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0720 PITCHER'S WAY - Health (2)
�720 PITCHER'S WAY Sea Meadow Village Hyannis A r� No. O v -r�-- Fee--------- -- ------ BOARD OF HEALTH TOWN OF BARNSTABLE 01ppCicationforlVeri Con.1tructioni3ermit Application is here y ade for ape it to Construct ( ), Alter ( ), or Repair ( )an individual Well at: Location — Add Assessors Map and Parcel cc ---- Owner Address Installer — Driller Address Type of Building Dwelling --- -- —— —---_— Other - Type of Building No. of Persons---- Type of Well Purpose of Well---� - - L _—_----_ Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Sig � -7 ----- — ---- - — � ------- ate �4 Application Approved BY — -- - ------—— —� - date Application Disapproved for the following reasons: — date Permit No. -- -- Issued-- -------- —------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, Tha the Individual Well Constructed (Altered or Repaired ( ) -------------_________----------------------------- Installer at f ------------------------------------------------------------------------------ has been installed in accordance with t e provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit Nco!A_ ®_ Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE ----— -- Inspector-- ----— - ------------- f No. - G ----- __- BOARD OF OF HEALTH TOWN OF BARNSTABLE ���Cication,�or�err �Con�trutt,ion�ermit • Application is here y made for a permit to Construct ( ), Alter ( ), or Repair (' .)an individual Well at: Location — Add 1 Assessors Map and Parcel C12�e 4A�_w._.- /a _ -_ ___ ____ _ - - - ---- Owner Address Installer — Driller Address .. , .. Type of Building Dwelling --- - --- - -- -- Other - Type of Building _--__- No. of Persons--- -.--------_ Type of Well_/ 'azl Purpose of Well Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. Sig ed -- __-_- _ _911- ante t� Application Approved Bye.„, —___— �/ _ -- date Application Disapproved for the following reasons: date Permit No. �- -t) ' —__--- Issued---------- . - ----------- ---------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS TO CERTIFY,/T'ha� the Individual Well Constructed (--rr ltered ( ), or Repaired ( ) by- 1 �-�� '` _- Installer 7�at �/ _.' :� i � has been installed in accordance with t e provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit Nt h -^ 0--i Dated-S 22A ---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE -- -- -- Inspector-- ------ _______-------- - BOARD OF HEALTH _- TOWN OF BARNSTABLE Ivell con0ruct ion Permit " No. �U`''i C� Fee Permission is hereby granted All('4/i2 1,2J1 to Construct ( to ( ), or Repair ( ) n Individual Well at: Street --------------------------- as shown on the application for a Well Construction Permit No.-- ------ Dated ---------------------------- DAT E - I Board of Health — .__ Rill %VWnD� 6 D �_' KALKUNTE ENGINEERING CORPORATION CONSULTING ENGINEERS February 10, 1988 Mr. Frank Mezzacappa DEQE Southeast Region Division of Water Pollution Control Lakeville Hospital Lakeville, MA 02347 Re : Sea-Meadow Village, Inc. , Hyannis Temporary - Tight Tank Dear Mr. Mezzacappa: On behalf of our client Sea-Meadow Village, Inc . , Hyannis we submit our request to install a temporary sewage holding tight tank in accordance with the DEQE Tight Tank Policy with variances as requested. 1 . Existing Situation: The enclosed letters, one from the Town of Barnstable Selectmen dated February 1 , 1988, and another memo from the Barnstable DPW Superintendent to Selectmen, dated February 1 , 1988, explain in detail the existing situation. Sea-Meadow Village consists of 54 units with 114 Bedrooms. The units are ready for occupancy except for sewer connections. Per the Original Schedule, sewer connections should have been ready by now. Unfortunately the project as designed was not implemented after bid opening becuase of unavailablity of adequate funds (bids came higher than anticipated) . Therefore, the existing situation presents sufficient evidence that there are "no feasible alternatives" for- sewer connection, and the only feasible way to .occupy the units, because of many time constraints, is to install a temporary tight tank and monitor it closely for satisfactory operation. Reasonable variances are being requested based on the precedent set by DEQE for a tight tank which was operated successfully for a period of 14 months in Barnstable. 2. Design Criteria : a. Size of Tight Tank: The design is for 35 units with a total of 75 bedrooms . 75 bedrooms @ 110 gpd/bedroom: 8250 gpd ' Sy'e„yr J I �I 7_ 1 �749 CENTRAL STREET. STOUGHTON1 MASSACHUSETTS 02072 (617) 344-8565 Mr . Frank Mezzacappa DEQE Southeast Region Page 2 Per the DEQE Tight Tank Policy, Volume Required : 8250 x 5 = 41 , 250 gpd : For a temporary tanx, the DEQE . required . volume of. 41 , 250 gpd is very big at prohibitive costs'. Instead -we are proposing a tank of 3500 gallons capacity for the same 75 bedrooms . We respectfully request a waiver of the DEQE policy in sizing the tank, and this is based on the precedent established by the DEQE in 1982. In 1982, Greenbrier development connected; for a period of 14 months, 75 bedrooms to a 2700 gallon tank, and the tank was maintained very well without backup or any problems. It was .a successful , satisfactory operation for a, total period of 14 months. : The Town is, very well experienced in handling a similar situation sucessfully, and therefore we request your approval to install a 3500 gallon tank for a total of 75 bedrooms. It is absolutely certain the length of operation is far less than the 1982 project. b. Theenclosed drawing presents a design for 3500 gallon tank and appurtenant facilities, prepared by Kalkunte Engineering corporation and stamped by K.N. Srinivasa, a. Massachusetts Registered Professional Engineer, No 29426: c . Alarms : At the site an "Outdoor Alarm Panel" will be installed. This consists of Weather proof flashing light . Weather proof horn alarm silencer button . NEMA 3R enclosure to house alarm relay and automatic telephone dialer Proposed "Chatter Box Model CB-4" manufactured by Raco Manufacturing and Engineering Co. , Emriville, California or approved equal . The float switch will be activated at three-fifths capacity. d. Pumping : The contents o.f the tank will be pumped on a daily basis by Canco company. Canco has designated tank truck(s) ' for pumping only fresh sewage and no septic waste . Sea-Meadow Village has entered into a contract with the company to trans- port the sewage . A copy of the contract is enclosed. e. Disposal of Contents : The sewage will be disposed into the Barnstable Water Pollution Control 7:.18 KAT -CUN'TE FNGINPYRING CORPORATION C Mr. Frank Mezzacappa ? DEQE Southeast Region Page 3 Facility, directly into the Headworks (grit removal structure) . This is acceptable to the Town and necessary arrangements have been made to receive sewage on a daily basis. f. Accessibility: The proposed tight tank is off the paved area, and the frame and cover projects . approximately four (4 ) inches above the existing grade which will eliminate entrace of surface water . To facilitate easy operation a permanent suction piping is installed. g. Location: The tank is located such that there is sufficient access at all times . h. Permit: After receiving the approval from the DEQE, Sea-Meadow Village, Inc. will obtain a permit from the Barnstable Board of Health prior to installation of the tank. i . Monitoring : The Barnstable Board- of Health will certify that they will monitor in accordance with their local and DEQE requirements that the system is properly installed and maintained. This certificate will be forthcoming at the time they issue the permit. j . Groundwater: The proposed tank is above the groundwater in the area. The tank will be purchased from a recognized manufacturer of TIGHT tanks. As the tank is at a great depth, uplift will not be a problem. k. Odor Control : The tank will be pumped on a daily basis and this should either minimize or eliminate odor problems. If there is a need for odor control, we will promptly resolve the problem. 1. Monthly Reports : Kalkunte Engineering Corporation will prepare monthly reports and submit the same to the Board of Health and DEQE. 3. The proposed Tight tank will be financed by Sea-Meadow Village, Inc. for its construction and satisfactory operation and maintenance.. Sea-Meadow Village, Inc. officers will issue a separate letter to assure adequate funds will be made available for the project implementation, if needed. 4. The proposed Tight tank will be disconnected immediately after the sewer connection is available. The tight tank will be cleaned and abandoned. 7: 18 KALKUNTE ENGINEERING CORPORATION r Mr . Frank Mezzacappa DEQE Southeast Region Page 4 Once again, we respectfully request that you approve the installation of a temporary tight tank for Sea-Meadow Village, Inc. with the variances as requested. If you have any questions please contact us . Very truly yours, KALKUNTE ENGINEERING CORPORATION K.N. Srinivasa, P.E. President KNS/ct Enclosures cc w/enclosures Barnstable Selectmen' s Off � Barnstable Board of Healthic Barnstable DPW, Mr . O'Brien, Superintendent Barnstable DPW, Mr. Russell Davenport, Asst. Supt. Barnstable DPW, Mr . Frank Lambert, P.E. , Town Engineer Barnstable DPW, Mr. Walter Jacobson, Project Manager Sea-Meadow Village, Inc. Mr . David Dronsick, CDAG Administrator 7; 1 8 KALKUNTE ENGINEERING CORPORATION 350 MAIN STREET PROPOSAL NO. 1158 WEST YARMOUTH, MA 02673 TELEPHONE(617)775-2800 ASeptic Services CANNONS - CANC® Pumping & Plumbing • Heating • Sprinkler Installation ENERGY CORPORATION Services C_C -- TO: Date Feb. 8, 1988 Ms. Candace Gordon Sea Meadow Village Rt. 28 Hyannis MA 02601 re: Tight Tank Pumping and Disposal Agreement Dear Ms. Gordon: We propose to pump and transport on a daily basis, sewerage waste from the proposed Tight Tank System. All waste is to be pumped by a clean truck and transported to the Barnstable Sewerage Treatment Plant on Bearses Way, Hyannis. The Barnstable DPW has requested that all sewerage be fresh,which will require that the pumping and disposal be done on a seven (7) day per week basis. If more than one (1) load per day is required, additional charges per load will be required to pay overtime labor rates to our on—call driver and for additional Town fees for the opening of the Sewerage Plant for access by our truck. All charges are based on a per—load basis, regardless of volume pumped. First load per day $ 65.00 Each additional load per day $ 85.00 Town disposal and access charges Cost + 20% j16 These rates are subject to change on thirty (30) days written notice. Invoicing to be doneweekly,with payment due in fifteen (15) days. Respectfully submitted, TERMS: This Proposal subject to revision it not accepted within 30 days and to approval by Credit Dept.of Cannors. SUBJECT to Mass.Sales Tax-where applicable. It is expressly agreed that title to all materials is to remain with Canco until contract is paid in full. Unless otherwise stated-bills to be presented each month for all labor and materials on the job site,and are due and payable within 10 days of receipt of invoice.Failure to make payment as above stated shall constitute work stoppage and a bookkeeping and finance charge of 1'h%per month or an annual percentage rate of 18%on balance past due 30 days and over.If not paid when due,the buyer is subject to reasonable costs of collection including attorney's fees. All labor and new materials furnished and installed by Cannons are guaranteed.This installation shall be in accordance with all local,state and utility codes governing such work. Master Plumber#5715 Master Pipe Fitter xM8703 CANCO P. Y JSC:raft By 'TT (('AeN�T��]T((����TT You are hereby authorized to furnish the material and labor specified above for which I(We)agree to pay the amount state n dTrdposaT,�aCtbr'dlr>N terms above and on reverse side hereof. Buyer WHITE-GNCO COPY YELLOW-CUSTOMER COPY PINK 6 GOLD-FILE COPIES Buyer ,0*TN(7-0` i BA8N9T1BLL. �O 1639. 0' f WAY�. 