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0294 TOBEY WAY - Health
294;Tobey.Way•Hy4nnis A=247-250 ; q ^ f t Y d ° ° . r3 TOWN OF BARNSTABLE .�-OCATION�`/ f oJzy &a y SEWAGE#,!�p/p..c-�311," VILLAGE ASSESSOR'S MAP&PARCEL.�?�/_7 v23p INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /oho CALxo� LEACHING FACILITY:(type)/Aj,-,e d442�.,y��) (size) NO.OF BEDROOMS 7 OWNER r PERMIT DATE: ���/� 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 J W i ;o ib — o3 Ito. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS YeS ftplitation for Mispo8AY 6psterd ConstrULtion perntit Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon( ) ❑Complete System Individual Components Locatio Addyss or Lot No. ?(t e/ �® �y ��y Owner's N e,Address,yand Tel.No. Assessor's Mapq cel l / life Iva c' Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Q� Dwelling No.of Bedrooms Lot Size 36 T g sq.ft. Garbage Grinder(/_�f Other Type of Building No.of Persons/ Showers( ) Cafeteria( ) Other Fixtures >� Design Flow(min.req fired) gpd Design flow provided Z gP d Plan Date Number of sheets Revision Date Title Jr e Z © 2Y Goaj 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 Hea Signed Date Z 3 9 Application Approved by - ` Date a `'1— b Application Disapproved by U Date for the following reasons Permit No. Date Issued -_.— ----------- -- __---------- ------ -- ---— - --- — A --  - — -- — -.. .--•----...,..-....,r .....,.��b;:,,;+-"""�.+r^aa'r�'_�"'!�h`�:.•++�.ii"n�'�`'NOfri*wr+i`^`^„„5,. dw'f,�" �.....-..,-.........-... --wwe..._.-�- •y,,:-yc�r...,,f•.,ro,-.«n-w.n..,.mrs^.-.,.K,v ........ ..R,,.. d-0 Io — 0 3b F' V Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computes: PUBLIC HEALTH DIVISION -TOWN OF BARNSTAB.LE, MASSACHUSETTS Yes r 9ppfitation for -Misposaf *pstrm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon( ) ❑Complete System R1 Individual Components Loyti Addys�Lo©of No. �O�ilo �j(l¢y Owner's Nape,Address,and Tel.No. Assessor's Mal 4 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. �or�-vl Cods 7 7l, �Otv� C 36 Z �S�`/ Type of Building: Dwelling No.of Bedrooms Lot Size/ sq.ft. Garbage Grinder Other Type of Building 9,0 3%,.de•9C e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.req fired) � , gpd Design flow provided gpd Plan Date .g d Number of sheets�—Z Revision Date Title 5 tf )A7e O Z y ©A e Size of Septic Tank Z42 a Type of S.A.S. Description of Soil t 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 He i . Signed Date Z- -3 .. Application Ap""proved by r - -5 Date Application Disapproved by V Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS ,f Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded Abandoned( )by ey at q e k a1 t has been constructed in accordance with the provisions of Title 5 and the for Disposal S stem Construction Permit No. a n(0 ,.Q A dated I`y— 1 o Installer Designer !l #bedrooms Ll Approved design-flow A V gpd The issuance of thi• permit shall not be construed as a guarantee that the system will func�io�Jas designed (� Date a ��3 I 1 Inspector / '! C 1� V e THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS Misposai Opstem Construction J)ermit Permission is hereby granted to Construct( ) / Repair( ) Upgrade(� Abandon( ) System located at Z% 7 d fJ Z° and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit Date _ `�e l 0 Approved by_ a"(,Q FROM :down cape engineering inc FAX NO. :15OB3629880 Feb. 26 2010 08:21AM P1 J, Thl o nies F. Ge Rvr,.Direaor 1 QP.IiIYSTABLE.I::i 7AAW3. fl'Uiblui: k9errlttlln •�9ayn.,R�1<i J. m !'l�oofraQ MeN.e4on,Director 200 Maio ;odrer4.,ki[yatm nns,MA 02609 Office.: 509-F,62-4644 Fax: 509-790-63w IBnstoeller& G?eslo.er 6_'.eirti!�ro..Kjon 1For. nlFcn n Date: � � �d See ate.Persnrnt# 02�ly-- D3� t�W4lC�d9Qlr�4_�llat;ll'ar�l C� ADesii�tma a; ' 0 2. /N&" -p Installer: �/a 1 M(t`>rcf.�44-- Address: ,3 Address: / • 0• Z— y —X 9 / �lSwas issued a permit to Install a (date) �}u [f i.WR T) septic systein.at��/ / U � .e GtjO based tin a design dn,wn by-Res dztc, r certify that the septic system referenced above was installed sabsLantia)ly according to the design, which may include minor approved change~ such wi lateral relocation of the distribution box and/or septic tank. I ctrLiPy that the s��lii`. system referenced above twas insWled with ioajo:r changes (Le. greater than 10' lateral relocation of the SAS or wiy vertical re(ncauml of any n GompoLent of the septic system) but in accordance wish State & Local kegulation% PILL .revi.3i.011 or certified as-built by desig„er, to .follow. OF DANIELA. � OJALA (;l►�at Il s 5i �atzare) CIVIL No.46502 �J $;Te- LO s�oaAL ket° esi.s�ier s ,�iigrt:ihirr;) (�1.(lix T)e9itmar's St;v.np Kom) PLVA�E E: Tljj :i't7 FSAiiT1 i'laIlij:.l�: yUIQLIt FIgA'l,:l'�f JD.Id'1 t.QDN. CEl�Ti�S��TF l7T ..._�._ _..—.._._.—_...._ _..._ .._.....--....—-F W[T:J, NOWT kj1F R5,`�To1JD. lJI'+I'f IL PQ T'FA THIS MHM1 .-DIJIlLi' CARD AZT pdEC-E�,lVED)GV` 1iL Att�c�15'Y'e4l3I,1�'1'QIIl�,IQ.'.H1FAT,I�Ys�'7aSiCr1�T. 'Ililfii�fd�:X4UU. Q;HcR1tb/SeprirJ1)nyiener i'e:rH-ffMl.ion,F.orrr 3 z6-QA.rfor,. i � k i TRANS. NO.: s CITY/'TOWN: 1 t—�y�., •..�.� _ «� APPLICANT: CV-N 4-i Z N1,e-r-J } ADDRESS: V" DESIGN FLOW: gpd REVIEWED BY: DATE: ({ 7��77 N/A` OIL NO 'Vlg� Legal boundaries denoted[310 CMR 15.220(4)(a)] Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided [310 CMR 15.2204(t)]. Plan proper scale? (1"=40' for plot plans, 1"=20'or fewer for 4 components) [310 CMR 15.220(4)] Easements shown [310 CUR 15.220(4)(b)] System located totally on lot served [310 CUR 15.405(1)(a) for I upgrades]- if not, a variance is required [310 CUR 15.412(4)] Location of impervious surfaces (driveways,parking areas etc.) [310 CUR 15.220(4)(d)] Location all buildings existing and proposed 310 CUR 15.220(4)(c)] Location and dimensions of system components and reserve areas. ! [310 CUR 15.220(4)(e)] System Calculations [310 CMR 15.220(4)(f)] daily flow j septic tank capacity(required and provided) soil absorption system(required andprovided) I whether system designed for garbage grinder I North arrow[310 CUR 15.220(4)(g)] Existing and pro osed contours [310 CUR 15.220(4)(g)] Location and log of deep observation holes (existing grade el. on each test) [310 CUR 15.220(4)(h)] Names of soil evaluator and BOH representative[310 CUR 15.220(4)(h) and(i)] Location and date of percolation tests (performed at proper elevation?) [310 CUR 15.220(4)(1)] Percolation test results match loading rate? [310 CMR 15.2421 Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] Observed and Adjusted groundwater (method for adjustment given or indicated) [310 CUR 15.103(3) and 310 CUR 15.220(4)(n)] } t i Address Sheet 1 of 7 I t ,I I I N/A. OK NO Location of every water supply,public and private, [310 CMR 15220(4)(k)] within 400 feet of the proposed system location in the case j of surface water supplies and gravel packed public water supply j within 250 feet of the proposed system location in the case j within 150 feet of the proposed system location in the case of private water supply wells Location of all surface waters and wetlands located up to 100 ft. i beyond setbacks listed in 310 CMR 15.211 and any catch basins �/ I j located within 50 ft. [310 CMR 15.220(4)(1)] I Water lines and other subsurface utilities located[310 CMR 15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1]) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] Stamp of designer[310 CMR 15220(1) and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] Test hole adequate to demonstrate four feet of suitable material? [310 CMR 15.103(4)] Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] Benchmark within 50-75' of system [310 CMR 15.220(4)(q)] I Materials specifications noted? [various sections of 310 CMR 15.000] System components not>36" deep (unless Local Upgrade Approval or LUA requested) [310 CMR 15.405 1(b)] i i i I I i I I 1 I I I I I I � 1 j I i { Sheet 2 of 7 Address I I i i 1 i 1 , i i 1 1 I i N/A OK NO �+ �'t 7�771t y �, " a z �7�r��m.,�, t�,,_ +ip�.