlppricatioh� for ;Dioponl 6pgtem Con tructiou Permit Application fora Permit to Construct 0(5 Repair)Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 7 p J�P"J ' 5-7— 14 v Owner's Name,Address and Tel.No- Assessor's Assessor's Map/Parcel 7 & t9 / n0 7 `�7 r Installer's Name,Address,and Tel.No. Designer's Name Address and Tel.No. N /?o A3 c)-t* )Ze 9 Type of Building: Dwelling No.of Bedrooms Lot Size�/4 Z3 Z sq.ft. Garbage Grinder( ) Other Type of Building Siti,G� FONNo.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 V gallons per day. Calculated daily flow gallons. Plan Date S'/4 —6 S Number of sheets eL Revision Date Title ,. Size of Septic Tank Type of S.A.S. Z 500 Q) CNAMRFW,_, 1 Description of Soil r. 9 Z.. 4 Nature of Repairs or Alterations(Answer when applicable) 1JL—j L ;Ac-+-4 FI CLD Z —50 0 Cs 1 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions offTit e 5 of the En*iro mn ental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss ea b ,th2s Beard of HeA6. Sign Date Application Approved by Date G S Application Disapproved'for e'following reasons Permit No. `r)-CC 5 '01l Date Issued ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(Do Repaired ( )Upgraded ( ) Abandoned( )by PAS`rtxR-'r- 7--_ C_A.0 A--r)07-4 at 70 i>o,,TtAL 'J i N YAN"kS MA- has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer PA-5M&2U EXCA,VAT 1 tY-J Designer— — 6/j" Tn �a7Zr�T The issuance of this qit" all not construed as a guarantee at the sys e 1 fu s designed. Date �I Inspector THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS li5po0a[ *pgtem Cou5tructiou Perron Permission is hereby granted to Construct( D)Repair( Upgrade( )Abandon( ) System located at '70 ?6►-jr')bc- ST fit';► f jA.)t S_ �VN and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constructipn mustbe completed within three years of the da�/, this 1 Date:_ o Approved b t "Y Town of Barlistable $ Regulatory Services j $ , Thomas F. Geller,Director "6 , Public Health Division L " � Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer& Designer Certitication Form Date: ��Oj'Sewage Permit# 02 ' l Assessor's MaplParcel Designer: } ✓ K,�•voic Installer: Fas+c- `- Address: LZ �. r s s(�`�� . ddress: ll�rj . aox t On � c,X Cr_vc- was issued a permit to install a (date) (installer) septic system at ` Y`�r � S� t-' based on a design drawn by (address) dated (designer;) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. �.. — S H OF R9gss9� (Insta er's Signature)' �� PETER T. o MCENTEE ^' CIVIL in o No.35109_ /STEA�� esigner's Signature) (Affix Desi re) PI EASE RETURN TO BARNN ABLE JJEALTH DIVISION CERTIFICATE OF COMPLIANCE •wII:I` NOT BE ISSUED UNTIL I$OTH THIS FORAM AND AS BUILT CARD ARE Y HC HEALIH IYISIODi. Q:Health/SepticMesiper Certification Form 3-26-04.doc McKean, Thomas From: McKean, Thomas Sent: Thursday, October 26, 2006 5:42 PM To: Taylor, Madeline Subject: Recent Amnesty Applications/Septic Questionnaires (:78Pontiac StreetROVED-This application is approved for three (3) bedrooms maximum (reference- Disposal Construction Permit 6 Cedar Street, Cotuit PENDING -The septic system distribution box and piping is located beneath the garage/apartment. How will the applicant address this? There are no variances on record allowing the system components to be located the foundation and living space. A minimum setback is required per Title 5. -The septic system has capacity for only three bedrooms. However, the submitted floor plans show four bedrooms, including the'office"with only a forty-one inch opening at the doorway. Please have the applicant submit revised plans showing three bedrooms maximum by opening the doorway to five feet wide (without any doors). 