Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
1037 PITCHER'S WAY - Health
1037TPITCHER'S"WAY;HYANNI5� THE CAPE CODER PAINTER J N" OF BARNSTABLE --� L `7 LOCATION ® /v . SfQ SEWAGE#�1 l � � NULAGE !�l r Z/SMSOSVM� P&PARCEL INSTALLER S NAME&PHONE NO. SEPTIC TANK CAPACITY d d LEACHING FACILITY:(type) _5�)C 45e (size) IX' ° NO.OF BEDROOMS OWNER PERMIT DATE: � 3 COMPLIANCE DATE: LJ J 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 ac'i Feet FURNISHED BY ;I _ ,� �� ; . �� .� � . � 1 _ � � � _ � U � � � . � l 1 1 '� OWN.OF BANSTpiBLE LOC 'A'ION VfLL .GE n h s i4,SSFSSOWS W IN5T1LBti.'S N 8c��®tdE NO :'. c� x c: ► crrx �. sa LEACiIl+iG +�►CILTT NO OF'E13 .0�3NdS ---� ja OR O�lTJ1GIZ 1Et1BT0A'Tk? f": Sep►n4ptt In�anae Betvieerx t17a E Maxi tumlu�JustecJ Geoult water Tal is la�1�G i3�ttom o Leac.hln Fac;ilicy --—.�. Diva a taY r Supply U14a1 ut.Id t�eac iceg l�ttcriary es►y vrel9s exist j wt%ei�a ac uvith�n Qp feet;of tsastu�ip Cuc':_Py) ; Fctat::_cy9 JefJlae�c8 and Leachln$ir�ca iey(�f uny wellond�exist Tee ' wtl�ii�300 foot� a9iiig Sucila'ry �� .�'.'r � - � � r � � r c'' r W � _� i � � 1 ., � � � � � � ` � W � � U, � � w � �. -` �� ` �. � No. ): 'o I s`�/ Fee B THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitatton for Disposal 6pStem Construction permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Locatio"n�dress or Lot NrL / � r Owner's N e,YA�ddres and Assessor'sdr ce dg - Installer's e,A dress,and Tel.No. �lGl/1 I signer's Nam Addreg , d Tel.No. � Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) / gpd Design flow provided � .c. gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank ©U Type of S.A:,;� � Description of Soil 34 Nature of Repairs or Alterations(Answer when applicable) S� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. . Signed i e- Date Application Approved by 4A f Date 3— Application Disapproved by Date for the following reasons Permit No. 17 —2-- Date Issued__ 6P�- �,r .. �"'s-s»t�F:c""��"1.-*.�;'.r ;`".�.-�'"• �frl"..-t'.�e"+ �r t"�:?Y.�.�+�.r^a. �{���„i ny_.•.`....,�'2�Y�..y`,r.,.{nif"''r1 i� "'n'�° '4 . f, �• N>. �,� all No. Fee THE COMMONWEALTH bF MASSACHUSETTS Entered in-computer: Yes PUBLIC HEALTH DIVISION =TOWN OF\BARNSTABLE, MASSACHUSETTS �4plication for DisposaY *psteta Construction Permit Application for a Permit to Construct( ) Repair Upgrade`( ) Abandon( ) ❑Complete,System ❑Individual Components Location,Address or Lot N O� /t��CJ Owner's Name,Address/afn�d Tel No Assessor's'Map�arc ,•� --� ! / r, /' 'E/ ✓ �' iu e� ,64•.1S Installer's hl e,Address,and Tel No./�i ,��yr °esigner's Name,Address and Tel.No 'a �to /��J7-iCec,7` �5,. ��' o��"��f�,/ C Type of Building: r l Dwelling No.of Bedrooms Lot Size `j sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures / /y /` Design Flow(min.required) f'Y�!/ gpd Design flow provided�ry D ,e. gpd Plan Date Number of sheets Revision Date Title /-� Size of Septic Tank.;• �� /d®U Type of S.A. �('U C_� �,__.g r Description of Soil // B y Nature of Repairs or Alterations(Answer when applicable) AZ_1 Date last inspected: . "h Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by �" ( _ r Date Application Disapproved by Date \� for the following reasons .- Permitl"o d ( � — � Date Issued - f r THE COMMONWEALTH OF MASSACHUSETTS 3 BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(j/J Upgraded,( ) Abandoned( )by at �� C /17 Gt,l has been constructed in accordance -' with the provisions of Title 5 and the for Disposal System/construction Permit No. d f ?- dated Installer Designer #bedrooms Approved des gn flo ! `-i �}B gpd The issuance of tthhii permitfshall not be construed as a guarantee that the system wi,�fizttcti�s nJ�as(designed. Date p L { Inspector !/ 1 _-------------------------- \:- --—--.-- - --------------- ------- ------- --------------------------------------- .- No. 1 �cj Fee Q THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct(`) Repair( Upgrade( ) Abandon( ) System located at 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 O l t r Approved by d%A-/NAJ- C- l�• �1 � G t-•`.�-Gt�- �.,aC�S-�vim, �?,=�-� �,,,�. ,� �.�,�,.� �cox r-� � � t,�.�� �t'o Town of Barnstable Regulatory Services Richard V. Scali,Interim Director = MMSTABM MAS& Public Health Division 039. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: Auv (7i 2017 Sewage Permit# Assessor's MapTarce127Z Designer: `J6 VA Installer: Address: &'a 40V Address: 4 0 2633 On was issued a permit to install a (date) (installer) septic system at 1037 P:tChe6 WC41 based on a design drawn by (address) �vfh nowr, QS dated 46, i (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was.inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. I I OF MqS I certify that the system referenced above was cons c e with the terms of the IAA approval letters (if applicable) DAVID o D. COUGH 1093 N No. 1093 (Installer's S' nature �FQISTER<O S'4NI TAR\PN (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc i Town of Barnstable r# Department of Regulatory Services 1 Public Health Division Date ��`o t MAR2�l -0 9 id3 . a �� 200 Main Street,Hyannis MA 02601 • rFo next� � Date Scheduled (J!' _ Time Fee Pd._ 1(56 Soil Suitability Ang sment for Sewa a Disposal Performed-By: VIP CD(�NR IJD w� S Witnessed By: LOCATION&.GENERAL INFORMATION Location Address W J 1. n l� (���� Owner's Name • ', Address Assessor's Map/Parcel: Engineer's Name 44�7h� y ll �/ NEW CONSTRUCTION REPAIR v Telo hone# C_ Land Use S/d e q ! Slopes(96) D Surface Stones /'✓ Li Distances from: Open Water Body to 0 1 fz Possible Wet•Area V� + ft Drinking Water Well ft Dmiha ge Way Y ft Property Line I j�V t tt Other {t SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pero tests,locate wetlands-in proximity to holes) cCt- o �1 1 Go s J • Parent material(geologic) r `�Cl0 DV�t�G517 Depth to Bedrock Depth to Groundwater. Standing Water in Hole:_ OD D t e Weeping from Plt Roa Vr'�('fe n Estimated Seasonal High Groundwater r-Nqh R 2- '1t H tr rl. TP DETERMINATION FOR SEAS.QNAL-HIGH WATER TABU Method Used:Depth Observed standing in obs.hole: In. Depth to still mottles[V10►f e f ' 32 In.' DejIth to weeping from side of obs.hole: —in. 'Groundwater Adjuattdont ft. Index Well# Reading Dato: Index Well level „ Adj..fhetor_Adj.Groundwater-Level,,,_, PERCOLATION TEST Ditto 7131 1717 mme I Observation Hole# Time at 9" 9 Depth of Parer 0 Time at 6" Start Pro-soak Time @ 1 Time(9"•6") MEnd Pro-soak ` Rate Mtn./Inch Imp l :Site Suitability Assessment: Slto Passed Sito Palled: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back-==----- "*If percolation test is to be conducted within 100' of wetland,you must first notify the, Barnstable•Conseirvation Division at least one (1) week prior to beginning. Q:\SEPTIC\PERCFORM.DOC _� 1 DEEP-OBSERVATION HOLE LOG Hole# Depth from Sall Horizon Soil Texture Sdil Color Solt. Other Surface(in.) (USDA) (Munsell) Mouling (Stnucture,Stoneif;Boulders. a aslstcncy.%'aI-ravall LO ��l1 Say s Coos DEEP OBSERVATION HOLE LOG Hole# 2. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. 0 (0 Srar, Lavrl (0 3 Z 24-13z. G Lo05e•' DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.. Consistency. Oravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stories;Boulders, Co Flood Insurance Rate Man: / -Above 500 year Mood boundary No— Yes �!___ Within 500 year boundary No��� Yes Within 100 year flood boundary No,-,- Yes Beath of Naturally Oeeurrins Pervtoug Material Does at least four feet of naturally occurring pervious matorial exist in all areas observed throughout the area proposed for the soil absorption system? Ye 5 If not,what Is the depth of naturally occurring pervious material'? Ceftifleati°n V� I certify that on '00J (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 wl the requ r ral experti a d exp�erlence described in 10 C M,15.017. R� "' •�H OF MqS Gh (�.( ,?