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HomeMy WebLinkAbout0017 TANAGER ROAD - Health 17 TANAGER ROAD HVANNIS 268-027 r � p � i I COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS I IOU DEPARTMENT OF ENVIRONMENTAL PROTECTION C MP RECEIVE® Y AUG 2 4 2004 TOWN OF BARNSTABLE HEALTH DEPT. TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 17 Tanager Road Hyannis Owner's Name: Gilbert Guimond Owner's Address: Date of Inspection: 8/3/2004 Name of Inspector: (please print) Patrick T. Sullivan r Company Name: Ready Rooter Mailing Address: P.O. Box 371 Sandwich,MA 02563 Telephone Number: (508)888-6055 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the i961rmation•reported:- below is true,accurate and complete as of the time of the inspection. The inspection was performed based on'my training and experience in the proper function and maintenance of on site sewage disposal systems. am a D1P co approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The Syste N -IZPasses Conditionally Passes Needs Further Evaluation by the Local Authority Fails Inspector's Signature: Z za4,� Date: jKli' t� 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. 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. 9 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D C. System Passes: -✓am 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" ection need to be replaced or repaired.The system,upon completion of the replacement or repair,as appro ed by the Board of Health,will pass. Answer yes,no or not determined (Y,N,ND)in the for the follow' g statements. If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic ank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank fai re is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approv d by the Board of Health. *A metal septic tank will pass inspection if it is structurally so nd, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or igh static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or un en distribution box. System will pass inspection if(with approval of Board of Health): brok pipe(s)are replaced ob ction is removed di ibution box is leveled or replaced ND explain: The system required pumping ore than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of a Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: i Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the and 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 deter Ines in accordance with 310 CMR 15.303(1)(b)that the system is:not functioning in a manner whic ill protect public health,safety and the environment: _Cesspool or privy is within 50 feet o surface water Cesspool or privy is within 50 fee f a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplie , if any)determines that the system is functioning in a manner that protects the public health,safety a environment: _The system has a septic tank and soil absorption system(SAS)a 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 wit ' a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is ithin 50 feet of a private water supply well. _The system has a septic tank and SAS and the SA is less than 100 feet but 50 feet or more from a private water supply well". Method used to determ' a distance "This system passes if the well water analysis,p rformed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates t t the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitr en is equal to or less than 5 ppm,provided that no other failure criteria,are triggered.A copy of the anal y is must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _ZBackup 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 and overloaded or clogged SAS or cesspool __vl Liquid depth in cesspool is less than 6"below invert or available volume is less than %2 day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped — Z Any portion of the SAS,cesspool or privy is below high ground water elevation. _ _,Z 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 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 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.] ,j'`)�Yes/No)The system fails. I have determined that one or more of the above 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 design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the cri ria above) yes no the system is within 400 feet of a surface drinking w ter supply the system is within 200 feet of a tributary to a rface drinking water supply _the system is located in a nitrogen sensitive ea(Interim Wellhead Protection Area—IWPA)or a mapped Zone I1 of a public water supply well If you have answered"yes"to