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Home My WebLink About0504 YARMOUTH ROAD - Health 564 YARMOUTH RD.,'HYANNIS Rainbow Movers, Inc. _ a x e 1 o s Parcel Detail Page 1 of 3 DAWNS AD-L.F— hIMS. aF ,p. 4 .�Y r �•:r!! 6 MA1 , T se ' Logged In As: Parcel Detail Tuesday, Ap Parcel Lookup Parcel Info Parcel ID 1,344-006 I DevelopeeY LOTS 11, 13& 20 Location 1504 YARMOUTH ROAD I Pri Frontage 83 Sec Road I Sec I Frontage Village HYANNIS I Fire District HYANNIS Sewer Acct I Road Index 18 00 Asbuilt Septic Scan: Interactive ' `' 344006_1 Map r - Owner Info Owner I RTS GROUP I Co-Owner C/O PREMIER REALTY Streets 1460 YARMOUTH RD I StreetZ City HYANNIS I state MA zip 02601 Country F— �'w Land Info Acres 11.26 Use COMM WHSE MDL-9� zoning �B Nghbd C115 Topography I Road Utilities I Location Construction Info Building 1 of 1 Year 1970 Roof �1 Ext STEEL I Built Struct I 1 Wall Effect�9800 I Roof(—' I AC NONE I Area covert Type Style I Pre-Eng Warehs I Intl Bed Wall I Rooms Model Ind/Comm Int Floor I'Ypical I Rooms Bath .0 Full Grade Average Type R Total ooms F i http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=28472 4/27/2010 r, � - t Parcel Detail + Page 3 of 3 16 1996 $136,500 $0 $0 $102,700 17 1995 $136,500 $0 $0 $102,700 18 1994 $149,300 $0 $0 $106,100 19 1993 $149,300 $0 $0 $106,100 20 1992 $165,900 $0 $0 $117,900 21 1991 $200,200 $0 $0 $168,400 22 1990 $200,200 $0 $0 $168,400 23 1989 $200,200 $0 $0 $168,400 24 1988 $171,700 $0 $0 $126,300 25 1987 $171,700 $0 $0 $125,000 26 1986 $159,300 $0 $0 $125,000 Photos Aw- IT I 4 `, 4 E � 6 ova http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=28472 4/27/2010 Town of Barnstable P# � Department of Regulatory Services s� Public Health Division Date s61q �� 200 Main Street,Hyannis MA 02601 Date Scheduled ( Time—� Fee Pd. Ld C/)) Soil Suitability Assessment for Sew-age Disposal Performed By: ► OW-)A �-r/��W r 1 witnessed By: ; Ili �`��:� ��` . LOCATION&.�GENERAI:�INFC)R1VIA�TION �:.`� � Location Address j O4 `r iamt(AT}1 ry q'D Owner's Name LA HAM /1AN�1GEMbasr Y1 �� Q,n.r�►�S LERs,rruG. =,vC•, � y Address P,v, Z,,X 9 edO Gf 1'/ H,14A,uxS,MR 07 Assessor's Map/Parcel: 3 N y lo Engineer's Name AAv.L� c.cltGNkNcdi;E 4-T/�T�fN✓�L �"�� NEW CONSTRUCTION REPAIR Telephone# 5yj) 36 4— 61gq q �Qg. Land Use ('0 44tA e t of I Slopes(% /' ) V Surface Stones �d h e j� Distances from: Open Water Body 100 t ft Possible Wet Area ft Drinking Water Well f ft Drainage Way_�� ft Property Line �D f ft Other ft ;1 SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Pt 01 1 ' �lal T 2j� �RKRGL' Parent material(geologic) 1 �6�`RGI 00+ W4LJh Depth to Bedrock �(7 Depth to Groundwater: Standing Water in Hole: yv h e Weeping from Pit Face d Q Estimated Seasonal High Groundwater "� DETERMiNATION FOR�SEASOI�TALHIGHWATERTLE Y Method Used: M T Ll 6J C�i Depth Observed standing in ohs.hole: ` in. Depth to soil mottles: 144 in 610 n e- 1 Depth to weeping from side of obs.hole in. Groundwater Adjustrnent ft T f — 213> q --3" Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ �+*'--' �'C.,Tr •-„� Observation �_ A, 2 � x '--+ der ; t• - t-=- Hole# � 'A � Time at 9" QDepth of Pert^ �/r]((6}/,t/]%"t — 6 �y\ Time at 6" �f �• Y./ I 0 -6 �— Start Pre-AACTmre @ Time ff-6) t.a..= C t�1 ` `5 i D;o7 7 -oo End Pre•soalc } c RateMinlln �mp� V4�1 Site Suitability Assessment: Site Passed r/ Site Failed: 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 Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORMDOC r �� '� D�EPOBSERVATIONHOL�E�LOG � Hole#�i��1.��, �, ; Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) L2^� C3 SRun�{ LDArI tp`(6Z�'�6 �Dv►e FI'iu�l� C MED- CbwMe sWD W YR DEE"P OBSERyA'T IOATaHOLE LOG w Mole# VMA Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) 0 -G MIXED Fits_ �— - S "3$ g %Vrx Lam (�YR��6 uhe Fria�1(� 3�-62- C M ED - (OWi C- ld Y(Z 6/3 Woke Los e . SRN E. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) i4-�kD SR1J�� IDANI JOYfLlG� tbne 161 4D - 1 D G 10- CS- S"D MF-61-3 �bKp- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) 10 - 2Z AQ �;WDvt t-oRM LDYRZ/j V�One 22-45 B LOA-1A � SRND 10�R q6 No we t r►'.q61e 4,- Oft C Me^CSC 613 Kos L,905e Flood Insurance Rate Man: Above 500 year flood boundary No— Yes Within 500 year boundary No ✓ Yes Within 100 year flood boundary No 7 Yes De th of NaturaHy Occurring Pervious Material Does at least four feet of naturally occurring pe7jous material exist in all areas observed throughout the area proposed for the soil absorption system? `�e-5 If not,what is the depth of naturally occurring pervious material? Certification ` I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CUR 15.017. Signature Date i Q:\SEPHC\PERCFORM.DOC LOCATION SE E PERMIT NO. VILLAGE �! INSTA LLER'S NAME & ADDRESS � - 4 �N , RA BA SfA6 �� B UILDE R OR OWNER DATE PERMIT ISSUED 2-0_ DATE COMPLIANCE ISSUED � — �c �, '` � l `� w �r `Y� 6. t,J &17 Fim$ .......... THE COMMONWEALTH OF+MASS,%CHUSETTS BOAR® OF HEALTH ®� a ....OF....... - .. .- ---------------•---------------- ?C`4v `L......-.__ . Applira#ion for Mqvaaal Morks Tomitrurtinn rrumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at �`'................. �crn�� id . l b Lot No.---------------------------------------•-- ---- ............. ....... s orLocgtiin-Address wner Address a •..................... ........................................ ...... --•---....---------•----•-..........•---......._._....--•---------•-----......•................... Installer Address Type of Building Size Lot............................Sq. feet Mng-No. of Bedrooms-__---.. ...,_--•---------------•----_-----Expansion Attic ( ) Garbage GrinderP4 —Type of Building e r_.__.. No. of persons........ ................ Showers — Cafeteria G� YP g P ( ) ( ) a Otherxtures -------------------------------- W Design Flow.._......�.0.........................gallons per person per day. Total daily flow_.....3�.dV. ......................gallons. WSeptic Tank 4 Liquid capacityl. allons Length---------------- Width................ Diameter_......:...... Depth.............. x Disposal Trench—No..................... Width.................... Total Length_.__._.___.._.._.._ Total leaching area ..rr. ._ sq. ft. Seepage Pit No..........I---------- Diameter--__-1 ......... Depth below inlet..._. ,.....AJ;ot, Ching area�l��l.:sq. ft. z Other Distribution box ( ) Dosing Jnl�( ) U� =- �, '/.�.. 'Percolation Test Result Performed by.__. ._ le._:_ �.�r�*^!✓..........................:........ Date...�_-�... ---- �..... aTest Pit No. L. .�-----minutes per inch Depth of Test�Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a l S �.................. -a.._._...._._.._... O fr t ......... f� C/_.... . Description of Soil.........i.� =.. --....... x U ---•--••------••--•----••-•--••-•---••--••-•••-•••••-••----•••••-•---•---•--•----••---•-------•-------------•-••••--••---•--------•-••••-•---•-----••••--•••-•-•••-••-•••-----•••......-••------•-•... w ...............----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- UNature 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 iI'i!.E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i u by/he board o.health. IV Sign ........................ Date Application Approved BY-------.. -------- ---------- ......--------•---..Date Application Disapproved for the following reasons:................ . -----.................... -..................................... -.................. _ ....................•----....---------- ........---........-•-•----•-•-•-••••------••-•••-••-------•--•---- ------ -�----------------------------.......-- // Date � � Permit No. Issued- c.................................................. Date _ �� No FlUg THE COMMONWEALTH OF�MASSACHUSETTS /c BOARD OF HEALTH OF......... ......... ............7� .:, Appliration for Vis at Works TimdrUrtiouiTamit Application is"hereby made'for a Permit to Construct ( ) or Repair j` ) an Individual Sewage Disposal System at , pj ................!o: .. � 1 "a .. ••-• . ... ........... ...............