%asp sqo Signature C t` Dati; °I� za� DAVID y� S C D. OUGHANOWIR �r1S41C�� "ENS pQ Q;\agPTl0Pfi1RCPORM.DOC °fir E VA LU P'� Y r � .. • UAMUAVUD Ln 0 OFFICIAL 117 Certified Mail Fee Er $ Extra Services&Fees(check box,add fee as appropriate) ❑Return Receipt(hardcopy) $ "���j r N} 3 ❑Return Receipt(electronic) $ \— Postmark �J r ❑Certified Mail Restricted Delivery $ Here A p ❑Adult Signature Required $ ❑Adult Signature Restricted Delivery$ n, O Postage J r%- $ rya Total Postage and Fees am Er, , - � Sent FEDERAL NATI MORTGAGE-ASSN N Siiee PO BOX 650043 City,- DALLAS, TX 75265-0043 �...... -„ Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS(RI-postmarked Certified Mail receipt to the. •A record of delivery eluding the recipient's retail associate. t1; signature)that is retained by fine Postal Service- Restricted delivery service,which provides g:_ for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders: Adult signature service,which requires the -j ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). - or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age intemational mail. and provides delivery to the addressee specified, ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent* with Certified Mail service.However,the purchase (not available at retail), of Certified Mail service does not change the •To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a i certain Priority Mail items. USPS postmark.If you would like a postmark on r, •For.an additional fee,and with a proper this Certified Mail receipt,please present your r endorsement on the mailpiece,you may request Certified Mail item at a Post Office"for c- the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record. .Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an. appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy.retum receipt, „r complete PS Form 3811,Domestic Retum Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records. Ps Form 3800,Apre 2015(Reverse)PSN 7530-02-000-9047 Town of Barnstable Bar 5ta A �THE Tqy, . Regulatory Services Department i e;eaC j RARNSCAULF- MASQ . Public Health Division v� i67q. `�� m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4990 1574 May 9, 2017 FEDERAL NAT'L MORTGAGE ASSN PO BOX 650043 DALLAS, TX 75265-0043 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 1037 Pitchers Way, Hyannis, MA was inspected on 05/03/2017 by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOA OF HEALTH o cK an, . ., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\1037 Pitchers Way Hyannis.doc Town of Barnstable URNSr"LE, 6;& Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA"02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO'REPAIR FAILED SYSTEMS (Town Code §36044 and Title V: 310 CMR 15,000) _ An"x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of effluent to the surface of the ground w . ❑Pumping more than 4 times during the last year not due to clogged or obstructed pipe. :. p ot sewage in o an over oaded or clogged SAS or cesspool ONE M YEAR DEADLINE CRITERIA • . Wtatic liquid level in the distribution box ab e outlet invert due to an overloaded or clo ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone 1 to a public well ❑Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA q Single Cesspool ❑Any"conditionally passed systems" (broken cover,relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching pit or cesspool with high liquid level, <12"below inlet (per Town Code §360-9.1) ❑Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts � Title 5 Official Inspection Form .W Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 1037 Pitchers Way r -1 J .�.� __-...ate m^•...___..._._„-:-......�v._.:��,.e...o..--;:..'a..:." Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448). Owner Owner's Name , information is required for every Hyannis MA 02601 5-3-17 t * page. City/Town State Zip Code Date of Inspection i Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information CS/.,y -78 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 5-3-17 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13._ Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 ,le a Commonwealth of Massachusetts ' :aal Title 5 Official Inspection Form x' 1-1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts a=1 f Title 5 Official Inspection Form :'f,. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or,break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 4 I C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health; safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 r � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments yr 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and'the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: r D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form f�A Subsurface Sewage Disposal System Form Not for Voluntary Assessments `�4_ !✓ 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town J State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within-100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. El ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with-no acceptable water quality analysis. (This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- j 10,000gpd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will.be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet bf a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection El ❑ Area— IWPA) or a mapped Zone II of a public water supply well t If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. } t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 I • I Commonwealth of Massachusetts f Title 5 Official Inspection Form -1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ Pumping information was provided by the owner, occupant,.or Board of Health ❑ Were any of the system components pumped out in the previous two weeks? ❑ 0 Has the system received normal flows in the previous two week period? ❑ N Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440� t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts f Title 5 Official Inspection Form �I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448). Owner Owner's Name information is H required for every y annis MA 02601 5-3-17 page. Citylrown State Zip Code Date of Inspection D. System Information Description: I ++I Number of current residents: 0 I Does residence have a garbage grinder? ❑ Yes ® No i Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected?, ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): 573 d/2 rs Detail: r a - 1 • L Sump pump? ❑ Yes ® No Last date of occupancy: = - , ; UnknownDate Commercial/Industrial Flow Conditions: Type of Establishment: { Design flow(based on 310 CMR 15.203): I Gallons per day(gpd) t Basis of design flow (seats/persons/sq.ft., etc.): I Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 1 _ Commonwealth of Massachusetts Title 5 Official Inspection Form �'l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ° !' ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ` ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts :a= Title 5 Official Inspection Fora �;, v Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town r State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2005 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.); Good condition. I i Septic Tank (locate on site plan): i Depth below grade: 12" feet Material of construction: r_ ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) I If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal i Sludge depth: 12 11 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 I Commonwealth of Massachusetts f Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt Lm' Today Real Estate 1-800-966-2448) Owner Owner's Name information is Hyannis MA 02601 5-3-17 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 611 Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade:'- ' feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 k Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts f Title 5 Official Inspection Form �N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract.(required). Is copy attached? ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Al Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): Good condition with stain lines above inlet invert. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts lay Title 5 Official Inspection Form - I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments `� �_�;!✓ 1037 Pitchers Way t J" Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis;. MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: Infiltrators 50'x10' ❑ 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.): Infiltrator leach field shows sign of failure with stain lines in d-box and surrounding stone Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth.of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts %, Title 5 Official Inspection Form -1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection D. System information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding; condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts 1a=1 Title 5 Official Inspection Form :I.-, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required_for every y H annis" MA 02601 5-3-17 , page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately _J4 3*_L] q 3 ' -P ? If j I ffivvv r + 3 65 r t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 a Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form fI1 ' 1-4 Subsurface Sewage Disposal System.Form Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water t ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 k Commonwealth of Massachusetts : I f Title 5 Official Inspection Form - I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1037 Pitchers Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) _ Owner Owner's Name information is required for every Hyannis MA 02601 5-3-17 . - page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file k t5ins•3/13 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 COMPLETE •N COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signat re item 4 if Restricted Delivery is desired. X ,c ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. D to of elivery ■ Attach this card to the back of the mailpiece, ✓ O� or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item Yes If YES,enter delivery address below: ❑No 4 3. SServvj e Type L'y'Certified Mail ❑ ress Mail �j ❑Registered �etum Receipt for Merchandise ' / ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes I 2. Article Number (transfer from serv/ce tateq =7 0 0:5 116 0 �;0.b 01 0191{ 013.3 o2-nn PS Form 3811,February 2004 Domestic Return Receipt k '. 102595 tsao UNITED STATE .... ...... Vista e • Sender: Please print your name, address, and ZIP+4 in this Vox • Town of Barnstable Health.Division 200 Main Street Hyannis,MA 02601 2111!1111 1111!11 11MI-1 fill ooK � Q 12 � Certified Mail#7005 1160 0000 0191 0133 I"Erg. Town of Barnstable j. Regulatory Services 'MASS. a v m Thomas F. Geiler, Director Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ~ January 24, 2008 Lucas S. Aguilar 1037 Pitcher's Way Hyannis,MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION THE STATE ENVIRONMENTAL CODE, TITLE 5. The property owned by you located at 1.037 Pitcher's Way, Hyannis,MA was inspected on January 24, 2008 by Timothy O'Connell, Health Inspector for the Town Of Barnstable. This inspection was conducted on the basis of the rental registration of the Town of Barnstable. The following violations of the State Sanitary Code were observed: 105 CMR 410.300 and 310 CMR 15.00: There were a total of six (6) bedrooms observed in this dwelling; two (2) were observed on the first floor, (3) three were observed on second floor and one (1) within the basement. However, the existing septic system (permit # 2005-560) was not designed for six bedrooms. .It was designed for four (4) bedrooms. You are ordered to correct the violations listed above within thirty (30) days of your receipt of this notice by pulling any required building permits (if applicable); You are ordered to remove the bedroom from the basement and (1) one from the second floor by removing the entrance doors and by opening all door- way entrances to each room in the basement to minimum of five feet wide openings. This will bring the total bedroom count down from (6) six to'the appropriate (4) four as designated by your septic permit. 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. 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. QAOrder letters\Housing violations\Rental ordinance\1037 pitchers way hyannis PER ORD OF E BOARD OF HEALTH J mas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Timothy O'Connell, Health Inspector QA0rder letters\Housing violations\Rental ordinance\1037 pitchers way hyannis 5 act. 121 Libbz2;,117 L-3 cJ FORM 30 C&w HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/T�,) . � 4 W (" � 9EPARTMENT 'Y-T— wM Sv0'. ADDRESS TEL PHONE Address l` Occupant Floor Apartment No. NQf Occupants- 1 11 v No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units Stories Name and address of owner 13 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: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks,.Flues,Vents: PLUMBING: Supply Line: A / ❑ MS ❑ ST ❑ P Waste Line: IV c1tv " H.W.Tanks S fetv 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 INSPECTO,7(See Over) "THIS INSPECTION REa Y IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PE-6IUFiY�' p INSPECTOR TITLE Y c., A: . DATE — r TIME ! P• • THE NEXT SCHEDULED REINSPECTION i P.M. f 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 11, 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. HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS FORM30 C&w BOARD OF HEALTH - CITY/TOWN DEPARTMENT ADDRESS { M Sy'0 TELEPHONE Address Occupant .ter Floor Apartment N.o. No ®f Occupants No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units�- No.Stories A Name and address of owner 1 J �j 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: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: --Central ❑Y.._.❑.N E ui . Repair- TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: V p- - f € ) ` "' ;�!- '` �' V V H.W.Tanks Safety and Vents 4 _ _e'V ,-IN 4) _. ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: ! T) (; U AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: ` v DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry l Den Living Room r,ry, Bedroom(1), till y 1C 4 t- A - Bedroom 2 Bedroom 3 Bedroom 4 j e"(1 1ram . 4k 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 INSPECTOR7(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PE J�UFtY� .� INSPECTOR `�--� TITLE DATE ` "'" �� 7r. TIME S %PmM w �- M THE NEXT SCHEDULED REINSPECTION- P.M. 4 410.750: 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 11, 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 41.0.353. (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. COMPLETE . ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery Is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addr9ssee so that we can return the card to you. g, iv by rf am C D to liy�9ry ■ Attach this card to the back of the mailpiece, / b or on the front if space permits. 