any question in ction E the system is considered a significant threat,or answered "yes"in Section D above the large system ha ailed.The owner or operator of any large system considered a significant threat under Section E or failed der Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact a appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No Pumping information was provided by the owner,occupant,or Board of Health _ Were any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) 3Z_ 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 than owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ,,Z _ 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(3)(b)] f , Page 6ofII OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_�a Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 33© (Z,P.D, Number of current residents:_f Does residence have a garbage grinder(yes or no): � Is laundry on a separate sewage system(yes or no):�3�[if yes separate inspection required] Laundry system inspected(yes or no): — Seasonal use:(yes or no):� _ z , Water meter readings, if available(last 2 years usage(gpd)): ��Znc.n S-< Sump Pump(yes or no):h;� Last date of occupancy: r COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or _ Non-sanitary waste discharged to the Tit system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information:r'7r,�,,,��,r 'V�, l��c,os ._Q,5 Se�,,� Q - iq�rt>* ZD Was system pumped as part of the inspection(yes or no): , If yes,volume pumped: :'cpogallons--How was quantity pumped determined? �`,d�, �c��,•Q ��,� "T,rut�`G Reason for pumping: TYPE OF SYSTEM -ZSeptic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool —Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) —Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odofsdetected when arriving at the site(yes or no): j Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 BUILDING SEWER(locate on site plan) Depth below grade: i ' �� Materials of construc—tion:_cast iron PVC_other(explain): Distance from private water supply well or suction line: p Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: /(locate on site plan) Depth below grade: I<!:),, Material of construction: concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: j'p` <Z"' x j`49" K 5 ' 7" Sludge depth: 'o ' Distance from the top of sludge to bottom of outlet tee or baffle: Scum thickness: 4/" Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: /3'' How were dimensions determined: tr_-, Vv\<—� - Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fib rglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee r baffle: Distance from bottom of scum to bottom of utlet tee or baffle: Date of last pumping: Comments(on pumping recommendati s, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence o eakage,etc.): Page 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 TIGHT or HOLDING TANK: (tank must be pum at time of inspection)(locate on site plan) Depth below grade: Material of construction:_concrete_metal fiberglass_polyethylene_other(explain): Dimensions: Capacity: gallons Design Flow: gall s/day Alarm present(yes or no): Alarm level: Alarm in rking order(yes or no): Date of last pumping: Comments(condition of ala and float switches,etc.): DISTRIBUTION BOX: (if present must be /ual, on site plan) Depth of liquid level above outlet invert: Comments(not if box is level and distribution to outvidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: (locate on site plan) / Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,conditi of pumps and appurtenances,etc.): 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: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:I leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.):fL T�"i t_/®d1�'-LA 3��� to\ b c�\` i�tiV��+J"�. C�C,`�..••R�e'°.1�z AS , V.aF.YC •� C"d �.7 \i�, `-ut �� �it1:�.owt�-G.. ®.� l�.v►�w�c���� �r.A��L7�.+,� � CESSPOOLS: (cesspool must be pumped as part 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 r no): Comments(note condition of soil,si s of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydrauli failure, level of ponding, condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 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. -70 la3 � 38 13 GL 0 O_ s0 a0 3 y Page 1 I of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 17 Tanager Road Hyannis Owner: Gilbert Guimond Date of Inspection: 8/3/2004 SITE EXAM Slope Surface water Check cellar✓ Shallow wells Estimated depth to ground water' �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:Imo? Observed site(abutting property/observation hole within 