�Y�.& k ,L�csar r r �' ,a ��''� `' LizS�'g*b'„``Mk� k i-.� A t L -• i 1'L-0��tAiV Size OK? [310 CMR 15,223(1)] i Inlet tee located ten inches below flow line [310 CMR 15.227(6)] Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR I 15.227(6)] i Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] I f Note regarding installation on stable compacted base [310 CMR f 15.228(1)] i fSeparation between inlet and outlet tees(no less than liquid depth) [310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for I upgrades under LUA[310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9".must have risers . on all openings and on the d-box) [310 CMR 15.2228(1) and 310 i j CMR 15.232(3)(f)] Three access covers(inlet and outlet must be 20" or greater) - j middle access at least 8" (by 7/07) [310 CMR 15.228(2)] Access to within 6 " of grade - one port for systems<I 000gpd, two for systems>1000 gpd[310 CMR 15.228(2)] j All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] ✓ Buoyancy calculation Required/Done [310 CMR 15.221(8)] j H-20 Where appropriate? [310 CMR 15.226(3)] ' Setbacks from resources [310 CMR 15.211] Required when other than single-family dwelling or flow>1000 d [310 CMR 15.223(1)(b)] First compartment 200%daily flow; Second compartment 100% daily flow[310 CMR 15.224(2) and(3)] "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] I i i I i Address Sheet 3 of 7 j i I N/A OK NO j i Located at least ten feet from any water line? [310 CMR V/ 15.222(2)] I i Disposal piping at least 18"below water line(when water and j sewer cross,see 310 CMR 15.211(1)[1]) Cleanouts required/provided? [310 CMR 15.222(8)] Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] ' Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches t and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] i Siphon problem/(leachfreld below pump chamber) Endcaps or vent manifold specified? Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310. CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) i Stable compacted base [310 CMR 15.221(2) and 310 CMR I 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided. (when i pressure sewer to d-box or steep pitch of gravity sewer) [310 j CMR 15.323(3)(a)] Riser if deeper than 9" [310 CMR 15.232(3)(f)] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] Minimum sump 6" [310 CMR15.232(3)(e) Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] i p( DD _fi�vr I Capacity(emergency storage above working---design flow)? [310 CMR 231(2)] Proper setbacks [310 CMR 15.211 (same as septic tai-lcs ] Watertight 20-in minium access manhole at least 20"MUST BE TO GRADE [310 CMR 15.231(5)] Service components accessible(not too deep with piping, 1 discomlects accessible Alarm floats- alarm on circuit separate from pumps specified? i Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and(8)] i Stable Compacted Base[310 CMR 15.221(2)] Buoyancy calculations needed?Provided? [310 CMR 15.221(8)] Address Sheet 4 of 7 1 i I I i ! N/A OK NO ' .,t Calculations correct? j4 feet of naturally occurring material demonstrated? [310 CMR / 15.240(1)] Required separation to groundwater? [310 CMR 15.212)] Aggregate specified as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.241] Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)]. E Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] g, SPIT ;CI �+131 OCMR �5253 .� Chambers and Gal. in trench configuration supplied with inlet every20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole(if>2000 gpd must i be to grade) [310 CMR 15.253(2)] I Aggregate 1'minimum-4'maximum. [310 CMR 15.253(1)(b)] 2' sidewall credit maximum[310 CMR 15.253(1)(a)] In bed configuration,inlet every 40 sq. ft. [310 CMR 15.253(6)] r s, Width T minimum T maximum [310 CMR 15.251(1)(b)] 100 feet-maximum length [310 CMR 15.251(1)(a)] Minimum separation 2x effective depth or width whichever greater(3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMR 15.251(2)] Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] JBE� S�� (ia�imu= ,�ze o�be o ie� 5000 �cl - �� i minimum 2 distribution lines [310 CMR 15.252(2)(a)] Maximum separation between lines 6' [310 CM RI5.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 ! CMR 15.252(2)(e)] j Aggregate depth below discharge pipes 6"minimum, 12" ! maximum. 310 CMR 15.252(2)(g)] Separation between beds 10'minimum. [310 CMR 15.252(2)(f)] i Bottom area used in calculations only[310 CMR 15.252(2)(i)] I i i i i I Address Sheet 5 of 7 I . I f i f i I N/A OK NO XAMAX Pressure Dos System ? Provided pump and piping ; f calculations as required [310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative . systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] i If used in gravelless system-make sure jet is directed as not to scour soil interface [Guidance Document] � i Inspections once per year(systems<2000 gpd) or quarterly i (>2000gpd) good to note on plan [310 CMR 15.254(2)(d)] Construction in fall -Did the plan specify that the fill shall meet the specification of 310 CMR 15.255(3)? iImpervious barrier and/or retaining wall? [Guidance Document] Impervious barrier installation must be supervised by designer[310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] Side slope not exceed 3:1 ? [310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2) and ! Guidance Document] ! At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] ,e`ems ,3' enz ppro.a .e eits' Check DEP Approval letters for credits and design conditions i I If used with pressure dosing do not allow pressure discharge j to scour soil interface i vWz lte�ir`i y e�;�lc��, YS eJf_Uh � ° lL�tees: Was DEP Approval Letter provided and/or have you I reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has applicant submitted a copy of a maintenance 13 Are the variances listed on the plan? [310 CMR 15.220 (4)(q)] jRLS Stamp necessary on plan if a component is within five feet of property line[310 CMR 15.412(4)] ' New construction or increased flow proposed- [Refer to 310 CMR 15.4141 Sheet 6 of 7 Address I !I i 1 i i N/A ®K NO �tgi�t " "A �t4, ,'�-` ^ Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? f I [310 CMR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CMR VY 15 216(l)] Mascellalzeozes ft3 ;aqgobt�r Pumping to septic tank? [310 CMR 15.229] Shared System[310 CMR 15.290] I I I i 1 1 i 1 1 i 1 i I i I i i i I i I 1 i I ( 1 i i I ! I I 1 i i I 1 I i f i i I Address Sheet 7 of 7 i I i Certified Mail#7006 2150 0002 1041 9631 Town of Barnstable ~ . Regulatory Services RARvsrasM Thomas F. Geiler,Director Fo �A Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 June 23, 2008 Sheila McNamara PO Box 764 W. Hyannisport, MA 02672 NOTICE TO ABATE VIOLATIONS OF 310 CMR: 15.000 THE STATE ENVIRONMENTAL CODE TITLE V: MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF SANITARY SEWAGE The property owned by you located at 294 Tobey Way, Hyannis was inspected on June 21, 2008 by David W. Stanton, RS Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration in accordance with Chapter 170 of the Town of Barnstable Code. The following is a violation of the State Environmental Code: 310 CMR 15.303: Systems Failing to Protect Public Health and Safety and the Environment: 4 bedrooms are present at said location. Septic system, permit #96-420, is only designed for a 3 bedroom dwelling. _ You are directed to correct the violation listed above before une 21, 2010 here are two options to correct the violation, please choose one of them: 1. 