Loading...
HomeMy WebLinkAbout0097 STERLING ROAD - Health ,! 9►7 Sterling Road Hyannis P W E B o l u TOWN OF BARNSTABLE LOCATION 97 S Ler)i'^!%QoI SEWAGE# /Z 9 VILLAGE n;S ASSESSOR'S MAP&PARCEL aG8• ,gO tl INSTALLER'S NAME&PHONE NO. 0 4 t3 EXea ya4;o n 41?7- OG S 3 f SEPTIC TANK CAPACITY �SOO LEACHING FACILITY:(type) lr (size) //A 3Z. NO.OF BEDROOMS y -1 '±f r, OWNER kcu+'n i7lc0rcoL PERMIT DATE: f'-S'-// 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 ! Al-a7' gj- 17 ' 3Z -IN' i33•a`1 �`' FRONT Ay•y5 A a I3y• 3`I �� � ' y E� No. l9-0 L t— 01� i Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplitatlon for Misposal *pBtrm (Coast rtion 3permit Application for a Permit to Construct( ) Repair(/upgrade( ) Abandon( ) ❑Complete System ❑Individual Components i Location Address or Lot No. q, -Cr hn 4 eD �even �Cner's Name,Adds,and Tel.No. 4-� Assessor's Map/Parcel �f0� e Z0 -2 — In tall g 's me Address,and Tel.'No. Designer's dame,Address and Te.No. CrSN � i:n� � Type of Building: Dwelling No.of Bedrooms q Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ll Design Flow(min.required) gpd Design flow provided G� V gpd Plan Date 111916 Number of sheets Revision Date Title 60 P06CO5 ewaa'D cs oys cc_.! Sis Fermi Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date — t Application Disapproved by Date for the following reasons Permit No. ao Date Issued r r r I No.,: - Fee lor Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS Yes PUB" IC HEALTH DIVISION - TOWN OF BARNSTABLE MASSACHUSETTS application for Misposal 6pstrut (Construction Permit Application for a Permit to Construct(;) Repair(4pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. e_r n ner's Name, ddre s,and Tel.No. 1 Assessor's Map/Parcel �Q ��� �pc/r�e12(� 4 (7 -2(0-1 - 2r/5 tat is ame,Addres ,and Tel.No. Desi ner's ame,Address,and Tel.No. ores IctCc.Ye V� -609 ti 7 7 y a53 Type of Building: L Dwelling No.of Bedrooms 1 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ' L Design Flow(min.req i tf red� ' «�°' K gpd Design flow provided ( U gpd Plan Date I g 1 O Number of sheets Revision Date Title ropose-o5ewQre -Disposal Sv/ste(Y1 Size of Septic Tank Type of S.A.S. / Description of Soil Nature of Repairs or Alterations(Answer when applicable) l Date last inspecteda Agreement: A The undersigned agrees to ensure the construction and maintenance of the afore described on=site sewage disposal system iii accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date 5 Application Disapproved by Date y - for the following reasons Permit No. Date Issued S 7 k THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,th t the On-site Sewage Disposal system Constructed( ) Repaired( � Upgraded( ) Abandoned( by [ t I3 C CU C1 f I Lo - L at -1 ! _ e(� 1 Q.p 0 n n I S has been constructed in accordance with the pro •sions of Title 5 an _the for Disposal System Construction Permit No. dated c r / Installer � T {'��' Designer a En �niaetIn #bedrooms Approved design flow 4 gpd The issuance of is jermit shall not be construed as a guarantee that the system will nc iRt}as design V. Date Inspector ----No Fee ( (/ -_-�U �� � --�------------ - - -------------------- -- ---- ---�_-----------_-------------------- ---- =V -------- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposaf 6pstem Construction ln Permission is hereby ranted to Construct( ) Repair( ) Upgrade( ) Abdon ) System located at !7 S e r I I cup 'D -k/G n n S and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction myst be completed within three years of the date of this permit. Date ' Approved by EXCERPT FROM BOH FEBRUARY 12, 2011 I. Variances — Septic (Cont.): A. Linda Pinto, engineer, representing Kevin McCrea, owner— 97 Sterling Road, Hyannis, Map/Parcel 268-204, 0.23 acre lot, multiple variances, septic repair. Linda Pinto was present and submitted a plan with two changes. She improved the location of the water line. She had realized that the existing tank was not within 10 feet of the water line so she moved this. Ms. Pinto added the note to the plan listing the variance of the pump chamber. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to approve the variances with the following condition: 1) must record a four (4) bedroom deed restriction with the Barnstable County Registry of Deeds and, 2) must supply a proper copy of the recording with the Barnstable Health Division. (Unanimously, voted in favor.) j 05/04/2011 12:10 FAX C7J001 w DEED RESTRICTION Whereas, Kevin McCrea is the owner of property located at 97 Sterling Road,Hyannis, Barnstable County, Massachusetts, by deed dated September 14,2010 and recorded in the Barnstable County Registry of Deeds on September 27,2010 in Book 24860,page 88, said c land being shown on the Town of Barnstable Assessor's Map as Map 268, Parcel 204,and amore particularly described on Exhibit"A"attached hereto and incorporated herein. Whereas,Kevin McCrea, as the owner of said Lot,has agreed to a restriction as to the number of bedrooms which can be included in any dwelling existing or constructed in the future on said Lot as a pre-condition to obtaining a permit for the installation of a new septic system; Whereas,the Town of Barnstable Board of Health, as a pre-condition to granting the permit for the installation of a new septic system in accordance with 310 CMR 15.000: The State Environmental Code, Title 5, is requiring that the agreement.for the restriction of the number of bedrooms in any dwelling existing or to be constructed on the Lot be put on n record with the Barnstable County Registry of Deeds by recording this document, Now',Therefore, Kevin McCrea does hereby place the following restriction on the above referenced land in accordance with this agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: The property located at 97 Sterling Road, Hyannis,Massachusetts and described on a the attached Exhibit"A.", may have a dwelling containing no more than four(4)bedrooms. Kevin McCrea hereby agrees that this shall be a permanent deed restriction affecting the above described premises. FOR TITLE, see deed recorded with the Barnstable County Registry of Deeds in Book 24860,Page 88. r RECEIPT BARNSTABLE COUNTY2011 REGISTRY OF DEEDS JOHN F. MEADE, REGISTER - Trans#: 71495 Oper:ETTA Book: 25364 Page 105 Inst#:-17628== Ctl#: 805 Rec:4705-2011 ® 1:55:17p BARN 97 STERLING RD DOC DESCRIPTION TRANS AMT 1 MCCREA, KEVIN --------- RESTRICTION County Fee $ 10.00 10.00 Surcharge CPA $20.00 20.00 State Fee $40.00 40.00 Surcharge Tech $5.00 5.00 Total. fees: -75.00 Ctl#: 806 Rec:4-05-2011 l# 1:55:17p DOC DESCRIPTION TRANS AMT POSTAGE FEE ------ County Postage Fee 1.00 Total charges: 76.00 CHECK PM 2229 76.00 .._...... . ................................. ....._... . . .......... ........... . ................._.............. . ..._..._. .......... f. Feb 08 11 1258p CSN Ergineerirg 1-508-548-547 8 p.1 t l F+�tl-�VJl l 13:33 t r om:MHKNZ. i Pltl-I-I rI 1 Z)M I >>ag- w 7aF J Town of Barnstable Board of Reatth �+ 200 Main ,Street -Hy�utis MA 02,601 03 t D� Agreement to Extend Time Limit for acting Upon a Variance Request In the Mutter of a variance request form received on �I}� { ('tr t4ye Petifloner�sJ, � � rcgordhq the property at Y �� I the petitioners) and the Board of Health agree that the Boar F Health 6s a l (insert date)to act upon the Petitioners'completed application for a variance In executing this Agreement,(Ile PeGtioner(s)heretq specifically waive any c ir'h for a const(t:cttve grant of relief based upon time limits applicable prior to the execution of this 9reement_ Patitioner(s): Board of Health: Signature,. .a.1 Signature: } eliianertsau QutilioneY'Y fRbyarLalivb ..h.afrrtY'iA Print: i. J Print: UVayno Mi er, M.O, Dace;,! . - Date:._ Address of Poil0cox(s)of PedWiler's RepreSbnratl►re 0 J. S'1.a� �sJ Town Of Barnstable i r.:&,cic1� _ ........ _ Board of I�lealth " .-fit' Public Health Division 200 Main Street Hyannis. MA 02601 Phone: (508)862-4644 Fax: (508)790-6304 file%ioxtend.doa THE Town of Barnstable �pP Tp� " Board of Health yP O; * IARNSTABLE. • 200 Main Street - Hyannis MA 02601 MASS. 9 V i639• �0 alf0�,ta Agreement to Extend Time Limit for Acting Upon a Variance Request In the Matter of a variance request form received on the Petitioner(s), f i Qt-�5& T R OT- Rr (Y-\ regarding the property at n.�S the petitioner(s)and the Board of Health agree that the Boar Health�as it� 10iN (insert date)to act upon the Petitioners'completed application for a variance. In executing this Agreement, the Petitioner(s) hereto specifically waive any claim for a constructive grant of relief based upon time limits applicable prior to the execution of this Agreement. Petitioner(s): Board of Health: Signature Signature: 'Petitioner(s)or Petitioner's Representative Chairman Print: L,-k�JD k- Print: Wayne Miller, M.D. Dater( Date: Address of Petitioner(s)or Petitioner's Representative Town of Barnstable Board of Health Public Health Division 200 Main Street Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508) 790-6304 file q:extend.doc !1 f tlifT�, DATE:?(� / FEE: + BARNSrABLE • MASS. 039. �� REC. BY Town of Barnstable SCEIED. DATE: Board of Health /"�� � � /c/ 200 Main Street, Hyannis MA 026 1 `- Office: 508-8624644 6" ayne A.Mi er,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul J, ff,D.M.D. VARIANCE REQUEST FORM LOCATION Property Address: �� S�e.rl�nc� 1 . 1-l�i annis Assessor's Map and Parcel Number: (off Ion Size of Lot: Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: APPLICANT'S NAME: CS N �'t t'l e:/tin h Phone S �' `l`t -3 2�-0 Did the owner of the property authorize you to represent him or her? Yes — No - PROPERTY OWNER'S NAME CONTACT PERSON ttJJ � ` Name: I�C.y►n �� Lax cti Name: LlACL 36 Address: q1 S4,:,1,^ b. Address: 3. , ee.-,�c.k.e h mA x Phone: Phone: -))o A`i- 3250 VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) :.3io C.M4 ij;211 )e.1 )—Lt �`\ C s<�S' �.•n;S NATURE OF WORK: House Addition House Renovation Repair of Failed Septic System i Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance.renewals[same owner/lessee only], outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi !� REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. } C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC Town of Barnstable oFVE ra, Regulatory Services Thomas F. Geiler, Director " MAS& Public Health Division ATE1 r,9. Thomas McKean, Director -200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 1 t�l L= Sewage Permit# 00/J-J Z 9 Assessor's Map/Parcel G� 8 - Installer& DesiLyner Certification Form Designer: Installer: 13413 CXCct V mJ i on Address: �� �� 1.o3a Address: JyTeaSerrH GN On �'•$ J / 13 4 a rXCdLV*J i oA was issued a permit to install a (date) (installer) septic system at 917 sic r)i nq J 61 . based on a design drawn by (address) L'S IV inng;fl)e r--r•i n 0 dated /J•9-10 R.'v. J• 20 • I/ (designer) __V_/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 distn'4ution box and/or septic tank.' Stripout (if required) was inspected and the soils were found satisfactory. 