150 feet of SAS) Checked with the 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: I Feet dfTM raw TOWN OF BARNSTABLE OFFICE OF DARTSTASL MAGI BOARD OF HEALTH 1 p f639' 367 MAIN STREET �'o rAv�• HYANNIS, MASS. 02601 VARIANCE REQUEST FORM All variance requests must be submitted fifteen (15) days prior to the scheduled Board of Health Meeting. ---c`�(o I 1 NAME OF APPLICANT KCKIIE.L N. S-T1L, E TEL. NO.Cu))�2$-7-11-1 ADDRESS OF APPLICANT 11 -T[ rOf\ a E R RED. N`j�(�fJ�115, M(1 p 2(v0 j NAME OF OWNER OF PROPERTY M I C.HA E L 1-I. ST i Q E S SUBDIVISION NAME plhlL ORK ACRE-5 DATE APPROVED ASSESSORS MAP AND PARCEL NUMBERZ►}IR PAR Z-( LOT SIZE , 2y �jCRLS LOCATION OF REQUEST (� �'Ar.If�C,E(� PAD. l-1`�►gt`1�1fS MA OZIo 01 VARIANCE FROM REGULATION (List Regulation) SE I- i1sC;k To '\AgR T4 r 3 c)' R V--GL .LA-f 10►� r i REASON FOR VARIANCE (May attach letter if more space is needed) 3E E 8:01 C E-D. / I 1 PLAN '= TWO COPIES OF PLAN MUST BE SUBMITTED CLEARLY OUTLINING VARIANCE REQUEST. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPROVAL � I • I i Grover C.M. Farrish, M.D. Chairman • i Ann Jane Eshbaugh James H. Crocker, Sr. BOARD OF HEALTH TOWN OF BARNSTABLE N August 10, 1988 APPLICANT: Michael H. Stines 17 Tanager Rd. Hyannis, MA 02601 Applicant seeks to wave the "33011 Regulation and add to his existing dwelling one bedroom, a dining room and a full bath for the reasons stated below: 1 . Applicant is the Editor of a local newspaper and a free-lance writer. He keeps an office in his home through necessity. His two children currently share a bedroom. By adding a bedroom, his two growing children ( ages 7 and 9 ) would then each have their own room; 2. Applicant proposes to upgrade his current Sewage Disposal System to a 1500 gallon septic tank, using his existing two cesspools as leaching pits. This would be a substantial im- provement to the current situation which would have to continue to exist should the variance sought be denied; 3. Applicant has analized the possibility of sellkig the exist- ing dwelling and building a new home to accomodate his needs. - Applicant has found this to be quite economically unfeasible. Applicant also desires not to relocate his family to a new neighborhood far from the one his children have grown up in. Applicant has owned this home for ten years. I1 Tanager Road Approximate Plot Plan Scale: 1" = 20' 92.39' j Iron Pipe Bounds i 5' 10 !d Proposed1500 Tank RXiS, iNca P � 16' 0 16' „ 22' 7.500" 26'0" 29' 30' 0" 27' 11' 6"► 22' 6" 32' 0' -0 . 115.22' i Addition 10 7' x �z 20' 0" 35, go 17' 0" / .34' 0" 100, 0" go go i I i Tanager Road (Private) 19, 0" 1 PROPoseD PLOT PLR 0 M iG4AE� S j i Q 5 1-1 TA►JAGER RD V�1 �1'���iSPoRT, Ma, I Q �, w � C�J Z J 2 I Ni �. J 15 jl �i; Z tfJ `n ul 44 CD �ii s,i Q 1- p W I Existing chimney 11 Tanager Road Front Elevation Present Revision 1.0 roof line 870830 I ..................... I I 1 I 1 1 1 fi 1 ! 1 1 I 1 1 1 1 I 1 i i I I I 1 I Finish landscape elevation I I I I i I i � r i REVISION 5.1 I 12 July 1988 Scale 1/8 = 1' Dining Room I Enlarge To 3'0" Kitchen And Case Off r Lbi 40' 0" Living Room f>ifYf„Y�f fif%taf f„�et>afat f,4f�fa>4,s t,Yf.Yif„Ytt.e 1 `YYY Master Bedroom i Farmer's Porch .. 1 ----18' 0" ►+ osD t��bi�iolJ: M►cN�E�.. Si�,.1�s ( 1 TR►�AGc.R Rp. .. .rzv UP i,•x` �Fourldation.Plan I�Tanager Road Stines addition No UP i 38' 0" i Existing footings Existing Fireplace 4' Knee Wall with poured top 12'10" { Existing 18' 0" —� concrete walkway ........................ Existing chimney Present roof line collar ti es in ca thedral ral area ..................... oo ....................................... 2 x 8 i existing 2 x 12 2 x 10 sill Existing 18' 0" footings 7,6„ Foundation Plan Tanager Road Stines addition Scale 1" = 1' 14' 4 1/2" i i f TOWN OF BARNSTABLE OFFICE OF DARNSTABL BOARD OF HEALTH Epp M6 9 � 367 MAIN STREET 3 py�Yk� HYANNIS, MASS. 02601 September 22; 1988 Mr. Michael H. Stines 17 Tanager Road Hyannis, Ma 02601 Dear Mr. Stines: You are granted a variance from the Board .of Health. Interim Groundwater Protection Regulation, limiting daily sewage flows to 330 gallons per day per acre in certain zones of contribution to public water supply wells. The variance will allow you to construct a bedroom at your dwelling located at 17 Tanager Road, Hyannis, Ma., with the following conditions: (1) A, 1500 gallon septic tank and distribution box must be installed and properly - --- .connected to the two leaching pits by a Disposal Works Installer licensed in the Town of Barristable in conformance to regulations contained in Title 5 of the State Environmental Code and Town