1025 Service Road West Barnstable PENDING The system consists of two old block cesspools per an inspection report which was conducted four years ago (out-of- date). Please have the owner hire a DEP certified inspector to conduct an inspection of the system and to complete a 16 page inspection report. We need to know whether the system is functioning properly and whether the block cesspools are in good condition. The revised floor plan is easier to read. However, it only shows part of the home. What about the remainder of the home? Are there in fact three bedrooms total plus one office which has a five feet opening without a door? 63 SecuritV Street DENIED-This property is located within a WP district on 0.26 of an acre. Only the two pre-existing bedrooms are allowed on such small lot. No additional bedrooms are allowed. The proposal to add a third bedroom is denied. 1 t% TOWN OF BARNSTABLE LOCATION 4"_ 5 SEWAGE # I?s �- VILLAGE ry%or X45 _ ASSESSOR'S MAP & LO'�±f/f,9 INSTALLER'S NAME&PHONE NO. �'� SEPTIC TANK CAPACITY LEACHING FACILITY:_(type) ^� S �'Ff d��.� (size) �-?-o'a Ar 0-02-3 .NO.OF BEDROOMS-3� BUILDER OR OWNER A#SA-e 77 r- PERMITDATE: '��i -®` 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 � . Y ,�•- r A DA4 ♦r ti. U.Sq TOWN OF BARNSTABLE SEWAGE # __ LOUATION ASSESSOR'S MAP &LOT 10 •. N • S VILLAGE —G Se INSTAL LER'S NAME&PHONE NO. C DO HJ SEPTIC. TANK CAPACITY (size) LEACHING FACILITY' (type) Np Of BEDROOMS 3 BMDER OR OWNER - 7 COMPLIANCE DATE: pERiMIT DATE. Separation Distance Between the: Feet am Adjusted Groundwater Table and Bottom of Leaching Facility Mg'm Facility (If any wells exist Feet private Water Supply Well and Leaching h' onsite or within 200 feet of leaching facilityWetlandsexisr Feet e of Wetland and Leaching Facility(If any Edg facility) win 300 feet of leaching . h') Furnished by O 60 ,ye �;. TOWN OF BARNSTABLE LOCATION 1 4 sT, SEWAGE # _VILLAGE N . ASSESSOR'S MAP&LOT j INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ck 00 c� J LEACHING FACILITY: (type) �l/�lei �T��`Ty�S (size) '362`��j/ -NO.OF BEDROOMS `e BUILDER OR OWNER I7 1 , PERMTTDATE: A'L�, - �''7 COMPLIANCE DATE:_4^ 24(Z Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 r (J� IV 4 � � TOWN OF BARNSTABLE LOCATIGN SEWAGE VILLAGE 0kJ3:- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) `0.OF BEDROOMS d� i BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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) n Feet Furnished by I Y.� No. r Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for Migponl *r5tem COtt$trurtton Permit Application for a Permit to Construct( )Repair(V�<pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No."781PoAAINC sln ( �. .6 Owner's Name,Address and Tel.No. Assessor's Map/Parcel 0?(09 q 0 ` w d✓3-l J Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 'Z) gallons per day. Calculated daily flow 3q gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank kCM Type of S.A.S. k sc,%PC��—r c�T►''+�`� Description of Soils 10 S A-1-40 Nature of Repairs or Alterations(Answer when applicable) Co.yQ C-i �v�-de f 1: w.M��1� Ems- o v�-&V a e=S /�t t c.t�r�v- �t,cr, 7 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 Certifi- cate of Compliance has been issued by this Bo Signed Date g",979 Application Approved by Date Application.Disapproved-for the.following reasons Permit No. e Date Issued Fee lJV � THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes -�. PU LIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS pplicatton for Migogaf *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(grade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 78 PA,71 Y G SC': �-�� S'.,Owner's Name,Address and Tel.No. Assessor's Map/Parcel 0?