3 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. Plah revision or certified as-built by designer to follow. Stripout (if required) wa ected`and the soils J were found satisfactory. OF LINDA J, ( taller's Si t e) esigner' Si ature) (Affix Desig Here) ' PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gaoffice formsWesignercertification form.doc x } f }f' Town of Barnstable Barnstable Board of Health A u`ca j y Mass. 200 Main Street,Hyannis MA 02601 m �Aj fD 3,I A�� 2007 OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. BOARD OF HEALTH MEETING RESULTS Tuesday, December 14, 2010 at 3:00 PM Town Hall, Hearing Room, 2ND Floor 367 Main Street, Hyannis, MA I. Hearing - Underground Storage Tanks: Peter Doyle and Dale Saad, Water Pollution Control Division, Town of Barnstable, owner— 382 Falmouth Road (a.k.a. 617 Bearse's Way), Hyannis, Map/Parcel 293-001, requesting a second extension on the replacement deadline of two tanks. APPROVED WITH CONDITIONS. The Board voted to approve an extension on the replacement deadline on both tanks to January 2012 with the condition that monthly testing are performed on the rain water for hydrocarbons and for chlorine. II. Hearing: Joseph & Inessa Katsman, owner—45 Straightway, Hyannis, second septic system inspection completed. CONTINUED TO SEPTEMBER 2011. The Board voted to request another "partial" inspection be made during the last two weeks of August 2011 (after the maximum use time frame). During the "partial" inspection, the Board wants to have the pit examined and pictures taken of the pit and its riser. III. Hearing:. Show- Cause for Stable Permit: Sally Burke, owner of Sea Flash Farm — 2346 Meetinghouse Way, West Barnstable, 14 horses, violations of Chapter 376-8 and 376-9. POSTPONED UNTIL JAN 11, 2011. IV. Innovation/Alternative System (Cont.): Winston Steadman, All Cape Environmental represents Brian Smith, owner— Fancy's Market, 699 Main Street, Osterville, Map/Parcel 141- 011, with Monitoring Plan for Sludgehammer System, requests revisions to Board of Health approval letter to change to General Use. Page I of 4 BOH 12/14/10 APPROVED WITH CONDITIONS. The Board voted to change the approval letter to General Use with the following conditions: 1) the DEP recognizes the application as "residential" in this situation where the system handles less the 2,000 gallons a day, as currently understood, and 2) the monitoring will be monthly for the first six months, then it will be quarterly for the next 18 months. After two years, the owner will come back to the Board to require the monitoring 4plan. V. Variance —Septic (New): A. Michael Pimentel, JC Engineering, representing Village Square South Condominium Association, owners — 39 Tower Hill Road, Osterville, Map/Parcel 117 — 072-A, requesting three variances. APPROVED WITH CONDITIONS. The Board voted to approve the variances with the condition that in the future when the systems at the complex fail, Innovative Alternative systems will be considered. Monitoring will be quarterly the first two years, then once a year thereafter. B. Robert Dunphy, Dublin Companies, representing Shawn & Robert Harris, owners — 141 Old Stage Road, Centerville, Map/Parcel 189-086-002, 0.23 acre parcel, one septic variance, demolition/new construction. WITHDRAWN. C. Peter Sullivan, Sullivan Engineering, representing Rhea Clark, Trustee, Marcia & Frederick Floyd Trust, owner— 29 Irving Avenue, Hyannis, Map/Parcel 286-005, 5,301 square foot parcel, requesting multiple septic variances. APPROVED WITHOUT CONDITIONS. The Board voted to approve the multiple septic variances without any conditions. D. Catherine Gulliver, owner— 254 Greenwood Avenue, Hyannis, Map/Parcel 288-178, 0.33 acre lot, septic system installed in 2005, homeowner requests additional time to connect to future sewer line. WITHDRAWN. Catherine chose to withdraw her request at this time. VI. Variance — Food (New): A. Julie Kimball, owner, Katie's Ice Cream, Too — New location at Cape Cod Mall, 769 lyannough Road, Hyannis, (formerly: Brigham's), toilet facility variance. APPROVED WITH CONDITIONS. The Board voted to approve the toilet facility variance with,the condition that only benches are used and no tables are to be used. Page 2 of 4 BOH 12/14/10 B. Mario Mariani representing Pain D'Avignon Cafe — 15 Hinckley Road, Hyannis, outdoor dining, air curtain variance. CONTINUED TO FEB 8, 2011. The Board voted to continue until Feb 8, 2011. VII. License: Disposal Works (Septic Installer): A. Robert Ruggiero, Acton, MA APPROVED WITH CONDITION. Robert Ruggiero called and is working with Stephen Poole today and they are unable to attend the meeting as their current project has demanded their attention. The Board voted to approve for a septic License with the condition that the. references are approved. B. Stephen E. Poole, Hudson, MA APPROVED WITH CONDITION. The Board voted to approve for aseptic license with the condition that the references are;approved. VIII. Old /'New Business: A. Enforcement of dumpster screening regulation. COMMENT.- The Board requested that the Public Health Division to send those who will not follow the ordinance to the Board for a Hearing so a resolution can be obtained. B. Two-compartment septic tanks at duplexes — New Policy. r� APPROVED. "When / if an applicant requests a local or State Code variance 1 : involving a setback distance to wetlands, high groundwater, or any other environmental type of variance (thus, not a variance request involving a setback distance to a foundation or property line), the ' Board of Health will require full compliance with Section 310 CMR 15.223 of the State Environmental Code, Title V. Specifically, when such a variance is requested, a properly sized septic tank will be required. Also, when such a variance is requested and the design involves facilities other than a single family dwelling unit or whenever the calculated design flow is 1,000 gallons per day or Page 3 of 4 BOH 12/14/10 greater, a two compartment septic tank or two tanks in series will be required. This requirement shall be enforced during the repair or upgrade of a septic system regardless of whether the repair or upgrade is proposed for the leaching facility only. However, this policy does not apply to minor components repairs such as replacement of the distribution box, tee, piping, or component lid. Currently the State does not specify when.we are to implement the two- compartment tank. This would create the policy that if someone is repairing their system and are in need of an environmental variance, they will be required to use the additional environmental protection of a two-compartment tank. Voted to Adjourn 5:40pm Page 4 of 4 BOH 12/14/10 � � 1 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY s Complete items 1,2,and 3.Also complete A.Z2' re item 4 if Restricted Delivery is desired. --�- Agent ■ Print your name and address on the reverse - .� �2 _❑gDiressee so that we can return the card to you. ', eceived by(Printed Name) C. Date of De'very ■ Attach this card to the back of the mailpiece or on the front if space permits. N I D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No ��4rb O'1ncaV. Arl n L S M 0"0 l 3. Sylke Type / El Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number t (rransfei from service'label)i' _ 7 00 9 16 8A =0 pO 0 9'4 8 9 =0 164 PS;Form 38.1.1,'February 20041 :Domestic Return Receipt 102595-02-M-1540 6 I I UNITED STATES POSTAL SERVICE First-Class Mail I Postage&Fees Paid I USPS I Permit No.G-10 I I • Sender: Please print your name, address, and ZIP+4 in this box • I CSN ���,, P.O."Box 2030 Teaticket MA 02536 Engineering � i 4 i I i I � I I iiilf???lf�?I?Ifi}�Iflilf4}}.11�1ilIEEE�F4�1?!3!?�1l11fl4l11'}}� I COMPLETE • ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X �Co Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery le Attach this card to the back of the mailpiece, or on the front if space permits. ;*, D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No wal�r /� � v i vnar,� 70 lifY pn4vn BVW IU 1r1Q,� MA 0-2-Ltp 3. ice Type YCertified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number ,7,010 9 it ! t r 16 8 0 t 0 0 0 0' 9 4 8 9='013 3t t l t (Transfer from service/abed w t c. +1 x PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 i UNITED STATES POSTAL SERVICE - fit. S . ail es Paid 5SP. r s Pe • Sender: Please print your name, address, and ZI0+4�in I I I I CS , .�% P.O.Box 2030 �►—��/ Engineering Teaticket,MA 02536 iIIIIfiIII7111IIIIl111lIIIIIII11111111411HIl -11 I) EIII.I J COMPLETE •N COMPLETE THIS SECTIONON DELIVERY 111111 Complete items 1,2,and 3.Also complete A. Sign ture item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. eive pL d Name) C. D afgof eIiv,ry ■ Attach this card.to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑tes 1. Article Addressed to: If YES,enter delivery address below: ❑ No TOUSO 0h O rw 3. Service Type $) ►""t C( m/Certified Mail ❑Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number i E f; (Transfer from'service label) 16 8 ;0 0 0 94 8 9 0171 I PS Form 381,1,February�2004 I Domestic Return Receipt 1o25s5-o2-M-154o UNITED STATES POSTAL SERVICE First-Class Mail. Postage&Fees Paid LISPS Permit No.G-10 I I • Sender: Please print your name, address, and ZIP+4 in this box • I CSN �,, P.O.Box 2030 <<�� Engineering 1'r1aticket,MA 02536 I4t}YlYf 4 !I!�}i1I1lY-I�lYI} ;. I °3Y'!Y I}�t!!-}7l1! !lYYllil! � . COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X `G� � ,�r� ❑Agent ■ Print your name and address on the reverse 1 i r �(J / El so that we can return the card to you.—.,.. g. ceived by( 'Wed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, I or on the front ifs ace permits. 