'Eliminate one bedroom so that a total of only three bedrooms are present at said location. The Town of Barnstable Health Department has a policy to eliminate the privacy of being considered a bedroom by installing a minimum five (5) foot cased opening with no doors, and no beds or people sleeping are allowed in the room. A building permit must be pulled to conduct the work for this option. 2. Upgrade the septic system to accommodate the number of bedrooms present in said dwelling. A septic permit must be pulled to conduct the septic system upgrade for this option. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. . QAOrder letters\Sewage violadons\294 Tobey Way.doc I Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH rho ras A. McKean, R.S. Director of Public Health Town of Barnstable Q:\Order letters\Sewage violations\294 Tobey Way.doc J l' Mvi r LPG, I UP) � , b7 ���I zero up ' Town of Barnstable Barnstable y Regulatory Services Departme A"meric;3 City + BARNS[ABLE ,. MASS Public Health Division 163q. 200 Main Street, Hyannis MA 02601 �O"' Office: 508-862-4644 FAX: 508-790-6304 Thomas .McKean,CHO APPLICATION FOR RE TAL RE RATION Date: j `f C Fee:$90.00 Per Unit Plus 925 for each addtl.Unit on the same parcel Property Location: c 2-0 Z5-S T- &'A-1Y1Y/SPefAC-7— Number of Rental Units On This Property Assessor's Map and Parcel: i Owner's Name: S e , c m l9&A Telephone Numbers (Daytime) 6a e- 7 Fe 7//, (Home Phone) ;6'49-- 71 e -- 17 I/ (Cellular) 6 l `/- 416e- 31�yG; Owner's Address: g,-4-.'/ P T Mailing Address: (if different than above) P.g �-V 0 Tpf :%y I Q Owner's Representative's Name (if Applicable): Address: N Telephone Number: f rn Occupant's Name: VII /oyS St sOIYAL- S omin 6�12 RE HI S e,s C- ,ygMe `7-013.6 Daytime Phone Number: 0 '2 G) :7 Cellular Number of Bedrooms: z— Check One: Is this a single family dwelling unit? [ , an apartment building? [ ] or an accessory apartment? '[ ] Do You Have Zoning/Building Division Approval for an accessory apartment? Will there be any children under the age of six who will be occupying the re 1 unit? (circle one) le No Was the dwelling constructed prior to 1979? Yes No I certify that the information provided above is true: Applicant's Signature n �a v FORM30 r&w HOBBSB WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CIT /TO N W b DEPARTMENT 2 dy dye �, c, ADDRESS �M S�y`e L PHONE Address 1 Uhe w 0,nplii Occupant_ Floor Apartment D o. o.of Occupants No.of Habitable Rooms No.Sleeping Rooms No. dwelling or rooming units_ No.Stories Name and address of owner Ri h _ML Poeimarm Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: U Stairs: v Li htin STRUCTURE INT. Hall,Stairway: Obst'n.: tj Hall, Floor,Wall,Ceilin 10 il Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: ct2 T gut.. rT IFIF O H.W.Tanks Safet and Vent ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other.- Egress Dual and Obst'n: General Building Posted - Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH ` MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTI01A REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTI S O R URY." INSPECTOR L '' TITLE DATE a TIME �j P.M. A.M. THE NEXT SCHEDULED REINSPECTION C P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises,shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as .prohibited:by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns,shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents,cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. 1 � Town of Barnstabk Department of Regulatory Services / Public Health Dflvisioll Date '7 020/0 200 Main Street,Hyannis MA 02601 9 �pFo MA'1 p o �MFeeADD .Ud Date Scheduled D Time— �d.— Foil Suitability Assessnient for Sewag jIsposal Pcrfonned By: `� /v` W �G e Witnessed By.; . . 1 L� A'I'ION. GENIC']f�AL I[1V][+®J[�I�/1tA I[d C, Location Address 0?9q jrj b vL) Owner's Name w. t4y,,,, Address Assessor's Map/Parcel: ��/ t� Engineer's Name .�- o NEW CONSTRUCTION REPAIR Telephone It A&� Land Use• &e4? Slopes(%) —� �» O (;� Surface Stones CIA,1 Distances From: Open Water Body . �,�qr � ft Possible Wet Area c900eft Drinking Water Wellft Drainage Way rty Line ft Other ®�� �P Yl i SKlrTCH: (Street name,dimensions of lot,exac orations of lest ho &pert tests,locate wetlands'i❑proximity to holes) t �v� �a IZ Parent material(geologic) �(/TL(//�j Depth Lo Recb'oek, Depth to Groundwater: Standing Water in Mole: Weeplhg I'lolll Pit Pepe AA:7Af Estimated Seasonal High Groundwater All _ D]CTERAUNA7CION FOR SEASONAL HIGH WAFER TABLE Method Used_ Depth Observed standing in obs.hole: In, Depili to wil lwj[dvl: �,r/ 1IT— Depth to weeping from side of obs.hole. _ Ili, Orouudwuter Adjustment e Ft• index Well I# Reading Date: Index Well level Adj,factor, A41.Orounclwuter level PERCOLATION TEST lUndn/ Z A'lnlm d � Observation ` Holc# ` Tinto tit 4" _ !�Depth of Pcrc Time at 6" Start Pre-soak Time @ LG•�� _ Time(J"-6") End Pre-soak Rate Min./Inch ld Site Suitability Assessment: Sile Passed_v SiI.q.Failed: _ Additional Testing Needed(YIN) A Original: Public Health Division Observation Hole Data To Be Coin leted on Back- - ***If percolatioaa test is to be conducted within 100' of Wetland, you must first notify tlae. Barristable Conservation Divisiola at least oaie (1) wee➢c prior to begiaauing. QAS EPT10PERC FORM.DOC -------------------- DE,El RO[35]ERVATIO1V�I®�, � LOG Depth from Soil HorizonHole # Surface(in.) Soil Texture Sdil Color Soil (USDA). (Munsell) MottlingOther (Structure,Stones;Boulders Con istenc % ravel JIS --------- DEEP OBSERVATION HOLE LOG Depth from Soil Horizon Hole# Surface(in.) Soil Texture Soil Color (USDA) Soil Other (Munsell) Mottling (Structure,Stones, Boulders. CQns!sLEncy %Qraveh DEEP OBSERVATION ROLE LOG Surface from Soil Horizon II®]a?