/ / �✓�c I Installer's Name,Address,and Tel.No. Designee s Name; ddress atnd ZeI.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures t Design Flow '53 3b gallons per day. Calculated daily now 39 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank !i�I s1 COC.o Type of S.A.S. Description of Soil ✓A F5 ^!� t Naiure of Repairs or Alterations(Answer when applicable) SZ -vs-(� o 0- 8 L-/ k 1 v- ,t yC_N C,6. (Iv-e _. o v_S► n L P `1 .v j.e;7-4.y_ . 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 Certifi- cate of Compliance has been issue o _Health. Si ned Date y _ y-. 1 ApplicatiotrApproved b __ __:_. . ,.- ,_._ _ Date "- Application Disapproved for the following reasons Permit No. —3 Date Issued ------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance ✓ THIS IS TO CE13.TIFY, t the�Se�wage�Disposal System Constructed( ) Repaired ( )Upgraded( ) Abandoned( )by Q d} ✓ at 1 W w°t/ has been construc_wd in c�dance with the provis s of Title 5 an�=tern Construction Permit No. +" dated Installer Designer The issuance of this p rmit shall not b .co strued as a guarantee that the system will function as designed. Date Inspector ----y------------------------------------ No. r 3 26 Fee o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS Iigpogar *pgtem f _ngtruction Permit Permission is hereby granted to Construct )Repair( <pgrade( )Abandon( ) System located at 7��1�R c S1 , and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction Tust be completed within three years of the date of this permit Date: Approved by �� _ NOTICE: This Form is to be used for the Repair of Failed Septic Systems Only CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) '2U-9 -- ) (700 hereby certify that the application for disposal works construction permit signed by me dated a12-a concerning the property located at ' > a, ,kx� S1 meets all of the r: following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system " • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility ✓• There is no increase in flow and/or change in use proposed " • There are no variances requested or needed. SIGNED : DATE: 4� . LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER' [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. S _ c►� ,� � o rn Commonwealth Of Massachusetts m F o Executive Office of Environmental Affairs U/V 1 ~ �� 0 19 � Department of to OHo Environmental Protectio T wluiam F.Wld Z AIW Paul C•lluod vid B. Struha Gommiw crw SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION PropertyAddreew 78 Pontiac Street Hyannis ,Mass . Addreesotoa.r,733 Stone House Road D&j4 dLsppuon-6/5/97 (11difterent) Moorestown , New Jersey Name of Iaspeotor.Joseph P.Macomber Jr. 08057 Company Name,Addreae and Telephone Number. J. P.Macomber & Son Inc . 508-775-3338 Box 66 Centerville ,Mass . 