367 Kin Slreel, Aannii, //lam. 02601 February 1, 1988 Mr Frank Mezzacappa Department of Environmental Quality Engineering Division of Water Pollution Control Lakeville Hospital Lakeville, MA 02347 Dear Mr Mezzacappa: The Board of Selectmen is writing in support of a request to be made by the developers of Sea Meadow Village in Hyannis for permission to install a tight tank on a temporary basis so that the development may be occupied while work on a pending sewer connection is completed. Sea Meadow Village is the first affordable housing project on Cape Cod that will allow people of limited means to purchase homes under the State's Housing Opportunity Program. A total of 85% of the 54 dwelling units in Sea Meadow Village will qualify as affordable or very affordable units. The Town of Barnstable has approved the connection of this project to the municipal sewer and has obtained a Community Development Action Grant from the Massachusetts Executive Office of Communities and Development to pay for the construction of a small pumping station and forcemain both of which are required to allow the development to connect to the Town's sewer system. A sewer discharge permit request was submitted by the Town of Barnstable to DEQE in December based on a larger scale project that has since proven to be unfeasible. The attached memo, from the Town's Department of Public Works to this Board, explains the situation as it currently exists and outlines a recommended plan of action to solve the problem. As specified in the attached memo, the proposed plan has been prepared in consultation with all parties at the local level. The success of this plan of action, however, hinges upon DEQE's approval of the use of a tight tank on a temporary basis and further upon the waiver of some of the design criteria included in the tight .tank policy document adopted by DEQE on October 1, 1975, and still in effect. For this reason, therefore, through you, we request that DEQE approve both the use of the tight tank as a short term (approximately eleven weeks) measure as well as a variance from the specified design criteria. Should you require confirmation of .any information provided herein or should you have any questions, please contact any of the, following individuals: Ltr to F Mezzacappa, Feb 1, 1988, re: Sea Meadow Village, Page 2 - Town of Barnstable, Department of Public Works Russell Davenport, Assistant Superintendent at 775-1120 x 186 - Town of Barnstable, Board of Health Thomas McKean, acting Director at 775-1120 x 158 - Executive Office of Communities and Development David Dronsick, CDAG Administrator at 727-8170 Sincerely, v Martin J F1 1 MT Friel Francis I Broadhurst Board of Selectmen Town of Barnstable Encl r gyp ; ti !J T� V :.J J f7 %qi/"LLI. nn >;aasrsnj : �a.C/�1C/iJ��i7l'�('/J?,L :�1 //r�/ //r. Knnz �o ,639. e0' SEC MAY 02601 COMMISSIONERS: (617) 775-1120 Et. 123 KEVIN O'NEIL. CHAIRMAN JOHN J. ROSARIO. VICE CHAIRMAN ROBERT L. O'BRIEN - THOMAS J. MULLEN SUPERINTENOENT .HILIP C. MCCARTIN February 1, 1988 To: Board of Selectmen From: Robert L O'Brien, Superintendent, DPW Subject: Sea Meadow Affordable Housing Project The purpose of this memo is to provide the Board with a status report on the sewer connection for the Sea Meadow Village project and a recommended plan of action to allow occupancy as soon as possible. Occupancy was originally planned for February 1, 1988, but it has been Postponed due to a delay in the connection of the project to the municipal sewer system. This project involves 54 housing units and 112 bedrooms and 85% of the units are classified as either very affordable or affordable under Chapter 40B of Massachusetts General Laws. A total of 46 of the housing units have been purchased under the State's Housing Opportunity Program. The Town of Barnstable received a Community Development Action Grant from the Executive Office of Communities and Development to underwrite the cost of connecting the development to the Barnstable sewer system. A grant of $340,000 was awarded to the Town of Barnstable for the sewer work and for some traffic management improvements to the intersection of Pitcher's Way and Route 28. The original intent was to include the Sea Meadow development as part of an overall solution to a sewer problem along Route 28, but after completion of design and the opening of construction bids it was apparent that this option presented too many problems to the end that the bids were rejected. Our normal design and bidding schedule for projects of this type were accelerated in order to accommodate the tight time frame of the developers of Sea Meadow Village. A Notice to Proceed with the detailed redesign of the sewer connection was issued to Kalkunte Engineers on January 29, 1988. The redesign calls for a small pumping station at the site of Sea Meadow Village and a four-inch forcemain from there to the treatment plant. Based on a preliminary engineering estimate prepared by Kalkunte Engineers, the construction of the redesigned project will cost approximately $175,000. This amount is well within the $340,000 CDAG amount. The Town Engineer has stated that the project should be completed by May 1, 1988. Based on this, the following is a detailed schedule of activities for the sewer project: n Memo to Selectmen, Feb 1, 1988, Sea Meadow Affordable Housing Project, Page 2 Notice to Proceed - Design February 1, 1988 Completion of Design February 29, 1988 Bid Opening - Construction March 18, 1988 Contract Award - Construction March 28, 1988 Completion of Construction May 1, 1988 Because of the delay in the sewer construction it will be impossible for the new owners of the affordable housing units to occupy their dwellings by early February as was originally planned unless a temporary tight tank is used as an interim measure until the sewer connection is completed. This approach was used to allow occupancy of the Greenbrier development on Southgate Drive in Hyannis in January of 1982 to allow occupancy of 25 units totalling 75 bedrooms for a period of fourteen months before the project could be connected to the sewer. During this period there were no problems with the system, which was closely monitored by the Board of Health. This type of .measure would have to be approved by both the Town of Barnstable Board of Health and the Department of Environmental Quality Engineering. After discussion the matter with the developer, Kalkunte Engineers, the Town's Board of Health, and the supervisor of the wastewater treatment plant the following course of action is recommended. I. Proceed with the redesign and construction of the sewer connection based on the schedule outlined above. This would allow the sewer connection to be completed by May 1, 1988, utilizing funds from the State's Community Development Action Grant already earmarked for this work to pay for the construction. 2. Work with the developer to obtain approval from the Department of Environmental Quality Engineering for the temporary use of, a tight tank to collect and hold sewage from the development subject to the following conditions: The developer shall Hire an engineer, at , their expense, to prepare the .__. necessary designs and obtain the necessary regulatory approvals for a tight tank system; Install at their expense, a tight tank system with a capacity of at least 2,700 gallons for the temporary storage of sewage; - Obtain an agreement with a licensed septage hauler to inspect the tight tank daily and to pump as necessary up to the point that units with a total of 35 bedrooms are occupied; - Have the septage hauler transport the sewage to the treatment plant, at the develop'er's expense, and dispose of it there; Memo to Selectmen, Feb 1, 1988, Sea Meadow Affordable Housing Project, Page 3 At the point when units with a total of 35 bedrooms are occupied then the tight tank is to be pumped daily or more often as necessary; and Upon the completion of the sewer connection project, remove the tight tank, at the developer's expense and return the site to an acceptably landscaped condition. This plan of action, if acceptable to all parties including the Department of Environmental Quality Engineering, will allow the occupancy of the affordable housing project at Sea Meadow Village in a timely manner while limiting the use of tight tanks to a short period (approximately eleven weeks). However, this course of action would require that the Department of Environmental Quality Engineering give a variance to its own policy regarding tight tanks regarding the size of the tank (2,700 gallons proposed vs 61,600 specified based on 500% of average daily flow per bedroom based on Title 5). It is important to note, however, that the size of the tank specified in the policy is based on a "permanent" installation. The only other option is to delay the occupancy of the development until the sewer connection is completed which will not only create a hardship on the developer, but also, quite possibly on some of the people who might lose their eligibilty to purchase the affordable units. I ROBERT L O'BRIEN Superintendent - - ---� � _ �, �� ! � �� ' 1 1( . i �-� Y � �� � � 1 � �°� � ��- � - �� _:f Fro m:The .Bernardin Law Firm To:15087906304 0810112016 12:33 #235 P.0011007 FAX COVER SHEET To: Timothy O'Connell Town of Barnstable—Public Health Division FAX: (508)790-6304 FROM: Judy Hynes Puopolo DATE: August 1,2016 PAGES: 7 Re: 720 Pitchers Way, MA,Hyannis,MA Please see the attached. I f From:The Bernardin Lava Firm To:15087906304 08/0112016 12:33 #235 P.0021007 Judy Hynes Pnopolo 11 Gardner Road Reading,MA 01867 July 25,2016 VIA USPS PPJOR TY MAIL Barnstable Deputy Sheriffs Office Civil Process Division P.O.Box 729 Barnstable,MA 02630 Re: Sea Meadow Village,Unit*6A 720 Pitchers Way Hyannis,MA 02601 Dear Sir or Madam: In connection with the above-referenced premises,enclosed please find the following: 1. Fourteen Day Notice to Quit for Nonpayment of Rent; 2. Letter to Joseph Murphy;and 3. Check in the amount of$45.00 payable to the Barnstable Deputy Sheriff's Office. Please deliver the Notice to Quit, along with the Letter, to Joseph Murphy at the noted address. I can be reached at the address above. My home phone number is 781-944-0865 and my cell phone number is 617-930-6732. Thank you for your attention to this matter. Sincerely, Judy Hynes Puopolo From:The Bernardin Law Firm To:15087906304 0810112016 12:34 #235 P.0031007 Date( Tenant Joseph Murphy Address 720 Pitchers Way, AA City,state,zip Hyannis, MA 02601 Fourteen Days Notice to Quit for Nonpayment of Rent Your rent being in arrears,you are hereby notified to quit and deliver up in fourteen(14)days from your receipt of this notice,the above described premises now held by you as my tenant. If you fail to so vacate,i shall employ the due course of the law to evict you. Sign by landlord or ant mey Reservation of landlord's Rights All monies paid to the landlord after your receipt of this notice will be accepted as use and occupancy and not as rent,without waiving any right to possession of the premises,and without any intention of reinstating your tenancy or establishing a new tenancy. Cure Rights of Residential Tenant at Will If you are a tenant at will,and if you have not received a Notice To Quit for Nonpayment of Rent within the last twelve months,you have a right to prevent termination of your tenancy by paying or tendering to your landlord,or your landlord's attorney,or to the person to whom you customarily pay your rent, the full amount of rent due within ten days after your receipt of this notice. Cure Rights of Residential Tenant under lease if you are a tenant under an unexpired written lease,and you have not received a Notice to Quit for Nonpayment of Rent within the last twelve months,you have a right to prevent termination of your tenancy by paying or tendering to your landlord,or landlord's attorney,or the person to whom you customarily pay your rent,the full amount of rent due within ten days after your receipt of this notice, CHAPTER 494.ACT OF 1977. From:The Bernardin Law Firm To:15087906304 0810112016 12:34 #235 P.0041007 Proof of Delivery ' i delivered this notice on .20 as follows. (check all that apply] by delivering a copy,in hand personally,to the above named tenant, at 720 Pitchers Way, #6A In the presence of ❑by leaving a copy,slipped under the dwelling unit entrance door,at the above described premises. by taping a copy to the dwelling unit entrance door,at the above described premises. by mailing a copy,first class postage prepaid,to the above named tenant atthe above described premises. r Signed by person giving notice From:The Bernardin Law Firm To:15087906304 08/0112016 12:34 #235 P.005i007 0 Judy Hynes Pnopolo 11 Gardner Road Reading,MA 01867 July 25,2016 HAND DELIVERED Joseph Murphy 720 Pitchers Way,#6A Hyannis,MA 02601 Re: Sea Meadow Village,Unit#6A Dear Joe, In order that I may begin to remedy the "violations" you reported to the Health Department,please let me know when my husband and I may gain access to the condominium to begin working to correct them. I propose the following dates and times: Saturday, July 30,2016,at 11:00; Sunday,July 31,2016,at 11:00,or Sunday,August 7,2016,at 11:00. Please call my cell phone to let me know which date and time will work best for you. I hope you are have been working to find suitable housing for yourself-- Sincerely, Judy Hyn Puopolo Cell#: 617-930-6732 From:The Bernardin Lahr Firm To:15087906304 08101/2016 12:34 #235 P.0061007 Judy Puopolo From: Chris Lebherz <lebherzlaw@verizon.net> Sent: Thursday,July 28, 2016 3:19 PM To: Judy Puopolo Subject: Re:Joseph Murphy Sounds reasonable.Ill see what I can do. On Thu, Jul 28,2016 at 2:40 PM,Judy Puopolo <Judy(0bemardinlawfirm.com>wrote: I am agreeable to waiving his rental delinquency, but want him out no later than September 15. This has been going on long enough. From: lebherzlaw@verizon.net[mailto:lebherziaw(averizon.netl Sent:Wednesday,July 27, 2016 5:43 PM To:Judy Puopolo Subject: Re: Joseph Murphy Please let me know what you propose. . Sent from my Thone On Jul 27,2016, at 5:15 PM,Judy Puopolo<Judy(�bernardinlawfum.com>wrote: I have attached a copy of the Notice to Quit for Nonpayment of Rent that is in the process of being served on Joseph Murphy. am amenable to working on a mutually agreeable resolution. Judy Hynes Puopolo From: Chris Lebherz fmailto:lebherzlaw@verizon.netl Sent:Tuesday, July 26, 2016 10:45 AM To: Judy Puopolo Subject: Joseph Murphy 1 i From:The Bernardin Law Firm To:15087906304 08101I2016 12:34 #235 P.007i007 Please be advised this law firm represents Joseph Murphy your tenant. As you know, Joseph has gotten behind on rent due to health related issues. You have asked him to move out. Joseph is agreeable to waiving all claims against you in exchange for a waiver of past rent and occupancy through the end of October. He actually thinks he can be out in September but we want to be safe. I hope a mutually agreeable deal can be reached. Chris Lebherz <Notice to Quit.pdf> 2 5"E Tati Town of Barnstable Regulatory Services * HARNSTAB E, 9 MAS& $ Richard Scali,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304. July 11, 2016 Judy Hynes 11 Gardner Road Reading, MA 01867 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY ' CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by ,you located at 720 (A6) Pitcher's Way Hyannis, MA was inspected on July 11, 2016 by Timothy B. O'Connell, R.S., Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint received at Town of Barnstable The following violations of the State Sanitary Code were observed: 105 CMR 410.500—Owner's Responsibility to Maintain Structural Elements Chipping paint was observed on the Bathroom ceiling. The living room ceiling also had chipping paint and water staining from unknown source of chronic dampness. 