17 D. Is delivery adcTress'jiff6rit from item 1 ❑ es 1. Article Addressed to: ( If YES,enter delivery address below: ❑No i 4 0 3. Service Type ®Certified Mail ❑Express Mail ❑Registered ®Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?Aft Fee) ❑Yes 2. Article Number 7 0 5 , 21'(Transfer from service?abeO 116 0��' t i i e t 1 100001,01911, ,8 1 PS Form 3811,February 2004 qy Domestic Return Receipt to2ss5 o2-M-1 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS c Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box •`' I' Town of Barnstable Health Division 1 200 Main Street �— Hyannis,MA,02601 f I ' Barnstable P�0F HF rpwy Town of Barnstable ao America city (';'Ij1 Regulatory Services Department �,(RARNSTABLE, D '9 "Ass. Public Health Division O\1�639• p�� �fo Mai 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO January 16, 2008 Lucas Aguilar w, 41 Wolley Road _�3 Hyannis, MA 02601 J As of October 1, 2006 a new rental registration ordinance was put into affect requiring all property owners of rental units to register their rental units with the Town of Barnstable Health Division. According to our records, you own the rental property at 1037 Pitcher's Way, Hyannis. Enclosed is an application. Please use a separate application for each rental unit you own. Should you need more applications, they are available online at www.town.barnstable.ma.us. Go to the Health Division page by looking in the Department Menu. There is a link to the Rental Registration information on the Health Division page. You may print out as many as you need, and return them to the Health Division with the appropriate 2008 fees included. Failure to comply with this ordinance may result in the issuance of a non-criminal ticket citation in the amount of$100. Each day of non-compliance is considered a separate offense. Should you have any questions, please feel free to call 508-862-4644. Thank you in advance for your cooperation. CERTIFIED MAIL# 7005 1160 0000 0191 0218 J:\Letter to Homeowner to Register.doc Barrett, Caitlin From: Stanton, David Sent: Tuesday, January 15, 2008 3:16 PM To: Barrett, Caitlin Subject: Rental signs Caitie, Here are a couple more rental signs I saw. I checked the database quick and it didn't look like they were registered yet. -1037 Pitchers Way, Hyanni. - 35 Gosnold Street, Hyannis Thanks, David r U " i Town of Barnstable 1"E' ti� Regulatory Services z Thomas F. Geiler,Director BARNSPABLB, 1639 `0$ Public Health Division A'ED ' Thomas McKean, Director .200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: C iB p Designer: Shay Environmental Services, Inc. Installer: Address: P.O. Box 627 Address: East Falmouth, MA 02536 �c cm�tl n (1 vk On d-' Os �' j (— °� was issued a permit to install a (date) (installer) septic system at 1 O 3-4- ?% - cC ar s I pm,cbased on a design drawn by (address) Shay Environmental Services, Inc. dated 1 Q 5 L6 - (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. y�H OF _ S CARMEN N a ler's o E. SHAY N No. '1181 _ � a �GISTER(G SgN17AR\P� esigner's Signature) (Affix De > tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNS—TABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form TOWN OF BARNSTABLE �CATIUN' , I CY SEWAGE # aO 56Z { t->F`�UI �dVa SESSOR'S MAP & LOT VLL�_AGE —jJq INSTALLER'S NAME&PHONE NO. .. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) , �� %C- (size) NO. OF BEDROOMS L BUILDER OR OWNER t V Gam, PERMITDATE: 'A-6 5 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 � �� � � � ]�V} � rJ 1 Iw\ �" p �, � n C.J � c ,� " .. ca• _ _ - ` (� �, �. . • 1, li r� No.aw 5 ~' FEE COMMONWEALTH OF MASSACHUSETTS Board of Health, pRt.1�TA�i� MA. j APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT � Application for a Permit to Construct( ) Repair>< Upgrade( ) Abandon( ) - ❑Complete System Xndividual Components i Location 1032c —?—AT-CAA&eSWAY AYANO Owner's Name i Map/Parcel# 2 2149 Address Lot# # Telephone# Installer's Name 0, pC� Cc�EP.V� Designer's Name 'Z)vm4yV TICS. I►JG Address 5 -j-•BEN-TAN c,M. pRmQ JT" Address �� �`MO�� l Telephone# 4n8 -_S31O Telephone# Type of Building S 1'D SM Tj A L. Lot Size V_ 8. 539 sq.ft. Dwelling-No.of Bedrooms 4 C Fou< )11 Garbage grinder 0�14 Other-Type of Building 1/ N wE No.of persons 4- Showers V,Cafeteria (yj L Other Fixtures A R my. I—,TG!!T� SLOW 1 L.AUaCs Y Design Flow (min.required) 444) gpd Calculated design flow 40 Design flow provided '�3•�'o gpd Plan: Date Number of sheets I ,, � qq Revision Date !� Title !sp n n&A S e p*i c SlAs4 y xn ��C Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator S"'? Date of Evaluation 10 1- 05 DESCRIPTION OF REPAIRS OR ALTERATIONS ,����� The undersigned agrees to install the abovgAascdbed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and fur o ace operatio until a Certificate of 4Com fiance has been issued by the Board of Health. Signed Date I' t Inspections +s�'*r �- . r.-,J- "' �!. ,`r z•,4 t}"` + a'' .::. �. _ �_�f� Y .";;t ..• +i y[ S.,`� n*s Iti {� y,r,,m� Ak No � P ? e FEE MONWEALTH OF MASSAC14USETTs Board of Health, MA. APPLICATION FOP, DES. POSAL SYSTEM CONSTRUCTION PERMIT t Application for a Permit to Construct( RepairX Upgrade( ) Abandon( - ❑Complete System*>�Jndividual Components t Owner's Name Location I � � �1"S"'C\-1�..f;� �A4a, �'rr-1NN15 Map/,'Parcel# ' Addresses Lot#'I Telephone# Installer's Name Q �-�S jr �C �jC�J\Ct Designer's Name (Emu. Svcs• TAC• Address 5 7''r,ENTDNJ aT �1 �p�7-� Address1MC)\JT4\ Telephone# l�I-� �`� 'C) Telephone# J5 -' �� Type of Building to 1 1� ��1 T Lot Size S:;9 sq.ft. 1 Dwelling-No.of Bedrooms 14 FOQ�Z� Garbage grinder 01A Other-Type of Building ��"" N6nit No.of persons iP�- Showers 0,Cafeteria(0 , Other Fixtures �lAT4�'`t, Design Flow (min.required) gpd Calculated design flow 4Q Design flow provided -� . • +Q gpd Plan: Date I `U Number of sheets 1 Revision Date Title C\ Pt7� Description of Soil(s)- Soil Evaluator Form No. Name of Soil Evaluator` Ofi MT,t\) SI�Ah Date of Evaluation !OS DESCRIPTION OF REPAIRS OR ALTERATIONS "kO \Gcl The undersigned agrees to install the above descd ed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and ( IT f er agr'es=to-no.t_o lace .ec.st m' operation until a Certificate of Com fiance has been issued by the Board of Health. V Signed . m Date _5 Inspections r No. � � COMMONWEALTH Of MASSAC14USETTS� FEE Board of Health,7�66 r MA. CERTIFICATE OF COMPLIANCE IANCE Description of Work: ❑Individual Component(s) ❑Complete System The undersigned here�e at the eewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ,Abandoned ( ) at has been installed in accordance with the provisio s of M 0 CMKQ 5.00 (Title 5) and the approved design plans/as-built plans relating to application No,tt d �cG� dated Approved Design Flow L 40 (gpd) Installer 1 Designer: -S ICE` Ar `! InspectoQ Date: ,g The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. CO 55(o 0 FEE l � COMMONWEALTH OF MASSAC14USETTS Board of Health MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is herebygranted to; Construct( j) (Repair( ) Upgrade(6-<Abandon( ) an individual sewage disposal system at s) h1 G k,0,�5,•,,, 4.v�` ( as described in the application for Disposal System Construction Permit N�o.: F. .?dated Provided: Construction shall be completed within three years of the date of thyis permit. All local conditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date 1 Board of Health_ 1 TOWN OF BARNSTABLE LOCATION' (o R �-� SEWAGE # 9 1 I j VILLAGE L/I ASSESSOR'S MAP & LOT3 9 �. INSTALLER'S NAME&PHONE NO. M-6 n(f SEPTIC TANK CAPACITY l e' LEACHING FACILITY: (type) 1k. Vq)eWC" (size) NO.OF BEDROOMS BUILDER OR OWNER PERMIT DATE: %a _�f- COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility - Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) C� Feet Edge of Wetland.and Leaching Facility(If any wetlands exist .within 300 feet of leaching ��/'lg,&— Feet Furnished by q - C ` 3 � �� fi - e _ f Pi.t I 2- 33 X a, S-Tile I -�a � - SEWAGE INSPECTIONS L0'_A.'I1ON,143 Haves RnAa -DATE 10/25/02 VILLAGE Centerville Mass. ASSESSOR'S MAP & LOT . INS�FC'r0a JOSEPH P. MACOMBER JR. SEPTIC,TANK CAPACITY 0 allons g No box LEACHING FACILITY; (type) Field (size) 10 X1 5 'X1 ' NO. OF BEDROOMS � . BUILDER 0 OWNER Frank thomas OWNER ' MAILING ADDRESS _ 1i_lverado Terrace TA7 i n aven Florida 33884 I D I 1 `4 _ �Y r - 9/16/03 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems. Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, o f�eM� J►�►AV ,hereby certify that the engineered plan signed by me dated 1�' =concerning the property located at ?VTQA� Wf1`P , 1A\?Wt 5 meets all of the. following criteria: • This failed system is connected to a residential dwelling only. There are.no.commercial or business uses,associated with the dwelling. U The.soil is classified as.CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or.may conduct deep test holes and percolation tests.at the site without a health agent present. i There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The.bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the. Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation ' D +adjustment for high G.W. IdT-•5 = 4-, Sb DIFFERENCE BETWEEN A and B SIGNED : DATE: 1 i I7 b 5106 . - NOTICE Based upon the above information; a repair permit will be issued for bedrooms maximum.. No additional bedrooms are authorized in the future without engineered septic system plans. gASeptic\percexemp.aoe �OP. Cl O� TOWN OF BARNSTABLE LOCATIONi��/� r f!R iS��Ss SEWAGE # 1Z Va,LAGE /� � /��J/S� ASSESSOR'S MAP INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type)r�/lir'`.� � � (size) NO. OF BEDROOMS BAR OR OWNER , -e c� PERMTTDATE: 'cf COM PLIANCE DATE: C5 L 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 chi gfacility) r` Feet Furnished by U � - No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS t� ZIppitcaltton for Otgpool *pgtem Con5tru`ctton Permit Application for a Permit to Construct( )Repair( ;),Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or LotNo. 7 1 Owner's Name,Address and Tel.No. As so' Ma Map/Parcel ; Installer's Name,Address,and Tel.No. y Designer's Name,Address el.No. Type of Building: S 00C ✓ CV 4 • CC' Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder W6 ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank AXV!g�&/ Type of S.A.S. Z6 ')e 4 4.X Z 4— !k Description of Soil `f Ci u,Idtr "_el� �a � r T d Nature of Repairs or Alterations(Answer when applicable) 'S Date last inspected: '1 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by jhis.B and of Hea th. Signed Date 7-0-7—f Application Approved by Date Application Disapproved for the following reasons Permit No. "r Date Issued ��, ----------- - ` i0Fee t Entered in computer: THE COMMONALTH.OF MASSACHUSETTS I 1. s G PUBLIC HEALTH DIVISION'-TOWN OF BARNSTABLE, MASSACHUSETTS Yes ' tl �tc4tia for �Digo�at *pztem Coris1ructiou ermtt Application for a Permit to Construct( Repair( dtpgrade( )Abandon( ) ❑Complete System ❑Individual Components r Location address or Lot No. 7Z J m Owner's Name,Address and Tel.No. ff 17i ) As sor's Map/Parcel S �.�J C Installer's Name,Address,and Tel.No. Designer's Name,Address 64Lel.No. . .Type of Building: t/OCA/✓C C&n 57. co Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Wh ) Other Type of Building No.of Persons A" Showers( ) Cafeteria( ) Qther Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date- Number of sheets Revision Date Title Size of Septic Tank AX6 qel Type of S.A.S. Z6i,X ti i/ .t' Z• -� !4 . - Description of Soil In Cbr L A c,,4�— 0 T i Nature of Repairs or Alterations(Answer when applicable)," } Date last inspected: ,�y Agreement: The undersigned agrees to ensure,the construction and maintenance of the afore described on-site sewage disposal system t � in accordance witli,;the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this$ and of Health. c a Signed Date 0 / %L— -7 Application Approved by Date Application Disapproved for the following reasons • } i F* Permit No. '" y Date Issued ^^ '^ riNIA� 5F MA:SS_ USE LTH ,r ARE, MASSACHUSETTS 'k_ < j -� ri�v.(Certificateb if C� riauce THIS IS TO CERTIFY, that the On site Sewag sposal System Con cted( )Repaired ( )Upgraded ( �) P , Abandoned( )by 14114 X 1 1 A 1't✓ �.✓U a�� ��� "at Al has been constructed in accordance it e provisions of Title 5 and the for Disposa System onstruction Permit No. dated_7'* :79_,F-:2 - Installer Designer ' ....�.... Theie�uance of this permit shall not be co strued as a guarantee that the s will function a esi ?_ Aj ! ` No. /— 7�6 Fee �_ 1 _ ! THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUEt"TS Mizvozar &pgtem Congri uction hermit Permission is hereby granted to Construct( )Repair( )Upg''r/aade�u Abandon( ) System located at ��3 / 7tG and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Const77;�;7� becompleted within three years of the date of this ermit. Date: Approved by ` r 4 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - Gd ASSESSORS MAP NO• Z PARCEL NO: L CERTIFICATION OF SKETCH AIIND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERINM (WITHOUT DESIGNED PLANS) L WI'444Y .��� hereby certify that the application for disposal works construction permit signed by me datedl �� / concerning the property located at meets all.of the following criteria: • The failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. 1 • There are no wetlands within 100 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than five feet above the ma.�dmurn adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14) feet above the maximum adjusted groundwater table elevation, Please complete the following: \� ( A) Top of Ground Surface Elevation(using GIS information) B) G.W. Elevation _+the iv(A1X. High G.W. Adjustment DIFFERENCE BETWEEN A and B t + SIGNED : ' DATE: (Sketch proposed plan of system on back]. q:health folder.cat i • o s C ti 4_ �J 1� •�S l.s .0 T+ • � r v TOWN OF BARNSTABLE LOCATION���-�2 �27�'- .5 QS eWIi-Z SEWAGE # VILLAGE ��r/� /S� ASSESSOR'S MAP & LOT �'C r INSTALLER'S NAME&PHONE NO. / i/ SEPTIC TANK CAPACITY /0 120 LEACHING FACILITY: (type), (size) NO. OF BEDROOMS BEER OR OWNER ' �� �`�/ � ct. I 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 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 pf1Fching cility) Feet Furnished ��•�d1l ',`�,/ /'°�''C' i -------------- 1 1 IL)O CAT ION EWAGE PERMIT NO. VILLYGE INSTA VLIF S NAME i ADDRESS BUILDER OR 4f NER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED No f Fx 3 dam..... . r THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH - -Wt/------....of ......... � � Appliratiou for Uhip aal Works Tomitrurtion jiumit I I Applicati n is he% made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �0 1'r h U"S �" ................. t ... ..................... ....................... ........................................ L at'on•Add ss r Lot o. ................ ... �. ---•• - - - --- � -..._._... — .' � ner i— Address �1 ... .f ., ....sue = :.. �- Installer Address d Type of Building Size Lot./� L.......Sq. feet U Dwelling—No. of Bedrooms............. _.___Expansion Attic ( ) Garbage Grinder ( ) •--------_-------- `� Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ----------------------- - - W Design Flow..................5.5........... _�_-,�allons per person per `y. Total daily flow.__--------��-_ . _-_-__-_gallons. WSeptic Tank—Liquid capacit .1��1(!gallons Length__._....•.. Width........._ Diameter..............•. Depth.....�-�f..- x Disposal Trench—No. .._.... Width_.._., . ..... Total Length---------- __ Total leaching area............ sq. ft. Seepage Pit No.--_____/-________ Diameter-___:__,f11_ Depth below inlet_....___....... Total leaching arealW_!(1sq. ft. Z Other Distribution box (1,,< Dosing tank ( /' . Percolation Test Results Performed by_____________ ____ _C1111` - __�6��... Date..../A`l7r ....... aTest Pit No. 1..A5 co ___minutes per inch Depth of Test Pit... Depth to ground water---_---- (r, Test Pit No. 2.�.0-minutes per inch Depth of Test Pit._...2�....... Depth to ground water-___-_/l/ .._..