02632 CERTIFICATION STATEMENT I oertify tLu I have psrsomally laap.ctad the"wage disposal eystem at this addrees and that the information reported below is trw, &O=Mvne mad oomplau u of the time of inspeatioa. The inspection was performed bawd on my training mad experience in the proper hrncd- mad =—tananca of om-site"wage disposal systams. The syetem: _ Passes Conditionally Passes _ wds Further ther Evaluation By the LOWApproving Authority Fail / Inspector's Signatures �� /� ��j� � Dar.: The 87stem Inspector shall submit a copy of this inspection report to the Approving Authority within thirV(30)days of completing this inipectiaa It the system is a ahar+d syetem or has a desip flow of 10,000 gpd or greater, the inspector and the system owner&hall sul,mis the report to the appropriate regional OMce of the Department of Eavironmantal Protection. Th&original should be "at to the system owner.'tad copies sent to the buyer, U appUcabla and the approving au rity'�� W9PECTION SUMMARY: Issv� o�a�l7 Check A. B. C, or D: ' A) .SYSTEht PASSES: I have not found Lay information which indicates that the system violates ary of the UDury criteria u daflned in 310 CUR 15.303. Any U11un criteria not evahsatd are Indicated below. B) SYSTEM CONDITIONALLY PASSES: A)u One or more system components need W be replaced or repaired. Ths system, upon completion of tha rvplacamaat or repair, pans_ iaspectiaa. Iadinte- ao;or not datarmined(Y, N, or ND). Describe basis of determination in all instaaces. If'not determine, explan why not) � _..Lis?. Tha septic taalc is metal, cra:5c,ed, strvctural�unaouad, &Lows rubetnatial iaIIltratioa or ezSltratioa,.or taa1:tanZura is imminent. Thaiystem will pass inspection U the existing w�pt'ic` tank is rrplaood with a Conforming septic tank as apprvo.d b7 the Board of Health. i4l xb�p �Q ,C 1, G `F �7e -'94 U t=aisle. (rerlted 11/03/95) 1 One VAnt•r Str••t a Boston, Massachusetts 02106 • FAX(617)SWI049 • Telephone (617)292•5S00 t� /Mind a,auycae rapw SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address.78 Pontiac Street Hyannis ,Mass . Owner: Patricia Hall Date of Inspection:6/5/9 7 B) SYSTEM CONDITIONALLY PASSES (continued) d,bW-, Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced _42 D The system required pumping more than four 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 C) FURTHER EVALUATION 15 REQUIRED BY THE BOARD OF HEALTH: AU)6 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: qLv 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. �Q The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. �j The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) O/THER N� (revised 04/25/97) Page 2 of 20 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 78 Pontiac Street Hyannis ,Mass . Owner: Patricia Hall Date of Inspection: 6/5/97 D] SYSTEM FAILS: You must indicate eir:er "Yes" or "No" as to each of the following: 1 have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. -Z 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. Asti 4r- A,�rJ Liquid depth in oes,� is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped" Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. �10 Any portion of a cesspool or privy is within a Zone I of a public well. /,,)0 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply t e system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area - IWPA) or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of a Department for further information. 1 . The septic is in failure because the tank, a4 leakage problem at the seam. 2 . Leach pit has failed in the past and has 21 of solid waste on the bottom . 