105 CMR 410.351 —Owner's Installation and Maintenance Responsibilities Bathroom ventilation fan is not working. Clothes dryer not properly vented to outside. The following violations of the Town of Barnstable Code were observed: 070-4 of the Town of Barnstable Code: Dwelling not registered with Town of Barnstable Health Division. You are directed to correct all the State Sanitary Code violations and source of chronic dampness listed above within thirty (30) days of your receipt of this notice and dwelling must be registered with Health Division within fourteen (14) days. -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. However, said violations must be corrected within seven (24) hours regardless of any request for a hearing. Non-compliance will result in a fine of 100.00 per violation. Each q g p $ day's failure tocomplywith an order shall constitute a separate violation. i i P ER OFT E BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Citizen Web Request Page 1 of 2 wi M r+ " � /� 42f2`/G rrl _.... ��+.e dioa� Logged In As: Thursday,J 2016 I" TOWN\oconnelt Citizen Request Management Route to Users Search Requests Create Requests Request Information Request ID: 56722 Created: 7/7/2016 2:50:11 PM Status: Assigned To Staff Assigned To: O'Connell,Timothy Health Office Anonymous: No Request Category: Chapter II : Housing Substandard edit Routine work: No Estimate: No edit Date scheduled: edit Estimated 7/21/2016 Change Estimated Jun July 2016 AA Completion Completion Date: Date: Sun Mon Tue Wed Thu Fri I Sat 26r27 28 29 30 1 2 3 5. 6 7 8 9 10 12 13 14 15 16 17 19 20 21 22 23 24 26 27 28 29 30 31 1 2 3 1 4 1516 Created By: Soto, Kathryn Priority: Medium edit Health Office - Citation Numbers: edit a Requestor Information Request Parcel Map: 1271 _� this rental. Email: Edit Requestor Information Track Request Progress Request Work History: TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date l Time: In Out Owner 1. Tenant n Addressr,11 Address 6� c ,^ Compliance Remarks or Regulation# Yes O Recommendations 2. Kitchen Facilities 3. Bathroom Facilities _- or — 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation i 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural1/� Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here TOWN.OF BARNSTABLE BOARUOF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date "' - „. _ Time: In Out � - Owner fi Tenant v,. '" 11 i w ;+ Address 44kr Address Compliance Remarks or Regulation # €Y Yes ,1d0 Recommendations s 2. Kitchen Facilities �.A i 3: Bathroom Facilities '���✓'� .--- r 4 WaterSSupply 5. Hot Water Facilities . 6. Heating Facilities L/ . .4.. 7. Lighting and Electrical Facilities' 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service ✓ 11. Space and Use ' _• 12. Exits 13. Installation andiAaintenance of Structural Wa Elements 14. insects and Rodents; t 15. Garbage and Rubbish Storage and Disposal l/ J'�r 16. Sewage Disposal F'.., 17. Temporary Housing 1 � t 18. Driveway Width 19. Number of Tenants Observed PART 11 ° 37. Placarding of Condemned Dwelling; ' i, ' * , Removal of Occupants; Demolition i O �riy .� Ye Numberof Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) . Person(s)'Interviewed Inspector �If Public Building such as Store or Hotel/Motel specify,here I, d _. a O'Connell, Timothy From: Payne, Celestine (DPH) <celestine.payne@ state.ma.us> Sent: Monday, July 18, 2016 3:35 PM To: joewillie08498@hotmail.com Cc: O'Connell,Timothy Subject: 410.000 - Housing Code Highlighted Attachments: 105 CMR 410.000-Hearings Highlighted.rtf Good Afternoon Mr. Murphy: I was told that you're seeking guidance with regards to a recent inspection from the Town of Barnstable. Please note that the Community Sanitation Program has no jurisdiction over the Local Boards of Health. I spoke the inspector Timothy Oconnell from the Town of Barnstable this afternoon and he stated that you didn't provide him with a mailing address for the inspection report. .Please call him at your convenience. See page 27 for your rights to a hearing. Also you can file a complaint against the Landlord in regards to your eviction with District Court located on Main Street or call 508-362-2511. Respectfully, Celeste Payne Program Coordinator i Commonwealth of Massachusetts W Title 5 Official Inspection Form 1011� 3 o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Ce�ntervill'i _ Ma. 02632 10/20/2009 _ every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see compleztbriess checklist at the end of the form. Important:when filling out A. General Information �I A formsfgq the I//1✓I computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use'the return key. Capewide Enterprises,LLC. Company Name Q P.O.Box 763 Company Address Centerville Ma. 02632 '700 City/Town State Zip Code (508)428-4028 S14454 Telephone Number License Number B: Certification 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 M' 10/20/2009 Inspe or's Signa r Date The system inspector shall submit a copy of this inspection report to the Appr�ving Aut0tarity(8gard' of Health or DEP)within 30 days of completing this inspection. If the system i a shared-4yste 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. U 10/01 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage isposal System•Page 1 of 17 J Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every 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: ❑ 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: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every 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 coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® El or liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ®. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis i and chain of custody must be attached to this form.] 1 ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. i ® ❑ The system fails. I have determined that one or more of the above failure l 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. t E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner"should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every 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? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related.to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 8 Number of bedrooms (actual): 8 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 880 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 1160 Phiriney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. City/Town State Zip Code Date of Inspection D. System Information Description: The septic system consists of a 2000 gallon tank,D-Box and two leaching pits. Number of current residents: Unknown Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d NA 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 10/20/2009 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available:. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Capewide Enterprises,LLC. 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 1983 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3'feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the building vents. Septic Tank (locate on site plan): Depth below grade: 28"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 2000 gallon Sludge depth: 1" t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 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. 35 i Scum thickness 0 8" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 14" 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.): Pump septic tank yearly.lnlet and outlet tees are in place.No evidence of leakage.Tank appears structurally sound. 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-09/08 W Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every 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 Yes 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.): Box is Ievel.Box has two outlet Iaterals.Water level was over inverts at time of inspection. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No. Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1160 Phinney's Lane(BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . Type: ® leaching pits number: 2 ❑ 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.): Sandy soil.System is in hydraulic failure.Both leaching pits were full at time of inspection. 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 - I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums. Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information.(cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ❑ drawing attached separately _ 3SS I 3 I y �0- 3S 2-. 3 t5ins-09108 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Botttom of LP 40' 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: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 J Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 1160 Phinney's Lane (BLDG. 3) Property Address Arbor Terrace Condominiums Owner Owner's Name information is required for Centerville Ma. 02632 10/20/2009 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE BOARD OF HEALTH J ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date — �1 Time: In Out Owner I ` Tenant Address � � Address P In Complia ce Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities Appmed;, -- I:tkl 11 T .dw .W E.+iiw 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed � � ��- PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) .:= Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here i i TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date 13`r® Time: In , f 5 Out Owner - Tenant Address ;L �� Address V1 Com liagee Remarks or Regulation# Yes XN0 Recommendations 2. Kitchen Facilities V Appmedr° ` I Nos r% 3. Bathroom Facilities dq 4. Water Supply V �cJ 5. Hot Water Facilities _ 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17.Temporary Housing / 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition 6 n Number of Bedrooms " Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector G (/ If Public Building such as Store or Hotel/Motel specify here Town of barnstabie Regulatory Services • a Thomas F. Geiler, Director = uAR AULM, X93. � -Public Health Division 'Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Officr,.: 508-S62.4644 Installer & Designer CtEtificatiqu lf!orW Date: 1 ri Desiner: :1c:_Cm41;,...' Installer: Address: Address: PO aosc 7(.3 - On_._..o..l Z 3 ._ �«� was issued a permit .o install a Ete) (instAlljz �� septic system at It to a <J ly�«,vl based on a design drawn by . dated (designer) I certify that the septic system referenced above was installed substantially accorditaf„ V, the design, which may include minor approved changes such as lateral relocation of tilt, distribution box and/or septic tank., I certify that the septic system referenced above was installed with major clean>,et, iix, greater than 10' lateral relocation of the SAS or any vertical relocation of any corxlpot)-Cn( of the septic system) but in accordance with State & Local Regulations, Plan revision oi, certified as-built by designer to follow. �(I179 � ei'�3 Signs iiru).. �-'• 1:' rvr, &.4i ('Designer's i e)/____ es g r's�- amp Mere) PLEASE; "TU TABLE BLI I A ' IVi ' N, u-rim- C;A'T.l�: O CO I.>(AN WILL NOT E I D A.�- LT RECEIVED a E !ST H W. vY�11R.: Q: health/Septic/Desiper Certification Form �0 -d 1920 2LZ 809 JNI2133NIDN38!' Wa bZ= SO 600Z-tPT-83Q 0�1 � �O l No. 00� .� X' GQ 3 IIIC«� Fee t/C✓ -THE COMMONWEALTH OF MASSACHUSETTS m s Entered in c puter:. Yes PUBLIC HEALTH DIVISIGN -TOWN OF BARNSTABLE MASSACHUSETTS ftptitatiori for Bisposai *pstem Construction Vermj� Application for a Permit to Construct( ) .Repair(VKUpgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1160 7ki v,na l's Liar-LA, Owner's Name,Address,and Tel.No. Rf-Lo ur Terrace t►�o Pti,nn c-t's �.". Assessor's Map/Parcel 2�1 3 $� ptd C�-.a -. \Nc A Installer's Name,Address,and Tel.No. :i4 n krP ,,-,j Designer's Name,Address,and Tel.No. LA-Ug - Qazii o 8 0- 7co3 5b 8- z-� Zis sy cra.lc�.r� r C-�1•-Ir-•t� � 3 -v 1 --� cr+s r �..�a c-e c„s►,,,•� Type of Building: Dwelling No.of Bedrooms �'`e�i�T�� � Lot Size 12( ,03_5± sq.ft. Garbage Grinder( ) Other Type of Building Cdbh 0 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 990 gpd Design flow provided S $ gpd Plan Date i l I i$)2009 Number of sheets ( Revision Date Title I wo Size of Septic Tank 'Zoo o trx,10b't Ioo o r Q2 Type of S.A.S. Go — c�. C",.) —\rt,,nc_G, Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1'%aC S 2tmD c 17 L b pa y Date last inspected: �Z, O 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. �4 Si Date 2 3 Zva Application Approved by Date i i '�- 6( Application Disapproved by Date for the following reasons Permit No. ( Date Issued / iiU.w ..,�r�..,.�.....w.m......,.._-.,,,:.._.-/�.•------ --�"'"+.�-�'M_p.+�rw'4 r�+,,.r.e�: -�•�,�..,+.F+�.+.�-...a.-:-'- �r:-"�- 'L�+--.r-*�.,�-a,K•yykw.s�:,, 4'r No. lf✓ l ✓ C/` f3k r Fee Q� • --• THE COMMONWEALTH OF MASSACHUSFTTS--� Entered in c mputer- / - PUBLIC HEALTH DIVISION 'TOWN OF BARNSTABLE,MASSACHUSETTS Yes 3 ftp'itation'for b sposal 6pstent Construction Vermu - Application for a Permit to Construct( ) .Repair(vil"Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 1160 P(,;n A e,,S L%a n o, _ Owner's Name,Address,and Tel.No. PL r :D o r T L f rtx c e -r�1-vim' iteo Ph,�rtc7'S.C.o..,P Assessor's Map/Parcel 2-1 3 $ Ud \4 ✓Mra Installer's Name,Address,and Tel.No,d :c(,t l n hi p-.>Ps Designer's Name,Address,and Tel.No. Y0Z6 a 30� �� 5dk Z� l der,?f+1y�3 Z� -a.l, `�\�-a, ✓v✓1 3 -O�-y'1 L F s r--(.-,A Type of Building: Dwelling No.of Bedrooms c CA 1 t'V Lot Size 12 co ,0 3 3_f sq.ft. Garbage Grinder( ) Other Type of Building Cc>r d o No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 8 8 g gpd Plan Date ill 1$ 6'Lo oq Number of sheets Revision Date Title 1 160 ek,e),l �S Size of Septic Tank Z oo o Lex.1 l oo u rV-4tj Type of S.A.S. (o V - 13,v c� Description of Soil �^- i• �, P Nature of Repairs o`rAlterations(Answer when applicable) r! ! pay y)( 0- 30y 20 (' O Date last inspected:�&o 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. Sign Date 1k IZO Zao ' Application Approved by Date 09 Application Disapproved by Date for the following reasons i Permit No. r}t x�� Date Issued �? THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-sit Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by at I l(o„ ( ,3. C.,— L-,.k1 t has been constructed in accordance ) with the provisions of Title 5 and the for Disposal System Construction Permit No _V�dated Installer co-A4,,,,)'%Lke E n (' ,9.n 5-PS L—L C Designer #bedrooms Approved design flow O gpd The issuance of this permit shaZVI ' be' strued as a guarantee that t 'he system ill func as de igned. Date Inspector - -- - --- - -- - - --L- --- -•------ _- .