Health Regulations. (2) The septic system must be pumped every 3 years with written certification submitted by a licensed septage hauler. (3) The dwelling cannot have more than three (3) bedrooms. Sewing rooms, dens, lofts, mudrooms, enclosed porches, finished cellars, and similar type rooms are considered bedrooms according to the Department of Environmental Quality Engineering. The office room cannot be utilized as a bedroom. (4) The dwelling must be connected to public water. (5) The dwelling must be connected to Town. sewer when the Board determines it's avialability. (6) Variance expires October 1, 1989. This variance is granted because it is an addition to an existing dwelling. The addition of one bedroom would allow for each of your two children to occupy their own bedrooms. i Mr. Michael H. Stines Re: 17 Tanager Road, Hyannis, Ma. September 22, 1988 . 4 It is the opinion of the Board that the addition of this one bedroom will not significantly alter the quality of the groundwater in the area. Very ly ou , Grover C. M. Farrish, M.D. Chairman Board of Health Town of Barnstable GF/bs SECTION 2 GENERAL PROVISIONS 2-1 Prohibition No person, company, corporation, entity, trust or firm shall in- stall a new individual on-site sewage dispoal system which will produce more than three hundred thirty (330) gallons per day. of wastewater discharge unless in compliance with the standards es- tablished by Section 3 herein. 2-2 Certification of Compliance/When Required A certificate of compliance with this article shall be received from the Board of Health or its designee prior to the commence- ment of any activity regulated by Section 2-1 herein. SECTION 3 STANDARDS 371 Maximum Allowable Wastewater Discharge Within zones of contribution to existing and proposed public supply wells, as determined by SEA Consultants, Inc. , Boston, MA. , in their report entitled "Ground Water and Water Resource Protec- tion Plan, Barnstable, Massachusetts, " dated September, 1985, which is on file with the Town Clerk, the maximum allowable was- tewater discharge from new individual on-site sewage disposal systems shall not Kceed three hundred eighty (380) gallons per acre per day. l : . . 3-2 Additional Limitations/Certain Areas In addition to the standards of Section 3-1 herein, within two thousand ( 2 , 000) feet of existing and proposed public supply wells the maximum allowable wastewater discharge from a new in- dividual on-site sewage disposal system shall not exceed two thousand (2,000) gallons per day, unless downgradient from said existing and proposed public supply wells. 3-3 Flow Rate Determinations To determine compliance with Sections 3-1 and 3-2 herein, was- tewater flow rates shall be determined according to Title V of the State Environmental Code, subject to the interpretation of 'the Board of Health. 3-9 New System Defined For the purposes of this article, the phrase "install a new in- dividual on-site sewage disposal system" shall not include the maintenance, repair and upgrading of an existing individual on- PAGE 15 site sewage disposal system. SECTION 4 ADMINISTRATION This article shall be administered by the Board of Health or its designee by verifying compliance with the provisions established herein. Within ten (10) working days of receipt of a request for a certificate of compliance, the Board of Health or its designee shall notify the applicant therefor as to the approval or disap- proval of the request. Upon determination that all provisions of this article are being met, a certificate of compliance shall be issued. However, in instances where an upgrading of an existing individual on-site sewage disposal system is proposed, the Board of Health may require from an applicant evidence that the . proposed upgrading will not adversely affect the groundwater quality. SECTION 5 ENFORCEMENT The provisions of this article shall be enforced by the Board of Health or its designee, which may, according to law, enter upon any premises At any reasonable time to inspect for compliance. SECTION 6 VIOLATIONS Written notice of any violation of this article shall be given by t-ye Board of Health or its designee specifying the nature of the % Lolation and a time within which compliance must be achieved. l• SECTION 7 PENALTIES Penalty for failure to comply with any provision of this article shall be three hundred dollars ($300.00) per day of violation. SECTION 8 SEVERABILITY Each provision of this article shall be construed as separate. If any part of this article shall be held invalid for any reason, the remainder shall continue in full force and effect. ARTICLE 4 . To see