'C+� D. Is delivery address different from item 19 ❑Yes 1. Article Addressed to: N a If YES,enter delivery address be w: ❑No 4�A. J Y �n2n is p��T MA b)-� 41 3. S ice Type LJOCertified Mail ❑Express Mail ❑ Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number i y ; . : i t 1 (transfer from service labl) ,7 Q 9 16 8 0 O q`O ;9;4 8 9 15;7f r e I PS Form 381,1;February 2004 j j j Domestic Return RecepP""' 102595-02-M-1540 UNITED CE ' r 't< � ; K;. w• �: Fir �s Mail :Paid FerrtaitNe: I • Sender: Please print your name, address, and ZIP+4 in this box • I I I I I CS11T P.O.Box 2030 Teaticket,MA 02536 Engineering I I r I I _ 1 f!f! 1, a � mt �t1E DATE: Hasa. 63A t►� RSC. BY ram_ Town of Barnstable S DA=s Board of Health �J 200 Main Staee� Hyannis MA 02601 Office: 509-M-46 4 Wayne A.Miller,M.D. FAX 508-79"304 Jumichi Sawayanagi �i Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM. LOCATION r Property Address "1 ��►ti� }ate Mi Assessor's Map and Parcel Number. Ad Size of Lot Wetlands Within 300 Ft Yes Business Name: No Subdivision Name: APPLICANT'S NAMEt Phone Did the owner of the property authorize you to represent him or heft Yes No < ce PROPERTY OWNER'S NAME CONTACPEERSON ° Name:Lein �►tae-o- Name. L4, m PAo t cl M Address: J�q1 irA,n!5 U. Address:CSKJ�t�. �u Av1- 2-030 TP��1c���M A Phone: Phone: 50t - 2-25-3 25-0 VARIANCE FR M RE TION(wt Reg.) FtEA�O,N FOR VARIANCE(May attach if more space needed) to cmP- IT-mi SrG1-6acLs � G°r1s �rntS SAS 4,.PL 51 11ctd S V*A&AC"- -- sks A-Got 131 1-6ij llt V.%riance SAS 4- CG 2. 90.1 MA V VAit a,%" SAS .l.o altar 1y t Met (o"Variants NATURE OF WORK: House Addition D House Renovation ❑ Repair of Failed Septic System Checklist (to be completed by office staff-pemon receiving variance request application) , Please submit copies in 4 separate caompleted sets Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) Completed seven M page checklist confimung review of engieeered septic system Plan by-b-itting aWncer or registered sanitarian Four(4)copies of labeled dimensional floor plans submitted(e g.house plans or-a-am kitchen plans) Signed letter stating that the pmpaty owner authorized you to represent himflrer fur this request _ Applicant understands that the abutters mud be notified by certified mail at ImA ten days pnor to miming date at applicants expense (for rifle V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) _ Variance request application fee colleted(no fee for lifeguard modification morals,grease trap vanance rMemis[SHIM ownURCSS a onlyl, outside dining variance renewals[sate ownedleasce only],and variances to repair failed sewage disposal systems[only if no expansion to the / building pill t/ Variance requea submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Cann$D.M.D. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC Af Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: Lot No. Owner: Address: Contractor: Address: Notes: STEP 1 Measure depth to water table / tonearest 1/10 ft. .............................................................................. .Date , month/day/year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: OAPPropriate index well......................................�...... OB Water-level range zone ..................................................... .STEP 3 Using monthly report"Current Water Resources Conditions" 3 determine current depth to water level for index well ........................... month/year ' STEP .4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), r and water-level zone (STEP 2B) determine water-level adjustment .......................................................................................... 3, STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water �. level at site (STEP 1) ................................................................. g Barnstable �TM�rar Town of Barnstable you AaAmedcacity Regulatory Services Department BARNSr"M MAM Public Health Division 200 Main Street, Hyannis MA 02601 2007 Thomas F.Geiler,Director Office: 508-862-4644 Thomas A.McKean,CHO FAX: 508-790-6304 CERTIFIED MAIL# 70083230006251783159 9/07/2010 ECOPW Chase Home Finance PO Box 24696 Columbus, OH 43224-0696 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 97 Sterling Road Hyannis,MA was last inspected on July 17, 2010,by Shawn McElroy; a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. • 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 Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. R OF O OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments s` 97 STERLING RD Property Address CHASE HOME FINANCE �� X Z4 tQ"►C�J �(f��(f �-� yj�y�' — �( Owner Owner's Name information is required for HYANNIS MA 02601 7/17/10 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 q I forms on the I4 computer,use 1. Inspector: only the tab key to move your DOUGLAS A BROWN cursor-do not use the return Name of Inspector key. DOUGLAS A BROWN INC Company Name � P.O. BOX 145 Company Address FCENTERVILLE MA 02632 n City/Town State Zip Code 508-420-4534 SI 4297 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 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails. ❑ Needs Further Evaluation by the Local Approving Authority 7/17/10 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 every page. City/Town 7/17/10 State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5ins•09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is 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 t5 ns•09108 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 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 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. El The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less than Y2 day flow t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of V Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. Cltyrrown 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•09M Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"o "y r 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): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 t5ins•09i08 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 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 every page. Cltyrrown Date/10 State Zip Code Date of Inspection D. System Information Description: ACCORDING TO AS-BUILT CARD SYSTEM CONSISTS OF A 1250 GALLON SEPTIC TANK D- BOX AND TWO 25X1X2 FT TRENCHES Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system?(if yes separate inspection required] ❑ Yes ❑ No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): HOUSE Detail: VACANT HOUSE VACANT Sump pump? ❑ Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft.,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ "No Water meter readings, if available: t5ins•09M Title 5 Official Inspection Form:Subsurface Sewage Disposal ewag po System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no) (if yes, attach previous inspection records, if any) ❑ 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•09108 Title 5 Official Inspection Form:Subsurface Se wage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . Approximate age of all components, date installed(if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints,venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 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: 1250 GALLON Sludge depth: HEAVY/THICK t5ins•09/08 Title 5 Official Insp ection Forth:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments y<o 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 every page. Cdyrrown 7/17/10 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 Scum thickness THICK Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): TANK NEEDS PUMPING 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•09i08 . Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene El other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for VoluntaryAssessments essments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. Cltyfrown 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 STAIN LINE ABOVE OUTLET PIPES 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.): STAIN LINE ABOVE OUTLET PIPES INDICATING HYDRAULIC FAILURE 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: NO OBSERVATION PORTS ON TRENCHES 15ins•0.9/08 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Pape 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments J" 97 STERLING RD Property Address CHASE HOME FINANCE Owner information is Owner's Name required for HYANNIS MA 02601 7/17/10 every page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: 2-25 FT ❑ 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.): 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•09JD8 ' Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. Cltyrrown 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.): TRENCHES APPEAR TO BE IN HYDRAULIC FAILURE Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): t5ins•09/08 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 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 every page. Cdyrrown State Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 D Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 97 STERLING RD Property Address CHASE HOME FINANCE Owner Owner's Name information is HYANNIS required for MA 02601 7/17/10 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 t5ins•09/D8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE t� LC"AT1ON . SEWAGE # VILLAGE ASSESSOR'S MAP LOT I INSTALLER'S NAME & PHONE NO. i SEPTIC TANK CAPACITY � , LEACHING FACILITY:(type) (size) d2 S I NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATERdA�- i BUILDER OR OWNER DATE PERMIT ISSUED: 1 DATE COMPLIANCE ISSUED: S' ',. VARIANCE GRANTED: Yes No i a. f � r ' 'i r , r 4 'i ar •" ..Y •..Lr y Q y 1 1 fa. �,'}'.' � �r r, 1, +(��'`A� � PL- ra. '... b Y�;.w..� �/�,,.;�,��.�.`�b�d��`r).7T �`•'i :•": . a 1F ,✓. a � rr'} � v 9 a t .✓T a ><. {• yew '��i;! J/ r ,�f� t L y {�ity{�+ < i a 1 ,r -' -swigf�.cx„� •Ft,,. Ry,�_" � 1 •• a C,r R i.tL�,, P ''"�•.7 r4,"} .1��� �y!•• _ « ^y�� �4 y4.."'t;.+~,i•47�+�^"•y9i ��a ,4t .� 4 f" 7�� L.A <. �{�t ;� r � jy t y•x 'S ( "` tiw- '`�T,2'� .�:k}- 'at{4�6. �'R���L✓��.'./ �>€�. r f 4" �!'i r }y 1��j� i�� � f� k}I �gt��l �•''�i�}~L3R44'ki�ta �t�- ���'"`:yI""yq. F °d �, .! Y .1: y "{"r�{ "lrn'S•� Lii'Cltlt' Al � ��� 'J a� k"�' �• t = 't '4'�Y' � ? 4t} �tp ��y" c �'y�ire, .x„�,� �30'�" �� '�� .LX�•,. 4 tL+~ •,r,,.l� L• y awr .�� �i � Lli+e. - 17r .•+• 1+j97� ,"'-•i'd ..�i,o.��/ L�(^� .. �,.r,�. ,�2 I ,� tFa, M•i +"� ,�,f���j X3' v `�t,� �� {'r 1 •.arf Y� 5"`'�,� 's�e �.' Y '+rr,�1x�. �, 4 [ �fa .. t- � gai�l � �t �Fs e;•. '�:.-j^� .'"�^=.1F jc1;�;, �1��T ., �� ,+ �i I ♦,,.,A � , ti 6j�, t�', 1 5 !'M�..�� �: ! �•t4 L�J�d.. �aysP��k� ��:• �1�j�'�N ��'sy'�-'�_• fiit�tr � �k �. t,,r• �`k�� "r r +� ��;, c. :,id0 `t <.1 ,,�r+.1 i• ..N�j�A`(1 , �. , � �) t1 #y } �. L iy e: r '', -"ram ...•. m- r•,s"`�; r/� ,Qt " ,y ! 'i�.A'•< � '� r` r°� `rf / i tJ.. ` v ., y y � '''� 7K i+ +:• 4� 'e.4. D �'``•,c�yc�' � i WW,DR. �'�t'��,.�• i ��� ;^ , ` A 1." i a,�F Z�hs. �� �. "f , y}?�x� i�� i k.{i ;t e `;A _ wr.^r-- _ •�i�f �'ti Sr r _ �• ,t� t .y,Li• 't. �i ,,ti ' �Q., f .f ��{{`� F,- -r s ) � �.a - s } f � �4, a�`+1"�� �r,,, r „�, ,.i ,�i Y 1 f�• ,�� � 4�. .._< ,.t`,�L4_-� y;. ,� � �Syi . I r 5 t .�• `t+yy'�, `:� ere �-"�- •: ��� 1� *<- F'y51'. �.�� LIj', :t � + " fret t �•:�`'y' S a��TMS � � i& �� �' a 4 �, w, ` '� ��4 �a^E�" ' , .5,,•4{{ a t�. 