__- - ----- - - ------ ---- -- -- - --------- -----NO. Fee l THE COMMONWEALTH OF MASSACHUSETTS �- PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal bpstent Construction j3ermit Permission is hereby granted to Construct( ) Repair Upgrade( ) Abandon( ) System located at 1 O ; n ✓l-E Le,,, U M G 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 ion must be cgmpleted within three years of the date of tZpermit.Date 1 1 Appro t [ TRANS. NO.: CITY/TOWN: Centerville APPLICANT: George Bartlett ADDRESS: 1160 Phinney's Lane, Centerville, MA DESIGN FLOW: 880 gpd REVIEWED BY: DATE: N/A OK O , Legal boundaries denoted [310 CMR 15.220(4)(a)] X Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] X Locus Provided [310 CMR 15.2204(t)] X Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components) [310 CMR 15.220(4)] X Easements shown [310 CMR 15.220(4)(b)] X System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- if not, a variance is required [310 CMR 15.412(4)] X Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(d)] X Location all buildings existing and proposed 310 CMR 15.220(4)(c)] X Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] X System Calculations [310 CMR 15.220(4)(f)] X daily flow X septic tank capacity(required andprovided) X soil absorption system (required andprovided) X whether system designed for garbage grinder X North arrow [310 CMR 15.220(4)(g)] X Existing and ro osed contours [310 CMR 15.220(4)(g)] X Location and log of deep observation holes (existing grade el. on each test) [310 CMR 15.220(4)(h)] X Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and(i)] X Location and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] X Percolation test results match loading rate? [310 CMR 15.242] X Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] X Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] X Address 1160 Phinney's Lane, Centerville, MA Sheet 1 of 7 N/A OK NO Location of every water supply,public and private, [310 CMR 15.220(4)(k)] X within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply X within 250 feet of the proposed system location in the case X within 150 feet of the proposed system location in the case of private water supply wells X Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins located within 50 ft. [310 CMR 15.220(4)(1)] X Water lines and other subsurface utilities located [310 CMR 15.220(4)(m)] if water line cross see 310 CMR 15.211(1)[1]) X Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(o)] X Stamp of designer [310 CMR 15.220 1 and 310 CMR 15.220(2)] X Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] X Test Holes adequate two in each of the rim and reserve q ( primary unless trenches as permitted in 310 CMR 15.102(2) or as approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] X Test hole adequate to demonstrate four feet of suitable material? [310 CMR 15.103(4)] X Test Holes adequate to confirm adequate groundwater separation? [310 CMR 15.103(3)] X Benchmark within 50-75' of system [310 CMR 15.220(4)( )] X Materials specifications noted? [various sections of 310 CMR 15.000] X System components not> 36" deep (unless Local Upgrade jApproval or LUA requested) [310 CMR 15.405(1(b)] X Address 1160 Phinney's Lane, Centerville,MA Sheet 2 of 7 �^1 N/A OK NO Size OK? [310 CMR 15.223 1 ] X Inlet tee located ten inches below flow line [310 CMR 15.227(6)] X Outlet tee 14" or 14" + 5" per foot for increase ft depth [310 CMR 15.227(6)] X Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] X Note regarding installation on stable compacted base [310 CMR 15.228(1)] X Separation between inlet and outlet tees (no less than liquid depth) [310 CMR 15.227(2)] X Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CMR 15.405(1) k ] X Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(f)] X Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (by 7/07) [310 CMR 15.228(2)] X Access to within 6 " of grade - one port for systems<I 000gpd, two for systems>1000 gpd [310 CMR 15.228(2)] X All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] X > 10 ft from building foundation [310 CMR 15.211(1)] X -Buoyancy-guoyancy calculation Required/Done [310 CMR 15.221(8)] X H-20 Where appropriate? [310 CMR 15.226(3)] X Setbacks from resources [310 CMR 15.211] X �y / 1�! 11t1 � �Qll ( k4f K dd Required when other than single-family dwelling or flow>1000 d [310 CMR 15.223(l)(b)] X First compartment 200% daily flow; Second compartment 100% daily.flow [310 CMR 15.224(2) and(3)] X "U pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] X f Address 1160 Phinney's Lane,Centerville, MA Sheet 3 of 7 N/A OK NO r Located at least ten feet from any water line? [310 CMR 15.222(2)] 1 X Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211 1 [1]) X Cleanouts required/provided? 310 CMR 15.222(8)] X Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] X Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] X Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] X Siphonproblem/(leachfield below pump chamber) X Endca s or vent manifoldspecified? X Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] X Materials specified (310 CMR 15.251(5) specifies various pipe types allowed) X ISTIuBVTIOk b�, o' . Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] X Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] X Riser if deeper than 9" [310 CMR 15.232(3)(f)] X Inside minimum dimension 12" [310 CMR 15.232(2)(b)] X Minimum sum 6" [310 CMR15.232(3) e ] X Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] X F Capacity(emergency storage above working=design flow)? [310 CMR 231 2 ] X Proper setbacks [310 CMR 15.211 (same as septic tanks)] X Watertight 20-in minium access manhole at least 20" MUST BE TO GRADE 310 CMR 15.231(5)] X Service components accessible(not too deep with piping, disconnects accessible) X Alarm floats - alarm on circuit separate from pumps specified? X Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and(8)] X Stable Compacted Base [310 CMR 15.221(2)] X Buoyancy calculations needed?Provided? [310 CMR 15.221(8)] X Address 1160 Phinney's Lane, Centerville,MA Sheet 4 of 7 N/A OK NO SIAEBS®RIM, l� SYSTEM (SAS,)�GEECLj ,_ 0 Calculations correct? X 4 feet of naturally occurring material demonstrated? [310 CMR 15.240(l)] X Required separation to groundwater? [310 CMR 15.212)] X Aggregatespecified as double washed 310 CMR 15.247(2)] X System Venting required/provided? (system under driveway or >36" deep) [310 CMR 15.241] X Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] X Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document] X Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253 6)] X Each structure with one inspection manhole (if>2000 gpd must be to grade) [310 CMR 15.253(2)] X Aggregate 1'minimum- 4'maximum. [310 CMR 15.253(1)(b)] X 2' sidewall credit maximum 310 CMR 15.253(1)(a)] X In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] X Wd Width T minimum 3'maximum [310 CMR 15.251(1)(b)] X 100 feet-maximum length 310 CMR 15.251 1)(a)] X Minimum separation 2x effective depth or width whichever greater 3x if reserve between trenches 310 CMR 251(1) d ] X Situated along contours 310 CMR 15.251(2)] X Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] X BED�SAS (Maxiiriu �size of bead or'field SOOO�gpc) ` . minimum 2 distribution lines [310 CMR 15.252(2)(a)] X Maximum separation between lines 6' [310 CM R15.252(2)(d)] X Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] X Aggregate depth below discharge pipes 6" minimum, 12" maximum. [310 CMR 15.252(2)(g)] X Separation between beds 10'minimum. [310 CMR 15.252(2)(0] X Bottom area used in calculations only [310 CMR 15.252(2)(i)] X Address 1160 Phinney's Lane, Centerville,MA Sheet 5 of 7 ' r N/A OK NO DID TFIE PI�A�1`1 �O1GE �� �. ON, Pressure Dosed System ? Provided pump and piping calculations as required [310 CMR 15.220(4)(r)] X Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] X If used in gravelless system - make sure jet is directed as not to scour soil interface Guidance Document] X Inspections once per year(systems<2000 gpd) or quarterly >2000 d) good to note on plan [310 CMR 15.254(2)(d)] X Construction in fill -Did the plan specify that the fill shall meet the specification of 310 CMR 15.255 3 ? X Impervious barrier and/or retaining wall ? [Guidance Document] X Impervious barrier installation must be supervised by designer 310 CMR 15.255(2)(b)] X Retaining wall must be designed by Registered Professional Engineer 310 MR 15.255(2)(a)]CX Side slope not exceed 3:1 ? [310 CMR 15.255(2)] X Breakout requirements met? [310 CMR 15.252(2) and Guidance Document] X At least 5 ft. from impervious barrier to edge of SAS (10 ft. recommended) [310 CMR 15.255 (2)(e)] X GpaveZless,System[ A�1 roval Letters `� Check DEP Approval letters for credits and design conditions X If used with pressure dosing do not allow pressure discharge to scour soil interface X w A--Z%rnaZcve wept'" ,�;y�le�?,CllA�lrov'l�etter� a �� '�� Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? X Is the technology being properly applied and does it meet all DEP Approval Conditions? X Is there a note on the plan regarding the requirement for perpetual maintenance agreement? X Any alarms involved on separate circuits X Did the applicant submit an operation and maintenance manual? X Has applicant submitted a copy of a maintenance X Are the variances listed on the plan ? [310 CMR 15.220 (4)( )] X RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] X New construction or increased flow proposed- [Refer to 310 CMR 15.414] X Address 1160 Phinney's Lane, Centerville,MA Sheet 6 of 7 N/A OK NO Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] X Is the system proposed on the same lot as served by private well ? [310 CMR 15.214(2)] X Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] X M+rs j ��� r% , ��'!*r�'�"'�('�1///,�/i/bidi�iiiiiiici���' �yi,°', „� �.• �� y,' r., s Pumping to septic tank ? [ 310 CMR 15.229] X Shared System [310 CMR 15.290] X , Address 1160 Phinney's Lane,Centerville,MA Sheet 7 of 7 'µ'✓1X'7 ... .i..'�W10�1ff5`9 F7l7li.'G'.O�tsoww,,.;�. ..,�...,.re .,., .,,,.... .. ... Town of Harnatsble >P:� l � 7 S� Z1npWfi *K at 16imsbrss im f PubUc'RWth 1XV0,lar am maw m wk fts*UA a!!o, Drec EdieButsd, i) U ,.•Thee_._.L--•-- � :r `. .. - ---�' • r sou Sumabitity.Assessmen t,jor Sdwago n sal , E,-T cs C LOCATION 6"N>t'.>QAL*VdRM& ON ,o,�ottl ... �11�.p Pyi�tn►✓►cr,i�F L.Q,vv1 d1��• owtr'�Na. ��e�r L Aedtyrrfwa . MAAteeno,�rM.prArea�3 1 0�gI 0 0 + 3CJyl CtlL'lIt C o S lf�w l�) •�••�• IMIm� Pc�t►I:Wert���..-+� �alttr�M���..+� • i o oew uatr+leas � urn'--=�-•--� _._.,�...�...�� •. !plheteNdt►diafWlenr dlat aittt ltwdettr a�pltloW�pu'�f1nt�t�M w�Nrab�1 p+ritra�lrel+rl 7130� In Penet�hddwek+liof--��o��.�;c.�stn • Drpd►t� l • 717X)Ob�s bensVlt%IMa� 7130" b.5s prpltgf7mrMwMrt 61wtd1y11ftiwbtfleln aMiq i�d,rrlttt fllgtlell RIB � 7 D8'1"MmMATION POR SUS014AL MON W&T&lil T11 M 16 dual D�rec�c7�oseru a q�n y;l3G �� aYA lose MW lw pull brIVM ellMdill�r 01.Iwlc b, a �yties.were�r.tele: 713_0 O�aiwl Ins wMi�►�ualot,.,... Ntd XWdl w Celn lovel.,:,.,.:.... Mti nlMl►._..�Ate f N ..�. pnCOLA7 ON TO4'1' 3b r drpteflrA [ All 7 �- WW�r—� 1���l'�^Irin.�� �• Saab AJ r�tl�ffrlMbifitYAa+iwn�e u�l�,..�a,..;�eS lteass►trd;�:�..... ta'n'tt� • alt rrb'Ate1b M btrirfor Oberitt�iJsn if*no To$e C oplowd a!944-••----- « t p.i�otf►tle�trl�>t to be 6olufted wl"14st Wes,7N+MVA R"I eo*to Hseutable CWWW"tlOUD.tyjgon atUsd one 11)wnk pvW to bg*p' & 1 :. lV•G'Cll'JO ..�1...Y1'n •. ..ur ..•:r�.�..t .... ; -.l..... -.-.......; low "WOW 'OXOM r Rd 2 3p L} - ��rY(o .. . 5 V2 _ - �. l3V G-Z N-EiJ 2 5Y 8MVI&TYON B'L�Dtit ol� .,.. _ D� ttt+ilftirtaae '{Y�kw f0i1"tft tdt t#r�s(iW NDbW . 06=0 S &-y Lz1�et q-l2 l2-3 U JIAI' ' aU -� C- LIs 2•si Ali D$E 'O$ BV1►TY 1$3X&,XW AD1! ' rau 0 •aM tbls Dail 'cWM,tn 1 Main M" DWAU& DMW IOBMVA77ON SOU LOG gas i eWr.a.� nvau aowatn Mobs tM MaeT�. i • Wawa At+ew tmi bouw4ory too..._ Ya ' MI�IioSgywtl�tro/�q► 1'���1. 'Yoea:,s. ' 1P�tEtyiiu�lnpd�ndDq►?le� Wt.4..., . Dap u le�tleur od atartslly exibtlat e+�t h,dl wu obr�Mwr tbr�+t�ltaut the • . • +rta d mr tie wil abroeptbx+ � �s , It rot,*0 to tbsdDptlo of ll;*I y casa n*pm kw m[wail.....,......r1. . c 2? q • 'n • 1 ...=�(dw)Y bRv��p+ped fhu q11�iu�r tattttL�Rw�-. �?-� � _ _ ____ '_ � ,, ; iof�nvyto�tl�1>Pevt�etiort tad flat qtt �beaa tesstyrb N�pt�lhratl by rn eoeeiro�et witD , , do To"trams& WWAW tlrtot4bod In$10C'Il ISSIT 7. �ott,�.voc V � i ti HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS FORM30 C&w BOARD OF HEALTH a 2 9-TA foL�. CITY/TOW N DEPARTMENT O A N N�S ADDRESS ��M SVBy`oW A,,�N TELEPHONE �S Address /11/60 eK I t4t�1�•r �N E_ Occupant_Ja o TT4 7 d nl A N Floor Apartment No No. of Occupants 2- No. of Habitable Rooms No.Sleeping Rooms 2 No.dwelling or rooming unitsZ4 0 `"_ o.Stories Z Name and address of owner 30I.. MA-LDO0(4A .;� f__aAtAVS _V4 6.A v Lt Remarks Reg.Reg. Vio. YARD Out B►d s.: Fences: Garbage and Rubbish / Containers: It Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress: and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: ` Roof VGutters, Drains: Walls: Foundation: Chimney: J BASEMENT Gen.Sanitation: Dampness: V Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: V Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ W Equip. Repair TYPE: I/ Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ Waste Line: H.W.Tanks Safety and Vent(s) 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 t Bedroom 1 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: s: Kitchen Facilities Sink / 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 'COE goS-1 CAO - Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES PERJURY." / INSPECTOR TITLE f-/f4(_-A9 Jti S Croef- DATE / S ' 200 f5 TIME ! 