if the Town will amend Chapter III, Article III of its bylaws by striking from Section 3-1 .6 (7) (F) (b) the words ""Water Table Contours and Public Water Supply Well Zones of Contribution", prepared by the Cape Cod Planning and Economic Development Commission, dated 1982 , "and inserting in place thereof the following: "Town of Barnstable Public Supply Well Zones of Contribution" PAGE 16 I prepared by SEA Consultants , Inc . in their study entitled "Groundwater and Water Resource Protection Plan, Barnstable, Mas- sachusetts, " dated September, 1985. ARTICLE 5. To see if the Town outl amend Chapter Section 3 3 5 VB A !and Article VB1B. III of its bylaws by striking o Business Districts and inserting in place thereof the following: 3-3 .5 VB-A and VB-B Business Districts 1 ) Principal Permitted Uses: The following uses are permitted in the VB-A and VB-B Districts: A) Single-Family Residential Dwelling (detached) . B) Retail Store. C) Professional or Business office. D) Branch office of a bank, credit union, or savings and loan institution. E) Personal service business. ,. . . - •- 2) Accessory Uses: The following uses are permitte as accessory -uses in the VB-A and VB-B Districts: A) Apartments, provided they are: a) Accessory to uses listed in Section 3-3.5 (1 ). (B through E) herein; and, b) Located above the first floor only; and c) Comply with the standards of Section 3-2.1 W (a through h) herein. 3) Conditional Uses: The following uses are perritted as condi- tional uses . in the VB-A and VB-B Districts, provided a Special Permit is first obtained from the Zoning Board of Appeals subject' to the provisions for such conditionalsrein uses asd subject required in the this specific Stan section. A) Restaurant or other food-service establishment, but not to include drive-in restaurants. B) Gasoline and oil filling stations subject to the following: a) There shall be no sale of vehicles on the same premises; and PAGE 17 ' TOWN OF BARNSTABLE LOCAT .ON - y �, $ $,� SEWAGE # VILLAGE /-�y.�_ �` ,/}' ASSESSOR'S MAP & LOT _ INSTALLER'S NAME & PHONE NO. P6, c/ SEPTIC TANK CAPACITY c. LEACHING FACILITY:(type) �°X� s ' 5 C�S3p /S (size) a NO. OF BEDROOMS L� PRIVATE—WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: �3 DATE COMPLIANCE ISSUED: / �-2 U g VARIANCE GRANTED- Yes No � '. �. r G , �� T-,y� - t_ dl G f �. A _ ' `V � s � w � . rA w 4 � r � � � ` � v � � �. A��. �' • TOWN OF BARNSTABLE LOCAIION '20 T_At3ACG-4- CQ SEWAGE # VILLAGE ASSESSOR'S. MAP & LOT INSTALLER'S NAME PHONE NO. JMW4 7, .tW)MY SEPTIC TANK CAPACITY /6®-0 64 LEACHING FA.CILITY:(type) /717-�.��J$Tl (size) NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER 'v'of� ;-nods DATE PERMIT ISSUED: DATE COZiPLIANCE ISSUED: VARIANCE GRANTED: Yes �No �.C-0 U O J a i �r �� -aU-6 I Y d Ij V Fss No. . .. /14f 0-e�- 16`'1 ........... THE COMMONWEALTH OF MASSACHUSETTS i 3 � 7J. —�--- I BOARD OF HEALTH _._--.�-.Q.\<U�►J... ------OF..... A2....5.��-C�............................... ApplirFation for Ui ipog al Works Tnntrnr#iun Vvirmit Application is hereby made for a Permit to Construct ( ) or Repair (Y an Individual Sewage Disposal System at: -I T �............. ......---------------................. ...............------------..........----- . •--... ...._...-----------------•----- 1. oo.n.n Address r '1_ ....... ........ . -A �= er A dd sN!�so. ..1- !h,►,�..1�5.. Installer Address D`2� � Type of Building Size Lot............... ............ . t U Dwelling—No. of Bedrooms.......... .__..Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) Cafeteria ( ) Q' Other fixtures ---------------------------------------------- w Design Flow..............5 5..........._..........gallons per person per day. Total daily flow...... ..........................gallons. WSeptic Tank—Liquid capacity/-`....gallons Length---/a ce_. Width. S. (---_ Diameter................ Depth._ "'�.`� x Disposal Trench—No..................... Width------------------_ Total Length......._.._......... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area.........._.......sq. ft. Z Other Distribution box (X) Dosing tank ( ) aPercolation Test Results Performed by........... .............................................................. Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit-_______...__.--_--- Depth to ground water_-__--__________---____. f� Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a •------•--•----------------------------------------•----....