# Surface(in.) Soil Texture Soil Color (USDA) Soil Other (Muos�ll) Mottling (Structure,Stones,Boulders. Co siste c 0 vel Depth from DEEP OBSERVATION HOLE LOG; Soil Horizon Hole# Surface(in.) Soil Texture Soil Color Soil (USDA) (Munsell) Mgttlln Other g (Structure,Stones;Boulders, Consi ten c a I Il-�'Voodl Insurance Rate my p. Above 500 year flood boundary No yes Within 500 year boundary No Yes Within 100 year flood boundary No� YesT � Dppt➢>I Of N11turalllp OceUrr➢ne Per Materig➢ Does at least four feet of naturally' pervious material exist in all areas observed throughout the area proposed for the soil absorption system }� If not, what is the depth of naturally occurring pervious matorial7 _ C'e>rt>t�ca�ion // - li certify, that on, C_ �"� (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 oegitired training, expertise and exper" nce described in CIO CMR 15.017. Signature \.6 Q,\SR?TICIPERCF'ORM.DOC i EXCERPT FROM BOH JULY 8, 2008 MEETING: I. Hearing — Housing: Sheila McNamara, owner— 294 Tobey Way, Hyannis, removal of one bedroom and upgrade the septic system. Annellen and Sheila McNamara presented their situation. They purchased the house in 2001. The house is occasionally rented out in the summer for 4-8 weeks during July —Aug. Last year the rental program approved the house (with 4 bedrooms) and the owners were unaware of any problem existing. This year it was identified that it is a three bedroom. They would like to keep the three bedrooms upstairs and not change any walls/doors. However, their handicap mother is interested in visiting and staying in the downstairs (dining room.) When she is there, they would like to not use one of the bedrooms upstairs to accommodate her downstairs. The options given are: to open up the dining room dooNay to 5 feet (i.e. French doors), to open up a wall or doorway upstairs,jor,�6 request a variance ,�:�— o for a septic tank to remain 1000 gallons and increase tl a leaching field to , accommodate the fourth bedroom. Annellen McNamara expressed interest in getting quotes to see if they can increase the septic system which may only �g� require one more infiltrator to the leaching system at this time. Upon a motion by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to Continue until November 18, 2008 Board meeting. (Unanimously voted in favor). An. q�V QAMINUTES\EXCERPT OF MINUTES\Excerpt BOH Jul 2008 294 Tobey Way.doc 11/av r' e_ 7] oG� 10 October 6, 2009 Barnstable Health Dept Attn: Sandra 200 Main Street Hyannis, MA 02601 FAX: 508-790-6304 Re:294 Tobey Way, West Hyannisport,MA Dear Sandra: As a follow up to our recent conversation, I'd like to formally request an extension for our hearing scheduled on 10/13/09 regarding 294 Tobey Way, West Hyannisport, MA. My sister and I are researching the options available to us and obtaining bids from various vendors. It would be greatly appreciated if you and the Board would consider changing the hearing date to March, 2010. If we are able to gather information sooner and make a final _ decision,we will provide you an update to discuss next steps. Just let me know if you have any questions, or if you need any additional information. Thank ou, eila McNamara 617-460-3106 cell 508-790-7114 home PO Box 764 West Hyannisport MA 02672 Annellen McNamara 781-899-5143 home 25 Linden Park Drive Waltham, MA 02454 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) M A� D� -2 , 4 dOE "51.PIT! Prom- �, �� � T-503 F.002/002 F-437 # � C�;Y\ / Ek-01 � ^JCLNovember 17, 2008 �Y - ock :# Town of Barnstable k Board of Health 4 J� •.Via.ii'a Street Hyannis, iv1A 02601 Rea IWeNamarEa Housing Hearing—.294 Tobey Way, West Hyannisport i r ji-,Wr Board of On July S, I an-tended the Board of Health Hearing.regarding .k Way Nest Hyarnisport to discuss the rmrmvalof one bedro q� k 41 systems. Tile hearing was very informative in providing my arid me thie alternatives available to us to abate the housing i mer.awar€of upon rentingour property this past sum r. s Ne woui d 1+ice to respectfully request a continuance of the h F F to allow tir_e to evaluate the various options obtain fee pro j lover,i nt sponsored programs to assist in the upgrade oft �qi obtainit this information, we will make a d€cision to ensur 4 g rtquiYed date. n, % �(�v/Y-- sueEZJr Z4 4 l'na.�a �t-inellen McNamara 94 T'o bey V1V ay* West l~iyan ispert, MA ?1€awe no e that any correspondence cari by sent to Sheila McNamara,at the follo,�7ir�; .address, sine€di.ere is no rnail.dtlivery to th.e T'obey Way address. Sheila 1-0_ 8ox 764 West 14-vrannisport, MA 02672 ,'- r Town of Barnstable—Public Health Division July 8, 2008 Hearing Property Address: 294 Tobey Way, West Hyannisport Cited Violation: 310 CMR 15.303—System Failing to Protect Public Health and Safety and the Environment Background. Owners: Sheila McNamara, 294 Tobey Way West Hyannisport (primary residence) Annellen McNamara, 25 Linden Park Drive, Waltham, MA(secondary residence) Occupant: Ann McNamara, 25 Linden Park Drive(secondary residence) Handicapped mother to Sheila and Annellen McNamara Usage: Sheila McNamara—approximately 10 months of year, September thru June Annellen McNamara—occasional weekends during September thru June and one week during June Ann McNamara—approximately%2 time 10 months of year, September thru June Rental Usage—July and August—6 to 8 weeks The structure hasn't changed since it was purchased in 2001. House: No intentional or purposefully operation of house as a 4 Bedroom in violation of housing/septic codes • Purchased in 2001 by Sheila and Annellen McNamara • Appraised as a 4 Bedroom house in 2001 i • Ttile 5 Official Inspection Form, 8/9/2001 -identified as a 4 Bedroom House • No structural changes made to property since occupancy > • Assessors Records—3 Bedroom House • Septic System Design—3 Bedroom House Condition of House: • Impeccable,maintained inside and out with well maintained landscaping. • Built in 1996 • No other housing violations identified. Septic Condition of Septic • 1,000 gallon septic tank, 5 infiltrations, 39 feet x 11 feet • Inspected in 2001 with purchase of property • Pumped in 2001 upon conveyance of the property, identified in good working condition 0 Pumped 4/10/06 by Bortolotti, system identified in good condition Review of Septic vs. 310 CMR 15.303 • Location, design, and type of septic tank meet code. • No backup of sewage due to overload. • No visible discharge on property. • No static liquid visible. • System is not being pumped more than 4 times per year • The tank is not more than 20 years old • System is being pumped as needed. • System is not being burdened by garbage disposal Requested Relief by Owners from Housing Violation: • 1st floor room with a door near bathroom is being used as a bedroom (no closet in room). The bedroom is occupied by our handicapped mother. Due to our mother's handicap condition, we respectfully request that this room have a bed, so our mother can enjoy the use of the property. • We are willing to take two twin beds out of an upstairs bedroom and convert use to a non-bedroom use. We request that no structurally changes be made to the door openings to increase to 5 feet due to difficulty of doing this given the design of the house--not sufficient space given hallway/stairs and attachment to other rooms. • The house was originally built with doors on the 3 bedrooms upstairs and a door on the 1st floor room near the 1st floor bathroom. We would like to return the property to how it was set-up prior to our purchase in 2001 without any structural modification. • As discussed above, the septic system is in good working order and given the current and proposed usage of the property the septic system will not be overburdened and impose a health threat to the community. r I } z { - j+�ppraiS81 S�NtceS"`Irtc' -t � { y File No.01090079 I E APPRAISAL OF i i i LOCATED AT: 294 Tobey Way Hyannis, MA 02601 FOR: I Mortgage Partners i i i I BORROWER: A. McNamara& S. McNamara AS OF: September 7, 2001 r . ,���' }.,,,�, ���.• �, ��s �, ,- rig .' '?