3 . Cover broken on tank. 4. Tees are missing in the tank.Reason for solids carry over to the leaching pit. (revised 04/25/97) Page 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHEMIST PropertyA,dds..w 78 Pontiac Street Hyannis ,Mass . Owner. Patricia Hall Date of Inspection; 6/5/9 7 ' Check it t:,�"have bean done: Pumping information was requested of the owner,oocupant,and Board of Health. ,�1None of the ey.tem components haw been pumped for at kart two weals and the system has bwa reosivmg normal Caw rater doing that period. LrSe vohuaw of water have not been introduced into the system reomtl,or as part of this inspection- �1►s buM plans have bma obtained sad examined. Note if thq are not available with N/A. - 'Oe faculty or dwelling was inspected for tips of sewage back-up. 4Z7he system does not nod"nm4a itary or industrial waste flow ,AThe site was inspected for aigss of breakout. ,1�-All system components,A&ding the 8*11 Absorptioa System, haw been located on the aite. z7u septie teak manhole-were uargvared,opened,sad the interior of the septic tank was inspected for condition of baffies or taw,material of construction, dima4ions,depth of liquid,depth of shidgs,depth of scum. Z711 rise and kcatioa of the Soil Aboorption System on the nits has beam determined based on-cd9tin8 information or ap by non-intrusive methods. The UcMV owner(and oowpaats, if different from owner)were pravidd with information on the proper+ aintamaz -of sub.- surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:78 Pontiac Street Hyannis ,Mass . Owner: Patricia Hall Date of Inspection6/5/97 FLOW CONDITIONS RESIDENTIAL: Design flow: 620 8.p.A./bedroom for S.A.S. Number of bedrooms: Number of current residents: 0 Garbage grinder (yes or no): 4)6 Laundry connected to system (yes or no):*j Seasonal use (yes or no):" Water meter readings, if available (last two (2) year usage (gpd):/IJIQ�9F- /n4Y0tb {'.�',SCL1'1�}14�iooS' o� � �( Sump Pump (yes or no):�(� JYt Y 6� m 9-ye- q&y)z o;= /0A vUU Last date of occupancy: COMMERCIAUINDUSTRIAL: Type of establishment: /�lQ Design flow: VI+ allons/day Grease trap present: (yes or no)a Industrial Waste Holding Tank present: (yes or no)�/¢ Non sanitary waste discharged to the Title 5 system: (yes or no)I Water meter readings, if available: 1)k ) _ Last date of occupancy: OTHER: (Describe) dA Last date of occupancy:�� , GENERAL INFORMATION ECORDS and information: System pumped as part of inspe ion: (yes or nolL If yes, volume pumped: �� allons Reason for pumping: TYPE OF SYSTEM Septic tanW soil absorption system LPL) Single cesspool 4)(,) Overflow cesspool �� Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) /Ly/ I/A Technology etc. Copy of up to date contracts' Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) (revised 04/25/97) Page S of 10 i ) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Properly Address: 78 Pontiac Street Hyannis ,Mass . Owner: Patricia Hall Date of Inspection:6 5/9 7 BUILDING SEWER: (Locate on site plan) ( Depth below grade:)i Material of construction: cast iron — 40 PVC —other (explain) Distance from Private water supply well or suction line Diameter 41' Comments: (condition of joints, venting, evidence of leakage, etc.) / S, n kzi 6h, SEPTIC TANK:zWemd'Gk1S (locate on site plan) 6) Depth below grade: 6 Material of construction: concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age dZ Is age confirmed by Certificate of Compliance �(Yes/No) Dimensions: y ld"�)ldf S 7 /7j ,4 Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 4� 22 ,/ Distance from top of scum to top of outlet tee or baffle:ld t Distance from bottom of scum to bottom of outlet teen or baffle: y/ How dimensions were determined: 11 VA�it1,f4X klv I j ,� �/� Q/(k, ,, f-,p f T>� rvleso S�{N�� r4' S�v�1Ltc2S l�P� Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural inte rity, evidence of leakage, etc.) Pump septic tank 'every 2 3 years : In1P.t, Rr n,)t.l at. ees are missing:Tank is half full Tank is structurally sound. GREASE TRAP: e (locate on site plan) Depth below grade:'64 Material of construct ion:?