-•---------•----•---------- ... --------------------------------------------------------------- 0 Description of Soil........................................................................................................................................................................ x U ----------•-•-••-•-------•------------------•---•-------•-•-•••-----•---------•--•--------.....--••••----------•--------------•------------------------•--------•-•-----•------------------•....-------- w UNature of Repairs or Alterations—Answer when applicable_____A' _1T14 ____ _ .___.1 � __Gl.(.o .._____. 5 T1� .. �-------17.0�------�-his?1,��------.UFAF,.ki-iAG------.Favc. -L.1.Ti�. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iT': _;; p 5 of the State Sanitary Code— further agrees not to place the system in operation until a Certificate of Compliance h b iss d y t e bo f heal e ...... .... ............ ..... ... .. .. ........................... .. =••1�'--...-8. _ Application Approved By......................... -- •----•...............-----------------._..._.............---•------- -•-----.......� .................... Date Application Disapproved for the f ollo ng reasons-------------------------------------•-------------------------•---------------------......................... -•-•----...-----••-•-----------------•--...--•--....----•----------••-•--------------------------•-----••--•---------•-----------------------------------------------------•-•---••---...-••--------•--- Date Permit No.------ .-- - ---------- Issued....... j csf,' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....:.....-O F....... �'7""--fIJ� ........................... .. . ....................... ... uprrtifiratr of fauntpfiattrr THIS IS TQ rFRTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) byGam'-� ,_.... �!.... .. ........•--•-•------ --------------...-------•-•-•-•-•---------•----------------------------------........--------------•-- .�/ � --- �nn at L Tim - --------------------------------------------------------------- has been installed in accordanc with the provisions 5 of The State Sanitary CoilkANTEE s des ibed in the application for Disposal Works Construction Permit No..�7....I............ dated__..`-- f?1!- ............ TIME ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GU THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................................................••••-----............... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH c� ...............�,:�?.�:'r^y........OF................:.... .�S..y: .--........ off. No.�...d..... FEE ............. `14sp gat 0 n orkt strnr#ion PlarAit Permission is hereby granted............ ?� �.. �``� to Construct ( or R 'r ( ) an Indiv' ual S wage Disp: System ------ -----------PC= -------•-•--- ----- -----� ---- -------�--��------------------------ Street as shown on the application for Disposal Works Construction Permit No.e, -----. �� Dated _ _1 . ..:............... /J3s6!���e� Board of Health DATE................................................................................ FORM 1255 HOSES & WARREN. INC.. PUBLISHERS - 7 �cFulg_- THE COMMONWEALTH OF MASSACHUSETTS -�-�- BOARD OF HEALTH 1 Q1 C'U.J...............OF..... LhGt`1 S 1 4i� (,�------------------------------. App iration for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (yQ an Individual Sewage Disposal System at: �-�- M __ � ...........o.... - LTAtJA6L JZC '4"7 -5----.._..._....... ---�------�--........_......---•------A---�----.....--- -----....._..(.o..-c------------------•----. tion-Ad ess or No. � a- j QH = ... ,��� --------- -• .. l -- ner Add r ss Installer Address Type of Building Size Lot...o_.2 4.Ac}St Dwelling—No. of Bedrooms............ __...........................Expansion Attic ( ) Garbage Grinder ( ) PL4 Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 0.1 Other fixtures ---------------------------------------------- Design Flow..............�:� gallons per person per day. Total daily flow......13®..........................gallons. R: Septic Tank—Liquid capacity/! .gallons Length---/O_G.. Width.::;._ C-.._ Diameter................ Depth... :_7 Disposal Trench—NTo. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No----------_--------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ ,`l-1 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_---__---_______..___.-. rZ4 Test Pit No. 2................minutes per inch Depth of Test Pit_______-_.--__---•-- Depth to ground water..--_-__________---____. a ---•----------------------------•--••---•----------•----------------------•-•-•---•-........--------......................................................... 0 Description of Soil........................................................................................................................................................................ x U •-----------•---•...