••-•--•-••••........••.. ..... Location-Address .,, or-hot No. FR ............ �!3°l,o m...t._. ..... - ......_ .........I........................... .. . Owner • .- Address t ---------------- ........ ......................................................... U Type of Building Size Address Lot...`.......................Sq. feet f Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a Type of Building ...... '.___ No. of persons.........(_e--------------- Showers ( ) — Cafeteria ( ) C�F Otherfixtures ! .±�.!----------------------------------------------------------------------------------------------------------•--.... Design Flow......._...? gallons per person per day. Total daily flow_:__.-_. gallons. W 0----------------•- -- �j °� WSeptic Tank— iquid capacity...t_ Mons Length................ Width................ Diameter__._._-_--_--_. Depth................. x Disposal Trei;c -No..................... Width.................... Total Length.................... Total leaching area...............__._sq. ft. Seepage Pit No._-_-_-_-_-.�_.___._. Diameter.._..._f ..._-__ Depth below inlet............. Total leaching are'40...._...sq. ft. Z Other Distribution box ( ) D6smg tank ( ) fir//'' j aPercolation Test Resu Performed by.... ��'' ............. --•---.. __!2 � Test Pit No. 1_._._ minutes per inch �Dho s It.................... Depth tti grounfl�wat¢r".'__.........�.__... w.. Test Pit No. 2..:.. .........minutes per inch Depth''of' Test/Pit.................... Depth to ground water......................... --------------••-----•-•-- O Description of Soil........ x .............. x f _ ._... - ........................... -------- .�. ' -------------- �., ----- W -•-•••......----•-------------------•-- ••-----•-------•----••-•--•- -•----......-------------------- ----------•-•--------•- ---•----------•-•-------•------•••--•-•- UNature of Repairs or Alterations—Answer when applicable.--____•__ ---............................................................... ---•- . ... ......................... Agreement .. •,; The undersigned agree to install the afore'described Individual Sewage Disposal System in accordance with the provisions of TIT:.;... 5 of the State Sanitary Code The undersigned further a.grees not to place the-'system in operation until.;# Certificate of Compliance has been"issued by the board of health. ; . Signedf .... ...........••-•..- ------• ---•••-•-•.--... ....-----••-----•-------.._..._ — _ ry. Date Application Approved BY :. IG - Date Application Disapproved for lie following reasons:---•--•-•--- --------------•-•-•----•---•----------• -•---.............. ` ...................-------•----•------------------------------------•--•--- ------•-----------. _ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �rrttf$rttte unto tnrr . THIS-IS TO CERTIFY, .That the Individual Sewage Disposal System constructed r Repaired ( ) bY••-•••-••-•-••••-•............4cnV ............................................................ �V -•--•-• Installer has been installed mce wi he pr si s o 't" e e Sani ary Code s gibed in the application for Disposal Works Construction P rmit No.. :_.___G? ............... dad___.. ............ THE ISSUANCE OF THIS CERTIFICATE SHAL OT BE CONSTRUE® AS. G RANTEE THAT THE S STEIVI WILL FUNCTION SATISFACTORY. DATE..........................: .:... = �j t_..._. Inspector--•-•-. ............... --- -• . -- =.� ........---- - - THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �+ v .. O. ,/.. ..g. r ` FEE... . ff El a n �t1 n Wnnotr ion : rrmit Permissionis hereby grante --.-•------------..............- ---•-••----------------------•-------------•--------••-----------•-----------------..------.---•---•----. F to Construct (A<or Rep i ) an ndividual ewage Disposal`System ;� Q-; ; --- .: � 6s=rciion �� -...as shown on the application for Disposal Works Permit .._._ ated� .,,r •....