/`/concrete tZ metalj(Z&iberglasW&4 PolyethyleneyAother(explain) Dimensions: A)H Scum thickness: V"? Distance from top of scum to top of outlet tee or baffle:.d2,4 Distance from bottom of scum to bottom of outlet tee or baffle: 4//� Date of last pumping: V/J Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) rr se trap is not pregeDt (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontiaued) Property Address: 78 Pontiac Street Hyannis ,Mass . Owner. Patricia Hall Date of Impeou=6/5/9 7 TIGHT OR HOLDING TANSs.� (locate oa site place) • Depth Wow dL Matarlal of explaia) - Dimaasions: to Capacity: Design flow: as/dgy Alarm level: I, Commaats. (condition of inlet tea,condition of alarm and float switch",etc.) Tieht or holding tanks are not present I DISTRIBUTION BOXZMC (locals oa sito plan) . Depth of liquid Ieval above outlet invert: IVA Commaats: (note if level and distribution is equal, evidence of solids carryover,evidence of lea>rage into or out of box,•tee) Distribution box is not level PUMP CHAMBER:-"( pocats on site place) Pumps is working osder.(yes or no) NI Commaats: (note oonditioa of pump cbs,mbes,oondit, a of pump+and appurt.aas►ces,etc.) Pump Chamber is not presen (revised 11/03/95) 7 r 'I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:78 Pontiac Street Hyannis ,Mass . Owner: Patricia Hall Date of Inspection6/5/97 SOIL ABSORPTION SYSTEM (SAS):! (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number leaching galleries, number: leaching trenches, number,length: 0 leaching fields, number, dime sicns: overflow cesspool, number: Alternative system: Name of Technology: 1 Comments: Nfetg condition saof 1,tsigns pf hydraulic f inure, level of ponding, condition of vegetation, etc.) o I a:Yes there are signs of hydraulic failure . 1 . Heavy solids in leach pit 2 Stained walls of the nit No signs of pon ing. All vagpt.at.i nn i S normal Hnnca hac hgpn irarant. fnr enmatj ma T.PgC-01l nrJ pi t. i c in f be upgpaded to the 95 Gede CESSPOOLS: Z ijVe_' (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: IVA Depth of scum layer: lyll Dimensions of cesspool: zz Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as pan of inspection) '/JA Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Cesspools are not present PRIVY: 'e— (locate on site plan) Materials of construction: Dimensions: /C Depth of solids: 41�ii Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) rivy is not present (revised 04/25/97) Page 8 of 10 i. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 78 Pontiac Street Hyannis ,Mass . Owner: Patricia Hall Date of Inspection:6/5/97 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) t 7 8 oN r1A c s (revised 04/25/97) Page 9 of 10 Iv SUBSURFACE SEWAGE DISf L SYSTEM INSPECTION FORM _ C SYSTEM INFOit IION (continued) Property Address: 78 Pontiac Street Hyannis ,Mass . Owner: Patricia Hall Date of I nspection:6/5/9 7 Depth to Groundwater/" Feet Please indicate all the methods used to determine High Groundwai ovation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, ba,. it sump etc.) --Z— Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groun r Elevation. (Must be completed) Installed new system at 94 Pontiac Street Hyannis ,Mass . in 1981 . Permit# 81 -228 No wat(5r encountered at 121 (revimod 04/25/97) Pa of 10 a•wwnP+.�n•rR-`.'.�.11J�aw•n1wl1I'TR Ar+nRnT+1'w►rnRww.n 1R\7i 1'l��rll�n .