'Yi tf� n ���-: ! ,r r ' :. '�A. a•Jr ,�r•.. .+�L 3 �� Jl ���� F �, c Y ,1. a � �f _ ., a 4 Q <.- �3�',a�. o. .�t ♦ r_ i <tia4y��'�341�1�y�T� �i y 41 g 7Mhi_. 3f ••ie. A� Ci a `rt@�`9t �.` 1�u i.,R 1PiJi� ��'C�� •�- t� �� .�w< �; � yr5•r�, u `y7 � ,.� fps' ��,�`,1`` ,�+! a� a,� '�id '-�.a,j 'i Mp 4 -r t =�"t t.'y a(•, �4.i�- 4 '.�ts�<t ,< '"ts 'jY(': 'yr 1 �.'�'ryR�t�y��t�� - k _ '. •ate i+,t - � y S (' e'`tt$�Y��. r W M c, $4 i �.��Y` • L -s,'i /+ ,, 4 �! :BSI tg • ; F. ���.aLy. � -- .... ,.-'' vr . . ... ...... ... rx ,' a IL �('.: f� ;7��Ij.I• ( ;:� t II !a ��• f y -Ar�..a� Sxy ! ��". ROXI I V • � •I¢j y. • �V da II( • 's•. ` �-!„ rr4r'''�i � � `"flJ l� « 't► yt �,�".e/i,'t'ti �, �:'! 3' ► X b� ,� � 'f �t,. x �,• � p.f(rp.y-�,�'#4a ��� v�.,. � 4 it �'n J 7 :•r� a / r � 3�i "p"��`' rF` �4 J� ' �!y�?'"� � ��� +y �t��^.,''� ray .y. C•'r.. c tr� r4 r e `� • �y`ttf( IRe �� �•' � } ^F��' S }t��^/ �•�' , ,� i�S'..- �, ,f��'�7 s i! r;i �v.w,i' � 5� � �� y t +i�'L. + �'�`t,-�a,`�+ r� µ,h � ?� s�;J„B •_s y�,p.e4� - x 14,f lip^�; r�J•"af�s�� � s �'„, y-.k'i � - 2vi.,{p+ 5r`''s . i� 1"'•a � "� �`Y ; M � r!r + f� 4��Z,�t`. '. !�r'r +, a ..,�. _ ti' � *��"��/i� Ts� fix,'- ' y �` +A;►, ,��„} +����`V {�. � =tx' ;4�j'�'�'` '� �bi.,.+�• � �l1 1 4 � � �" / '!"t.J !� '� t „ �'1�` •' sv� ^��Y>` J 'a'� `'. _ _ _ . 7+ir .!�', # +';i'. ��;�r•,:-+�� �y;;''..�#f ��1 ,�'r , pia +j�tj ?g� � ay..•,.�f►n.,.. . Jf ' �C� ,x s } �. <� 3 mid_ �G�Jf. _ • .' 'x` song _<� ' 'i Jf • a1i' ! ,t �'—�. �_ - ter•. 9��1 F - �' •J � `�{rj ,fit.^��' �r. h` f � r R fi++v g �' b .0 i +6 k�L l Jd-7 Y� wg�.S°- 1 � t,� a'�'. 7�'r �y���T�� •�_ � - 'R„!��#'1� � ' �+�+y vT ^�w -¢,'�„ n"�_ � J �.� � � � .1* _ a,sRy.Y ��l►yy 0���f. i°-y�i�,ya�A"'��J��,,,_-, ,f� � � ,.(y_�f. 'h � ! � p�, � � � T 7 P� rT Fib ��!' _.'K Y',f!'F�.ty {+i.t � "fY� .�T�.:�'-•�_aJ.^ - ,r y�+ht ^y,�.*J' � ..t s 4 .��``Jr..e� � f���"! � �#t•'�, rT a+:r�Z'a.! r' _�. f yTF' �� 5 .F' t �3'N Y} J1, y <4'c�-cf r� �� X. r•k�S�t yi'#�. nr7:t�^ � r '�� 'S}" I �,., I 1 1 �,,V��`�, s •4„�i- �"�,}•'°.,,''asr�'e�y/f'�. , • p ..y r• -�; • �' ,.t }4't e, J �y _.'�►'3 g fia � a.� � �, ,. , �''4 �s ��0'4'�� sto's +r-t ,� ;" I s e• V, C PA 41 � +.: J" � 1, ` � #y� �'4 p f'-, s��. � ! I/ ' �i 7t• ►. � sty t.. � � ., f '+ .. � ,.� ' � � , a y���. _- °� �.v•`" r°`T!„fF..^i�,i�N'a��J�' -j e�� ����'1rp.'s,',ti�#J�#�E���� p , .� d.�,i.,,.�} b.� ^� .1 � r �l.� lv �„ b �� ``•",�� .. �'iz? �,t \ { Y}n'�) �,� ���' f y �xj; `A r'` , tZ,Yf�,wx• � � 1 �d�s'� �� ! �� tvAw 71 gi rr4�" .'*�; 'yr� ,t 'fit• " •.+• i -- - �,`.��,d'1,,"'�t�"�'�`'.;�`S. � � fig° ?t f `ttt .c •� �t '5;.. },.r�!"� � %a `'�,�a �t® �.y ,� ® {� ,l.� Y •� 1, l' Ri �t•i:. • d � � 'Ai " i'Z"'_rn.�FA� ,. tI � t iE9 _ t A r. ccj, �• �.a t P s, { v r •'€ { �'L jvyy.S yr$ 7 ,.• ,�,lt. .! --- st i M ! 7ira�d,. t o}• .•qrra, f �,}� .•D 'IV ���,, T {t�4 .rr 'ti•t.�f .t •. i4 ��1. �._rt! �� ew � ?K 1 +(•,� '° >•y d4r`}',"ti}i� !�t..`t/4,';"c+y,�,Y Y �I�;t •.� � .: :irr. tom■ IA 1 t ti. �.�\,tt}rt,."f•��.{ rw.'r�y� �,����u�9tU �. '� �. P y ��x%�• �' err IA'"�•}, :, k`.i'�L:r`��L-,��c �1�}�?t'I��� n• , '`�.`"'�,'sy �IKBk� 'a�i ^.� y + �, R ` ,� t J .1 P. M'�"kfvl MIT r{,of )y'lryµ�s •- �, .� } 74 �,�2 i'ti�rtt �" Jt�p@' Y� �t r�✓/ti';! F'�"r"�" � -„��+�,,,,-,,,;y.�f .�s»s.�, .+�'',.ci�s'r �"` • 9t ^tea` `(' •*�`r '�f x� It . a r} 4fF 'V!"}I �t .r7 R�l;r•. Ek ri'�'._ t�'�-" �°'"' sfP. �"��a L •• Fh :i' t t t11 i�/} --} 'w CvE .1 •��v,`% � y'#`T i _ �1�=! .r'�/ . .� .(� �G ,� C1. r 'R 'Rt.9ietr ��' tt� .. --^•--�---l�..f �+ (�..•v-5 , � k !1 ,66 t,l 31 �! crP,�➢t!t't a 7 d t i v - �' ��`''�= 'E�; t�: a 7�j'�+'�.L�''�t ,S�5t. r t t�t�fi,r�.)•;i ` �'�t; rya � ,,y� =`���t �;�;'. ��� , ' � �� �°�,�� ,�,-r �`• �. �,,..1 +.�`�,+� t�4w• �:3' �`x �t •�'. E',t b �`�tL.'iff i.�i.�,•. �: �.. �• f ;.i'c`_t"a.. , •, {-,`^)C.v P` �.1 } a�r..j.,�C�- vt,i ����E tJ�v rl!<:1� •yid t �! .'�• ti l ' j to !x� �a 1}tit. c p q.�, m �k '',;4 R rrf *� h i•!{ �Will 1 � .Ail J- ,p to P M7y tkf yt: n't<Y7+;'� F-`,' 4' $1 i' •.i• - 'd{ 4fF y4 •+O d� ��,Y ti '' j.+ 1 ♦ a •-.+ r• , r d a: •� {1�I ri^ y, . r� �L 1' it SJ 1 e {c ,,!t1r i r/ .f ✓ ['x'�f stt t+ °i)�i,r J i y +Irk�yta••:. J' ra r, } a.~Y ? ; "r 3: s• /Y>4, ��1� d �. 'C 1 k �/ l•/�i.(V..ti �/ 1 "! ;tea ` 6 I�,,� `�'•'^�.-S�.• Ik* t �y`��i.,l.• � �yt,•v ii t �f±�!"YS �'S � ar}_ � t•- •,��,}s- � y*,1M�`'%t' �.�c{qr, r. t"a�►��«� `'2'�°i.,., .t Hl•�,�1�)y�� t r r �, � tom•a5tf� t'. -1 in>I I•` ,;4 ,6 t.yY } Yal3.� -,�>i 1 J +. T e.• (. y r � �5••a E,a.8,r'�ft'e1 {' • f v,i °, J' }S y IT A a ► .� f.;' x�4, �r'•� k ' a "r(°�/ t 1•6r:. , '' , V 1 rt rr # t t� • y 1'i..-Sr •t *. --(��(-.'. t • ' ,�{j � 114 _ ty� ��"1-r ���.• �,::.�•/F••�". �. 'c .�•j'a !..'X !' °ti # ► Syt •; b ,[gjti,r, t:.._ _ ;f( P S IjG•,:�k „r"�ay.., rye. i�.p.�a Ail ••'IUUff{Y..r t. ,' • z' ,�J _,_31 ; > ,4 ti p $�• E. e; ti.l�: i • .}', tt'+-: a t Z.Q `r}tr/ `?'.,•t} 1''•X „a ,w •I'fl� r�,, lU. 'y,.• I.yt, ,4 r ,S,tw3a` `Yaxg '7 .141 $y }, c +`t t lrt s'r"t y r d CC�y �e Ge�� -r! rtl��+y'��l:jf�� a�4: .n• �. '�' �;r y.�� ,�',�.�•�oc_`.R`!`1/f :�i'���1 tt`�}�;,t�icy"�t'j� '+/ '' �••ait�. �F •h"?�v��'�"�r"�'=l`w �`.Ct,��a•���' t�+ +'/q/9r.-_ r �f'..,.G� _r >tt r�y � r•%,+! ��,±-'..'st`e:l.,F>�p�r��_Y �„g.� t��� ,�� ���� �'a*<��r r � `��'' , � t;li`t 1�'.;1 of ��.'•f f r�r���� �- I• ✓ �'k�� 9 �� `.���_\�,� 7R���.�r',."� "i,i u ���,'."` i''�'"��t�'�:�t'ti f"�s 4 A'�sa ';C ,�._ i f 4 � y- .� .� �"- 'fit•� �y�'�� �`�+��7•.is, R �.�gl4,t; } ��yf.R ] �i•�c � �. ��+;C ,�i ,{,tt z' ( (-.7.�f'��-'Irv>� ,,,. y. _ .�•d,�;.s.._!p�cAyig�'5.�, d.- t ;:l\+fit '`,yY�t•," i J911. ? a�j44i.,,2.# a � i` '(�/`.'T -t.�•�dflol` '1 3. -` h.8ts 6i�'�-c,.4 ,n�ri,°�kk� -;n., -/ �� vd v i r�. _� i+' � � ✓ .��t>r r- c .. v fib, ,: All IF, r��, y. s:''fi,; �"g '. �jn •�i� y�.x �- a t ,. '?( F.�g! itt� �h • ar �'J4tT tip' '4ti+tr f•. l'�.t IA+.� t., � � '�,'t�1 �>���,�t / ,.•�'�� +K..?4 �"� .1u! � ""u,�,r'r. ;� _� ..y,.v' - '� �,.,,"r,^i ��l.a r.0 � :�A. •� , �y .�„��, ?t t t ro� �+ )C r ti,,"£ .Y�xa+, t �, + _;!v ,E�� •�' � -��Ir<`.. t; '.�n� r,�,�y.� 1�,"n .i )} j..Q �r r �"'7�'!.Y >,�,r..'�;�t,?:�1'/.��,{i,F n/��� p ,1.� �;V��"7 ��°`y'��r`��._✓�`^'v i�'�.�''�k•• rl�,,,r�;�l��+w��;,t �'1�lk �z��L'3ow�a�0.�;��•', ,,�.'!f/ c•P; �3+r..' :1 t ''j � ft��r -C' i'.1"�•T tit[j.''' 1.F E ;�` i =-I/.w.< '�' r ' rt y t:-,�r� - „-,' aSr �,.-,..•e,,,vt,/�, �t '�'�tg7en�F,y � � inll .y" JA}r. 1f +_�+`'i)- c}��. r :;` �`.f `.fv V 4•f:_�-vt^� -// �1" � -,1 p;cl "a.e''i �i's" ► a"8J V7 vi?•,e'.?�.i� � F*\W {' r a - <'�, t at : '1.''�. 4. i t i /� _ - t $ t t>• Z vt"f s � ,��'e'• \„ ,�e•. F� tF L, iL � -Tom"-_. 31 ��'�a �� .ic,� r� b�'� � d �.�+••'�}.R 5�"�.�Z '.,r�,lf•'A �� � 1�i'. • f h.* t;d�*• �s��'k .�� :,�-�..1- � :� � �•� ^�,�rv�:'`,��'�•r �;. t-, �`�?< ,�,`,�t"at ,fir n�PtF�a �1v�r ,�'>t�1�Y j� t�; „+?� Wit.+� t 1��,,...;tt!'-n�,. tr r.f- _ ��jt 1F`.rM�f�'. ��y'�� a•y�..r ,�s N,:�C µ:fa`:,� '1.,.���'a �,�.,i',�.�Tt�.,. ��'°Dti ��'^�G!lN�j1; . 3��' /` f.t� \t`Rj��, .,d��y � �°Fj,�:Jr l ?�'���:• Y: '� -` X`,.'. Q ,n M ,. �'�rt •..Y'�'ti �,1+'��j��. ,1,'4+1: r r,, t , r a '• t t`. .f +-r-�+ra:-•' ,f ^^---• ;%�- c �: � �£� •.o , 'x rA e,��i• ,�✓y•H,,�"�I• �!•' W-� 't�E 1'�li.. q �#A{4 t. .A � g `•t•st--,'� 1"! r4+ ( ,I L ', `S � � �: 9 P�.-v�at f C,.b r•} . Yzt �; }. !'t� fr �t`'r5 � \- / %rj Ir�a1/ r7:1e „}���•b �i; r'% .^ V r �a. to 4•'V,ri>••n. 2 •-xl �,-•a iA�� ""'�..�, " .j'.. i `j- .•�y _; '�_,,.! .` i � ,?..:��� , #d�P'v! �.;�.��jI � t ..°� `�t/��� +;+! :�•t�' s�',�•! ��.j`•---tiy.:�� � �,,'�:,� fis �,,� '!'E`t��t,:. ,`,.�s' ...: ��-,K: 'cr ,d !�`H •� ...;�•� a•'4t1�"4'`'�''' �,.;y,�,{�� �.Sti ;y�_�yg a '_t'r� ;��-1"�'''��q��.-�`k�,� ��r`.� '�a�j�r�•�' �"-�n� �t�'��J'�'An'`-. `•'.. , 1,d '- i7' f �:'iti }.f1 a ,r' "'9 ` ��-P � .e , ti w �'' m��j:• ,Y �^,E/° T.Y,rr� �;ry''7'• .A•,� n'�6ty� 'rrt ..' �•.��?�t ,A.�,�,;.^',� t, ✓ �a� � �. r !;?� ' , +S / jc yt l�r -,\• ..;1. + ¢ - + di s,. I / ��� �°d,�""{���f '��r //;4�+�4si ��s( t�-• :fir JPis�trr:. 'k}.�'} \/a �, F ��s�4.� � '���," �����r�Y�,��,• 7 � ti �L u� �yy^8� � � 1:tP� �;F��^�.�•" ��,''`v �.- t y�O: I r f.'%° J. .�. � -� -,�x7..�-'� 4�. 7 C.-. f .J°�' ' -°` t"*A+•'�' � !!,:a'Mi r}� K�,N���t Jj�',� {"F./�� 1 `t � K,.�+ �'� .r r (1 f �.,, Sfi,..�,» rr � ��".y �;•`x�' ?.t�.`»•l�i '', �.- �ki��'! � �n�� ;� •+'C�,�t:��. q.!tyV' � �r t a,'+ •��' Zia r�• i �! �,,,,�9•'�� r. rylf e ,w��(r���� rL I 1� S e}}�{��(;rt \S (qJ� ¢�t�h�.s1 gv3�.r� `� c� _r i53 'v�``y�i`{�y���.j�:�(,� ' l�� �+�t•^��'�tf n.I_. ? ': \!�h�"•Y.,fC..�.; P+F '��.. 'a 7-.;'n)��'' y�`'?./�`F�� •�+ �t�'� .:�i�.%`� o �'`,�TjJcFr'`'w _.� ! 8µq,r. • `' 1'fin i{ ° •�rr1l��'� 1. 1,•1` y l' r e++4,y, .R.r:.. a 'ckk :a' t - �. f�..� -�1�'4^}// ! !7 e,,��•y R Elr�t.l#�5{- k:•,r ,t � tJ f� h'�. \, �:':yr � �.. � ��� ��..•'"} �.,w �• - Town of Barnstable P# Department of Regulatory Services Public HeaIth Division Date ! Z Z o 1639. 639 200 Main Street,Hyannis MA 02601 Date Scheduled ���rI' d Time l(= 0 Fee Pd. Foil Suitability Assessment for Sewage Disposal Performed By: Lind.,,) 1 Lr1 PAWitnessed By: v��W, LOCATIOnN' & GENERAL INFORMATION Location Address q� S few/ O� [l / /r�� Owner's Name 14 y� /✓1 e � Address Assessor's Map/Parcel.' Z b 8 /'L p �6 Ann A /L[4— Engineer's Name L/µ peA �.J� NEW CONSTRUCTION REPAIR +y Telephone# JAI! 7 37 '-17 7 . Land Use n P - hQ i Slopes q Surface Stones No Distances from: Open Water Body I L3 ft possible Wet Area 100 ft Drinking Water Well ft Drainage Way A ft Property Line 93 I ft Other_ ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands fn proximity to holes) IU 7P-2- Parent material(geologic) ACtG I �yaS h Depth to Bedrock Depth to Groundwater. Standing Water in Hole: l u Weeping from Pit Face_Loa u _ Estimated Seasonal High Groundwater Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE .�.- Depth Observed standing in obs.hole: In. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in, Groundwater Adjustment fr. Index Well# Reading Date: Index Well level s Adj.factor— Adj,Groundwater level Observation PERCOLATION TEST bate It 1 to Hole# Ti me at 9" '", �j Depth of Perc Opt Time at 6" q ` C3 start Pre-soak Time @ C):00 Q Lu / 'Time(9"-61) End Pre-soak ��%� / ►i --t Rate MinJlnch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTICIPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. i ten 2v,%Gravel) ©- 30 3,o - 34 1.0 9- 34- Sb 6 MS Ito �..