� ........ ........... DATE............. --- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS ,5 COMMONWEALTH OF MASSACHUSETTS µ• .` EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS a a DEPARTMENT.OF ENVIRONMENTAL PROTECTION TITLE 5 t : OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS {j SYSTEM FORM SUBSURFACE SEWAGE DISPOSAL *{ x PART A a . CERTIFICATION #f Property Address: 504 Yarmouth Road ° Hyannis,MA.02601 a 1 i Owner's Name: Laham- Owner's Address: 499 Route 6A East Sandwich,MA. 02537u f! Date of Inspection: 10/10/2006 Name of Inspector: (please print) Brad J White Company Name: Wind River Environmental Mailing Address: 107 N'Main Street Carver,MA 02330 Telephone Number: (508)-866-2576 "{ s , CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal systern 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 nay fy A training and experience in the proper function and maintenance of on site sewage disposal systems Iam a DES'' approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The systeM . cn X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 10/19/2006 The system inspector shall submit a copy o his inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority:' Notes and Comments System Passes. *Note septic tank is not H-20 Loading there was concrete poured on tank but it is not H-20 loading. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 504 Yarmouth Road Hyannis,MA.02601 Owner: Laham Date of Inspection: 10/19/2006 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are,indicated below. Comments: System passes B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. . Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally. unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a.broken, settled or uneven distribution box. System will pass,inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain:. } The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): t broken pipe(s)are replaced obstruction is removed ND explain: Titles G Tnc —t;—F—A/1 /7Ml1 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 504 Yarmouth Road Hyannis,MA.02601 Owner: Laham Date of Inspection: 10/19/2006 C. Further Evaluation.is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS,and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Titles All';IIMO 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 504 Yarmouth Road Hyannis,MA.02601 Owner: Laham Date of Inspection: 10/19/2006 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X_ 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 _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. _X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X_ 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. IThis system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] _No_(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. T41. 4/1 cnnnn 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 504 Yarmouth Road Hyannis,MA.02601 Owner: Laham Date of Inspection: 10/19/2006 Check if the following have been done.Yod must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health _X_ Were any of the system components pumped out in the previous two weeks _X_ _ Has the system received normal flows in the previous two week period? _X_ Have large volumes of water been introduced to the system recently or as part of this inspection X Were as built plans of the system obtained and examined?