--•--•-------•----•--------•-----•-•---•------------------•---•-•....-••-•-------------------------•--••----------•-•-----------------------------••------------•---•--•------•---•- w x -•--•------------------ .......................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable._.._. -'______-L 15K ...... S........................................ - i Q--------T�s-IQ...... x, ....... -� `-j ' '--------F G!.L.iT S �.� ---------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 4- 5 of the State Sanitary Code— further agrees not to place the system in operation until a Certificate of Compliance has­ >ss d y the bo d f hea �r C Date Application Approved By--•--•....... L/Date Application Disapproved for the f ollo ng reasons---------------------------------•---•--•-•------------------------------------------------------.......----•--•- --------------•-----.._.....----------•------------------------------------•-----•-------------------••-------------------••--•-------•--------•-------••-----•-------------------•-----•----......... / Date Permit No..-•-. ......... ._..`. _V`_�....--•-_. Issued--•--- {--- ------------------------------ THE may-- L.�.. � COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Cnrdif iratr of (�outpfiFanrr THIS IS TQ_C_ERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by . �- ------------------------ .... ... c - Installer .has been installed in accordance with the provisions of'TITIE 5 of The State Sanitary Code s des ribed in the application for Disposal Works Construction Permit No..` __..'a�L7............. dated- ..1.-��- ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH > > -' ! ( _yr.J.........0F..............................................' N .................... -7 c�G fNo.: ..3.....n .... FEE ............. Disposal Works Tonstr ion "truth Permission is hereby granted = - ..... _�r��-u------••-------•------------------------------------------------------------------- to Construct ( 1 or Repair ( ) an Individual'Swage Disposal System at No.--------j / �`-'r '►arc , X Street as shown on the application for Disposal Works Construction Permit No J". ?f 7Dated.7/C__`.t. .................. Board of Health DATE............................................................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS . 11 Tanager Road Approximate Plot Plan Scale: 1" = 20' 92.39' Iron Pipe Bounds 5' Proposed1500 Tank Existing Leach Pits 16' 0" 1 6' I 22' 7.500" 30' 0" 26'0" 29 27' , 11' 6"� 22' 6" 32 0 0, 115.22' Addition 10 7' s� 20' 0" 35' r 17 0 34' 0" , WIW - 100' 0" Tanager Road (Private) 19 0" PRoPoScp PL_o-T PU\O ' M lLP1\u ` 11 Tanager Road Approximate Plot Plan Scale: 1" = 20' 92.39, Iron Pipe Bounds 5' � Proposedl5oo Tank Existing Leach Pits 16' 01. 1 6' I 22' 7.500" 30' 0" 26'0" 29 27' N , 1 1• 6" 22' 6" 32 0 'M. 115.22' Addition 107' :a A 20' 0" 35' ---� i;•:::: 17' 0" 34' 0" . 100. 01. Tanager Road (Private) 19 0" PROPoscD PLUT PU�0 I`�iC�q�� �i��►�� 1`1 TA►JA G I= R ICU. 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORK Address of property U U V) a v p Owner's name o' '\ J �54- � a r . s x7 /' 6- el Date of Inspection Rc� �� ��y R� ,� o PART A CHECKLIST Check if the following have been done: 1Z Pumping information was requested of the owner, occu ant Health. P , and Board of None of the system components have been pumped for at least two and the system has been receiving normal flow rates during that and period. Large volumes of water have not been introduced into the / system recently or as part of this inspection. v As built plans have been obtained and exami available with N/A. ned. Note if they are not —� The facility or dwelling was inspected for signs of g sewage back-up. ZThe site was inspected for signs of breakout. All system components, excluding the SAS, have been located on site. the The septic tank manholes were uncover the septic tank was inspected for conditioneofdbaffles, andhorinter tees , of material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has bee on existing information or a n determined based pproximated by non-intrusive methods.. The facility owner (and occupants, if different from ow provided with information on the proper maintenance of* SSDS,�ere N 9 0 s �, E' SUBSURFACE SEWAGE DISPOSAL SYSTEH -INSPECTION FORM PART B SYSTEM INFORMATION / FLOW CONDITIONS If residential 4 number of bedrooms 0 number of current residents garbage grinder, yes or no Es laundry connected to system, yes or no ti1v seasonal use, , yes or no If nonresidential, calculated