(,m ' 1� . az 6It, C i K Sid DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color 'Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,.Stones,Boulders. o si ten % rave 3�Ll 3L- l0 b e, 41.V DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency %Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi ten I Flood Insurance Rate Map: / Above 500 year flood boundary No Yes V Within 500 year boundary No-7 Yes Within 100 year flood boundary No._b' Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perv'o s material exist in all areas observed throughout the area proposed for the soil absorption system? �I e S If not,what is the depth of naturally occurring pervious material? Certification I certify that on "i Lv v L (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required ai ing,expertise and experience described in 310 CMR 15.017. Signature Date Q:\SEPnOPERCFORM.DOC az 2 5 a i MTA yVA Home: Departments:Assessors Division: Property Assessment Search Results / 97 STERMI®TG ROAD Owner: JAIS, STEPHEN C&COLLEEN Property Sketch Legend Map/Parcel/Parcel Extension 268 /204/ u Mailing Address E JAIS, STEPHEN C&COLLEEN ' I, d�3 Q Mill (y 97 STERLING RD HYANNIS, MA.02601 i 2005 Assessed Values: Appraised Value Assessed Value Building Value: $238,900 $238,900 Extra Features: $9,200 $9,200 Outbuildings: $0 $0 Land Value: $ 192,100 $ 192,100 Interactive Property Map: ap requires Plug in: Totals:$440,200 $440,200 1 have visited the maps before f s First time users Show Me The Mao Click Here April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: JAIS, STEPHEN C&COLLEEN 11/15/1995 9909/276 $135,000 AUTHIER, RAYMOND R&MARY W 1655/60 $0 AUTHIER, RAYMOND R M-792 9909/274 $ 1 2005 REAL ESTATE Tax Information: Tax Bates: (per$1,000 of valuation) Land Bank Tax $79.90 Town Fire District Rates Other Rates $6.05 Barnstable-Residential $2.12 Land Bank 3%of Town Barnstable-Commercial $2.80 Hyannis FD Tax(Residential) $669.10 C.O.M.M. -All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $2,663.21 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial $2.10 Total: $3,412.21 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.23 Year Built 1970 r♦ Appraised Value $ 192,100 Living Area 2907 Assessed Value $ 192,100 Replacement Cost$284,379 Depreciation 16 Building Value 238,900 Construction Details Style Cape Cod Interior Floors Carpet Model Residential Interior Walls Drywall Grade Average Heat Fuel Gas Stories 1 1/2 Stories Heat Type Hot Water Exterior Walls Wood ShingleClapboard AC Type Central Roof Structure Gable/Hip Bedrooms 4 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 3 1/2 Bathrms Total Rooms 9 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL2 Fireplace 2 $5,000 $5,000 APTX Extra Apartmt 1 $4,200 $4,200 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second.Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) I J �DOw� a �T n N � y �X !1 VA h- 7 �orOw ,�' s � 5 � VX 7 � LS � � . a �" � ,� �s � ¢/�� Q o ) s G C �) � Y ��. � ���. P I \^r' • � 1`r^w � J �--, � g o � T Q �, G TQ 3 t1 + � s �S' � �" o--, 4 3' . S' �- � • , Town of Barnstable Health Inspector Office Hours ° Regulatory Services 8:00—9:30 • IRLAAAMN9MBM - l:00-2:00 y Massa. $, Thomas F.Geiler,Director. Only Public Health Division Thomas McKean,Director 200 Maui Street;Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1. General Information: Address: J 5iuA6 20,46 Map c,-)&9 Parcel a2 Name: ��,�A,1-( � 5 Phone: _77 '�4��f 2. How many bedrooms exist on your property now?. 2a. Please include a copy of your floor plans. 3. _Is the dwelling connected to public sewer? YES or NO If the dwelling is connected to public sewer,skip questions 4-9 below. 4. Location of dwelling is INSIDE or OUTSIDE a Zone of Contribution to public supply wells? S. Is the dwelling connected to an ' ONSITE WELL or to QP:EUBLIC:RWA1TER? 6. Is a disposal works construction permit on RK YES or Bed y 6a.If yes,how many bedrooms were approved accor ng to this permit. Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Divisio YES or NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO FOR OFFICE USE ONLY TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY The Public Health Division has no objection to bedrooms at this property. f Signed: C E .A _ QC-�G Date: -------------- Inspector(Print): UEF- enrnE (l Q;Ahealthhvpfiles/amnestyapp COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVE® MAY 3 12005 . TITLE 5 TOWN WHEOF BARNST DEPTABLE OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION pp Property Address: 9 7 Sterling Road q Hyannis rL1) A- Owner'sName: Colleen Jais A� ,v`=I-;�• Owner's Address: Date of Inspection:_ Name of Inspector:(please print) W i 1 1 i am E_ Robinson Sr. Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1089 Centerville, MA Telephone Number: (SOB) 775-8776 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant too Section 15-340 of Title 5(310 CMR 15.000). The system: //passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: ; ��. Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heatthvr DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies'.sent to the.buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use Title 5 Inspection Form 6/15/2000 page 1 Page 2 of l I , OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 97 Sterling Road Hyannis Owner: Colleen Jais Date or Inspections Ef a y 0 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. Syste Passes: 1 have not found any information which indicates that any of the failure criteria described in 310 CIAR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repa" d.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer es,no or not determined(Y,N,ND)in the for the following statements.If"not determined"please explain. Th septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, xhibits substantial infiltration or exfiltration or tank failure is imminent_System will pass inspection if the - existing ta ik is replaced with a complying septic tank as approved by the Board of Health. 'A metal ptic 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 expla" : 0,servation of sewage backup or break out or high static water level in the distribution box due to-broken or _ obstruct pipe(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval tBoard of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND expI " Th system required pumping more than 4 times a year due to broken or obstnKted pipe(s).The system will pass inspec ion if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is rcmovod , ND explain: Page 3 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 97 Sterling Road Hyannis Owner: Colleen Jais Date of Inspection: C rther Evaluation is Required by the Board of Health: onditions exist which require further evaluation by the Board of Health in order to determine if the system is failing o protect public health,safety or the environment. 1. Sy em will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the sysl m is not functioning in a manner which will protect public health,safety.and the environment: esspool or privy is within 50 feet of a surface water esspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. Syste 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: _ e system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surf cc water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone I 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 front a iT'l-rihis'systcm ate water supply well••• Method used to determine distance passes if the well water analysis,performed at a DEP certified laboratory,for coliforth bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and. - the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. (her: 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ' CERTIFICATION(continued) Property Address: 97 Sterling Road Hyannis Owner: Colleen Jais Date of Inspection: X—,P-/—D 5 D. Sy; tem Failure Criteria applicable to all systems: You m t indicate"yes"or"no"to each of the following for all inspections: Yes N 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 V2 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 100feet of a surface water supply or tributary to a surface water supply. _ Any portion of a cesspool or privy is within a Zone I of a.public well. _ .Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free.from pollution from that facility and the presence or ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] (Yes/No)The system fails.I have determined that one or more ofthe 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. Larg Systems:To be cons ered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must ind Cate either"yes"or"no"to each of ttte following: (The following criteria apply to large systems in addition to the criteria above) yes no _ the system is within 400 feet of a surface drinking water supply _ the syst\is within 200 feet of a tributary to a surface drinking water supply _ — the system Ys located in a nitrogen sensitive area(Interim We Protection Area—IWPA)or a mapped Zone 11 of a�public water supply well It you have answered es"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 uwncr or operator of arty large system considered a significant threat under ection E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system own r should contact the appropriate regional office of the Department. 4 Page 5 of 1 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:_ 97- Sterling Road Hyannis Owner: Cnl 1 PPn Jai s Date of Inspection: 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 V/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? t/ Have large volumes of water been introduced to the system recently or as part of this inspection T. 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 baffes or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? lel �/ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? Ile size and location of the Soil Absorption System(SAS)on the site has been determined based on:, Yes no/ _v Existing information.For example,a plan at the Board of Health. V_ Determined_ in the field(if any of the failure criteria related to Part C is at issue approximation of dtstance- is unacceptable)[310 CI AR 15.302(3)(b)) � 5 ' Page 6 of I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 97 Sterling Road Hyannis Owner: Colleen Jais Date of Inspection: -S`"•��/-Gj3 . FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 5.203.