� ,-'` 6k`10628 P 228 Bamatabte ,,- ' qr; s'JParcel No`247 250 air Barrower.A.MCNamara'B-0-RA. amara - :'C entpwnec Claudia�lotalew �' oca+ ant .ir owner ranant " Vacant X Fee S' le " Leasehold act T PUO `"� CondwNnlum HUO/VA on MOAS' ° O /Wb' ., Pro rights appraise Ma Reference"12 N Cornelis Trail 25 001 O 127 Nei hborhood or Pro'ect Name Washin ton Farms Sale Price$ 285,000 Date of Sale PendingDescriAddrption BelmontunMA 02476 eslconcesswns to be b seYer None Known Lender/Client Mort lage Partners Appraiser Francis W. Fowler Address Grasso A raisal Services Burlin ton, MA 01803 Uryan X Suburban Rural Predominant Single family housing Present land use% Land use change Likely Location occupancy PRICE AGE One family 80% ❑x Not likely ❑ y Built up 0 Over 75% 25-75% ❑ Under 25% $(000) (rra) In process Growth rate ❑ Rapid 0 Stable ❑ Slow 0 Owner 95 175 Low New 2 4 family ❑ Tenant-5 700 High 150 Multifamily To: Property values � Increasing ❑ Stable ❑ Declining ❑ predominant Commercial 10% Demand/supply ❑ Shortage 0 In balance ❑ OversW* Vatant(05%) Marketing time Under 3 mos. X 3.6 mos. Over 6 mos. vacant over 5% 300 40 kVacant 1 10% Note:Race and the racial composition of the neighborhood are not appraisal factors. Neighborhood boundaries and characteristics: See addenda. Factors that affect the marketability of the properties in the neighborhood(proximity to employment and amenities,employment stability,appeal to market,etc.): of the sub'ect to shopping amenities of all t es, downtown em to ment markets, and recreational amenities. The The roximi sub'ects location within a short distance of Centerville center and within a hale mile to Crai villa Beach, and H apple ort Golf Club. Market conditions in the subject neighborhood(including support for the above conclusions related to the trend of property values,demand/supply,and marketing time --such as data on competitive properties for sale in the neighborhood,description of the prevalence of sales and financing concessions, etc.): The overall market conditions within the area are considered to be very good with stable to appreciating values. Demand is good with certain market se ments dis la ing an undersupply of listings. Marketing times are resently in the 1 to 3 month ran a with some to erties selling within 1 month of listing. Sales concessions, interest bu downs and otherspecial financing considerations are not typical in the market. Consistently low interest rates,the ready availabilit of financing, a continuing strong regional economy and record low Line m to ment rates continue to drive the current strong market conditions. YES NO • Project Information for PUDs(if applicable)--Is the developer/builder in control of the Home Owners'Association(HOA)? Approximate total number of units in the subject project Approximate total number of units for sale in the subject project Describe common elements and recreational facilities: N/A Topography Level/Rolling Dimensions not available Above Average Corner Lot Site area 71 Acres x Yes No Size Irregular Specific zoning classification and description Residential R 40 Minimum lot size 1 Acre shape Appears adequate Zoning compliance ❑ Legal 0 Legal nonoonfo!"Ming(Grandfathared use) LJ Illegal No zoning Drainage Avverage/Ng brhd View Hi hest 8 best use as improved: X Present usen Other use(explain) public Private Landscaping Additional Utilities Public Other Stretoff-site ImPAsphaltts Type Q ❑ Driveway Surface Stone Electricity Q ❑ Apparent easements None a arent Gas ❑x Ctublgutter Dirt/Grass ❑ X No Sidewalk None FEMA Special Flood Hazard Area Yes Water x FEMA Zone C Map Date 07/02/1992 Sanitary sewer ❑ Private Street lights Overhead ❑ ❑ FEMA Ma No. 250001 0008 D Storm sewer x Alle None Comments(apparent adverse easements,encroachments,special assessments,slide areas,illegal or legal nonconforming zoning,use,etc.): There were no a agent adverse easements,s ecial assessments,or encroachments noted at the inspection. See attached addendum regarding zoning... FOUNDATION BASEMENT INSULATION GENERAL DESCRIPTION EXTERIOR DESCRIPTION 1 Foundation Concrete Slab N/A Area Sq.Ft. 1096 Roof No.of Units N/A %Finished 0 Ceiling eY s_E No.of Stories 1.75 Exterior Walls Cl haltbd/S n le Ba.emene Joists Walls yes _E Type(Det./Att.) Detached Roof Surface As halt Basement Full Ceiling Concrete Floor yes _ C Design(Style) Cape Gutters 8 Dwnspts. Aluminium Sump Pump None Walls Concrete None Existinglproposed ExistingWindow Type Dble Hun Dampness None noted Floor r 5 Stom1/Screens Thermo/Yes Settlement None noted Age(Yrs.) Outside Entry Yes )— AgEffe tive(Yrs.) a rs. 2 Manufactured House No Infestation None no Bulkhead Area S .FI ROOMS Fo er Livin Dining Kitchen Den Fami Rm. Rec.Rm. Bedrooms #Baths Lau1 Other1.0 Basement 1 1 F 1,0 Level 1 1 1 1 1 3 1 F 8 • Level • 4 Bedroom s 2F Baths 1,946 S are Feet of Gross LivingAt Finished area above grade contains: 7 Rooms' CAR STORAGE: ' KITCHEN EQUIP. ATTIC AMENITIES INTERIOR Materials/Condition HEATING © None x None FHA Refrigerator ❑ Fireplace(s)#1 ❑ Floors HdWd/C U Good Type g Garage x #of c Walls Plaster/Good Fuel Gas Range/Oven Q Stairs ElPatio Drop Stair ❑ pew Wood El Attached 1 TrimlFinlsh Wood/Good ConditionAv Disposal ❑ P . Detached Vinyl/Good UGood CO Built In COOLING Dishwasher 0 Scuttle Porch Open --- ❑ Bath Floor n Flnor �] Fence 0 . G ATE : V9/01 PROPERTY A O O R E S S 2 9 4 Tobey Way---------- Hyannis,Mass. ------------------------ on Iho aboyo dole, I Inapootod the oeptlo sylte*M at the aboyo address. Thli ayslom conalala of the following; 1 . 1 -1 000 gallon septic tank. RECIF1 f:.. 2 . 1 -Distribution box. ,S- Infiltrators. i j CUU1 eased on my Inipectlon, I oerllly the Iollowlnp oondlil nv, 4 . This is a title five septic system. TOWN OFBAttwZ>iiruLr. 5: The septic system is in proper working order HEALTHDEPT. at the present time. 6. Pumped the septic tank at time of inspection. Please note;Inlet cover of the tank is under the deck. A hatch way should be installed for service access. SIQNATURL7, 4�- Name : _� ,L )�jsQaktr-jj.,_w---- Company, Joy •.ph_P _ N•cotab•r_b Son , Inc , A d d r e a a ;_ Box_ 66 --_-------- . __CencsrYille � Ne ,-026�1-0066 Phone:--- S08 775- 7338 - - _w w w w w wr TM15 CERTIFICATION OOE$ NOT COHSTITVTe A OVARANTY OR WARRANTY y JOSEPH P. MAC0MBER & SON, INC, T+nk�.0i��poolll,�+chll�ldt' Pvmpid , Init+llid Town 3#wtr Cvnn#vtlont P<0. Box 66 ContirYlll+, MA Q2632-0066 77$-)))0 776,6(12 A' I I -\ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 294 Tobey Way yannis, ass. Owner's Name:Claudia Dio tevi Owner's Address: Same Date of Inspection: 8/9/01 Name of Inspector: (please print) Joseph P.Macomber Jr. Company Name: J.P.Macom er & Son Inc. Mailing Address: ox 66 Centerville,Mass.02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT I certify that 1 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 Section15.340 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: 4ELD The system inspector sha ubmit 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. Title 5 Inspection Form 6/15/2000 page 1 Net 2 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 294 Tobey Way Hyarints,mass. Owner: Claudia Dioltevi Date of lospcctioo: Inspection Summary: Check A,B,C,D or E/ALWAY complete all of Sectlon D System Passes: I have not fou�anynformation hich indicates that any of the failure criteria described in 310 CMR 15.30 or in exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order _at._the present time. B. System Conditionally Passes: 4A One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y,N,ND) in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old' or the septic tanJc(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing taak is replaced with a complying septic tank as approved by the Board of Health. •A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced _ obstruction is removed ND explain: 2 Page 4 of I I f OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 294 Tobey Way ` Hyannis,Mass. Owner:Claudia Dioltevi Date of Inspection: 8/9 01 D. System Failure Criteria applicable to all systems: `' You must indicate"yes"or"no"to each of the following for a1inspectiohs: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ischarge 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 bo above outlet invert due to an overloaded or clogged SAS or cesspool gw�e) Mr,4er,S ijft #t . /Liquid depth inrG466PQ is less than 6"below invert or available volume is less than 54 day flow t/ Required pumping more than 4 times in the last year NQT due to clogged or obstructed pipe(s). Number — �of times pumped :!