flow: Water meter readings, if available: V`�k 02 &14&5 Last date of occupancy GENERAL INFORMATION Pumping records and source of information: mow, Aa �y System pumped as part of inspection, yes or no if yes, volume pumped 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) ' Other (explain) Approximate age of all components . Date installed, if known. Source of information: NO Sewage odors detected when arriving at the site, yes or no 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: (locate on site plan) depth below grade:— / material of construction: V concrete metal FRP —other(explain) i dimensions: / X / /mod U C., C' L, 7� sludge depth ..LLB distance from top of sludge to bottom of outlet tee or baffle . _ scum thickness distance from top of scum to top of outlet tee or baffle lea distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence o, leakage, recommendations for repairs, etc.) H 'klr� C -L ul cx L'I 5, o✓ c r o s l n ,-1- f 4 k`, C' DISTRIBUTION (locate on _site plan) depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of eakage into or out of box, recommendation for repairs, etc.) CA-c i ti s nN 4- PUMP CHAMBER• A11iq (locate on site plan) pumps in working order, yes or no Comments : (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs, etc. ) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORH PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required; but may be approximated by non-intrusive methods) If not determined to be present, explain: Type. leaching pits and number leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number le Comments: (O /�G�� 1 A- �.iI -e —&-i (note condition of soil , signs of hydraulic failure, level of ponding, conditio� of vegetation, recommendations for maintenance or repairs,etc. ) a'� v t v.J Al. r r �.'�� P t S c N • 'S d o U� �e� � �o c s O ✓11 �r g� G�S S H I.e—-�o cii. CESSPOOLS (locate n site plan) • lo /� /ram 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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) PRIVY : ( locate on site plan) materials of construction dimensions depth of solids Comments : i(note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) • 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION Continued SKETCH OF SEWAGE E_SPOSAL SYSTEM: include ties to at least two permanent referen ces nces landmarks or benchmarks locate all wells within 100' 3q Oil �1'� • 5� 6 p.�36x 1500 Y<ic �cti�t pU�✓�lo�J S DEPTH TO GROUNDWATER depth to groundwater method of determination or approximation: L / J b G d� l tom. /� [�. C� llc c_ n � S ®19 �z NunS is 'SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C / FAILURE CRITERIA l Indicate yes, no, or not determined (Y. N, or ND) . Describe basis of determination in all instances. If "not determined", explain why not) ._.� Backup of sewage into facility? . Discharge or ponding of effluent to the surface surface waters? of the ground or Static liquid level in the distribution box above outlet invert? Liquid depth in cesspool <6" below .invert or available , 1 2 da flow? / Required pumping 4 times or more in the last year? number of times pumped Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy: . below the high groundwater elevation? within 50 feet of a surface water? within 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a u ? public well . _ within 50 feet of a borderingvegetated w g wetland or salt marsh (cesspools and privies only , not the SAS) . N within 50 feet of a private water, supply well? less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well .water analy, _ for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. 13 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector —' 1 �; c. S Company Name � (�J' l � ; •. '^^s �� �i � �5�.�. ��3"o s Company Address yo V /3aN S � JG✓ /�A �v ✓ �N� � s /l/1CA\ -0,26 60 Cert ftcation Statement I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. The inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and manitenance of on-site sewage disposal systems. ChLe�one: I have not found any information which indicate s that the system fails to adequately protect public health or the environment as defined- in 310 CMR 15.303 . Any failure criteria not evaluated are As stated in the FAILURE CRITERIA section of this form. I have determined that the system fails to protect public health and the environment as defined in 310 CMR 15.303.. . The basis for this determination is provided in the FAILURE CRITERIA section of this form. Inspector's Signature Date ✓ Original to system owner Copies to: Buyer ( if applicable) Approving authority Ae-