(for example: 110 gpd x iI of X410 Number of current residents: /t Does residence have a garbage/grinder(yes or no):,!Lt 0 Is laundry on a separate sewage system(yes or no):/,0 [if yes separate inspection required] Laundry system inspected(yes or no):&o Seasonal use:(yes or no): •tJ Water meter readings,if available(last 2 years usage(gpd)): 2004 — 109, 000 Sump pump(yes or no): ti 2003 ----gT, 000 Last date of occupancy: / COMMERCIA USTRIAL Type of es,ablis ent: Design flow(b ed on 310 CMR 15.203): gpd Basis of desi flow(seats/persons/sgft,etc.): Grease trap resent(yes or no):_ Industrial aste holding tank present(yes or no):_ Non-s waste discharged to the Title 5 system(yes or no):_ Water eter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part o the inspection(yes or no): If yes,volume pumped:__gallons--How was quantity pumped determined? Reason for pumping: TYP F 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/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tigbt tank Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): t. ® ' - 6 I'agc 7 of I I OFFICIAL INSPECTION FOI01—NOT FOIL VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:_97 Sterling Road _Hyannis Owner: Colleen. Jais Date of Inspecllon: K_/ UUILDINGIS IVER(locate on site plan) Depth below adc: Materials of a nstruction:_cast iron _40 PVC_other(explain): Distance Gon private water supply well or suction lute: Comments( n condition of jousts,venting,evidence of leakage,cic.): SEPTIC TANK: t,/(locate on ., site plan) Depth below grade: .� y Material of eonstruc ion:� oncrete metal fiberglass_pol)'cdiylene _otlscr(explain) — — If tank is metal list age:_ Is age confsnned•by a Certificate of Compliance(yes or no): certificate) —(attach a copy of Dimensions: Sludge depth: S_;, i Distance Gorn top of slud4c lu bottom of outlet ice or basic: _ Scups thickness:-y sue" ' Distance from top of scum to top of outlet Ice or baffle: Distance Gorn bottom of sculls to bottom of outlet ice or baffle: I low were dissensions determined: 0 Pf.:�w e,a U ,,('. 3 Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structwal integrity,liquid levels as related to outlet invcn,evidence of leakage,etc.): I i-S_b CREASE TRAP: ocatc on site plan) - Depth below grade: Material of eons" tion:_concrete metal fiberglass_polycdiylcnc—olhcr (explain): — Dimensions: Scum thickness: Distance front I p of scum to top of outlet tee or baffle: Distance Gom ottom of scum to bottom of outlet ice or baffle: Date of last p iping: COItUticnts(o pumping recontniendations, islet and outlet ice or baffle condition,structural integrity, liquid levels as rclalcd to inlet invert,cvidcncc of leakage,ctc): 7 Page 8 of 1 I =- OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SENVAGE DISPOSAL,SYSTEM INSPECTION FORA] PART C SYSTEM INFORAIATION(continued) Property Address: 97 Sterling Road Hyannis Owner. Colleen Jais Dolt or impcctlon: TIGHT or HOLD G TANK: (tank must be pumped at time of inspection)(loca►a on site plan) Depth below gra e: Material of cons ruction: concrete_metal fiberglass_pulyethylene other(explaut): Dimensions: Capacity: gallons Dcsign Flow: gallons/day Alarm present(yes or no): Alarm level: Alann in working order(yes or no): Date of last pumping: Comments(condition of alann and float switches,etc.): D1STIUDUTION BOX:ZCIC present must be opcncd)(locatc on site plan) Depth of liquid level above outlet invert: 6 Conunents(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of - leakage into or out of box,ctc.): `� r PUAIP CHAMDE (locate on site plan) Pumps in workin order(yes or no):Alarms in work' g order(yes or no):— Conuncnis(n c condilion of pump chamber,cundition of pumps and appurtenances,ctc.): 1 Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 97 Sterling Road Hyannis Owner: Colleen Jais Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): L111/0cate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: aching galleries,number: , leaching trenches,number,length: v2- — - S 1 leaching fields,number,dimensions: overflow cesspool,number: innovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): r' P _ 7 w � /�- � ) !e�;%�•C.1-t!e:3 t,c� c5 � 1� y�' c., �a:,��.%' CESSPOOLS: (cesspo I must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to in et invert: Depth of solids layer: Depth of scum layer: " Dimensions of cesspo Materials of construc on: Indication of groun , ate inflow(yes or no): Continents(note co dition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): _ PRIVY: (loc a on site plan) Materials of co traction: Dimensions: Depth of soh s: Comments note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:97 Sterling Road Hyannis. Owner: Colleen Jais Date of inspection: -1- SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. • a 13 - - 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 9 7 S t P r I i n C1 R ad HWannig Owner: COI 1 @pP Ja i a Date.ofInspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water l,�z feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local,excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: 6\ ��f�e ' sv /1r9 ll TOWN OF BARNSTABLE LOCATION ter SEWAGE # VILLAGE ASSESSOR'S MAP ST LOT INSTALLER'S NAME PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (sue) NO. OF BEDROOMS-PRIVATE WELL OR PUBLIC WATER. BUILDER OR OWNER 1 DATE PERMIT ISSUED: J DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r O'S s f T ' TOWN OF`BARNSTABLE L01`ATION SEWAGE # l! VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY ' LEACHING FACILITY:(type) (size) ,�02 NO..OF BEDROOMS PRIVATE WELL OR PUBLIC WATERZ�. BUILDER OR OWNER —� DATE PERMIT ISSUED:��-�.�� DATE COMPLIANCE ISSUED:- �..�/ 8- VARIANCE GRANTED: Yes No�� 1 o`�` I� II ,e �=. L �„:� � ��� , _ . r: - �-�-- � . � - .. r� . w ASSESSORS MONO; Fmc PAMN THE COMMONWEALTH OF MASSACHUSETTS' BOARD OF HEALTH oVA ..........OF............. Appliration for Disposal Works Tonstrudion Prrmit Application is hereby made for a Permit to Construct (-<or Repair an Individual Sewage Disposal System at: . ......101:2........................................ ......Za2p..... ................................................................. Add Lot No. 0 L,1, .------_......... ...........................................0.................................................... Owne��r Address .......................... ............ .................................................................................................. r Installer Address Ins a------------ Type of Building Size -----Sq. feet U Dwelling—No. of Bedrooms.__........4...........................Expansion Attic Garbage Grinder aOther—Type of Building ............................ No. of persons.................._.._...... Showers Cafeteria< .........Other fixtures ....................... ................................................................................................................. 0 W Design Flow.........J1.0.........................gallons per per-&fZ@n per day. Total daily flow............ ....................gallons. 1:4. Septic Tank—Liquid capacity............gallons Length................ Width....._........._ Diameter................ Depth......_..._..... Disposal Trench—No. .......Z........ Width....../............ Total Length........!?��. ... Total leaching area.....IA!-----sq. ft. Seepage Pit No..................... Diameter.._..........__.__.. Depth below inlet.................... Total leaching area..................sq. f t. Z Other Distribution box Dosing tank ( ) - Percolation Test Results Performed by....ZA Z&9.. V6..../ Date... ................o .. Test Pit No. I---15LIn...minutes per inch Depth of Test Pit...J.A.2...... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...______.__........___. ............................................................................................................ ------7..... ---------- ................ --- WO 0 Description of Sgil a. ......... .......... ------lj?�..... ....... ....... ............................................................................................................................................... ............I........ ...............................................................................­­.......................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ...........I........................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TjITHL- 5 of the State Sanitary Code— The undersigned further agrees not to place thesystem in operation until a Certificate of Compliance has be issued 2by 'he boar of iealth. SigneSi d.. .1. .. .. ........... ... ................. ....................... ............. Date Application Approved By.......................... ...... ------------------------------ ......... ... Date Application Disapproved for the following reasons:............................................................................................w................ ......................................................................................................................................................................................................... Date PermitNo.......$7.$....... .................... Issued_---•--------------------••--••-.....--•---•.....•-•--- Date No.. '.. _...._ I�O FEs., �.... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH , ppliration' for Disposal Works Tnntrurtinn rumit Application is hereby made for a Permit to Construct (—)"or Repair ( ) an Individual Sewage Disposal System at: T----�-`ram--••'•'---•----• - ..... ................... Location-Address or Lot No. ..-•--------'---------...............................................•-----•...---____^'--._..._ ..........--......................................._.............................................. Owner Address W Instale Address V Type of Building Size Lot__1921__2_ .Size feet �., Dwelling—No. of Bedrooms............ ................._..........Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No, of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures _________________________________ W Design Flow.........J_/d__________________________gallons per fewion per day. Total daily flow............ _r-_______.._____________gallons. 04 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No. .......9......... Width......I_............ Total Length........ Total leaching area....J_i a.'./......sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (k< Dosing tank ( ) Percolation Test Results Performed by____L N ?.___vk%!.___.l!' ...____� � :__ Date._ /' .............. � Test Pit No. 1._G_ _____minutes per inch Depth of Test Pit---,/__4_2...... Depth to ground water________________________ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -•-•------•••---•-----•••-••••--•_.._-•-•- ••----•-----•-•--••'-----------------------•---"-'--......._._... - 0 _ d Description of�Soil---"�� ��-��-...._.., ✓F__._..rc. G- � ...__ __._ � s W - U Nature of Repairs or Alterations—Answer when applicable................................................................................................ --------------------------------•---------------------------------------------------•-•---......._..---------------------------------------•-----------•-•-- ........................