(If they were not available note as N/A) _X Was the facility or dwelling inspected for signs of sewage backup? _X _ Was the site inspected for signs of breakout Were all system components,excluding the SAS,located on site`? _X 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 _X Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance"of subsurface sewage disposal systems The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no _X_ Existing information.For example,a plan at the Board of Health. _X Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable);[310 CMR 15.302(3)(b)] T;tl. G i--1;— 17nr,,, All 1;/')M11 5 _ 1 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 504 Yarmouth Road Hyannis,MA.02601 Owner: Laham Date of Inspection: 10/19/2006 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no): [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment:_Warehouse_ Design flow(based on 310 CMR 15.203):_330gpd gpd Basis of design flow(seats/persons/sqft,etc.): Sq.Ft. (2 bathrooms)2 sinks—2 toilets Grease trap present(yes or no):NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings,if available:Not available Last date of occupancy/use: Approx 3months but still used sparingly OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unknown Was system pumped as part of the inspection(yes or no): No If yes, volume pumped: _gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _X Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy No Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)_ Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Approx 1970's per age of all components and as built plan. Were sewage odors detected when arriving at the site(yes or no): NO Titles G Ino—t;n Rnrm 6 Page 7 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART C SYSTEM INFORMATION(continued) Property Address: 504 Yarmouth Road Hyannis, MA.02601 Owner: Laham Date of Inspection: 10/19/2006 BUILDING SEWER(locate on site plan) Depth below grade: 42" Materials of construction: cast iron X 40 PVC_other(explain): Distance from private water supply well or suction line:N/A Comments(on condition of joints,venting,evidence of leakage,etc.): Building sewer is in good condition. SEPTIC TANK: X (locate on site plan)Inlet and outlet covers to grade Depth below grade: 28" Material of construction: X concrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: 8' x 5%2" x 4'-10" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: flocking Distance from top of scum to top of outlet tee or baffle: 10" Distance from bottom of scum to bottom of outlet tee or baffle: 18" How were dimensions determined: Measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Inlet and Outlet tees seem to be in good condition.Liquid level is normal GREASE TRAP:_(locate on site plan) Depth below grade:_ 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Titles G Tn ..f;n Pn 411'�/')000 7 1 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 504 Yarmouth Road Hyannis, MA.02601 Owner: Laham Date of Inspection: 10/19/2006 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:N/A(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box � g ,etc.): PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): Titlo G lncnartinn Rnrm �ii�i�nnn 8 F Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 504 Yarmouth Road Hyannis,MA.02601 Owner: Laham Date of Inspection: 10/19/2006 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type —X leaching pits,number: I @ 6' x 6' (Cover on surface)(4' from pipe to water—high stain indicates liquid reaching as high as 30"from the pipe to the water. leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): soil is dry no signs of hydraulic failure.Vegetation is normal. No ponding to the surface. 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 or no): 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.): T;t1. G 9 xa ve s * 4t ', r F� ;'r,, %g dkt'Y! ' . _ � . a - ve` +F y n! k ;3t r 4 ;! r p,7 Page 10 of 11 y: + k# �,} '� f 5 S "SLF L+ �t ° ,j + 4 yri, yM1 }� - -*' f t rFr,,i kf t' e t.r Aid ' ,- ,Wxf�--fll%P� Y :.�. f 'i J'4 '.F i "i+ XI 33 x,Yk' r. :e t � sr r .J t r, rS.r k'}^°S Yr•r-r }�lifjd` ' Elie �.j.� ,t! 1 a,•p t Fk3 +b 7v} x �5 II ?¢,'y'ssll�' Ada ! 1 < < °:" , '. + '' ,,. t r _' i.�4 fit; 4'�-vi OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS , ,- a 1. j 5 �� r SUBSURFACE.SEWAGE DISPOSAL"'SYSTEM INSPECTION FORM I, �, ryxr 4 PART r,st` " < w + T + 4_`zz•.c K Y •'J'- .' 