�ty portion of the SAS, cesspool orlprivy is below high ground water elevation. y portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface — � water supply. Ay portion of a cesspool or privy is within a Zone I of a public well. -ny portion of a cesspool or privy is within 50 feet of a private water supply well. y 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 collform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to,this form.( (Yes/No)The system fails. I have determined that one or more of 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. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes now (/ the system is within 400 feet of a surface drinking water supply /th system is within 200 feet of a tributary to a surface drinking water supply e system is located in a nitrogen sensitive area Interim Wellhead Protection Area— IWPA or a mapped — — y g �_ ) PPe Zone 11 of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner 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: 294 Tobey Way yannis, ass. Owner: Claudia Dioitevi Date of Inspection: MTOT Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No /Were Pumping information was provided by the owner, occupant,or Board of Health 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 ? 4/ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) 4Z_ 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,4cluding the SAS, located on site? Tthe Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition fles 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: Yes no i 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)] 5 I Page 6 of 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 294 Tobey Way R—y-a-Tinis,mass. Owner: Claudia Dioltevi Cr Date of Inspection: 8 9 01 FLOW CONDITIONS RESIDENTIAL -7 , Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 C 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no): ++" Is laundry on a separate sewage system es or no): [if yes separate inspection required] Laundry system inspected(yes or no): f� Seasonal use: (yes or no):A,2 Water meter readings, if available(last 2 years usage(gpd)): QQ -•-,� Sump pump(yes or no):� JIDd! Last date of occupancy: �nwp�� s COMMERCIAL/INDUSTRIAL Type of establishment:_ 4 Design flow(based on 310 CMR 15.203): #JA gpd Basis of design flow(seats/persons/sgft,etc.): gM Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: AM OTHER(describe): A/A GENERAL INFORMATION Pumping Records Source of information: 7 A MIA Was system pumped as part of the inspection(yes or no): M If yes, volume pumped:Z"� Ions--How as aqua ity pupped determined? Reason for pumping: NJ JC,tt 6V -F :jpSeptIc OSYSTEM tank,distribution box, soil absorption system Single cesspool Overflow cesspool Privy d1 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) f Tight tank C?6_Attach a copy of the DEP approval /A Other(describe): App oximate age of Il comp vents,date installed (if known)and source of information: perp Were sewage odors detected when arriving at the site(yes or no):(b 6 Page 7 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: ,294 Tobev Road Hyannis,Mass. Owner cla udi a Dioltevi Date of Inspection; R/9Jt71 BUILDING SEWER(locate on site plan) Depth below grade: 40 Materials of construction:&ticast von 240 PVCA1f other(explain): Af V Distance from private water supply well or suction line: ld Comments(on condition of joints, venting, evidence of leakage,etc.): Joints appear tight No evidence of leakage System is vented throug the house vent. SEPTIC TANK; (locate on site plan) l���C� S Depth below grade: �� Material of construction:_concretemetal{lQfiberglass,/{�polyethylene P—other(explain) ,tr//f If tank is metal list age: Is age confu7ned by a Certificate of Compliance(yes or no):We (attach a copy of certificate) Dimensions: Sludge depth: 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: O Distance from bosom of scum to bortplm of outlet tee or baffle: How were dimensions determined: 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.): , Pump septic tank every 2-3 years.Outlet tee is in place. Could not get to the inlet cover. It is under the deck.' Hatchway- should be made for acess.The tank is structurally sound and shows no evidence oUeakage.Pumped tank at time of inspection. GREASE TRAP locate on site plan7? Depth below grade: Material of construction: concrete / metaLtAfiberglass I/L9polyethylen5i other (explain): AIX Dimensions: w Scum thickness:T , 4 Distance from top of scum to top of outlet tee or baffle: 4)4 Distance from bottom of scum to bottom of outlet tee or baffle:_ Date of last pumping: 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 is not present 7 I Page 8 of I I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:294 Tobey Way Hyannis,Mass, Owner: rialiaia Di of tPvi Date of Inspection: R.1 A.1 n 1 TIGHT or HOLDING TAN}C,trAf—, (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: ZO Material of construction:Vconcrete metalfiberglass el Polyethylene Z/4 other(explain): .4L9 Dimensions: Capacity: gallons Design Flow: jW gallons/day Alarm present(yel or no): Alarm level: Alarm in working order(yes or no):/fH Date of last pumping: Comments(condition of alarm and float switches, etc.): Tight or holding tanks are not present DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 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.): Distribution box has one lateral.No evidence of solids carry over / . No evidence of leakage into or out of the box PUMP CHAMBEPA419e(locate on site plan) Pumps in working order(yes or no): /� Alarms in working order(yes or no):_VI Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is—not present 8 i Page 9 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 294 Tobey Way Hyannis,Mass. Owner:Claudia Dioltevi Date of Inspection: 8 9 01 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) S—infiltratnrs in sPriaG_ If SAS not located explain why: Located. Type aching pits,number:_ aching chambers,number:� il��'191�J leaching galleries,number: 0 leaching trenches,number, length: D AIV leaching fields,number,dimensions: overflow cesspool,number: I�L 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.): Loamy sand to medium sand No signs of hydraulic failure or pondina Soils are dry.V c{etation is normal- CESSPOOL-St (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: W Depth of solids layer: AN Depth of scum layer: Ali Dimensions of cesspool: AA Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): Cesspools are not present_ PR IVYZjjr,(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.): Privy is not present. 