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT- 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... ..........................--.... Date ApplicationApproved By............... ..................... ................................ � a —Da�-- ,Applieation Disapproved for the f o owing easons----------------•----•--.-.-••----•-------------------------------------------•-•---------•-----•-•-----•••-'•-- ---------•------•.................................'----------'-....•-------------•---------------•---------------•-------------------------•••--...-••---------•---------•-•---••-•-----•---•------•--•- Date Permit NO_. -. Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......_OF (trrtiftra 'af nniit# tnnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) - y... ,x Installer has been -- -- --••--------:- ;_ at ns a ed n a�cordan �it i floe p`rtWisi( moo: TITLE �f5 gf-The- Stale Sanitary Code as described in the application for Disposal Works Construction Permit No___________________ ___________________ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......................... -.....ZI....................... Inspector_...... .............................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH NO ..........: ...........................OF.............................. J(,......_.-_._...-.-_.._-.__._._ .. . .._ .,..... FEE._��. . .......... Disposal Works Tw�antrnrtinn anti# -� Permission is hereby granted -------------- ------------------------------•--...---•---------.._..-------.....------..._:_..........---...._.. to Construct ( ) or Repair ( ) a id u PSft4ft�Dbposal System at No. -- --- 7--------••--------___- ------------•- tons as shown on the application for Disposal Workstruction Pe t No_____________________ Dated.......................................... ^ ... Board of Health DATE............................................................................... �' FORM 1255 HOBBS. & WARREN, INC.. PUBLISHERS �:' ., �R. ASSESSORS MAP NO: Co 8 1-umvi�L T ION ,PA,R 26q SEWAGE PE RMIT R0. IHt5TA LUE 's NA14E ADDRESS 0wN ER QATE PERMIT IssvEv DATE C 0 M P L I A N C E ISSUES 73r - So ' �a �Y US a l� 1 � � ti ,l > , M, veld saielsdn �8 d C`- r ueld saieIsUMOP HYAN N 15, MA W Main St TOP OF FOUNDATION 24"diameter concrete covers EL=50.0 raised to wrthm 6'of finish grade 24 diameter cast iron cover 6 CAP BYESWEETAIR' (or as noted) inspection Port and cap with magnetic 3 I,25' raised to finish grade marking tape to within 3"of grade J'M IN 6.25' 6.25' 6.25' 6.25' 6.25' inspection Port(See Note#4) Suom,Rd • Ewstmg EL=49.7f EL=50.0(m1n) EL=50.l+ EL=49,6(mrn) 5'SorJ Remo val(See Note#/9) � A/f % \//�i��/��� /�i�/'! s / HIGH GROUNDWATER LEVEL CALCULATIONS: ° Biodiffuser Unit Starting 49.6+ PVC Tee Depth To Water Table (I 1-15-10): 9. 1' (EL=40.4±) Pond z �n 49.2+ 49,4+ Appropriate ro riate Index Well: MIW-29 Port Coupler ro Front fi Existing 48.8+ 3 2::oe rve y u"e Water Level Range Zone: C (3-4) S cn Current Depth To Water Level (1 01251 1 0 4t 1 1/25/10): 8.35' (Averaged) 40mr!HOPE Liner(See Note#24)Cff Poured Exrstm 48,5* Tn�`t B`aokiny 49.69 MWater Level Adjustment: 3.5' (Averaged) ` at al bends 48.52 46,44 Estimated Depth To HI h Water: 5.6' (EL=43.9± o :" 48.3_ 47.50 47.50 NW p 9 ) Existing O ? Ewstmg 57^ LnLOCU5 4700 4.01+ oa a Proposed 42.5+ Gas Baff/e r: 44,/± 6'r .......,., r.,...,_.r; l Longest Run /0,_-� 4' e' TWENTY(20)AD✓` B/ODIPFUSEk'(1/OOBD) EL=43.9+estimated High Groundwater Existing DO-5 LEACH CHAMBERS AND FOUR(4)PORT 3.5't Adjustment m 5 1 T E LO C U 5 EXISTING 1500 GALLON 700 GALLON (H-lO RATED) COUPLERS IN BED CONFIGURATION --�-EL=40.4 Observed Graundwater 6.25' 6.25' 6,25' 6.25' 6.25' N �/ �/ R 33 25 NOT TO SCALE SEPTIC TANK U-BOX LEAC/ ! C/ AMBfg,5 EL=40.3+Bottom of Test Hole PUMP CHAMB ER I I p n- 1 .) A55e55or'5 Map 2G8 Parcel 204 Q FLOW I ROFI LE PLAN VIEW 2.) Deed Book 22371 Page 95 3.) Plan Book 2 13 Pacje 85 NOT TO SCALE SCALE: i" = 10' 4.) This property is in a Zone II of a Public Water Supply 5.) Flood Zone: C VARIANCES REQUESTED LOCAL UPGRADE APPROVALS: 310 CMR 15,403 LEGEND Living Living family #2 i2.� EXISTING SPOT GRADE Family VARIANCES: 3 10 CMR 15.21 I (Setbacks) I.) Sod Absorption System not 10'from Property Line 246 PROPOSED SPOT GRADE Bath 5' Held 5'Variance Requested -------24 - - EXISTING CONTOUR Bath 2,) Soil Absorption System not 25'from Catch Basin I 24-- PROPOSED CONTOUR W WATER SERVICE LINE Bath Ee Bath 13' Held 12'Variance Requested Proposed Relocation and 51eevngof a� OVERHEAD UTILITY LINES Kitchen Room 3,) Sod Absorption System not 25'from Catch Basin 2 Water Service Line(see Notc#22) � UNDERGROUND UTILITY LINES 23' Held 2'Variance Requested 49.. G GAS SERVICE LINE I00' Buffer �t - TOP OF BANK Bdrm#I Bdrm#3 Bdrm#4 4.) Sod Absorption System not 20'from Cellar Wall Zone Family 15' Held 5'Variance Requested ` W /p// -a--a a LIMIT OF WORK 5,) Pump Chamber not 10'from Water Service Line b• � � ,P EDGE OF CLEARING First Floor Second Floor m Held 3'Varvance Requested Existing.septic Components to ] Y� - FENCE be Removed(see Note#2/) l '? "I ' �� /� TEST HOLE LOCATION P VARIANCES: 310 CMR 15.212 (Depth to Groundwater) Exrstmg septic Tank to 4'3"' /S.` >� OO 1O ST SEPTIC TANK F LOOK PLAN be L/tdized(see Note#20) � �' �� 0)' Basin DB DISTRIBUTION BOX 6.)Sod Absorption System not 5'from Estimated High Groundwater / `'�' ''° 4' Held I'Variance Re nested LrmrtofWork 7,, O PC PUMP CHAMBER NOT TO SCALE 6l (see Note023) h 7 t 5AS 501L ABSORPTION SYSTEM \ Reserve RESERVED FOR FUTURE USE 10.P ° . 9► . Catch lO'mIn �`ST �� �5b o `.� Basin `� UTILITY POLE 50'Buffer f�� / 4,, i /\/ a 4a � CATCH BASIN Zone r.,7 ! / �\ / 3 FIRE HYDRANT / O�-� /4 , � IN5TALLERTO LOCATE ALL UNDERGROUND DRINKING WATER WELL AND OVERHEAD UTILITIES PRIOR TO THE ■ CONCRETE BOUND CONSTRUCTION NOTES 5 U OYA N CY / // ' START OF CONSTRUCTION AND RELOCATE //� �` ��\\� /o IF NECESSARY(SEE NOTE#15) 700 GALLON PUMP CHAMBERS 1 .) ALL WORK SHALL CONFORM TO,THE STATE ENVIRONMENTAL CODE,TITLE 5 (3 10 CMR 15.000): WEIGHT OF DISPLACED WATER: (7r x 32 x 1.4')x 62.4 LBS./FT3. = 2,470 LB5. T \ .�� a �, / STANDARD REQUIREMENTS FOR THE SITING, CONSTRUCTION,INSPECTION, UP, RADE, RND EXPANSION WEIGHT OF PUMP CHAMBER(EMPTY): (n x 32 x 6.75') - (;r x 2.52 x 5.67')x 15-0 Lt35./FT3 =1 1,928 LB5.y ,ryj� ��`Qxi I p'� '� 3 OF ON-SITE SEWAGE TREATMENT AND DISPOSAL SYSTEMS AND FOR THE TRANSPORT AND DISPOSAL OF WEIGHT OF SOIL: (;t x 32 x 0.75') - (n x 1 z x 0.75')x 110 LB5./FT3. = 2,073 LBS. 4, e pe� Q��O' // °; 5,5011 Removal(See Note#/9) 5EPTAGE, AND THE LOCAL BOARD OF HEALTH REGULATIONS, TOTAL WEIGHT OF SEPTIC TANK AND 501L = 17,335 LBS. L op���/ // a 40mr1. NDPELrner(seeNote#24) 2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE 15 POTENTIAL FOR e w.o x/ 14,00 I LBS.y >--:2,470 LBS,T(NO BALLAST REQUIRED) 4B /� �� / d °. ��� °. Post*Rail Fence section VEHICLES OR HEAVY EQUIPMENT TO PASS OVER IT SHALL BE DESIGNED TO WITHSTAND AN H-20 4 / 47 3tK Q \c �,�y / Proposed 345(See Plan View)LOADING. IF UNDER AN IMPERVIOUS SURFACE, SYSTEM SHALL BE VENTED TO THE ATMOSPHERE. ; �yw\�� O / / e ° �w p� a .4.° / Remove Pavement to Here 3.)TO MINIMIZE UNEVEN SETTLING, ALL SYSTEM COMPONENTS SHALL BE INSTALLED OWA STABLE ` \ LOT 28 t �oqo MECHANICALLY-COMPACTED BASE,ON SIX INCHES OF CRUSHED STONE. ° // SYSTEM DE51GN CALCULATIONS \Area= 1o,231 5.�.± , 4.)COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK,THE DISTRIBUTION BOX, AND THE BENCHMARK 501L ABSORPTION SYSTEM SHALL BE RAISED TO WITHIN 6"OF FINAL GRADE. LEACHING FIELDS, 4-- ire / To Corner Concrete TRENCHES, AND OTHER 501L ABSORPTION SYSTEMS WITHOUT ACCESS MANHOLES SHALL HAVE AT SEWAGE DESIGN FLOW REC�UIRED:4 BEDROOM OWELLJNG @ l lO GPD/BEDROOM= I / p LEAST ONE (1) INSPECTION PORT CONSISTING OF PERFORATED 4" PVC PIPE PLACED VERTICALLY TO THE 440 GPD REQUIRED EL=50.4(Assumed Datum) BOTTOM OF THE SOIL ABSORPTION SYSTEM WITH A CAP,TIED WITH MAGNETIC MARKING TAPE, SEWAGE DESIGN FLOW PROVIDED: TWENTY(20)A05 BIODIFFU5ER UNIr5 AND FOUR,(4)PORT / ACCE551BLE TO WITHIN 3"OF FINAL GRADE. 45=+ I� COUPLERS 1N BED CONFIGURATION Ben 5 Pond }G.2 5,) PIPING SHALL CONSIST OF 4"SCHEDULE 40 PVC OR EQUIVALENT. PIPE SHALL BE LAID ON A At =[20X 6.25X4.7r72/FTX 0.741+[4X l,OX4.7FT2/FTX0,741=446,76PD EL=44.3 /1 MINIMUM CONTINUOUS GRADE OF NOT LE55 THAN 2% FROM THE BUILDING TO THE SEPTIC TANK, AND 9 NOT LE55 THAN I%OTHERWISE, 446 GPO PROI/IOfD> 440 GPD REQUIRfD / 1'1 �S)a \ 6,) DISTRIBUTION LINES FOR THE 501L ABSORPTION SYSTEM SHALL BE 4"DIAMETER 5CHEDULE 40 PVC 5EPTIC TANK CAPACITYRf0U1RE0: 440 GPDX 200% =660 GPD REQUIRED (OR EQUIVALENT) LAID AT 0.005 FT/FT. UNLESS OTHER AS NOTED. WISE NOTED, LINES SHALL BE CAPPED AT END OR 5EPTIC TANK CAPACJTYPROV1DED: EXJ5MV6 1500 GALLON S 5.s SEPTIC TANK 7J LINES FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIRST TWO(2) FEET BEFORE PITCHING TO PUMPCHAMBfR CAPAC17-YR5QU1RE9: 700 GALLON(WITH 440 GALLONS 5T0RA6,EABOI/fALARM) THE 501L A55ORPTION SYSTEM. DISTRIBUTION BOX SHALL BE WATER TESTED TO A55URE EVEN PUMP CHAMBER CAPACITYPROvIDED. 700 GALLON(WITH 453 GALLONS STORAGEABOI/f ALARM) DISTRIBUTION. 8.) GROUT TO BE USED AT ALL POINTS WHERE PIPES.ENTER OR LEAVE ALL CONCRETE STRUCTURES IN A GARBAGE D15P05AL 15 NOT PERMITTED WITH 7H15 DESIGN FLOW , r.. ORDER TO PROVIDE A WATERTIGHT SEAL. 9.) HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO OPERATE OVER THE LIMITS OF THE SEWAGE `i -3 DISPOSAL FIELD DURING THE COURSE OF CONSTRUCTION OF THE SYSTEM. I CERTIFY THAT I AM CURRENTLY APPROVED BY THE �r��h4-0 , Edge of wetland �� _ DEPARTMENT OF ENVIRONMENTAL PROTECTION PURSUANT TO �" %�- 10,) IN ACCORDANCE WITH 310 CMR 15.22 1, ALL SYSTEM COMPONENTS SHALL BE MARKED WITH 310 CMR 15,017 TO CONDUCT 501L EVALUATIONS AND THAT MAGNETIC MARKING TAPE. THE ANALY515 BELOW HAS BEEN PERFORMED BY ME /Q CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND 1 1 .)THERE ARE NO KNOWN WELLS WITHIN 100' OF THE PROP05ED 501L ABSORPTION SYSTEM. EXPERIENCE DESCRIBED IN 310 CMR 15,017, 1 FURTHER 4G 4 CERTIFY THAT THE RESULTS OF MY SOIL EVALUATION AS //\0 - 12.) FROM THE DATE OF THE INSTALLATION OF THE 501L ABSORPTION SYSTEM UNTIL RECEIPT OF THE INDICATED ON THE ATTACHED 501L EVALUATION FORM, ARE ��� K'=/3/ CERTIFICATE OF COMPLIANCE, THE PERIMETER SHALL BE STAKED AND FLAGGED TO PREVENT USE OF ACCURATE AND IN ACCORDANCE WITH 3 10 CMR 15.100 THE AREA THAT MAY CAUSE DAMAGE TO THE SYSTEM. THROUGH 15,107 13.) THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE SYSTEM AS DESIGNED UNLESS CONSTRUCTED }` ITE PLAN A5 SHOWN ON PLAN, ANY CHANGES SHALL BE APPROVED IN WRITING BY THE DESIGNER. . 14,)THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION BY AN AGENT OF THE Linda J. Pinto, Certified Sli Eva BOARD OF HEALTH AND THE DESIGNER. THE DESIGNER SHALL CERTIFY IN WRITING THAT THE SEWAGE o luator SCALE: 1 " = 20' DISPOSAL SYSTEM WAS INSTALLED IN ACCORDANCE WITH THE TERMS OF THE PERMIT AND THE Survey iPork bp.' APPROVED PLANS. 