30 P.M. ' A.M. THE NEXT SCHEDULED REINSPECTION 'y .®' P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety 9 P Y 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 ll, 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. ( ) P PP Y (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). I Failure to comply with an provisions of 105 CMR 410.600 410.601 or 410.602 which results in an accumulation of gar- bage, PY Y Y 9 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. QC,fi��-, _'-- j �.:SENDER: COMPLETE:THIS SECTION COMPLETE THIS SECTION 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 � d ❑Addressee so that we can return the card to you. B. eived by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No I VIA.tS t-AC 1 VOV' 'fit 3. Service Type ft r .Jb a b 1, ®Certified Mail ❑Express Mail ❑Registered ®Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Ye 2. Article Number r 7006 0810 0000 35241 84455 (Transfer from service labeq ; + t e t I . PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE arol aiL y.._.,.... ,. ..... ::.. r., S Permit No.G-10 77 :TM • Sender: Please print your name, address;tand ZI0+41ri-thls box��. f k d TowfS of-Bar-nstahle_,._•.__ I 4a0Health Division OtVI �` 200 Main Street Hyannis,MA 02601 i J ...._ flit III Illi;i1t11111 I I$ iltif! if itiIf ttt tltllltffllf l t tlflfl P17- Certified Mail#7006 0810 0000 3524 8455 �oFz rows Town of Barnstable Regulatory Services � TkiEt.NS'rAQLE, ' 9 MASS. Thomas F. Geiler, Director �p 3639. PTEbMAtN, Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 February 16, 2007 James McAuliffe 1'af 21 Ward Lane Westborough; MA 01581 5 ' 23 � NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY 2 CODE II —MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 1160 Phinney's Lane Unit 31), Hyannis was inspected on February 9, 2007 by Timothy O'Connell, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration in accordance with Chapter 170 of the Town of Barnstable Code. The following violations of the State Sanitary Code were observed: 105 CMR 410.482 - Smoke Detectors. Smoke detector on second floor not working. You are directed to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by fixing or replacing smoke detector on second floor. 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\1160 Phinney;s Lane 3D.doc Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who.performed the inspection. aPERORDER OF T E BOARD OF HEALTH as A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Loritta Tinan, Tenant Cc: Timothy O'Connell, Health Inspector QAOrder letters\Housing violations\Rental ordinance\1160 Phinney;s Lane 3D.doc Certified Mail#0000 0000 0000 0000 0000 ��z r Town of Barnstable n�- Regulatory Services > � Thomas F. Geiler, Director A tft3.9 14i. > public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 C- date a ( re city,state,tip NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000 STATE SANITARY CODE II -MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. 16 The property owned by you located at �3a O was inspected G' b "7 (Addy s) on_/_ by `7d , (date)) / Inspector's name) Health Inspector for the Town of Barnstable, (Reason for inspection) The following violation(s) of the State Sanitary Code were observed: State code violation number-violation des i tion 105 CMR 410.Li - 5.7> 105 CMR 410. 105 CMR 410. 105 CMR 410. Q:\Order letters\Housing violations\Rental ordinance\template.doc 105 CMR 410. The following violation(s) of the Town of Barnstable Code were observed: (Town code violation number-violation description) §170-_- §170-_- You are directed to correct the violations listed above withindaYs._ ( ) — of your receipt of this notice by '# (written, ) (#Z 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. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: - (Name,tenant,owner,Fire Dept.,Building Dept....) Cc: (Health inspector's name) (Generic codes located at QAOrder letters\Housing violations\Rental Ordinance\GENERIC CODES.DOC) QAOrder letters\Housing violations\Rental ordinance\template.doc FORM 30 HAW HOBBSR WARREN'" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOW _ w DEPARTMENT A RESS a N e y`0 TELEPHONE Address Occupant_- � Floor Apartment, 7No.—3_D ___ No. of Occupants_(:�� No.of Habitable Rooms "1 No.Sleeping Rooms__X_—.— No. dwelling or rooming units_!✓ __ NQ.Stories .-__ Name and address of owner 1 / 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: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ' 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 I o Bedroom 2 a Bedroom 3 Bedroom 4 Hot Water-Facil. Sup.Ten.,Gas,Oil, Elect.: Sta s, Flues, e ,Safeties: Kitchen Facilities in SWe Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPOR SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJU ' INSPECTOR q TITLE DATE -2—"r ` 4— TIME 1 0 P.M. A.M. THE NEXT SCHEDULED REINSPECTION 172b P.M. I i 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shali be deemed conditions which may endanger or impair the heaith, 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 al y 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 helalth 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. I (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. i 1 ef-\� as � wParcel Detail Page 1 of 3 :c4 _ k Aga t 4 Logged In As: Parcel Detail Thursday, Febru Parcel Lookup Parcellnfo Parcel ID 273-089-OOL Condo Unit UNIT D Condo Complex ARBOR TERRACE Building BLD 3 _�_... Location 11160 PHINNEYS LANE Pri Frontage ......... .._-_ Sec Road Seca Frontage i Village HYANNIS Fire District 4HYANNIS Sewer Acct I Road Index'1242 Interactive Mapi Owner Info Owner MCAULIFFE,JAMES R I Co-owner MACDOUGALL, JOSEPH W Streetl i21 WARD LN I Street2l city IWESTBOROUGH w _ I State(MA j zip j01581 Country US Land Info Acres 0 useCondominiu MDL-05 Zoning ` Nghbd0001 _........ _ - .............. Topography I Road Utilities I Location Construction Info Building 1 of 1 Year 1983 Roof Gable/Hip- - . ._._...I Ext Wood Shingle Built Struct Wall Effect 11063 I Roof jAsph/F GIs/Cmp I AC I None Area Cover Type Int;"�"�"� '��� Bed Style(Condominium !Drywall_"_.. 2 Bedrooms Wall rY Rooms Model(Res Condo.___ Int Bath Floor= Rooms http://issql/intranet/propdata/ParcelDetail.aspx?ID=20997 2/8/2007 Parcel Detail Page 2 of 3 -y Heat A ��� Total �AS(fo12] de Average PIUs Elec Baseboard 5 Rooms Gra Type - — Rooms B:MFt506) Heat Found- Stories 2 Stories Fuel 1 ation s Permit History Issue Date Purpose I Permit# IAmount Insp Date Comments Visit History Date Who Purpose 10/15/1997 12:00:00 AM Lloyd Kurtz Meas/Listed Sales History Line Sale Date Owner Book/Page Sale P 1 14/15/1983 MCAULIFFE, JAMES R 3728/218 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2006 $241,200 $0 $0 $0 2 2005 $209,300 $0 $0 $0 3 2004 $229,600 $0 $0 $0 4 2003 $92,200 $0 $0 $0 5 2002 $92,200 $0 $0 $0 6 2001 $92,200 $0 $0 $0 7 2000 $69,000 $0 $0 $0 8 1999 $69,000 $0 $0 $0 9 1998 $69,000 $0 $0 $0 10 1997 $70,900 $0 $0 $0 11 1996 $70,900 $0 $0 $0 12 1995 $70,900 $0 $0 $0 13 1994 $65,300 $0 $0 $0 14 1993 $65,300 $0 $0 $0 15 1992 $74,400 $0 $0 $0 16 1991 $123,400 $0 $0 $0 17 1990 $123,400 $0 $0 $0 18 1989 $123,400 $0 $0 $0 http://issql/Intranet/propdata/PareelDetail.aspx?ID=20997 2/8/2007 -Parcel Detail Page 3 of 3 I � y, 19 1988 - $72,200 $0 $0 $0 20 1987 $72,200 $0 $0 $0 21 1986 $72,200 $0 $0 $0 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=20997 2/8/2007 Town of Barnstable Regulatory Services BARNSTA.BLE, * Thomas F. Geiler,Director MASS. 9 1639. ,m Public Health Division �f0 MA'S A Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 February 9, 2007 Attn: Hyannis Fire Health Inspector Timothy B. O'Connell conducted a rental inspection in accordance with Chapter 170 of the Town of Barnstable Code. In accordance with the State Sanitary Code, 105 CMR 410.482, the Health Department is required to notify the Fire Department if there is a smoke detector violation, or possible smoke detector violation. The following property had possible smoke detector(and\or CO detector)violation(s): 1160 Phinney's Lane Apt. 3D,Assessors Map-Parcel: (273-089): Smoke detector on second floor which is hard wired is not working properly. Plug in back will not stay seated within S.D. unit. Timothy O'Connell-Health Inspector Q:\Order letters\Housing violations\Rental ordinanceUire ViolationsTIRE TEMPLATE.doc �� P� � � i FORM30 HOBBSS WARREN'M THE COMMONWEALTH OF MASSACHUSETTS BOARD OF H ALTH LN CITY/TOWN f W V DEPARTMENT ° 1 _ t� ai c ADD SS 0 8 TELEPHONE_ C'1 Address - ---Occupants Floor Apartment No.—C �_.__ No.of Occupants No. of Habitable Rooms Lf No.SI eping Rooms _No.dwelling or rooming units__ __ No.Stories`' Name and address of o rl __ 2�____ 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: Stai rs: Lighting: 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: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) 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 G Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: - - Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n.- General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT 1 IGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR TITLE DATE :2— 3�— TIME ' v v _— A.M. THE NEXT SCHEDULED REINSPECTION P.M. .. P � .. ft -t + •,J"Mn � . t�. sy}> �� �:i .y eta a .,.s., ,4+ .. ..+`a�'_ - 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. � �1S�cc��t1 I �T`1 e-SC\ a I 2h Z'I I VJI ��6C..p l Parcel Detail Pagel of 3 t € f D€ £ Loqq.ed In As: Fn v, r1a Parcel Detail Parcel Info Parcel ID 273-089-001 Condo Unit UNIT A . Complex ARBOR TERRACE Building 1BLD 3 Location 11160 PHINNEYS LANE Pri Frontage Sec Road Sec _. _ ._._..,.. . . Frontage` village`'::HYANNIS Fire District HYANNIS Sewer Acct Road Index 1242 lwuari„ Interactive Map .. " Owner Info owner(PARKER. BRADLEY R Co-owner .......... ......... ........ ...._..._ _... ......... Streetl 160 WILLOW RUN DR Street2 . City=CENTERVILLE State MA Zip02632 Country'US Land Info Acres O Use I Condominiu MD(-06 Zoning Nghbd 0001 Topography� Road Utilities Location Construction Info Building Built Struct. �p_......,, ,,:„,m„: wall Year -M _ Roof r•_._ . Ext 1983 Gable/Hi Wood Shingle Effect, _._....,. Roof.._ __._...._._.�..._ AC 1063 Asph/F GIs/Cmp None Area:_ v _.____�._ Cover- Type .... ......... Style;COndominlum� Int,D all Bed Bedrooms wall' Rooms 1 m �..._..�,._,_._ Int. ..... �...._,,, .,,.,_...�_...� Bath;---, ._... Model;Res Conde Floor', Rooms http://issql/Intranet/propdata/ParcelDetail.aspx?ID=20994 3/2/2007 Parcel Detail Page 2 of 3 Grade Avbrage Plus Heat Elec Baseboard Total 5 Rooms astiol?I Type u Rooms j R . . Stories 2 Stories Heat. Found- .._, Fuel. ation Permit History ......._..................... Issue Date Pur ose Permit# Amount Insp Dare Comments Visit History _. Date Who Purpose � Sales History............ _.._.... Lime Sale Date Owner Book/Page Sale P 1 6/15/1992 PARKER, BRADLEY R 8056/178 2 6/15/1992 PARKER, ELIZABETH C 8056/174 3 6/15/1988 PARKER, ELIZABETH C TRS 6319/280 4 4/15/1983 PARKER, ELIZABETH C 3719/154 �..Assessment History_ _. .... ...... ._._... Sage# Year Building 'value XF Value B Value Lana Value Total Par( 1 2007 $248,700 $0 $0 $0 ; 2 2006 $241,200 $0 $0 $0 3 2005 $209,300 $0 $0 $0 4 2004 $229,600 $0 $0 $0 5 2003 $92,200 $0 $0 $0 6 2002 $92,200 $0 $0 $0 7 2001 $92,200 $0 $0 $0 8 2000 $69,000 $0 $0 $0 9 1999 $69,000 $0 $0 $0 10 1998 $69,000 $0 $0 $0 11 1997 $70,900 $0 $0 $0 12 1996 $70,900 $0 $0 $0 13 1995 $70,900 $0 $0 $0 14 1994 $65,300 $0 $0 $0 15 1993 $65,300 $0 $0 $0 16 1992 $74,400 $0 $0 $0 http://issql/intranet/propdata/ParcelDetail.aspx?ID=20994 3/2/2007 Parcel Detail Page 3 of 3 117. , 1991 $123,400 $0 $0 $0 18 1990 $123,400 $0 $0 $0 19 1989 $123,400 $0 $0 $0 20 1988 $72,200 $0 $0 $0 21 1987 $72,200 $0 $0 $0 22 1986 $72,200 $0 $0 $0 Photos ........ RI a A r�SYvy �ff� http://issgl/intranet/propdata/ParcelDetail.aspx?ID=20994 3/2/2007 Ar&oi I..iqu. G o^ o's Quu'J 1i•t 3 TOWN OF BARNSTABLI� LOCATION 1 PAO InAW h/l,t SEWAGE # VILLAGE ASSESSOR'S MAP & LOT i INSTALLER'S NAME&PHONE NO. !, SEPTIC TANK CAPACITY LEACHING FACILITY: (type) d � �+ �I (size) ��IO NO,OF BEDROOMS ' I BUILDER OR OWNER A / �//Ate. G pn�o ASS�Cy 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 of lea hi facility) Feet Furnished by '-rIl pt Ion FD/� a _ r 706J1H 10 Pt, 1: 19 DATE 1219105 -V I S 10 PROPERTY ADDRESS 1160 11h.inneys Lane unit 4 fLyann is 7.3 -U S Ob� Nass 026.01 On the above date, the septic system at the address above was Inspected. This system consists of the following: 1.6 1-2000 gaiion tank., �L IV-411 2., 1- Dista.i&u.t.ion 9ox.d 3. 2- 1000 gai.ion eiach.ing pits Based on Inspection, I certify the following conditions: 4.1 7h.is .is a. 7.itie Five seRt.ie system (Woda) 5.- The septic .system .is in RaoRe2 woak.ing olden at the /22esent time.. SIGNATURE Name: Robert A. Paollni w { Company: Joseph P. Macomber & Son ing_. 014V Address: P. 0. Box 66 Centerville, Mass 02632 Phone: 508-775-3338 or 508-775-6412 JOSEPM P. MACOMBER & SON,. INC. Tanks-Cesspools-Leachfieids Pumped &.Installed Town Sewer Connections P.O. Box 66 Centerville, MA.026.32-0066 775-3338 775-6412 • . 1 COMMONWEALTH OF MASSACHUS. ETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—.NOYFOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PARTA CERTIFICATION Property Address: .. 1160 %h.ih au.A anA!ln.it 4 y¢nn. h Owner's Name: Aa&oa 7eaaace CondoA Owner's Address: d a m e� Date of Inspection: 12/91 nM - Name of Inspector:(please print Rab rt. Al 0.l"' Company Name: P ea .S:o.n Inc. Mailing Address: en eav e, a6.6.