1. t a 44#a ' �k� r SYSTEM INFORMATION(continued) k. .,.,, yyr i „ !L rr "-.v 5 s x.1 k �"` k .,s F5 '� !r { h r.}.,t B r* ! g �* ;� y. t.. n E s ,N 't ,a`.Property Address: -504 Yarmouth Road '• lW r ., h r ,� Hyannis,MA.02601 34} ,�. 'Owner Laham r . t ... . - r tis f kxN�1;r`�T'�`°Date of Inspection:10/19/2006 ' t . - S gtA y 't �3 1 gf. 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E.i' s - dt �.o. `cF.xt tii r I c4"3'u5x t a.-( r s r x ,} ' l0 _. > e7'j11A?G,lnanotIYn Fnrm!/1 SM(lrlfl'er •t § } ` -;m....,` ''' "+3A'.0 3 �Js"_'t ";;S:R''rc�rim ,s ' C�2`a y +`harr'+�,�y"yet JrhH ti k, ,/1 }s a£ a''"f'r:u� u^x L�f+- ..vt} x t ...f .`.f".Y' 4, 0. .,.a E d.°.'FVto ....... _.,?-•�&..h. .,.x.:r+ cJ.:..±`t".a. . ..:Y ".. 5,�,dY Y,,, - -. - - Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 504 Yarmouth Road Hyannis, MA.02601 Owner: Laham Date of Inspection: 10/19/2006 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 9'+ feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: x 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: No indication of groundwater @ 8' per slope off.Taken from surrounding area. i y Titles S Tner�artinn Fnrm (./1 f/7M11 1 I ►mac.� � � dh I Date: 1 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: RflA-V\loovy hwexs ZY, BUSINESS LOCATION- ��{' ��2drQU i t A. MAILING ADDRESS Mail To: �0�-1,�1 �-�� Board of Health TELEPHONE NUMBER: Town of Barnstable CONTACT PERSON: _ t _ E P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: Hyannis, MA 02601 TYPEOFBUSINESS: tw kyu:-z Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO f 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(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) 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 Any other products with "poison" labels Paint brush cleaners (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 TOXIC AND HAZARDOUS MATERIALS RE RATION FORM NAME OF BUSINESS: RA / Jv�3D�v YYlO U Eh`3 S .L,v C . Mail To: BUSINESS LOCATION: ,!�0 y T/±g al D y T Y AD Board of Health MAILING ADDRESS: Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: 7 7/ ^ IA c? I Hyannis, MA 02601 CONTACT PERSON: &,TR Al Me Ery RN E t EMERGENCY CONTACT TELEPHONE NUMBER:FIO-9aa-1 Dao- o7Y0- a 107 (1ibME) Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalli g, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? 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: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business P-- of�SOY[ �01Y +.� t 1 • ti L 9Q ` •t�4 -� V c 4C DIST I •. • 4'C1' vn•r' Io,0•0o , U Box 77 MIN 1000 2• MIN1000— GAL. _ r GAL. e• PRECAST OR SEPTIC 6 i1 a BLOCK c ee S TANK ,',e • SEEPAGE PIT C- -r.••.d. 4`\;``-emu` ��4 — -- 20 MINIMUM _+I•,' '• o r • ? y�a ` FOUNDATION I. ,• — — — — ��` / �/ ANC I /e WASHED STONE - ELEVATION SKETCH SCA!_E = 4 z c ;� o bry q�' 1 0 ,- 10 t 1 { + r c C i� � j � � .o�s.•�:.v try ��:�.v �F II ✓A4?,EHAuS� La-/G Fmp,.o/Ee3 x soq— jv�,e»`o, Ph'r�r•�a S E.� Cv,u7v�-��. � f = 30 0 r fl ^7 ' f V Z•; /YIAr, SQLL•x�,•gd4E Di4iL'f sT<oc�.� Fo -rN�_: Sysr&-A-7 c / ETy C. TPw I ✓`>✓&Wl94-e-S: l B e, S,i• >< Z. S' 9P<'%.` 4 70 9•�v , g i !� �y��'`►'oU qh� ' �oT-*ra.» �9 S.r r t�a9 p�/s.F - `19 q.p . s� \ 94, 7"�•TNi. $ Z4- '7 s'F 54'j t c J 4 V,--y7' i 1 ` lz��S%, � y SOIL L O• + roA- 9 I---- _ Z. t T y3 - P y �� '✓ �` E L E VAT I ON SCHEDULE PROPOSED SITE PLAN ��vi M6D1 I INV AT FOUNDATION _ y4, oO O SEWAGE SYSTEM DESIGN 2 1NV INTO SEPTiC TANK _ I N 3 1NV OUT OF SEPTIC TANK = `13 .45 64RNS7-,,9&Z (;wyQ,,Vy S � /°ilfi�SS• Jrlo c A$ L 4 1 NV NTO DISTRIBUTION BOX SCALE 19y� 5 I NV OUT OF DISTRIBUTION BOX = O r C PsI11a. NATV 6 INV INTO SEEPAGE PIT _ P.G CAPE COD SURVEY CONSULTANTS j TEST BY : C. e.�.v�rf v -- ROUTE 132 ( TOWN INSPECTOR; -Af L,,,4 7 BOTTOM OF PIT c � HYANNIS,MASS. BACKHOE OPERATOR A MV+StOM eosrae ewveY CoNeuLT►wre, +eta ElT MADE ON _.__._l1yLl $_._ - i. BOTTOM OF STONE LAYER et-Afe