48 HOURS ADVANCE NOTICE 15 REQUESTED. 15.) LOCATION OF UTILITIES 15 APPROXIMATE AND CONTRACTOR SHALL BE RESPONSIBLE FOR Floats shall be Installed A & M end SETYICPS DETERMINING THE LOCATION OF ALL UNDERGROUND AND OVERHEAD UTILITIES PRIOR TO 5o they can be reached BIB Route 2B, Suite 9 COMMENCEMENT OF ANY WORK, THIS INCLUDES, BUT 15 NOT LIMITED TO, REQUESTS TO DIG5AFE, ANY TEST HOLE LOGS from manhole cover. ��,,("OFM,�s Nest Yarmouth, NA OR873 PRIVATE UTILITY COMPANIES, AND THE LOCAL WATER DEPARTMENT. Pb. (SOB) 739'-1777 Emefl.• enmlenddcomcast.net . � Oyu, 16.)CONTRACTOR SHALL VERIFY THAT ALL WA5TELINE5 ARE CONNECTED BY WATER TESTING WITHIN THE 49.2± �211 Delivery Line UNDAJ. DWELLING PRIOR TO INSTALLATION OF ANY SEPTIC COMPONENTS. Test Hole#I (EL=49.5±) Clean-out INTO �-4 I" REVISION 02/04/1 1: Added Variance for Pump Chamber; Revised Water 17.) CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO INSTALLATION OF ANY SEPTIC Depth Layer Sod Class Sod Color Comments Quick Disconnect •:. Service Relocation. SYSTEM COMPONENTS. Gate Valve 0-30 Fill I CF Poured Fr STEP' REVISION 01/20/1 1: Revised Groundwater Adjustment; Relocated 5A5 15.) INSTRUMENT SURVEY CONDUCTED FOR PROP05ED WORK ONLY. SITE PLAN SHALL NOT BE USED 30"-34" A/E Medium Loamy Sand I OYR 3/1 1 3 N - Concrete jd ENy Water Service; Added Pump Chamber; Added Variance; Revised Notes. FOR STAKING, OR ANY OTHER PURPOSES. 34"-50" B Medium Sandy Loam I OYR 6/6 50"-1 10" Cl Medium Sand I CYR 5/G 40%Gravel 47.50 3/8„ Bleeder Hole Thrust Blocking Check Va at all bends PUMP N OTE5 REQ U I RE M E NTSI : / �-� fl Prepared for: lve 19,) SOIL REMOVAL: ALL TOPSOIL("A" LAYER)AND 5UB501L("B"LAYER)SHALL BE REMOVED FOR A Perc @ 70" I 37 5afety Volume DISTANCE OF FIVE (5) FEET LATERALLY FROM THE 501L ABSORPTION SYSTEM DOWN TO THE CLEAN P#13 124 57" Alarm ON 1 .) USE ONE MYERS 5RM4 (4/10 HP) PUMP OR EQUIVALENT, CAPABLE OF PA55ING A Kevin McCrea SAND LAYER(EL=45.3±), AREA TO BE BACKFILLED WITH CLEAN SAND MEETING THE REQUIREMENTS OF 3 I 0 CMR 15.255(3) AND COMPACTED TO MINIMIZE SETTLING. Test Hole#2 Pump(EL=49.5±) Pump ON 2"SOLID AND PUMPING 13.0 FT OF HEAD AT 42 GPM. 97 Sterling Rd., Hyannis, MA 0260 I " INSPECTION NOTE: Pump OFF 2.) ALARM SHALL BE A RED WARNING LIGHT WITH AUDIBLE ALARM LOCATED WITHIN THE 20.) EXISTING 1 500 GALLON SEPTIC TANK TO BE UTILIZED, PVC TEES TO BE INSTALLED ON INLET AND Depth Layer Sod Class Soil Color Comments I�"Sump BUILDING A5 SHOWN ON THE PLAN. PRIOR TO FINAL INSPECTION BY THE ENGINEER, SYSTEM Proposed Sewage D15po5al 5y5tem OUTLET PIPES IF NECESSARY, AND A GAS BAFFLE INSTALLED IN THE OUTLET TEE. _;I• 3.)THE CORDS FOR THE FLOATS SHALL BE ONE CONTINUOUS PIECE FROM THE PUMP NEEDS TO BE COMPLETE INCLUDING BUILDUP FOR COVERS, 97 5terlin43 Rd., Hyannis MA 0"-32" Fill 42.8+'• CHAMBER TO THE DISCONNECT PULL BOX. THE CORDS SHALL BE ENCASED IN 2-112"TO 3" 21.) EXISTING SEPTIC COMPONENTS TO BE REMOVED, ANY CONTAMINATED 501L SHALL BE REMOVED 32"-36" Nff Medium Loamy Sand I OYR 3/1 FOR A DISTANCE OF FIVE (5) FEET LATERALLY FROM THE SOIL ABSORPTION SYSTEM AND REPLACED 36"-48" B Medium Sandy Loam I CYR 6/6 CONDUIT, Prepared by: WITH CLEAN SAND MEETING THE REQUIREMENTS OF 310 CMR 15.255(3). AREA TO BE COMPACTED TO 48"-1 10" C I Medium Sand I CYR 5/6 40%Gravel ^� 4.)ALARM AND PUMP TO BE WIRED TO DIFFERENT CIRCUITS. / MINIMIZE SETTLING, OO GALLON PUMP C H AM 5E R 5.) ALL PUMP, WIRING, ALARM, AND FLOAT INSTALLATIONS SHALL CONFORM TO 22.) EXISTING WATER SERVICE LINE TO HOUSE TO BE LOCATED AND REROUTED AS SHOWN ON PLAN, MASSACHUSETTS STATE PLUMBING AND MA55ACHU5ETT5 STATE ELECTRICAL CODES A5 WELL CSN DATE OF TESTING: 1 1/15/10 NOT TO SCALE AS TO MANUFACTURERS SPECIFICATIONS. r+•� N �" ALL SEPTIC COMPONENTS TO BE A MINIMUM OF I O' FROM THE WATER LINE. WATER LINE SHALL BE /► v/ SOIL EVALUATOR: LINDA J. PINTO, P.E., CSN ENGINEERING Engineering SLEEVED IN A SECTION OF 2" PVC PIPE WHERE ANY SEPTIC COMPONENTS ARE LE55 THAN I O'AWAY. BOARD OF HEALTH AGENT: DAVID STANTON, BARNSTABLE HEALTH DEPARTMENT 09 23.) LIMIT OF WORK SHALL BE AS SHOWN, A ROW OF DOUBLE STAKED HAYBALE5 SHALL BE PERCOLATION RATE, LE55 THAN 2 MIN/INCH IN "C I" LAYER CONSTRUCTED ALONG THE LIMIT OF WORK LINE PRIOR TO THE COMMENCEMENT OF ANY WORK, GROUNDWATER ENCOUNTERED @ 109"(EL=40,4) 0 20 40 60 P.O.Box2030 Phone:(508)299-3260 24.) INSTALL A 40 mil HDPE LINER FROM EL 48.8± TO EL 44.8± AS SHOWN ON PLAN (SEE PLAN VIEW). Teaticket,MA 02536 Fax:(808)548-5478 SCALE ►"=20' C:\C5N\RR-5terling\RR-5terling-SDS Plan.dwg Date: I I/8/10 Scale:As Shown I By: UP I Check:MA I Project No. C5NO129 SOIL TEST 20 FT MIN. rl<=-��,� 7-Z° P2J�aSerU TOP OF FOUND. — ---------------- -- ----- ----- 10 FT. MIN. \ OBSERVATION HOLE I OBSERVATION HOLE 2 OBSERVATION HOLE 3 CONCRETE - -- , DATE OF • TEST 1 � 2 DATE OF TEST DATE OF TEST _ COVERS ` ---41 SCH 40 PVC - ---- ,�; 'J PIPE - MIN. PITCH WITNESSED BY 7 Dc-IA/rV/A/C WITNESSED BY WITNESSED EY. a I/ 8" PER FT PERC. RATE — MIN./INCH PERC. RATE MIN./INCH PERC. RATE MIN./INCH n. 4' CAST IRON ( OR -- 1 ELEV.= 2y, O ELEV. = r ELEV,= EQUAL) PIPE- MIN. 12 MAX PITCH 1/4'' PER FT I Z. 2'-o ,:�`� �/ix��'Tifi����y�,�'y��.�' f 2 ' ,c�rr,� � -� - •- .� � r ,;- -- _� FLOW LINE ° r-LEVEL /` w'.�ts.•�,,,J ��"c�n�'� �. ,, .. 6 6 ,Goc�✓ s ,c..,�,/o/G 10 MED. COAlL S6 S/I'N/' MIN —- - - - - -- ---, 2 3,o-S o _sz ,4,_r r.___dh_ ,� _ a_ �,(, 2. , I �-c�,/GOL3j'L�S EL= EL= ..�,..... -:�. ��- EL:. 2Z ---EL = 22 j } DIST I � BOX WATER AT %�`� EL = / 2 WATER AT EL = WATER AT _.. EL = LOCATION M A P i /.7 —GAL — -- - ------.— SEPTIC r -��,UG� LEGEND: TANK i EXISTING SPOT ELEVATION 00go - - - r I EXISTING CONTOUR - - - -00- I j In FINAL SPOT ELEVATION 00.0 iFINAL CONTOUR _- PROFILE OF SOIL TEST LOCATION BOTTOM OF 'r?eNC�� - - !� SEWAGE DISPOSAL SYSTEM TELEPHONE POLE -Cr NOT TO SCALE I HYDRANT �l TOWN WATER VV ___ W CATCH BASIN i i -- i i'/¢a��a/3�c: /-/iGf•> LciA.9��. E� - f S y � -: GENERAL NOTES L fJT/9ifL'& 14,4;DIAL. S' '/c .. ':?c` L H 1 ALL WORKMANSHIP AND MATERIALS SHALL ; ``� �� I LJ12ac-+rw D L /JGNJ/ i $ 1'STF/✓% CONFORM TO D E.C.E. TITLE 5 AND THE I TO'dUN OF RULES FA REGULATIONS ' o FOP THE SUBSURFACE Dt ;ROSAL OF SE`XAGE Ste- o ��.-y� �i — 0�_ 2. ALL COVERS TO SANITARY UNITS SHALL BE_ o "� ' BROUGHT TO WITHIN i2,1pF FINISHED GRADEX —4� � L �� 3 EXISTING AND FINAL GRACES SHALL REm4IN vA1?-,A1,ce /S !'c=�Dc�,Pc�U F ir+I /�iJ /wSv; scL a, .h�. 33� Gam` Die S�=�K-; i ESSENTIALLY THE SAME I N QV � � AGO � DETERMINATION -�� 4 NO AS T CO'V►FAS�ICEEN�:�Hu� TCIWA; .. t, L .-- ` -- _ _ _ _ _ _ _ _ /3� �3.� s�c3 �• •••• •b• - �Tvr C� -"'/`3fT r ZON114G REGULATIONS ONrt�fER / APFLtC4kT ."S 830 C"aA<, � /J'9Y YVN/�.N /5 tifURE Tfy,�aiV 7f�E T(_" OF;AIN SUCH DETERMINATION FROM n \ tree C(!/5%ii i'S 2411 DIA, COVERS —� _. (00 GAL1G/9y !�!//-f/CN ` oc-'4D rJE /3coc./JARE,D f5y � IAT Ai✓" RGPR E AUTHORITY Tf•/E TOW/V OF /3pfiA/5TA�3�E /3� SIJ�AT/DIVA 5 THIS P =•'v IS VALID IF !T ..� STl►Me��:;; '�-yk3 LEH//VG F/E C.DS. a ... 4 / / '0 PLAN VIEW _ sIGN � � ONE 8" SCLIC SECT/O.v i IN RED. THIS OFF CF 4- SJME S { �'`7 ''3 �<� � cF :4 VA/'3/ANCE �Fc�U/REO F�M � 7+� •Z F�� A ~A�:C RESf . NSIBI LIT Y FOR INPOR' 4710N N1a'Nt, C' L ;� . f'� CONNE`T/Cnr TO C 4TCH A FROM GA7CH f'�A` /V' TO SAC. /NCo /�AG/C / J'Y rN �OPIES WHICH DO %k r-4VE pRtGINAL --FRAME,,ME,, a COVERS SHALL L•- I. o � �� �A5°N Tc 8E v►'Ra7E�' T/r;HT zszz�zz BE SET WITH MASONRY UNITS l/H!�i/A/vCE OF J5,• -TAMPS AND SIGNATURES r*\ I WHICH ARE TO BE MORTARED 6. ALL C " Ir; IN PLACE SHa F ,_ 0 THE SANITARY SYSTEM +� CAPABLE OF WITHSTANDING H-10 U. _ O ` +-----__ Y i r7 �G � � �_>�.. ��' _ - 'NG UNLESS THEY ARE UNDER OR WITHIN INLET �t . . ,.. . , - 311MIN. OUTLET iU FT, OF DRIVES OR PARKING AREAS. H-20 r ��/ g `�, y,! Q ``. - ` �s ti —�► - 611MIN. FLOW LINE LOADING SHALL BE USED UNDER OR WITHIN 10 FT OF DRIVES OR PARKING AREAS i-�--- /' ►-i I 1 r 2 Q1} `� ,� p I 2 MIN. C.+ \ RAI C�� c. REM -ABLE COVER 7. SETBACK REQUIREMENTS (MINIMUM) 10 M I N. UTLET PIPES X FRONT SIDE k REAR � :.o A S REQUIRED `� / APPROVED BOARD OF HEALTH / AIL T /2 ---- - - °' L N OF M 3 4 FT MIN. o INLET FLOW ��`P Jq� o•. OUTLET o� ti� ✓ i; `� �/ LIQUID r � '\LINE 1 _� RICHAW) DATE AGENT vn/ .yyo. ."r ��� 1AE ERN DEPTH _ .691 y 111 211 b PROJECT LOCATION: is OL AN h NQ o I . . � �c-�ii•- 2 G 8 �.a�cL�.. Z c�I-{ INLET TEE PROVIDED -- --- --- -- PER SECTION i 5 10.2 APPLICANT: A IV,,' 2l'� ,+ 2:;L( � J,r TITLE 5 O23/ FTz± ` / CROSS SECTION VIEWOUTLETS : jai _ OUTLET TEE N0. Of= -• �- P�rea►��} LIQUID DEPTH TEE DEPTH O'HE RN =-_ zZ SEPTIC TANK DETAIL BELOW FLOW LINE I� 90 o. 2'P° `'``y I and Sr-)A/ NOT TO SCALE 4 FT 14 INCHES D w T. BOX DETAIL '`��/o G1;TE S`�` Use 5 FT. 19 INCHES NOT TO SCALE NA( �pN� - � ;�,�� 1 lechnology, Inc.6 FT 29INCHES x G-��G.12,�! �/c7l-ice t t w \ %' 8 FT Q� C,'Tim C Tc7ec- .> 4,_1 ,EiE S✓ICY+.'Sig; y 1/ i>F 1 ,, 341NCHE5 7 FORMERLY R, J. OHEARN NC. I A�,,L Fr/Ai-4,01 4OCA7").3�/_$ ArV4D ,fLA'V4'%)WV.S, _rAIC �1D,,A, GXfsr,A,& En ineers - Land Surve ors - Sonitorions + ! `` i �� � •z� sf-�E� DESIGN CALCULATIONS U/T/�.-✓T/E� 9 y 35 ROUTE 134 - UN/T 3 - P O. BOX 237 91 �/i9rc'fitiL�C� / w�E;,3,s,;/��'�t:� ' WS5T: e Z5 x /SO /e 'EC, VhRGL� NUMBER OF BEDROOMS 'y , , SOUTH DENN/S, MA. /6 i� /9' PfiOVI/�Lsp , . OK / GARBAGE DISPOSAL UNIT 14V0 Zi% ,C />ut : MJitJ /�J S /�2�PvSED P�/t�i9 y� VA IL, 5 •,,, • _ ".R° REVISIONS o / TOTAL ESTIMATED FLOW c f�e24PCSE c� ,QGSEr2t/� I//J,t'. 8° ..5 ��y°`' J,r,',u?Ejc' Cl- '/y.3 /S /a \ E�15T•' 2=- x /S - �Et) •�. .._ `�. � / ,� � � ti !;' GAL / BR /DAY x •-� BR. ) .. Y'��,� GAL./DAY � �° °°•°�C+ = REQUIRED SEPTIC TANK CAPACITY.. -. /� ` _GAL. `T /8 ACTUAL SIZE OF SEPTIC TANK � � _ GAL. lt�C. .4i3 . � LEACHING AREA REQUIREMENTS fi SIDEWALL AREA _2.O GAL./S.F.-DA,/ /t3� !r/a ifs, , LV / art,°•.•• ..° •a BOTTOM AREA GAL./S.F. op, LEACHING CAPACITY ( BOTTOM + SIDEWAL,. ) _ `83O GAL /pn✓ der.: f� < !_ /�. �k' /. / �'t'G '+. QF 4����•`°'� a.'3 es x /x /.O = /tea . . ✓ !. 3 r,. .Ia.Im J 3 W/T/•> ,�A!• SCALE / „ - DATE 3 RESERVE LEACHING CAPACITY.................... _ GAL. Fcai� SfG,'t✓ !'</^F*F•ti?S �' ���., v / y USA c- . / `� _ q. �. + 6. 4$ [/-SL!.) $'C:�� :rr r R. BY / J PPD. 6Y D A � ..:✓:ems �' ; � y �.= Y /n/t/E7 Eta%e 7' O /3t>77- 'I OF •C C-"•�'?C`//,i t rr� !,4�/, / .,�i, r c t .ti' Ti5'sG c' Joe No. S HE E T OF ., � � , �n��•�S i I�'r.'�'v"3- /•�/i-'i=17�C:Tc` C-� /�3. � �Z /. 5' •/1.��'va-c- /a'/ISf=e'ta�-=,.�. •�/��/ TIWfS fs T' FORM / /e7 }.' .".'#yy,4,r -.. x... -. -. ::r. w��'; .' ,.',. .. .. ., a ..• �:f' ,�. _ Y- .�,. f i}: ,Xt.-., 't,. Y v - •.: .. ....,5m, ;4" e y 10 �i5te b .::..f. ?q!!Z • ':-.4t1 ,��.. yCi� `:W, '-.°..'• n: '•.' a •1!'�1 �.:.lt.'.." At