9 • Page 10 of I I OFFICIAL. INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) PropcM Address: 294 Tobey Way yannis, ass. OwoerClaudia Dioltevi Date of Inspection: 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. . k pc, 10 r Page 1 I of 1 1 OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address'. 294 Tobey Way Hyannis,Mass. Owner: Claudia Dioltevi Date of Inspection: 8/9/01 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: Ob�Iocal desi Tans on record-If checked,date of design plan reviewed: 1 butting pro a bservation hole within 150 feet f SAS) ecked with Board of Health-ex plain:(�166Tl� � /�$ Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Used water contours map. Gahrety & Miller Model 12/16/94 I 11 `i•'T.R T�n T�'.TT{T.—JT'Plfn IITIT i'Trft'l+7ft•.1eT T�If/1R*t'lIA1 Tt�TAL/1f1R�1t 1T .TTTT�4!!Tr—..�•.r...' TOWN OF Barnstable (10ARD OF HEALTH SUIISURFACF SEHAOF DISPOSAL SYSTEM INSPECTION FORM - PART D '- CERTIFICATION •••T'1�T•'.•'.:.—T.III.�.T.TTTT111',ItRI TII►J'fnfTr'1T1•r�•i r'I{RRT\RR�►—T�►Rr1�1RR� ewn ..+rrrr--. —..� -TYPE CA PRIHT CLEARLY- PROPERTY INSPECTED STREET ADDRES$ 294 Tobey Road Hyannis,Mass. ASSESSORS MAP, BLOCK AND PARCEL OWNER' s NAME Claudia Dioltevi PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr.. COMPANY NAME Joseph P. . Macomber y ion Inc COMPANY ADDRESS Box 66 Centerville Ma 02632 Street Town or City State E I P COMPANY TELEPHONE (508 ) 775 3338 FAX ( 5087) 790- 1 578 w w CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and omplete as of the time of .-inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Cone . 2/system: PASSED The inspection tihich I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 16 . 303 , Any failure criteria not evaluated are as stated* in the FAILURE CRITERIA section of this form , I \\_' System FAILED* The inspection which I have con cted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 3.10 CMR 15 , 303 , and 'as specifically noted on PART C - FAILURE CRITERIA of this inspection fo m . r Inspector Signature Date FD� Dne copy of this ce .ification must be provided to the OWNER, the BUYER Where applicable ) and the BOARD OF HEALTJI, ""If the inspection FAILED, the owner oroperator shall u* p p pgrade ' the system within one year oC the date of the inspection, unless allowed or required otherwise as provided in 3.10 CMR 16 . 306 . partd .doc TOWN OF BARNSTABLE LOCATION / e 1 SEWAGE# _%`yil� VILLAGE ram,4 i a ASSESSOR'S MAP& ,4;0_—� INSTALLER'S NAME&PHONE NO. CA'uA COW, SEPTIC TANK CAPACITY food' LEACHING FACILITY: (type 22!�=t(�±g—/G 'e.S (size) -19A-11 © NO.OF BEDROOMS B�OR OWNER 1X00 l N b C192: PERMITDATE: 43.' COMPLIANCE DATE: k Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leachinffacility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet,of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by K:��1�14 4 104 ly,4 -� �' �� � , � ��� r , � �:� �� = , 1 � \ / � 1 . l �. _ }n - � 1 F a. ,C. a SEWAGE M VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS / BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any weUs exist on site or within 200 fect of leaching facility) Feet Edge of Wetland and Leac .ng Facility(If y w Hands exist within 300 feet o le n rliry) Feet Furnished by .•c .,. w _ 4 V � � � Y' / � , �1 / �� \ �o � � � `� �\ _ 5, , �.� � ��\ 4 t; i� � _ ' ��� i; No. '�F a� Fee e3- THE COMMONWEALTH OF MASSACHUSETTS 11 PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Mfi5po.5al *p$tem Con!6trurtion Permit Application is hereby made for a Permit to Construct(jo)or Repair( )an On-site Sewage Disposal System at: Location dres oft oAdd, st,6yq . wn� / Tel.NfPA'/J, Install e, re and Tel.No. �% Designer's Name,Address and Tel.No. ffe�ww �Q 923 AOW7�- 4.4, Saes 36 Z g e 32 Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder V-10) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 1313-V gallons. Plan Date 8 Number of sheets Revision Date Title &'77 ZZ-f D e'S AG.y Ao't Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue. t Board of Health. .q,r 6i Signed Date Application Approved by ' Application Disapproved for e following reasons Permit No. 91 —�� Date Issued VFee ° C� THE COMMONWEALTH OF MASSACHUSETTS a y f r PUBLIC HEALTH'DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Application for igool *pgtem Construction Vermit Application is hereby made for a Permit t,-Construct�)or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. ,�-9 //' Own rr e,Addr s d Tel.Ng''',# LQT /2 -7 06 tr" l d A-'r' ,n p�' !�• H�rfw�v�SPon-T �!A . I/C� V L-� A"I 'k/ n Instal e, d and Tel.No. � - Designer's Name,Address and Tel.No. A)6Gr � �fil� �. Sae 3 G z 8/3 Z Type of Building: Dwelling No.of Bedrooms Garbage Grinder$jo) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 'Jh gallons per day. Calculated daily flow 3 y gallons. Plan Date S23 S(. Number of sheets Revision Date 7 &, vTitle 5& / A.,AS4 . ePcn, 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 Certifi- cate of Compliance has been iss�bBoardf Health.Signedµ Date � � Application,Approved by t. Application Disapproved for'We followmg reasons i a Permit No. �// - � Date Issued t1 ----_--=_ --_—_----- __=________-_—_-_______--i---_ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance - THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( r repaire'&replaced( )on, by for X99 as ov..ra ® constr cted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.. '1 dated Use of this system is conditioned on compliance with the provisions set forth below: No. •. Fee as THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS . i9; 0$a1ip5tem Con5tructionerrrYit Permission is hereby granted to �' d4 to construct( ��repair( )an On-site Sewage System located and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within two years of the date below. Date: i Approved W��e-,.w 101, , , , , : , < i „ ACCESS COVERS BE WI THIN ilk I N VER T EL E VA T I ONS . DES I GN CR I TER I A GENERAL NO TES 2B.O !2" OF FINISH GRADE FIRST 2 TO INVERT AT BUILDING. . 40 __ DESIGN FLOW: 1. THIS PLAN IS FOR THE DESIGN AND BE LEVEL I O .._ . _ �; INVERT 1N SEPTIC TANK: � 23. 6 BEDROOMS 'AT_ 1 G. P. D. PER ...' >. ` CONSTRUCTION OF THE SEWAGE DISPOSAL MIN": 2- OF 330 • PVC 23 35 BEDROOM ___�G. P, D. SYSTEM ONLY. _ �!� ' INVERT TANK" S 0 PEASTONE SCHEDULE o ,1 - i INVERT IN DIST. BOX: � �23. 17 _ _ 5 NO - GARBAGE GRINDER 2. ALL CONSTRUCTION METHODS AND MATERIALS 3 3/4- _ ! l/2' DIA. INVERT OUT D1 ST. BOX: 23. 0 -- AND MA I NTENANCE-OF THE SEPTIC 5YS TEM 5 INFILTRATORS I L TRATORS W/4 STONE WASHED STONE O MASS. D.E.P. TITLE 5 - �_ OUTLET AROUND. 39 X 1! _OVERALL INVERT I N LEACH CHAMBER: 22. 92 SHALL CONFORM T �.' SEPTIC TANK REQUIRED: AND LOCAL BOARD OF HEALTH REGULATIONS, 1O' 'MIN. c 1000 GAL D-BOX _r- _ 1 N L Is. BOT TOM OF LEACH CHAMBER: 22. 0 30 G. P.D. X 150x - 495 " GAL . - 5£P T I C TANK / ADJUSTED GROUND WA TER: 14. 9 3. ALL SEPTIC SYSTEM COMPONENTS LOCATED / /� , � _ - -- SEPTIC TANK PROVIDED:»_IOoO GAL . - UNDER AREAS SUBJECT TO VEHICULAR TRAFFIC PROFILE : NOT TO SCALE i / OBSERVED, GROUND WATER 10. 5 OR GREATER THAN 3' 'IN DEPTH SHALL BE CAPABLE OF WITHSTANDING N 20 WHEEL LOADS. BOTTOM OF TEST HOLE l : 9. 5 SIZE OF LEACHING FAC/L1 TY REQUIRED (AA) : i INDEX WELL . M 1 W 29. ZONE C DESIGN PER C RATE C 6 MIN/1 NCH 4. ALL SEWER PIPE SHALL BE SCHEDULE 40 / / I �� ,. 