-02632 Telephone Number: 5 0 8=7 7 5 3 3 CERTIFICATION STATEMENT I certify that I have personally inspected the..sewage disposal system at this address and that the information reported below is true,accurate and complete.as of the time of the inspection.The inspection was performed based on my training and experience in,the-proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to.Section.15:340 of Title 5(310 CMR 15:000). The system: xzxpasses -Conditionally Passes 04P Deeds Further cation by the Local Approving,Authority Inspectors Signature. Date: The system inspector shall submit a copy of this inspection reportto the-Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system-is a sliared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner.shall submit the report to the appropriate regional office of the DEP.The original should be sent to-the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This'report only describes conditions at the time of inspection and under the conditions of use at that ^ time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Page 2 of 1 I OFFICIAL INSPECTIONYORM—NOT FOR VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION-FORK PART A CERTIFICATION(continued) Property Address: 1160 Ph'inneyz Lane /in it 4 yanazz Owner: 4/tgoa 7ea2ace Condos Date of Inspection: 1219105 Inspection Sum`mary: .Check A,B,C,D or.E/ LWiA veomplete,all of Section:D A. System Passes: qCS N 0 I have not found any information which indicates'that any of the failure criteria described in 340 CMR 15.303.or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below: Comments: Se12,Uc -6y.5t zem .is .in pzope2 w62k.ina oadez at the .12,2e6ent time. B. System Conditionally Passes: 'a o One or more system components as described in the."Conditional Pass"section.need to be.replaced:or repaired.The system,upon completion ofthe 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. no The septic tank is metal and.over-ZQ 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: no Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or duo to a broken,settled.or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken pipes)are replaced obstruction is removed distribinioii box is leveled dr replaced ND explain: ...no The system requited pumping more than 4 times a year due to broken or obstructed pipe(s),The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain. 2 . Page 3 of 1 I OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1160 P h.inneyz Lane Unit 4 71'yanzz Owner:. 4/t.go z 7e22ace Condos Date of Inspection: 1219105 C. Further Evaluation is Required by-the Board of Health: no 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: n o Cesspool or privy is within 50 feet of a surface water n o 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 mariner that protects the public health,safety and environment: no 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. no The system has a.septic tank and SAS and the.SAS is-within a Zone 1 of a.public water�supply. n o The system has a septic tank and.§A&and the SAS is within 50 feet of a private water supply well. a o The system has a septic tank and SAS and the SAS is less than 100 feet.but 50 feet or more fron!a private water supply well".Method used to determine distance v i,6 u a t " F "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: Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART A , CERTIFICATION(continued) Property Address.• 116 0 %h.inne y s Lane lln i t 4 K n i� Owner: R2goa eaaace Condoz Date of Inspection: 1219105 D. System Failure Criteria applicable to all systems: You must indicate"yes":or"no'.':to each of the-following:f6r 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 X clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool .. _ X Liquid depth in cesspool is less than.6"below invert or,available volume is less than'h,day flow 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.pon-ion of a cesspool or privy is within.50 feet of a private water supply well. �. _ —7_ 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 certifed laboratory,for eoliform bacteria and volatile organic compounds indicates.that the well is free from pollutionarom: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 WT..] NO :(Yes/No)The system fails.I have determined that one ormoreO.f the above failure..criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner gcApuld 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 1.0,00.0 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 X the system is within 400 feet of a surface drinking water supply _ X the system is within 200 feet of a tributary to a surface drinking water supply _ X the system is located in a nitrogen sensitive area(Lnterim 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. 4 i Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSALSYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1160 -%hinn.eu.6 Lane Unit . 4 lluann.i 4 /'lass Owner: R2&o/t .teaaace Date of Inspection: 1219105 Check if the following have been done.You 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 tote as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up T X _ Was the site inspected for signs of break out X _ 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 b_affles 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.t a 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)] 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS .SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM � PART C SYSTEM:INFORMATION Property Address: 1160 Ph.inaagz . Lane Unit 4 Kuann.i�s Owner: ,4ail.oa tea2ace . Date of Inspection: 1219105 a FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 8.. Number of bedrooms(actual): 8 DESIGN.flow based on 310 CMR 15.203(for example:110 gpd x#of bedrooms): 8 8.0 Number of current residents: unkn o w Does residence have a garbage grinder(yes or no): no Is laundry on a separate sewage system,(yes or no): no [if yes separate inspection required). Laundry system inspected(yes or no): n o Seasonal use:(yes or no):nQ Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no):_a.0 Last date of occupancy:?2 es e n t COMMERCIiALaRDUSTRIAL Type of estakohnient: NIA Design flow(bag anda Basis of dbsipn'`flow(seats/persons/sqft,etc.): Grease trap present(yes or no):T Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system-(yes or no):_ Water-meter readings,if available: Last date of occupancy/use: . OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: y e a2.2e y Was system pumped as part of the inspection(yes or 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 _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: 20 yeazz Were sewage odors detected when arriving at the site,(yes or no):no 6 Page 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:1 160 %h.inneys Lane lln.it 4 Kuann.is Owner:Rakoic Teazace Condos Date of Inspection: 0 5 BUILDING SEWER(locate on site plan) Depth below grade: 18 Materials of construction:_cast iron X 40.PVC_other(explain): Distance from private water supply well or suction line: C mnoen s(on condition of joints venting,evidence of leakage,etc.): �oinzz alte .t.igh.t , dented thorough &u.iid.ing SEPTIC TANK:)e-(locate on site plan) 2000 ga t i o n s Depth below grade: at glade Material of construction:Xconcrete_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: 12'X5' 8"X6' 6" Sludgedepth: taace Distance from top of sludge to bottom of outlet tee.or baffle: t a a c e Scumthickness: t2ace Distance from top of scum to top of outlet tee or baffle: t2 a c e Distance from bottom of scum to bottom of outlet tee or baffle: tea c e How were dimensions determined: n2 e a u e a e d Comments.(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid.levels as related to outlet invert,evidence of leakage,etc.): umI2 .tank yeaage In.iet 9 au.t ee.t tea—i azzv_ in n0alm 7-4znk : A .s auc u atty .sours GREASE TRAP:n o(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.): gaeaze t2/2a i s not Rae sent 7 Page 8 of I I OFFICIAL:INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM �-- PART C SYSTEM.INFORMATION(continued) Property Address: 1160 %h.inneU,3--Lane Unit 4 NUann,z A Owners Aa90at 7ea2ace Date of Inspection: 1219105 TIGHT or HOLDING TANK: n 0 (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass - . polyethylene other(explaiui): 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.): Tight o2 h6id.ina tanks aze not Pzzzen.t DISTRIBUTION BOX: Y e (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.): Box ii PR)JOP. Ha.t. 3 Pafona0.t All cn0ir/ C�1b bL�B�b 61rb g6��6��E to 02 out 01 9Ok., PUMP CHAMBER: n o(locate on site plan) s+p� Pumps in working order(yes or no): Y Alarms in working order(yes or no): 9mments(note condition of pump chamber,condition of pumps and appurtenances,etc.): l um12 cnamgea .is -no.t /2aezent 8 Page 9 of 11 OFFICIAL.INSPECTION FORM—NOT.FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 7 16 0 %h.inney s Lane Unit 4 fluann.i.3 Owner:. flat-o? 'Teaaace Date of Inspection: 1219105 SOIL ABSORPTION SYSTEM(SAS): .(locate on site plan,excavation not required) If SAS not located explain why: Located see Rage 10., X Pe leaching pits,number: 2 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.): Loamy to medium .6and,- No z.i nz o a.iZuae oa 2onidng., day vegetation .ins noamaX CESSPOOLS: no (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: e 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.): cezz/2oo.2.s aze not 12ae.6ent PRIVY: n o(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.): pa.vy i-6 notes aae sent 9 Page 11 of 11 OFFICIAL INSPECTION-FO'RM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE-DISPOSAL SYSTEM INSPECTION.FORM PART C SYSTEM INFORMATION(continued) Property Address: Y 9 6 0 P h.innauUs Lane lln yann.ch Owner: 4a8..oa Zeaaace Condos Date of Inspection: A SITE EXAM . Slope Surface water Check cellar Shallow wells Estimated depth to ground water 7 0' feet 1 Please indicate(check)all methods used to determine the high ground water elevation: �N 0 Obtained from system design plgns on record-If checked,date of design plan reviewed: u es Observed site(abuttingproperty/observation hole'within 154 feet of SAS) Checked with local-Board of Health-explain:q,6 n °L ^ry no Checked:with local excavators,installers-(attach documentation) 1 Accessed database=explainAtiR:iown:,gaanbtaI ip- ma.-ub e�s You must describe how you established the high ground water elevation: �.L.sed. : Ca,?a Cod Comm.iz ion 1dat ea 77at a Corit ouaz And .Pull tia Glatea Su/PiY Idete head paotaczi.o.n aaea.e ma Se t 9995 Glatea aesouaces OLtice cane co co.mm.is.ion Leaching Pit 4-eet Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Wthod 4 8 . Therefore,the vertical•separation distance between the bottom of the leaching pit and the adjusted groundwater table is 5 5.,2 11 Page 10 of 11 010 CIAL INSPECTION VOW NOT FOR VOLUNTARY.ASSESSMENTS SUVWURFACE SEVVAG DISPOSAL SYS'1�EM INSPECTION FORM /1 PART C. \ SYSTEM INFORMATION(continued)' Property Address: 1166 Ph.inrze z Lane 11nit 4 yann4-6 Owner: R49oa enaace Condos Date of Inspection: 12/910 5 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks:Locate all wells within 100 feet.Locate where public water supply enters the building. 100 t� 10 a•,mnr+r.�nrr��•.•r wwn,ann�"••a ' - Bl RAV BOARD OF HEALTH TOWN OF t! CTION FORM - PART D CERTIFICATION SUBSURFACR 9EWA08 DISPUSwow A4 SYSTEM It18E'F _.T ,-+:-+:*-+++„*'�*w"'""''""'""",n"'.�++rA•. -TYPS OR PRINT 066ARI.Y- PIIOPERTY INSPE,OTfaD 1160 P h.inne yh Lane Un ii 4 STREET ADD4ES5 ' A9S.ESSORS MAP, BLACK AND 'PARCEL Ra&o2 7eaaace -Conodq6.. OWNER's NAME PART'.* D C�RTIFICAT�;ON NAME OF INSPECTOR R09e,et Pao"ni 41 COMPANY NAME o.be h :PIS. l�acom9e $ Son Inc Box 6 6 C.en-�ezv.itle lea a�' 02632 ` COMPANY ADDRU rqo •. Town-or City. A& • LIP Stra.Ot, COMPANY TELEPHONE ( 508. 1��'7.5 - 3338 FAX 1' 508',)190 � f 578 CER'r-uiCATION. STATEMENT Ir; certify that. I have persotial'lY ,ins-Pected ..the sewage .dratesaatidyStem �►t this address and that m�lfaf iinspe�tiion�rT erted Js in9Fect�'Qnewasoper•Formed and any omplete as of the recommendations regarding upncedin thenproperefunction- arid maintenaneeeof on- with my trainilig and exp.�rie site sewage disposal systems . 11410. Check one: T, XXXSystea PASS'tD , The inspection whic.M I have conducted has ,•nr t• •found any information . which indicates tlia:t the systam. fails to ' adequately. protect .publiv health or the enviropment as defined in- .310 CMR. 16; 30.3, Any failure criteria Ovt eva.luated are as stated in the FAILUIM CRIURIA ;see.tion 0-f this, for)n. System FAILED* fouThe inspection which I have 'C�� ted -has.ronment�intacoordanc�switiitem fTitleails to protect the public liealth and Q 61 314 CMR 15 . 3o3, and as • specif icalIV noted on -PAT- 0 FAILURE CRITERIA of this inspec'tionf e ;., Da 0 Inspector Signature' rovi'ded :to the •OHMS th*e BUYER' ne copy of this certi,fi.catior must 'be >7. where appli•.oa.bl*) and th!s I3PARD Oi* HEALTH w * if the inspection FAIL•EU., thv .owner' .or gperatox the, system. within o'ne year of the date of the i�napection, unless. a];'la�wsd ar requ#;red : . ^, V'a"w4 ne as provided iri gA40 CMR COMMONWEALTH OF MASSACHUSETTS ;=E 17 EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION "} ; '. : s y TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Arbor Terrace Condominiums Property Address: 1160 Phinnev's Lane, Bldg, 3, Unit B Centerville. MA 62632 Owner's Name: Arbor Terrace Condominiums Owner's Address: 3oZ 6 Date of Inspection: September 7, 2005 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number: (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: September 9, 2005 The system inspector shall su t a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of comple ing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1160 Phinney's Lane, Bldg. 3, Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ 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: 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): broken pipe(s)are replaced obstruction is removed ND explain: 2 • Page 3 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1160 Phinney's Lane, Bldg,. 3, Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1160 Phinney's Lane, BIdQ. 3, Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7. 2005 D. System Failure Criteria applicable to all systems: You must indicate either"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 ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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 detennined 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 System: 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. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1160 Phinney's Lane, Bldg-, 3. Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping infonnation was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ _ Was the site inspected for signs of break out? ✓ _ Were all system components,excluding the SAS,located on site? ✓ Were the septic tank manholes uncovered,opened,-and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes No ✓ _ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1160 Phinney's Lane, Bldg. 3, Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 8 Number of bedrooms(actual): 8 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 880 Number of current residents: n/a Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAVINDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped in 2003-per manager 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 ✓ 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Installed on 1111182-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1160 Phinney's Lane, BIdQ. 3. Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments (on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 40" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 2000 zal. Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: 5" Distance from top of scum to top of outlet tee or baffle: -- Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Measurinsz stick Coirunents(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert There did not appear to be any signs of leakage A steel cover was to grade. GREASE TRAP: None (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.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160 Phinnev's Lane, Blde. 3. Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 TIGHT or HOLDING TANK: None (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 andfloat switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box level was normal. PUMP CHAMBER: None (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.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160 Phinnev's Lane,Bldz, 3, Unit B _ Centerville. MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 2-6'x 6'(1000 gal.) leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number, dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Commnents (note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): One leach nit(43) had 5'of liquid on the bottom. The bottom to grade was 9' The cover was to grade The other nit(#4)had 4'of liquid on the bottom. The bottom to grade was 10 5' The cover was 10"below trade There did not appear to be any si ns of failure. CESSPOOLS: None (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: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Commments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: _ 1160 Phinney's Lane, Bldg. 3, Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7. 2005 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Li (A) 4� ` t� w J -4� 10 Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DI POSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1160 Phinney's Lane, B1dg. 3, Unit B Centerville MA Owner: Arbor Terrace Condominiu s Date of Inspection: September 7, 2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 40 +/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-I f checked,date of design plan reviewed: Observed site(abutting property/observation hoe within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours mans Checked with local excavators, installers-(attacI documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable toyogrgphic and water contours nLUI, the snaps were showing approximately 40'+/-to ground water at this site. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will fun�tion properly in the future. There have been no warranties or guarantees, either expressed,written or implied, elating to the system, the inspection andlor this report. 11 COMMONWEALTH-OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Arbor Terrace Condominiums Property Address: 1160 Phinnev's Lane, Bldg 3 Unit B Centerville. MA 02632 Owner's Name: Arbor Terrace Condominiums Owner's Address: Date of Inspection: September 7, 2005 Name of Inspector:(Please Print) James M. Ford Company Name: James M.Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number: (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true;accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: September 9 2005 The system inspector shall su t a copy of this inspe7neprt to the Approving Authority(Board of Health or DEP)within 30 days of comple ng this inspection. Ifym is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATIONS (continued) Property Address: 1160 Phinney's Lane, Bldg. 3 Unit B Centerville. MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7. 2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ 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: 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. J 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: I 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): l broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1160 Phinnev's Lane, Bldg. 3 Unit B Centerville, MA Owner:, Arbor Terrace Condominiums Date of Inspection: September 7. 2005 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. i 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1160 Phinney's Lane Bldg, 3 Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 D. System Failure Criteria applicable to all systems: You must indicate either"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 ✓ 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 I of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. i _ ✓ Any portion of a cesspool or privy is less than 100 feet but,greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] 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 1 Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. T 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) i 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 i 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 I "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM. PART B CHECKLIST Property Address: 1160 Phinney's Lane, Bldtt 3 Unit B _ Centerville. MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant, or Board of Health ✓ Were any of the system components pumped out in the previous two weeks ? Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ 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 ofthe 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: Yes No ✓ _ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)). 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM_ PART C SYSTEM INFORMATION Property Address: 1160 Phinney's Lane, Bldg. 3. Unit B Centerville, MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):. 8 Number of bedrooms(actual): 8 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 880 Number of current residents: n/a Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No 1 Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): epd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of infonnation: Pumped in 2003-Der manager Was system pumped as part of the inspection (yes or no): No ' If yes,volume pumped: eallons--How was quantity pumped detennined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system Single cesspool I_ Overflow cesspool F 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 j 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 infonnation: Installed on 1111182-per as built card ` Were sewage odors detected when arriving at the site(yes or no): No I 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160 Phinnev's Lane, Bldg 3 Unit B Centerville, AM Owner: Arbor Terrace Condominiums Date of Inspection: September 7;2005 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage, etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 40" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 2000 eal. Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: S" Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Measuring stick Conunents(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were Present. The liquid level was even with the outlet invert There did not appear to be any signs of leakage A steel cover was to Yrade. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): j 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.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160 Phinna's Lane. Bldg. 3 Unit B Centerville. MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 TIGHT or HOLDING TANK: None (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: ✓ (if present must be.opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box level was normal. PU3IP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alanns in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): I ' 8 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160 Phinnev's Lane, Bldg.3 Unit B Centerville. MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7. 2005 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: _2-6'x 6'(1000 ag l.) 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.): One leach'pit_03)had 5'ofliauid on the bottom The bottom to trade was 9' The cover was to Qrade The other pit 04) had 4'ofliauid on the bottom. The bottom to Qrade was 10 5' The cover was 10"below grade. There did not appear to be anv signs of failure. CESSPOOLS: None (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: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160 Phinnev's Lane Bldg 3 Unit B Centerville. MA / Owner: Arbor Terrace Condominiums Date of Inspection: September 7. 2005 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Li - - --- f � w J 10 C Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160 Phinnev's Lane, Bldg 3 Unit B Centerville. MA Owner: Arbor Terrace Condominiums Date of Inspection: September 7, 2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 40+/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: i You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours mans the mans were showing approximately 40'+/ to ground water at this site. — I C r This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the systent will function properly in the figure. There have been no warranties or guarantees,either expressed, written or implied, relating to the system, the inspection and/or this report. . 11 No. UC1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zpplication for Migpogaf *pgtem Congtruction Permit Application for a Permit to Construct�X)Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /160 AIIIIV416 CA/ Owner's Name,Address and Tel.No. Assessor's Map/Parcel I-D©L %,e j o `o/V 0 Q Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 3S® CRN� T Gv 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) `5, 0)c �C� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board o e Signed Date Application Approved by Date�D� Application Disapproved for a following reasons Permit No. 'a t-W A — y Date Issued 10 2- 0 3 + No. Duo 3 - LN Fee � v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: -tz P Yes ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpprication for Miopoal *potem Con6truction Permit Application for a Permit to Construct(X Repair( )Upgrade( )Abandon( .) ❑Complete System ❑Individual Components. Location Address or Lot No. ff&C' 0111AWCy& 41/ Owner's Name,Address and Tel.No. r' Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. � ^b ANC o �� �� ------ - w 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 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil, Nature of Repairs or Alterations(Answer when applicable) ,.V/ k klw L�CEV,5N/ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board We � Signed rl�l A Date a '.�\ Application Approved by I �� d�-. Date /0 Application Disapproved for a following reasons Permit No. (,d - 9 Date Issued l v - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate-of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired(/)Q Upgraded( ) Abandoned( )by at Il 4 U nM " s has been construct d��'n accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. odd 3-��� dated !U 9/d Installer Designer i The issuance of this pe t s 11 not be construed as a guarantee that the system it onlV dg igne.� . Date 2 Inspector �-- ' ��d .� �" 7 _ _._ --------- � . . _ - No. it] JP THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,} MASSACHUSETTS y Migo5ar &pg;tem Construction Permit - Permission is hereby granted to Construct( )Repair Upgrade( )Abandon( ) System located at It 6 o n na 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:Construction must be completed within three years of the date o ermit.n Date: I 0 1-0 Approved by \// TOWN OF BARNSTABLE LOCATION 1 U P III NN F P4' A A1 SEWAGE # C AiT ASSESSOR'S MAP & VILLAGE INSTALLER'S NAME&PHONE NO. A k v C o SEPTIC TANK CAPACITY le £ (size) LEACHING FACILITY: (type) II -------------- NO.OF BEDROOMS a('�0,'�' �£✓1°(°c/ .0 COS/SOS Q BUILDER OR OWNER. D 3 PERMITDATE: p o,3. •. COMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within.200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) ------------------ Furnished by i ' a �> 5 • Y \ j 413< e 3Ya COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION � W � I TITLE 5 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Y Property Address: 1160PHINNEY'S LANE CENTERVILLE,MA 02632 Owner's Name: ARBOR TERRACE CONDO'S UNIT 3 B Owner's Address: C/O CAPE COD AND ISLAND PROPERTY MANAGEMENT Date of Inspection: 7/2/01 Name of Inspector: (please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS Mailing Address: P.O. BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes r.. _ Conditionally Passes _ Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 7/2/01 The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. "-'Notes and Comments THE SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS FOR PROPER MAINTENANCE.RECOMMEND,,REMOVING BUSHES FROM AREA OF LEACH PITS ""'This report only describes conditions at the time of inspectitln Mid wideN the conditions ol'use at that (line. 