- Pi ••--••-••••---••-------------�--•-----••----•••----•-•. ....•--••• ••-•-.......----.........._.............._ Description of Soil1 ` /n'--- ----- --- x -1 -f p _ v -ya W ---------------------------------------------------- ................................................. ------------------...................................................... UNature of Repairs o- rations�—Agsver when applicable------------------------------------------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of�T' ;:. y g g p y 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issu the board of he lth. . - / c'' y�i%s mil.-•- 6r� - --... `. f �..- Signed. r ...••. . �� Date Application Approved By..... ,�f � �./%6 ---------•••......---•----•• ....Z=7 sil------------- Date Application Disapproved for the following reasons:................................................................................................................ ....-•-------------•-------....---•----•--•----•-•---••--------------------------•---.......•------•----.----------------•-•-----•••------------------------------------------------•••••-•------------- Date PermitNo......................................................... Issued_....................................................... Date r" No.CaD..�. aFps.... .."'......... . THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH . r ................... ...._.....'.......:OF...........................--•----.....--------------------------..............---------- ,� lirtt c r hipati a1 ,ark C� as x c#i at p at�i# Application is hereby made for Permit to Construct_.>( ) or Repair ( ) an Individual Sewage Disposal System at: � ••- - ``1 L t'on-Ad re s � t .- ' Address Installer;t Address Q Type of Building Size Lot..........._.................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of;Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Q' Other fixtu-set- ."=--- ----------------------------------- Design Flow.....................................1, allons per person per-day Total dairy flow_.._...._.._.._._.__......_.._...__.._..._._gal WSeptic Tank—Liquid cap/ac�ty-=-----------gallons Length................ Width___.... ....._ Diameter................. Depth.......•-_...... x Disposal Trench—No........... ....... Width._._ .t.!a�.... Total Length........... y�._ Total leaching area____._=_�P__.--_sq. ft. Seepage Pit No....._.__l.._______ iameter..______J Depth below inlet.................... Total leaching area. ...sq. ft. Z Other Distribution box ( Dosing tank Percolation Test Results Performed bY____________________________________________ ...... ... Date..........._......_.._......___.. � Test Pit No. l...°' __d_minutes per inch Depth of Test Pit____t3�.._ Depth to ground water.._._..r,�1�`7...__. Test Pit No. 2..........�"minutes per inch Depth of Test Pit.....`... ...... Depth to ground water....... ....l__.__ a -".......................................................... Description of Soil---•-•- "�` Lw� �.-- ----� ` �' � ° e ` -- --------------•-- ----------------------- ---•----•------------ -- .... ... ------......--•••--•---------•••----••••--......•-•-----••--............ U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------_............................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of-T T E, p 5 of the State Sanitary Code-The undersigned further agrees not.xo place the system in operation until a Certificate of Compliance has been issued the board pf hea th, Signed............ � /ft�' 1 � Date Application Approved BY ........................... ---- ------•------ Date Application Disapproved for the following reasons-......................................-....................................................................... ..-••-------•-•------•----....--•...••------••-••----•••-•-•...-•-----•---------------------•-•••---•-----••-••--••------•-••••-••-••-----•-•--•--•••-••--•-----••••------------------•-•---••---•----- Date PermitNo.--•-----•-•-•-••-•..........: ... Issued_....................................................... � Date .14 F THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. �rr�ifirtt�r laf ��r�t��ittatr� THIS JS TO ER 17Y That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) byt1 .0. ...... ------•. •-•••-•---•........... ..••---...... � I�11 at- has been installed in accordance-with the provisions of TITLE j of The'State Sanitary 0ae as described in the application for Disposal Works Construction Permit No......................................... dated------------.................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE fW y p tor.-...... r� ' a+x d ^3 , vIns ec THE COMMONWEALTH OF MASSACHUSETTS BOARD OF A, N / FEE........................ Uhlpsa�...VorLzv Mat .wn 7. Permission is/hereby granted••-- --- ..... to Construct o3Rtpair/ an4ndivid�ua�Sewage Di�spps stem/ at No.----•--------- ..�� - f ----------.-•--• 1 Street as shown on the application for Disposal Works Construction Permit No-------_-_-------- Dated......._.................................. �i ICA/ oard of Health DATE...... V ` . ....................................................... FORM 1255 HOSES & WARREN, INC.. PUBLISHERS ma's :. .. •r.� .. � _ F.,.,.c. '5,.... RR Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: % ff'r hkZ! � We Gc O&k j?,jjVa-7 BUSINESS LOCATION: 7 r( Cl,4-c-71 <I, uvkN MAILINGADDRESS: �P.�_� V& o x Z 3Z ( y Mail To: TELEPHONE NUMBER: d� -7 1 6' I cl C Board of Health ��� � � Town of Barnstable CONTACT PERSON: � L9 y �� il +� P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: ��07 ��I Hyannis, MA 02601 TYPEOFBUSINESS: 't^/�`lf t&✓ G Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: `�- ti o Z � 2 — (i M- _1VA"_(J - A44 0 "(9 TELEPHONE: J D 7 g ( °t. b LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(forgasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) i Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers An other products with " c. Paint brush cleaners y P poison" labels (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Date: TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: MAC L`N-)MOSES iuVC d bw XMb5Plt60E- BUSINESS LOCATION: J'1S MAN S Q^T MAILINGADDRESS: Po 66A q 1i SO Wiw-S6 6bQY Mail To: / TELEPHONE NUMBER: ?TOO 579-65G Board of HealthTown of Barnstable CONTACT PERSON: 1 E �� P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: %0 2 RD Hyannis, MA 02601 TYPEOFBUSINESS: A9/6 T- YQM/2-60)A) GQUTMIGS 51Z�0)0 Does your firm store any of the toxic o hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Paint brush cleaners Any other products with "poison" labels (including chloroform, formaldehyde, Floor& furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids Pal WT�) KIE (dry cleaners) Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS I, I HYANNIS. MA 9T SEPTIC INFO AT i I ��`'�� ,ygNOUGtiAogo ECOaTEC H-US NOTTO r t� PROPOSED SOIL SCALE �- ABSORPTION / u-nuThES SYSTEM WATER LINE ► RpUTE 28 FALMOUTH ROAD ® / - —SEE DETAIL GAS LINE ON BACK TY L ® C US M A P ° POLE $ I Is O ELEVA TION��� T 66.83 v / 2 ® \ ° OF -FOUNDP���� O by 12 �65 OAK I ` K �; I -, / 12 in LOT 211, O / OAK AREA = 18539 sf+— C) A\ �� PLAN BOOK 271 PAGE:84 ASSR MAP 272 PCL 149 v D O 65 �� C� - `� 01 —� 6 5 �- Y,t 66 / / AN \ PA'VED DRIVEWAYPLC , a a '0 SCALE: I in = 20 ft O 20 40 PRINT ON Il x 17 in 66 2ofr PAPER FORPROPER SCALE � - 65 q LEGEND EX'S SEPTIC COMPONENTS CONT0U9� SIl )16 EXISTING T T Ypl �I 1000 GAL THIS IS A MINIMAL SEPTIC TANK C®L.OR GRADING Q PROPOSED DISTRIBUTION BOXIN PLAN USE COLOR PLAN ONLY TEST PIT ® FOR INSTALLATION FULL DETAIL IS BEST R VIEWED IN l FULL COLOR 0IF L - 0 W P R` 0 L . El I I TOP OF FOUNDATION RAISE COVERS TO WITHIN ALL PIPE TO BE 4 in SCH. 40 PVC EL = 66.83 +— 6 in OF FINAL GRADE U AND TO PITCH AT 1/8 in/ft MIN 65.40 - D—BO MAX —} EXWING USE H-20 62.4 - -� 