��-a—.r- - .. TOWN OF Barnstable BOARD OF HEALTH \ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CEIITIFICATt()N `� �:-•Tr•f�••.•::.—T.t=It�.�+'n/nr+w'r1.11n TtR�rs.Ptnrrs'1^tww' www�T�R�wiI 7 awn ..vrrr'„ ' -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 78 Pontiac Street Hyannis ,Mass . ASSESSORS MAP, BLOCK AND PARCEL OWNER' s NAME Patricia Hall PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J. P.Macomber & Soif 'Inc . COMPANY ADDRESS Box 66 Centerville ,Mass . 02632. Street Town or City State LIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX (508 ) 790 - 1 578 w CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system a this address and that the information reported is true , accurate , and complete as of the time of�inspection , The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. XXXXXXXXXXXXSystem FAILED* I The inspection which I have conc ted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date . �, One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or" perator shall up grade system within one year of the date of the inspection, unless allowed or required otherwise as provided in 3.10 CMR 16 . 306 . partd . doc �G LLJ _ Sbfy �71 THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualificatigns as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. June 8. 1995 Acting Director of the ton of Water Pollution Control i ... -LEGEND - LOCUS_ PROPOSED CONTOUR . ' r 5 ro G . Lr 99. PROPOSED SPOT GRADE `;�B , 21 EXISTING CONTOUR c R�' wo r EXISTING SPOT GRADE 'e°` ® - ` Benchmark set TEST PIT Right COr^. ehd re t, wall EXISTING WATER SERVICE wEsr Mnw srrz r sT E7,=97,01 (Assumed) LOCUS MAP N.T.S. _ _... UP/6 99,71 _.�.: .� .. E �,£; x�9 �)6 P. R Fc , 1�067' `�' ,' `� • 23, lU ,.4 W. I ! GENERAL NOTES: --� It LGT 8 EXISTING 97,10 10 1• ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL ,3 BEDRl70M Deck ! t �� o BOARD OF HEALTH AND THE DESIGN ENGINEER. r,� 0,26t AC. WOUSE (#78) I ;S i ' , Map 26 9 A �F LtJul� ! k c.n 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS Pro , OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 1J 7 ; `° p" `�; •�'t'�' ! 0\ LOCAL RULES AND REGULATIONS. CAssumed) z f a r+r el 1 TOF=101,93 ! ! ! + X .w- .11 i 3. THE SEWAGE. DISPOSAL SYSTEM SHALL NOT. BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE p r 0i � DESIGN ENGINEER. 553 � Ln I Batt , 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING c> > , ' ! ' ! FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN U1 ° � _ J 7 a � tld 6? 0• ! ENGINEER BEFORE CONSTRUCTION CONTINUES. o f r ) ��°i 'r II { • I i 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. I — G -w --G +'100.58 d • • I 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF �'` Y` •-- -�" �""W �� '4 rt x `4,99 I � ! THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF 99.1 �,.:. ti p j t :�• I HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. pave `\ 100,57 it , \ K �r !� I ^7 p 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE, 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A.S. 9 9,35 "� ° `� i B. SEPTIC SYSTEM COMPONENTS SHALL BE INSTALLED AS DESCRIBED 148,86t ` r IN 310 CMR 15,000 SUBPART C. 8S°11'03" W ~~� 10. ALL AREAS DISTURBED DURING CONSTRUCTION ARE TO BE RESTORED EXISTINCi. S.A,S, AS AGREED UPON BY OWNER AND CONTRACTOR. ' 1 TO BE ABANDONED 11. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING ~"" M..-•�.-°. '.`.W CONSTRUCTION. Exr UNG SEP-TrC LALVk' 12. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS TOP OF TANK EL,=94,04 IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. 