330 GPD / 0. 75 - 440 S.F. ` 1s.2 H / /// 4/95 READING 9. O. 4: 4 ADJUSTMENT OR APPROVED EdUAt. `� / /' m.�. PROVIDED: 5 1 NF I L TRA TORS W/4 STONE 5. BEFORE CONSTRUCTION CALL 'DIG-SAFE". / .- , / / .-� '• i / / I �" 39 -h I I OVERALL 1-800-322-4644 AND THE LOCAL WATER DEPT. _FOR LOCATION OF UNDERGROUND UTILITIES. `. 14.s i , '( r r ' ! I AA-Y39+ 1 1 XI I 1 + 1 ) -48Q. S.F. . r 6, VERTICAL DATUM IS: ASSUMED / 24.5 ,+•25.7 �. R�57.50 7. FOR BENCH MARKS SET. SEE SITE PLAN. ,-�� \I \\ , 1 ! // i ' --- /3.9 / 8. NO DETERMINATION HAS BEEN MADE AS TO F ! \ i \ 25.1 / ��- r - ---- ____- 25 39� S OIL T�S T PIT DATA ' COMPL/ANCE. WITH DEED RESTRICTIONS. OR I _ 4` INDICATES INDICATES ZONING REGULATIONS. IT SHALL REMAIN /' ,I \ "o \ \� -F2g0 ��_ PERCOLATION - OBSERVED �` _ TEST �' GRdUNOWATER THE CLIENTS RESPONSIBILITY TO OBTAIN I 1 \ �� P-e 9 ALL PERMITS. SPECIAL PERMITS. VARIANCES / / 1 \ �\ "Z5.3 4 2 ETC. FOR THIS PROJECT. / /✓ I `, �\ `� '?,,�28.i3 TP+►_1 TP# 2 / - / \ GRND EL 19.5 GRND EL. 24. 1 ,+25.2 9. I T`SHALL REMAIN THE CLIENT'S RESPONSIBILITY 2s.ss 1\ G.W.EL. » IO.S G.W.EL. NIA To HAVE THEPROPOSED BUILDING FOUNDATION / // / �� \ \ \ 0•, 0• , M' 24. 1 DESIGNED TO ACCOUNT FOR THE EXISTING' GRADE / G i \ \ \ \ `"� \ TOPSOIL AND SOIL CONDITION'S AT THE LOCATION,OF THE V' z{" r9.4 \\24.2 +n 14.4o i 13.4 /\ i) c+ > 24. �/" \\ 25.b0 1 4 SUBSOIL PROPOSED BUILDING. ear E �� b / 17.2+ /. ,, t \ ;, l 23. 1 i 7 ,'5 �rr E FILL 0&�1 l 10. THIS SEPTIC SYSTEM DESIGNED IN ACCORDANCE • 'L' r� _� ' = �- --► �! �cATct► eAs N l3.® I � -� ,� � , � j WITH 310 CUR;15:005 (5). THE SURD/VI SION WAS Ear D / }� ti/ !' carol BASIN 1 > ENDORSED BY THE PLANNING BOARD ON AUGUST F. 1994. // �� �� �•� /� 2s.e`� ► 1 5.5' 14.0 2k.42 .� MEDI UM I1. UNSUITABLE MATERIAL (TOPSOIL. SUBSOIL i s.ls I �i ' / L� tit FINE SAND FILL ETC. ) ENCOUNTERED BELOW THE INVERT / / z4.4e MEDIUM OF THE 'LEACH CHAMBER TO BE REMOVED FOR A / / / �� - �� N� , '° K �i FINE SAND DISTANCE OF l 0 AROUND THE CHAMBER DOWN TO 13.2 c L O T 12 THE CLEAN. SAND LAYER AND REPLACED WITH / � i u D i' \ I / 30. 889- S.F g CLEAN MEDI M $AN 1 , / l 10.5 � r No WATER 22.2� !0' 9.3 13' - 11. l DATE:` APRIL 18. 1995 . '2 ' / �� ` � STEPHEN HAAS /� _'--�" TEST BY. ED BARRY i I a WITNESSED BY: 24.I // g�Q +29.5 � 2 PER RATE:-- MINi`1NCH 22.1 per, / � • 1 \ z I F I TP 1 19/}i I L j I ,�, / LOT / 2 TOBEr' WA `/ 1 `► I loon en z I / / `,y�1•' /'i W H YA /V/V / 5.P OR T SEPTIC!TANK +29.6 PRE A-BOX / SWAGE ° \ / • W O C / xr ORP .. G.4 C E 2 G7 A (JG U S T 23 . / 9:9 e t> r ,,.. -. r. _,� �. .:, o / i .• .. : / h .�'14 G'L�" _ ,S'TJ'.�' I�'.EYl NG` Bi VG .I1lT.�E.�'R .I.NG' . I NG . ' I / / s IMF ee lt rR ro s .: �•,•- z� a.- ...n• _ / / ., , ari4 STONE RouNa , / � a .3 " I 1 / ♦ f ,. . 129Ot _ N eB _ 55 24 W 0, O 20 4 O 1` V /PDR CALC AN/CFW ' CHECK CF D N. SAH ,FIELD: B W R , ...... ......._--.---.. ALL SYSTEM S SHALL SYSTEM PROFILE MARKED WITH CMAGNETIC TTAPE OR BE NOTES PROVIDE MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS ASSUMED n 0 2" eR �\ ACCESS COVERS TO WITHIN 6" OF FIN. GRADE PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE '' p�AJ TOP FOUND. EL. 26.91' FILTER FABRIC OVER STONE 2. MUNICIPAL WATER IS EXISTING O\a \ 2% SLOPE REQUIRED OVER SYSTEM 25.0' 3. MINItaUM PIPE PITCH TO BE 1/8" PER FOOT. MINIMUM J5' OF COVER OVER PRECAST 4. DESIGN LOADING FOR ALL PROPOSED PRECAST PRECAST H-10 O o� RISERS (TYP.) PRECAST RISERS UNITS TO BE AASHO H-19 a a 2'0 4"OSCH40 PVC MORTAR ALL H-10 0 0 PIPES LEVEL 1ST 2' COMPONENTS 5. PIPE JOINTS TO BE MADE WATERTIGHT. 4 (TYP.) L. 22.5 ENDS ri SIDES 23.3' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE TObey " EXISTING 14" ro ro ds°�`. °'. %°B;jo '°o^o°2^ l0 ° ° ° ° o o°o$g' °°o°o°°° WITH 310 CMR 15.000 (TITLE 5.) L Cu 1000 GAL H-10 00 � � 000 � ° ° � 000 0000 > o o 0 o ky. TEE 23.2' 1 ���� O a�Cl� o0 0 0 �oaa 4 —D��O o o ° o SEPTIC TANK TEE # °°O°O°O° OO � pO � pO � C o 0 0 � OOOOOOO � OO ' o 0 0 o Ville Be° h 6" MIN. SUMP °°O°O°O° I�aMIJM�IJaac�a O p ��I��IJaaI�I��I� >o°o°o°o° croi *r °o°o°o°o°o°o O > o 0 0 0 00°0°o O O O O O 0 0 O O O '°°o°o°o° (RE—USE) o ° o 0 0 ° 12" MIN. TNT. DIM. ° ° ° ° a�oaaa000�o ooaoaao�aoa 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND GAS BAFFLE :' ° ° ° ° ° ° >°°°°o°o° Op°o°p �o°o°o°o° °°° °0°0°0°0 oaaooaaaa�� 000000 oaaoaoa�a�a :°0°0°0°0 22.8' 22.63 °0O°O° °O°O°°o° NOT TO BE USED FOR LOT LINE STAKING OR ANY 0 - 0 ° '•Oo°°o° °o°o°o°° 20.5 1 0 0 0 0 ' ° OTHER PURPOSE. Cb LH-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 3/4"-1-1/2" DOUBLE WASHED STONE (3) UNITS REQUIRED 9. COMPONENTS NOT TO BE BACKFILLED OR 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 40' X 10' CONCEALED WITHOUT INSPECTION BY BOARD OF COMPACTION. (15.221 [21) 5' HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. ( 1 % SLOPE) ( 1 % SLOPE) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LEACHING CALLING DIGSAFE (1-888-344-7233) AND FOUNDATION— EXIST. SEPTIC TANK 24' D' BOX 15' FACILITY 15.5' BOTTOM TH-1 & 2 VERIFYING THE LOCATION of ALL UNDERGROUND & LOCUS MAP NO GROUNDWATER FOUND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT WORK. NOT TO SCALE UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE 11. ANY UNSUITABLE MATERIAL ENCOUNTERED PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON H-10 SEPTIC TANK IF NOT SUITABLE. SHALL BE REMOVED 5' BENEATH AND AROUND THE ASSESSORS MAP 247 PARCEL 250 PROPOSED LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED AND FILLED WITH CLEAN LEGEND SAND. 99 — EXISTING CONTOUR / X 99 EXIST. SPOT ELEV. I 99 Ln SYSTEM DESIGN: PROPOSED CONTOUR [98•41 PROPOSED SPOT EL. TH1 / TOBEY WAY GARBAGE DISPOSER IS NOT ALLOWED TEST HOLE \ DESIGN FLOW: 4 BEDROOMS ® 110 GPD = 440 GPD 2% SLOPE OF. GROUND / !� USE A 440 GPD DESIGN FLOW C-0-D UTILITY POLE SEPTIC TANK: 440 GPD (2) = 880 FIRE HYDRANT � _. _ __.. - / _ _ � -RE-USE EXISTING SEPTIC TANK** NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING LEACHING: SIDES: 2 (40 + 10) 2 (.74) = 148 GPD TEST HOLE LOGS — _ — �P��/ BOTTOM 40 x 10 (.74) = 296 GPD / LOT 12 +. o� ENGINEER: ARNE H. OJALA, PE, SE / 30,889t SF PQQ�o o�P TOTAL: 600 S.F. 444 GPD ��' / USE 3 500 GAL. LEACHING CHAMBERS ACME ORE UAL WITNESS: DAVID STANTON, RS R> // � � ) ( EQUAL) o4/ �� WITH 2.25' STONE AT ENDS 5' BETWEEN UNITS AND 2.6' DATE: JANUARY 29, 2010 � �// �e AT SIDES MIN/INCH 2 PERC. RATE _ < CLASS I SOILS P# 12827j EXIST. a N DWELL. TOP FNDN ELEV. ELEV. \ N ELEV. 2s.s' MA C 26.0' 0" 26.0' 110 APPROVED DATE BOARD OF HEALTH h TITLE 5 SITE PLAN FILL FILL I / rs' O EXIST. ST OF w rn / p \/ / 24" 24.0' 28" 23.7' CV // �� N 294 TOBEY WAY 2 WEST HYANNISPORT 26 TH 1 _ PREPARED FOR _0 1� / ' \ BENCHCORNER OF BULKHEAD (ON WOOD) 00 1g2a ELEVAnoN = 2ss c c BORTOLOTTI CONSTRUCTION/ PERC I �1 i/ 25 27 McNAMARA 22 / N / MCS MCS I \ i �AN OF 2� to ©eIEL ;' JANUARY 29, 2010 2 �. . 1 OYR 7/4 1 OYR 7�4 129.01' FEN �'�� �� 0A �GN � +�q off 508-362-4541 l � �!`n oFniqS� �'VI downcape.com _: fax 508-362-9880 9 ° c� EXIST. LEACHING FACILITY. NOTE: APPROX. N0.46502 MOW/! cape engineering MC. 126" 15,5' 126" 15 5' I LOCATION ONLY (AS-BUILT TIES NOT K CLEAR) r � v �F G�STE civil engineers Scale: 1 = 20 ess`a A �� r NO`'GROUNDWATER ENCOUNTERED I< - - . land Surveyors 939 Main Street ( Rte 6A) ' 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P. P.L.S. YARMOUTHPORT MA 02675 > 0-003 10-003.DWG(SBO)