10000 00 GALLON aobu�oa o EXISTING GARB 0 PRECAST °oo$oO&�o o°eto�o°qoo�A u p G R °8 DRYWELL SEPTIC TAT 62.a5 �����oa aapo q�a�o ao p.o � OT EXISTING REFER TO DETAIL BOX 6 in SO�L AB 61.75 SORPTION A OWED j 61.92 STONE e /� sroNe ease IF New BASE 61.65 s II ��LSIIVII —REFER TO i EXISTING 33 ft 5-12 ft DETAIL BOX Ln O NO GROUNDWATER _ BELOW 59.65 MOTTLING OBSERVED i 54.50 Of SEWAGE DISPOSAL s9C �P S9� SYSTEM PLAN DAVID yo ti o D. DADVID G� TO SERVE EXISTING DWELLING COUGHANOWR an u(COUGHANOWR FEDERAL NATIONAL No. 1o93 Na. 461 0 4 MORTGAGE ASSN. qP O •• OWNER(S) OF RECORD I 1 s PRovE O ES�� 1037 PITCHERS WAY O� At�P HYANNIS, MA 155 Geo Ryder Rd S PROPERTY ADDRESS Chothom, MA 02633 1 -_ Davidcou@Hotmall.c.m!DATE, AUGUST 1, 2017 - 508 364-0894 IPG.1/2 -)oa# ET.E-4201 inecoE DATE: JULY 31, 2017 E'30L TEST LOG PERC# 15439 DESIGN CALCULATIONS SOIL EVALUATOR: DAVID D. COUGHANOWR, ASE #461 DESIGN FLOW: 4 BEDROOMS X 110 GPD = 440 GPD WITNESSED BY: DONALD DESMARAIS, HEALTH DEPT. SEPTIC TANK: 440 GPD X 2 DAYS = 880 GALLONS TEST PIT No GROUNDWATER ENCOUNTERED USE EXISTING 1000 GALLON SEPTIC TANK IF IN PERC AT 50 in - 2 MIN/INCH IN C SOILS SOUND STRUCTURAL CONDITION. IF NOT INSTALL ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER INCHES HORIZON TEXTURE (MUNSELL) MOTTLES NEW 1500 GALLON SEPTIC TANK. 65.65 0-6 Ap SANDY LOAM 10 YR 3l2 NONE FRIABLE I DISTRIBUTION BOX: INSTALL UNIT DEPICTED BELOW. 62.65 6-36 Bw LOAMY SAND 10 YR 4/6 NONE FRIABLE SOIL ABSORBTION SYSTEM: 36-128 C MEDIUM SAND 10 YR 5/4 NONE LOOSE THE LONG TERM ACCEPTANCE RATE FOR A CLASS ONE 54.98 SOIL WITH A PERCOLATION RATE BELOW 5 MINUTES PER INCH 0 74 A R FOOT. N GROUNDWATER ENCOUNTERED E C GALLONS PER DAY PER SQUARE O O O TEST PIT 2 2 MIN/INCH IN C SOILS THE 26.5 ft x 16.5 ft x 2 ft LEACHING GALLERY ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER WITH CUT CORNER DEPICTED BELOW CAN LEACH: INCHES HORIZON TEXTURE (MUNSELL) MOTTLES BOTTOM AREA=(26.5x16.5)-1/2(6.5x3)= 427.5 s . ft. 65.50 0 10 Ap LOAMY SAND 10 YR 3l2 NONE FRIABLE I� q 10-34 Bw LOAMY SAND 10 YR 5I6 NONE FRIABLE SIDEWALL AREA _ (26.5+16.5 62.67 +20+7.16+13.5)x2 = 167.3 s . ft. 4-1 C MEDIUM AND 10 YR 5l4 NONE 00 q 3 32 S LOOSE 54.50 Q TOTAL AREA = 594.8 sq. ft. FLOW CAPACITY 0.74 x 594.8 = 440.1 al/da 9 y INSTALL THE LEACHING GALLERY AS CONFIGURED 100 oD 0o Gc��1 L L Oo N CEP T I CT NK BELOW. FLOW CAPACITY = 440.1 gal/day WHICH EXCEEDS ENS �� D O o DD��� 'I THE 440 gal/day REQUIRED FOR A--FOUR BEDROOM DESIGN. TANK TO BE PUMPED DRY AT TIME OF INSTALLATION AND EXAMINED FOR STRUCTURAL INTEGRITY. INSTALL NEW PVC OUTLET TEE EQUIPPED WITH A GAS BAFFLE. @OIL A o 0'QWR rUJJ DU►V REPLACE WITH A NEW �[ ] Comm now pn rm I in 1500 GALLON TANK Nk o• •• oo � 1 0 � ►• TAPER IF CRACKED, ROTTED --- -OR OTHERWISE < 20.0 ft "- COMPROMISED. DRYWELL b - c UNIT o 4- 0 00 + HHE 41 NOT Lo Lo TOc °0Lo �o SCALE 4. 4 4.83 .83 83 �0 4 2 2 4 i I 8 ft-6 in 26.S0 ft I INLET OUTLET 500 GALLON DRYWELL I' COVER COVER DIMENSIONS & DETAIL INSTALL ONE INSPECTION ' - _ RISER TO WITHIN THREE � IN DROP L -� , ,cE ' INCHES OF FINAL GRADE —I► Jl� FLOW LINE �L "J & INDICATE LOCATION FROM _ H-10 ON AS-BUILT BUILDING 10 in = UNI T A i in TO D-BOX 4= 33 48 in in LIQUID GAS a00000, 000 pD000' LEVEL BAFFLE 5 6 in STONE BASE /F NEW SEPARATION BETWEEN INLET & OUTLET CROSS SECTION VIEW TEES NO LESS THAN LIQUID DEPTH INSTALL AN APPROVED GEOTEXTILE I CROSS SECTION' VIEW FABRIC OVER STONE La _ o 0 �/ 28 3/4 in TO � 24 in o 3/4 in TO �� 1a ' D 1 S T R l : U T 1 O N O /� • in I-I/2 in GRAVEL DEPEFFECT HTIVE )-I/2 in GRAVEL DIMENSIONSD-BOXL TO RUN LEVEL 1 DETAIL FOR 2 FEET BEFORE PITCHING DOWN 46 in 58 in 46 in 150 in r ALL STONE TO BE DOUBLE WASHED AND 12 in FREE OF IRONS, DUST AND FINES IN PLACE C MIN _ -- -- � N FROM TANK TO o ^ SAS 6 in STONE BASE 21 CROSS SECTION VIEW n 2 -INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. -ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM O REQUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15). -INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND T UTILITIES BEFORE EXCAVATING FOR SYSTEM. -ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES & APPLIANCES, AND PERIODIC PUMPING OF THE SEPTIC TANK. -SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. SEWAGE DISPOSAL SYSTEM PLAN 11037 PITCHERS WAY HYANNIS, MA AUGUST 1, 2017 ETE-4201 PG 2/2 I 1 f ,FYN �.. � - �•A 1 co 5. i y I I i i B FF=52,00 TYPICAL SYSTEM PROFILE A R E A PLAN ==A FDN TOP FINISH GRADE= r . ' NOT TO SCALE FINISH FINISH GRADE OVER TANK= S/, 00 GRADE OVER PIT= - LO r 2 / P/ TG'M&k :5 Wf-/Yj /S., 5 3 9 S. A:, . - O O 1 i • • 0 1 1 0 O /VO !�1 S, l� !/ 1 / / / N VO 4, V', 'r�' P V C OR 97.67 C. I . TEES 47,33 .......�.....•a-_,- .'--. ./E 7-.�,..�•... BSMT 7' YV ` GAL. SO4FLR S"n • . / 1 ° • • . / • e 1 REINFORCED DIST. BOX 4725 , CONCRETE g ' ' ' ' • • ° • o e o TO BE INSTALLED ON ° ' ' ' • , ' ' ° ' A LEVEL STABLE BASE ° • • • • o e a 1 SEPTIC TANK • 1 0 • • • t • / 1 / / 1 - Q TO BE INSTALLED ON A ' • • o ' ' ' 1 LEVEL STABLE BASE c ( i + 1 0 1 • • • 1 + • 0 1 2"-1/8'1- 1/2 "WASHED PEASTONE ALL 1 1 • 1 • • . • . 1 1 1 BRICK 81 MORTAR COURSES AS + e • ° e o ° REQUIRED TO BRING COVER TO GRADE AROUND FREE OF IRONS, FINES �07 AND DUST IN PLACE h 24 "C.I . MANHOLE COVER a3/4 TO 1 -112 "WASH EDCRUSHED LEACHING PIT 1(� S_9 0 3�. 02 „� _ Y FRAME SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL 4 +t� IRONS FINES AND DUST IN / J PLACE -'� FOR FIN. GRADE � SEE SYSTEM PROFILE \, SOIL AND PERCOLATION v 1a PREC/9ST CQA/G/1�T[= oC _ 4 DATA fl SEE DE'7>4/LS Fr P.QOF/LF 1 PRO. ;W7- Ie ' �� �`- - - 8 P E M I N I N. r_ .Tp � ,� _ � PE RC.C RAT L " 'o FOR INV. ELEV SEE °T ' C. D. SPOHR 0 4 ° •' TAKEN BY : — INLET _ . ° , - SYSTEM PROFILE PRO 4` ?> LINE - �G��. F'.�fJ1_ I� F��!!'P P,W. I y • ° WITNESSED BY. 0 R) 40 \T ° o OPENINGS W/4-1/8 OUTER DIA. a I -3/4" o ;, DATE , �= J \ b* l'zFL, v 7' ° • o INSIDE DIA o - °,`• TEST PIT -GND ELEV. t� ex—SEE PIRAF/LE — 4O -TOTAL o o = loco Gam[ FaeEr�sr �1 i �c L V ! e 1) o AREA -_° '� 3 ii b E s L t of-.'"/l 1 � vcre�r�ct�c cii�v� 1 Q F 25, /6, 3 .= F- ° o o _ g NO k T LEDGE ow /,2E D vSE ° rypj" GkC)F�E _ * /6� 2 % . �\ o 0 0 0 o o _ u ' ° ° �q�� OR YVATj'P. ON W �- '' u o 0 0 0 0 0 0 COfaRSE $kOWI�:; 0 0 0 0 0 0 0 0 OVA —-- i 59AID ! f �I,� _,� d e 6 _ 6 DIA . ! ' AYE�f'S crRAVE'4.. / T> G. LDS`_ Z_j � - -- -- -- -- BOT. PERC. HOLE I� jQ EFFECT.1VE DIA. - --- - - --- DOWN tI I � LEACHING PIT - SECTION NO SCALE DESIGN DATA - NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM N0. OF BEDROOMS DISPOSAL ; ow LEACHING PIT NOTES. EST. TOTAL DAILY EFFLUENT GALS. �LEV4T/Q/l/5 2�195ED 0" A,9VE-A4CA17- EDP" I . CONC. TO BE 4000PS.I a 28 DAYS . SEPTIC TANK GAL. C�/ILTE_kL_1A1H 0,— /-OT ySSUAIT'D E4..V.0 2 . REINF W 61 x 6 '� 006 GA. W. W. M. PLAN REP • 3. 2 'AND 4 ' SECTIONS ARE AVAILABLE FOR GENERAL NOTES $A�2,'115T1� L+E" �E'EG/STi2Y GREATER DEPTH REQUIREMENTS pLrAM F��''K• 2-7� 1 . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN NOTE : .37 ± ACCORDANCE WITH TITLES OF THE STATE SANITARY CODE EXCAVATE TO ELEV. OR LOWER AS DATED JULY 1,1977 8r ANY LOCAL RULES APPLICABLE. REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPR'D. IN MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL WRITING BY MR. CHARLES D. SPOHR. WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY COMPACTED IN PLACE. 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLiNG, SIDE AREA - �S. F.�_S. F./GAL '�'� GALS NOTIFY THE ENGINEER ANDBONKJOF HEALTH FOR INSPECTION. -� 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED. r1 - BOTTOM AREA= / S. F.@ S. F./GAL GALS TOTAL AREA - " ��=� S. F TOTAL ` � --- GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT 'WRITTEN " APPROVAL BY CHARLES D. SPOHR. LEGEND 6. FOUNDATION INSPECTION READ WHEN EXCAVATED. OWNERS BUILDERS : A_-�EA PLAN + 50.0' EXIST. GROUND ELEV. 50.0' FINISH GROUND ELEV."UNDERLINED" CL ti�K � >�LY/V IV BU/L•�JE•%�S `��:gv�-�l� �k'C.