99 67 INV,(OVT)=92,7f AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). of Mks 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. o PETER T, 5 MCIVIL PROPOSED SEPTIC SYSTEM UPGRADE 78 PONTIAC STREET, HY No. 35ios AN N I S, MA R£1�5�� F�SIONAI ANC Prepared for: Steven Barrette, 78 Pontiac Street; Hyannis, MA Engineering by: Surveying by: SCALE DRAWN J08. N0; J `6( —✓ Englne&it l�or�r Terry WornerP.��S 1"=20' P.T.M. 131—05 to Vi 12 West Crossfield Road 22 Long Road Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. (50§) 477-5313 (508) 432-8309 5/14/05 P.T.M. 1 Of 2 t ' { EXISTING F.G. .EL:. 95t NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:92.0 FOR A DISTANCE OF 15' AROUND THE EXISTING F.G. EL: 95.0t(EXISTING) F.G. EL: 95t PERIMETER OF THE S.A.S. MAINTAIN 2% MIN SLOPE OVER S.A.S. INSTALL RISERS OVER INLET & OUTLET INSTALL RISER OVER D-BOX TO 2-500 GALLON LEACHING CHAMBERS INSTALL RISER 0AND CHAMBER/S TO WITHIN 6" OF FINISH GRADE WITHIN 6' OF FINISH GRADE SHOWN ON PLAN AND SET .GONER/S y, IN SERIES WITH STONE ALL, SIDES WITHIN 6`�OF FINISH GRADE L 36' L-13'(MAX) 4' SGH 40 PVC 4" SCH 40 PVC 1n EXISTING 1a' @ S= 1% (MIN.) 6' @ S= 17 (MIN.) aaapaaa DOUBLE WASHED STONE1/8' 2 EFF. DEPTH ®seas® 2' LAYER ❑F 1/6' 7 e 1000 GALLON INV. ELEV.=92.00 INV. ELEV.=91.83 EXISTING SEPTIC TANK 4!. 5,2' 4' DOUBLE WASHED FFECTIVE WIDTH = 132' STONE INV.EL: 92.7t INV. ELEV.=91.50 INSTALL INLET & OUTLET TEES EXISTING TOP CONC. ELEV.=92.3 BREAKOUT ELEV.=92.0 GAS BAFFLE TO BE INSTALLED ON INV. ELEV.=91.50 ®amaa OUTLET TEE AS MANUFACTURED BY D-BOX SHALL BE SET LEVEL AND TRUE 7O GRADE 7UF-TITE, ZABEL, OR EQUAL ®® ®®esMEN ON A MECHANICALLY COMPACTED SIX INCH CRUSHED BOTTOM ELEV.-89.50 .8 S, = 17 D, �� STONE BASE, AS SPECIFIED IN 310 CMR 15,221(2). 5' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = 23,0' SEPTIC SYSTEM PROFILE T.P. EXCAVATION OR G.W. NO G.W, ENCOUNTERED LEACHING SYSTEM SECTION N.T.S. BOTTOM OF TP ELi 84.1 PETER T. (3) 5" DIA.OUTLETS p McENTEE lh -s s---I f" ") 2, CIVIL J No, 85109 DESIGN CRITERIA61 �a SOIL LO �" "" NUMBER OF BEDROOMS: 3 BEDROOMS S� ;j aT,t r_.�— — -� ,�� 1.� 2. DATE: MAY 13, 2005 i (,y I SOIL TYPE; CLASS I V H-10 LOADING SOIL EVALUATOR: PETER McENTEE i DESIGN PERCOLATION RATE: 2 MIN. IN. ---BOX INSPECTOR: DON DESMARAIS -AGENT t1�i DAILY FLOW: 330 G.P.D. nrs (REF# P-10,984) ('11 CL I DESIGN FLOW: 330 G.P.D I Elev. P Depth 4 GARBAGE GRINDER: NO (THERE SHALL BE NO GARAGE DISPOSAL) 9&4 A 0" I I LEACHING AREA REQUIRED: (330) = 445.9 S.F. SANDY LOAM _ 10YR 3/3 .74 ®® 0 ®®® g51 8 SANDY LOAM 4" EXISTING SEPTIC TANK: 1000 GALLON CAPACITY jrq-f9a ®®®®11�®0Ea® 33" 10YR 4/5 ®®®®&2E3®®®M®®®EME3®®® 92.4 C 36' - USE 2--500 GALLON LEACHING CHAMBERS IN SERIES 102" PERC !� SIDEWALL AREA: 2(13.2' + 23.0') X 2 = 144,8 S.F. a p BOTTOM AREA: 13.2' x 23.0' = 303.6 S.F. a" KNOCKOUT 66" TOTAL AREA; 448.4 S.F. 20" OIA, COVER 0MED. SAND DESIGN FLOW PROVIDED: 0.74(448.4) = 331.8 G.P.D. 4" KNOCKOUT 4" KNOCKOUT 62" 10YR 5/8 4" KNOCKOUT PROPOSED SEPTIC SYSTEM UPGRADE 84.1 136" BACK OF HOUSE 78 PONTIAC STREET, HYANNIS, MA PERC RATE: <2 MIN/IN ("C" HORIZON) 500 GALLON CAPACITY, H-10 LOADING NO GROUNDWATER ENCOUNTERED Prepared for: Steven Barrette, 78 Pontiac Street, Hyannis, MA Engineering by: Surveying by: SCALE DRAWN JOB. N0: CHAMBERS S,A,S. LAYOUT Engin"dngAbrkr T07Y,4 ArM%WA,L,S' NTS P.T.M. 131 -05 N.Ta - 12 West Crossfield Rood 22 Long Rood Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET NO. (508) 477-5313 (508) 432-8309 5/14/05 P.T.M. 2, of 2