��i► /'LvT Pr,.a� BOX 37/ C�FL�,'✓G /A! A4Vo A-1A//.S "AQ, 4750 PIPE INVERT. ELEV. RE DATE DESCRIPTION klAll 0.2 �c. ?,_ F11--lk TEST PIT LOCATION SEWAGE DISPOSAL SYSTEM 4G wov. 29,I /980 23Y O/?� i5L f3/\fG?S�C,(QY�Y/NCB. o o SEPTIC TANK F O R LYNN BlJ I L DERv CLARK [] DISTRIBUTION BOX `OT# 2 I P I TCHER ' S WAY/ BE S LEI, 4 " C. I . PIPE HYANN I S, MASS. ,� Charles D. ttt+ tttti- 4 BIT. FIBER PIPE - TIGHT JOINTS spOm PROPERTY LINE y1Nn DESIGNED. C D SPOHR DATE - �3 CSC:. DRAWING NO. fS';+�{tyAN - DRAWN: C' - SCALE.AS SHOWN I �_- I � l �E M IN . CODE DISTANCE K MAP SEC PCL LOT HOUSE CHECKED: C. D. S . �tta�tT nlaealx - - - •NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. VENT PIPE (O Least 24 inches tally--- �� SECTION A _-A ALL OUTLET PIPES EMU DIE 3_ 10' min. from-- Schedule 40 PVC w/Charcoal Odor Filter \ ( DISTRIBUTION BOX SHALL BE • .. FT isting Foundation house to septic tank PROFILE VIEW OF ADDITION TO LEACHING SYSTEM SET LEVEL FOR AT LEAST 2 FT. 12 TE covER Septic tank covers must be ----D-BOX cover must be ----------- ----P OF FOUNDATION = ELEV. 100.00 (Assumed) within 6 in. of finished grade _ .' I _ within 6 in. of finished grade .,r - - "-j-'- -Grade over Septic Tank - 9900 Grade over D-Box - 98.50 I --Grade over SAS - 98.50 3" of 1/8 - 1/2 Washed Peastone--- \ 3 - 5.OUTLETr �- ` KNOgCOU TS . ` 3/4• to 1 1/2 Washed Crushed Stone \ //' T - \ \ \ 5.5• OUTLET I ,� , I 12• MET 4• PVC (CAPPED) INSPECTION PORT TO BF x S - 0.02 _ 3 HOLE H-10 INSTALLED AND TO BE WITHIN 6' OF GRADE \ 8• - ST. BOX 3' Maximum Cover Top OF Sy"tem 0- -96.25 `, - _ _ _ I .{a_ •jam X 1637 1•debm YIAy _ 0.01• _ 12' EXIST. ------- SaD•Ot or Greater EXIST. PIPE $ rn 1,000 GAL -----'---------- -- s� ! . ,I 1ss• 4" - SCH. 40 T ,.7s'+ r` o 30' .. Per foot 10" F.tfecfive Depth FROM EXIST. FOUNDATION rn SEPTIC TANK u� a o 5 PLAN SECTION CROSS-SECTION R .... rn CONCRETE FULL M. I' H 10 II Ln �0.83 (10 inches) 7 Units e 6.25' = 43.71), s+� a> d > rn o m > rn r 3.125'r-- -- -----A3,7y 3.125' 3 HOLE H-10 DISTRIBUTION BOX SYSTEM PROFILE to 6 in of 3 d stone e °' > d �m � compacted stone > u u rn NOT TO SCALE - 3. Not to Scale - -` > > 3.5'- 3.5' 'I Effective Length fB 1%1 Pad Ltka%d'~y 9.1)e NA,TE. C C U - 3 y SOIL ABSORPTION SYSTEM (SAS) GENERAL NOTES 6 In.of 3/4•-1 1/2• 0 10' o compacted stone < Effective Vidth INFILTATR❑R HIGH CAPACITY (H-20 LOADING)/ GEORGE ❑'BRIEN , 0 0 1. Contractor is responsible for Digsafe notification. Verification of Utilities NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE m (OR EQUIVALENT) Not to Scale and protection of all underground utilities and pipes. 0 w Bottom of Test Hole 1 Elev.-88.50 NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18" /EFFECTIVE HEIGHT IS 10" 2. The septic tank and distribution box shall be set Groundwater Observed --NONE OBSERVED__ level on 6" of 3/4"-1 1/2" stone. ------------------- -------- 5. Backfill should be clean sand or gravel with no stones over 3' in size. 4. This system is subject to inspection during installation PERCOLATION TEST by Carmen E. Shay - Environmental Services, Inc. -_ 5. The contractor shall install this system in accordance with Title V of the Massachusetts state code, the approved plan Date of Percolation Test: OCTOBER 17, 2005 and Local Regulations. Test Performed By. CARMEN E. SHAY, R.S., C.S.E. A 6. If, during installation the contractor encounters any Results Witnessed By WAIVER (Per Barnstable B.O.H.) B E soil conditions or site conditions that are different F 1(t'AVATOR• Shay Env. Svcs. 8 from those shown on the soil log or in our design Percolation Rate: Less Than 2 MPI 0 32" - (40 FOOT RIGHT OF WAY) g ------ installation must halt & immediate notification be -- _ --- -- _-----__ -_ _---- - -_ - made to Carmen E. Shay - Environmental Services, Inc. ----- ------------------------- Test Hole Test Hole -- ---------------------------------- - - N© 1 No 2 - -------- _----- septic system unless noted as H-20 septic components. DEPTH SOILS ELEV. DEPTH SOILS ELEV. g 8. Install Tuf-Tite gas baffles or equals on all outlet tee ends. 125.00 pipes. 0 98.50 0 98.50 --- 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC I es. -- --- - I Sandy Loom Sandy Loam f i 10. All solid piping, tees & fittings shall be 4" diameter 10 YR 3/2 10 YR 3/2 Schedule 40 NSF PVC pipes with water tight joints. 0"-9" As 97.75 0"-6" Ae 98.00 h " �lox i TEST HOLE #2 �9 11. Municipal Water Is Connected to ALL OF The Residence and Abutting ' Sandy Sandy 11 • • • • • ELEV.= 99.50 r - Properties Within 150 Feet. loom Loom THE PROPERTY LINES ARE APPROXIMATE AND 10 YR 5/6 10 YR 5/B 9"- 42• B• 95.50 r 0'- 50' C s"- 36' Bw 95.50 COMPILED FROM THE SURVEY PLAN GENERATED BY Medium/Coarse Medium/Coarse TEST HOLE #1 r CAPE & ISLANDS SURVEYING OF MASHPEE, MA Sand Sand - ENTITLED CERTIFIED PLOT PLAN OF LOT #21 PITCHERS WAY, HYANNIS, MA" 2.5 Y 7/4 2s r 7/4 ELEV.= 98.50 EXISTING FAILED AS _ _ --- DATED DECEMBER 31 1983, AND PLAN BK 271 PG 83 - AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN 24•- 120 C, 88.50 24'- tzo c, _._ �-- - IT SHOULD BE USED FOR NO PURPOSE OTHER THAN _- THE SEPTIC SYSTEM INSTALLATION. _ EXIST. 1000 GAL SEPTIC TANK i-O i I EXISTING SASTO BE PUMPED OUT AND REMOVED. gg _ NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE 1 0 TOPJ OF FOUNDATION ECT BENCH MARK FROM THE EXISTING SAS TO BE DISPOSED �- ---------------� OF AS PER BOARD OF HEALTH SPECIFICATIONS. LOT #22 ' ELEV. = 100.00 (Assumed) i THERErmi N-C r rir1 .•I'S ARE ESEII LLN T. W:T 20/1c' OF THE P)70DEQll! Perc _____ Depth to Perc: 42" to 60" i Cn ASSESSORS MAP 272 PARCEL 149 Perc Rate= 2 MPI coo I i � LOT' 24 Groundwater Not Observed .� I I EXLTI/VC # LEGEND No Observed ESHWT i EXIST. i DECK 4 BEROOM ADJUSTED H2O Elev. - None DRIVEWAY I 110L,E ---- - -- DENOTES PROPOSED #4 1 04X 11 SPOT GRADE 2-18• DIAM. ACCESS MANHOLES I I 6 - I ; X 104.46 DENOTES EXISTING SPOT GRADE PL C=. � PROPERTY LINE I INLET > - + T ; i 96P - PROPOSED CONTOUR OuTf - - - - - -97 EXISTING CONTOUR THE ACCESS COVERS FOR THE SEPTIC TANK. LOT #21 DISTRIBUTION BOX AND LEACHING COMPONENT 98 _ �• -" -. �:^..:Tl'y'�� SET DEEPER THAN B INCHES BELOW FINISHED I I ' - GRADE SHALL BE RAISED TO WITHIN 6. OF I 11539 Square Feet STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE I I , - " DEEP TEST HOLE & PLAN VIEW INSTALL ruF-nTE GAS BAFFLES OR EouALs I ' PERCOLATION TEST LOCATION 3-24• REMOVABLE COVERS ' I . - 6 FOOT STOCKADE FENCE i 3- min. elewance g7 NLET 8• min.T-LY min. Not to outlet 1Y saET ----- --- e• min. _ OUTLET t9� i + Llgv� _ 9.25 PLOT P LAN E S I .r 4'-0• min. -- i ; % s 2 91 2 - o..e.is. :• Liquid depth i / I Z 1-- OF PROPOSED SEPTIC SYSTEM UPGRADE I i t ` ,. •.,. .- .. 'j I _ 1 PREPARED FOR 4! -1 -1 �- MR . GERALDO DASILVA CROSS _SECTION END-SECTION AT TYPICAL 1000 GALLON SEPTIC TANK y # 1037 PITCHERS WAY NOT TO SCALE H YA N N I S, MA Design Calculations �i OF NPY) �NOFM - - I �`G0 �� Assn PREPARED BY: Number of Bedrooms 4 Equivalent to 440 Gal./Day OOj ���` y� CA T ' `�i� r�. ��r r T� Garbage Grinder: No W �40 F o C E l�,lr/L/11l/J l/i lNl Leaching Capacity Proposed: 440 Gal./Day Septic Tank : - 2 x 440 Col./Doy = 880 USE EXIST. 1000 GAL. Septic Tank. S Ln ENVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch 0. Bottom Area: 0.74 gal/sq. ft. x 500 sq. ft. = 370 gallons �� P.O. BOX 627 �STE Sidewall Area: 0.74 gal./sq. ft. x 99.6 sq. ft. = 73.7 gallons 0 20 40 50 EAST FALMOUTH, MA 02536 SAN Providing: = 443.70 gallons � ITAR\P� TEL/FAX : 508-539-7966 Use: (7) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, � SCALE: 1 "=20' DRAWN BY: CES ATE: NOVEMBER 3, 2005 TO BE USED WITH 3.5' OF WASHED STONE ON THE SIDES, AND 3.125' OF WASHED STONE ON THE ENDS. NO STONE UNDER. PROJECT SD826 FILENAME: SD826PP.DWG SHEET 1 OF 1 SCALE: 1 "=20 # --- -- -- -