'IYiis inspection does not address how the system will perform in the future under the same or different conditions of use. Title S InenFrtinn Fnrm All 51?0 h:', 1 Page 2 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1160PHINNEY'S LANE CENTERVILLE, MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 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: THE SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS FOR PROPER MAINTENANCE.RECOMMEND REMOVING BUSHES FROM AREA OF LEACH PITS 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. n/a 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: n/a n/a 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: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed NU explain: n/a Page 3 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1160PHINNEV'S LANE CENTERVILLE,MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 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 I of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance n/a "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. s- 3. Other: n/a 4 z Page 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 1160PHINNEY'S LANE CENTERVILLE,MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 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 X 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 n/a. 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. [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 forma (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 _ X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet ofa tributary to a surface drinking water supply X 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 C 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 lids 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. d Page 5 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1160PHINNEY'S LANE CENTERVILLE, MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 Check if the following have been done. You must indicate "yes" or"no" as to each of the following: 0 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 back up? X _ Was the site inspected for signs of break out X _ 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)] i ` S Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1160PHINNEY'S LANE CENTERVILLE, MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15N3 (for example: 110 gpd x#of bedrooms): 220 Number of current residents: 8 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CM 15.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a 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: n/a Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: n/a Was system pumped as part of the inspection(yes or no): NO If yes, volume pumped: n/agallons-- How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X 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) _"right tank Attach a copy of the DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1982 Were sewage odors detected when arriving at the site(yes or no): NO �i Page 7 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160PHINNEY'S LANE CENTERVILLE,MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 BUILDING SEWER(locate on site plan) Depth below grade: 54" Materials of construction:_cast iron X40 PVC_other(explain): n/a Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 48" Material of construction: Xconcrete 1. metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed'by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 2000G L 12' H 6' 6" W 6' 6"" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 17" 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.): THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE SYSTEM RECOMMEND MOVING BUSHES OFF OF SYSTEM. GREASE TRAP: _(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations;inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a' Page 8 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160PHINNEY'S LANE CENTERVILLE, MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): DISTRIBUTION BOX IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY. 1 PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO ' Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a 4; R Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160PHINNEY'S LANE CENTERVILLE, MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type LEACH PITS leaching pits, number: 2 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a : -innovative/alternative system Type/name of technology: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation,etc.): THE LEACH PITS APPEAR TO BE FUNCTIONING PROPERLY.TOTAL CAPACITY IS 3000. GALLONS. RECOMMEND THAT BUSHES BE REMOVED FROM LEACH PIT AREA CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) t Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a Page 10 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160PHINNEV'S LANE CENTERVILLE, MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. I Page I I of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1160PHINNEY'S LANE CENTERVILLE,MA 02632 Owner: ARBOR TERRACE CONDO'S UNIT 3 B Date of Inspection: 7/2/01 SITE EXAM _Slope Surface water _Check cellar Shallow wells Estimated depth to ground water 10 feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record- If checked, date of design plan reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators, installers-(attach documentation) YES Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: USGS MAPS AND CHARTS-10 FEET tt " o PROP.4"VENT WITH CHARCOAL [NISH•GRADE OVER D-BOX- 72.4'+ 4 SCHEDULE 40 PVC MIN.SLOPE 1 /o FILTER TO ABOVE GRADE ' ' GENERAL NOTES TOP OF FOUNDATfON = 72,$'+ r PROVIDE PRECAST CONCRETE EXTENSION _ _ ,- FINISHED GRADE OVER BIODIFFUSERS= 72,Q�3i - 71,LL3 RISER WITH CONCRETE COVER TO F.G. OVER = SLOPE @ 2%MIN. 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE @ FND. EL.= VARIES INLET&OUTLET COVERS FOR BOTH TANKS REMOVABLE WATER-TIGHT COVER OVER INSPECTION PORT WITH METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL RISER TO WITHIN 6"OF FINISHED GRADE ACCESS BOX TO WITHIN CODE AND ANY APPLICABLE LOCAL RULES. 1 F.G.OVER TANK EL.= 72.rj'± F.G. OVER 1,000 GAL.TANK EL.= 72,tt'-I- 5"DIA. OUTLET(S) 3"OF F.G. (ONE PER ROW) 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE I3 DESIGN ENGINEER. OUTLET TEE „' 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL 48 MAX. 60"MAX. SYSTEM UNLESS OTHERWISE NOTED. �-� 3" SEE NOTE 21 TOP OF SAS/B.Q. = 67.43 PROP.4" SEE NOTE 21 " " 3"DROP MAX 16 3 9" - _ " 2" DROP MAX. SCH.40 PVC l 4. TO PREVENT BREAKOUT,THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 2"DROP MIN SLOPE Q 1%min. c0 3 3"DROP MAX. g�� ^ -_-1 PROVIDE WATERTIGHT ELEVATION =67.43' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 10" SLOPE 1,6 min. -�- 14" *68,5, / JOINTS(TYP.) _ 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 14" 4"PVC IN FROM / 1.33' " THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. CONTRACTOR 48" - - SHALLVERIFY SIZE 48 68..35' , SEPTIC TANK 4"PVC OUT TO (TYP.) 16 AND CONDITION of LIQUID 68.10 . 0.90' 110.75"(TYP) 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. LEACHING FACILITYHHMEXISTING TANK LEVEL + 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 12" 6" -.-) CONTRACTOR SHALL VERIFY 67.50' MIN. 67.33' 67.00' 66.10' (laid flat) 2:.675'(34.5") (STONELESS SYSTEM) 7• LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK CONDITION OF EXISTING TEES 6"CRUSHED STONE " (TYP.) FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS AND REPLACE AS NECESSARY 22 ZABEL FILTER 5.0 OVER MECHANICALLY MODEL#A1801-4x22 6"CRUSHED STONE (TYP,) 14.375' NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH COMPACTED BASE (GAS BAFFLE ON BOT.) OVER MECHANICALLY 5'MIN. AND DESIGN ENGINEER. EXISTING COMPACTED BASE 50.0'(TYP FOR ALL ROWS) PROPOSED 8, ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 74.00'ESTABLISHED 2,000 GALLON SEPTIC TANK 5 OUTLET DISTRIBUTION BOX ON A NAIL SET IN TREE AS SHOWN ON PLAN. 1 ,000 GALLON SEPTIC TANK _ TO BE INSTALLED ON A LEVEL STABLE GROUND WATER ELEV.= < 60.17' Length=8-3.5" Width=5'-5.5" Height=5'-7.5" BASE. FIRST TWO FEET OF OUTLET ; 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT TANK DIMS. PER 50 - BIODIFFUSERS PROFILE BIODIFFUSER VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES v S �^� EXISTING 2,000 GALLON SEPTIC TANK WIGGINS PRECAST TO THE DESIGN ENGINEER. CROSS SECTION VIEW �+ *CONTRACTOR TO VERIFY EXISTING PROPOSED 1 000 GALLON SEPTIC TANK DISTRIBUTION BOX DETAIL (H-20) 50 - ARC 36HC (#3610BD) H-20 BIODIFFUSERS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC.STRUCTURES SHALL BE MADE WATERTIGHT. ELEVATION PRIOR TO ANY WORK& � NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING TEST PIT REGULATIONS. OWNERIAPPLICANT IS TO OBTAIN SUCH DETERMINATION FROM SWING-TIES � ` •` ' ". PM DATA APPROPRIATE AUTHORITY.. PERC NO.: 12759 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS 20 HC-1 HC-2 HC-3 r DESCRIPTION � ' ' S se � � � s u5 fi INSPECTOR: David W.Stanton 'R.S. LOCATED UNDER PAVEMENT DRIVES OR TRAVELED WAYS IN WHICH CASE ` /^� a1, :..w y..�. „,.. A. �o Bo,� MAP 274 !t EVALUATOR: Michael Pimentel, E.I.T. THEY SHALL WITHSTAND H-20 LOADING. . . ''' PARCEL 31 ? SEPTIC COVER IN(1) -- 20.3 30.5 ) HC-1 _ C.S.E.APPROVAL DATE: Oct. 1999 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. SEPTIC COVER OUT(2) 24.9 35.1 .. .. 3 DATE: November 10 2009 Z �o s,3 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE Q ae i O BIODIFFUSER CORNER(3) 35.8 52.1 -- ''` 41, TEST PIT M 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. BIODIFFUSER CORNER(4) 26.3' 63.7` -- x. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, ti ELEV TOP- 71.00' ZONE 2 - FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). MAP 273 T ,t 1 ,. BIODIFFUSER CORNER(5) 73.9' 99.8' -- xd3s ELEV WATER= <60.17' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN PARCEL 23 ` SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. MAP 273 (4 BIODIFFUSER CORNER(6) 77.T 92.9' -- �' ;1 x' PERC RATE= 2 min./inch PARCEL 89 Na aw'° t 16. PROPOSED PROJECT IS LOCATED WITHIN: uj DEPTH OF PERC= 30"-48" # c� :, 3 ASSESSOR'S MAP 273 PARCEL 89 HG BU1t a r �" TEXTURAL CLASS: 1 3) U off( OWNER OF RECORD: ARBOR TERRACE CONDOMINIUMS q1 NG 3 Y # ADDRESS: 1160 PHINNEY'S LANE MAP 273 a� O UNIT 3D 2p f 0" 71.00' CENTERVILLE, MA 02632 � . z 11 PARCEL so I R oM a • ; :� k 4" Litter CSC EX1S • 70.67 2 1 DICK 2,gED G ,a , • • Loamy Sand FEMA FLOOD ZONE C ;�. irk � .� �.; � s� tr A S1" (5 ( ( DaFE�72•$+ ;. •..• , �► 12" 10Yr 312 70.00' COMMUNITY PANEL# 250001 0005 C ' LOCUS ; �12 MAP 273 ' Via'" x , • s B Loamy Sand 17. DEED REFERENCE: DEED BOOK 20295, PAGE 144 PARCEL so OYr 5/6 1 0 18. REF : PLAN BOOK 37 G 7 '� • 68.5 PLAN REFERENCE: LA 00 0 PAGE 4 • 6) '� ' Perc 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. ,.,. 48" Loamy Sand 67.00' L nd t�/ C-1 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE THIS PLAN IS TO BE USED ONLY INDEX PLAN SWING-TIES PLAN • ' �" � �* " FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY • • ;; '• 66 65.50 SCALE: 1"= 100' SCALE: 1 =20 ` ,, � r • .:3. FOR OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. CONTRACTOR SHALL NOTIFY ENGINEER 48 HOURS BEFORE THE FOLLOWING*- -, • ;; O USES S 1.VERIFICATION F SOILCONDITIONS AND/OR GROUND WATER EL. IF NECESSARY). ,: .: , � •:. _�. �.._ �,. . ,_.. 21. IN ACCORDANCE WITH 310 CMR 15.401 -�15.405,THE FOLLOWING LOCAL UPGRADE 2.VERIFICATION OF LEACHING PIT ABANDONMENT(IF NECESSARY).��.� ' ��;. P. . '`,:: � , � � �� a::: ,• �_ APPROVALS ARE REQUESTED FROM 310 CMR 15.221 (7): 3. FINAL INSPECTION OF ALL COMPONENTS PRIOR TO BACKFILLING. �r - <• M-C Sand (1.) A 2.0'WAIVER(3.0-5.0')FOR THE MAXIMUM COVER OVER THE LEACHING FACILITY. 2.5Y 6/6 C_2 (2.) A 1.0'WAIVER(3.0-4.0')FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. t /� (loose; 5-10%gravel) EXIST.WATER LINE LOCUS PLAN (APPROXIMATE LOCATION ONLY; PAVED PARKING TO BE VERIFIED)(TYP. OF 5) / SCALE: 1"= 1000' PROPOSED 5-OUTLET H-20 DISTRIBUTION BOX 130" 60.17' Benchmark � G< ^ Nail in Tree No Mottling, Standing or Weeping Observed Elev. =74.00 DESIGN DATA TEST PIT DATA Approx. M.S.L. LEGEND `� PERC NO.: 12759 EXISTING 2,000 GALLON SEPTIC INSPECTOR: David W.Stanton, R.S. �a NUMBER OF BEDROOMS DESIGN O �G S TANK TO BE UTILIZED AS 2"GAS �� (DESIGN) 8 50x0 EXISTING SPOT GRADE G vP OF THIS DESIGN 0 mac, EVALUATOR: Michael Pimentel,E.I.T. _ GAS DESIGN FLOW 110 GAUDAY/BEDROOM - - 50 - - EXISTING CONTOUR GAS GAS GAS GAS-''�� \, C.S.E.APPROVAL DATE:' Oct:1999 , �a GAS-� TOTAL DESIGN FLOW 880 GAL/DAY DATE: November 10, 2009 --� 50 PROPOSED CONTOUR ks, 2 G) DESIGN FLOW X 200 % 1,760 GAUDAY TEST PIT#: 2 E/T/C EXISTING UNDERGROUND UTILITIES USE EXISTING 2,000 GALLON SEPTIC TANK(1st TANK: 48hrs) ELEV TOP= 71.00' a► /LIGHTBT 3P3 USE PROPOSED 1,000 GALLON SEPTIC TANK(2nld TANK: 24hrs) <60.17' GAS EXISTING GAS LINE ��E POST 116o UN ELEV WATERW W EXISTING WATER LINE B,,,ONG3 'aeogoom INSTALL 50 -ARC 36HC (#3616BD) BIODIFFU:SERS (H-20) PERC RATE_ � TEST PIT LOCATION 12" O UN1T 3B 2- SVp 114 pWELL G DEPTH OF PERC= t B01L ID 3 71x5' ` ✓ -� O 10A� N�3C EX1p oaM SYSTEM CAPACITY O O C� EXISTING 2,000 GALLON SEPTIC TANK U E TEXTURAL CLASS: 1 2,B G T _ #AArOO p1NG 3 EX,STING pWEL'i1N / BU1� (TOTAL L.F.OF BIODIFFUSERS)(4.8 SF/LF)(0.74 GPD/SQ.FT.)= GPD ^ - O O PROPOSED 1,000 GALLON SEPTIC TANK PROPOSED TOTAL 50 ARC 36HC H-20 71x3' N 14" 15,3' UN1y 3D 2_BEDROOM (250.0)(4.8 SF/LF)(0.74 GAUSQ.FT.)= 888.0 GAL.LEACHING/DAY BIODIFFUSERS IN FIELD CONFIGURATION \ p� 1 i " O pWE�11NG 0" 71.00' 1.0 ' EX1ST E)C1ST1N o 13" Litter PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE 2O pBGK 2-BppRO G 4" 70.67, DwBLX_XtAG TOTALS: A Loamy Sand 10Yr 3/2 � PROPOSED DISTRIBUTION BOX(H-20) �2 N 13 71 x2' 72 12" 70.00' 1 TOTAL NUMBER OF BIODIFFUSERS: 50 PROPOSED 4"PVC VENT PIPE; 2� 71x2' ��� ^ 6" l \�2 MAP 273 TOTAL NUMBER OF COUPLINGS: 0 B Loamy 10Yr 5ltnd Q PROPOSED ARC 36HC(#3616BD)BIODIFFUSER(H-20) EXACT LOCATION PER OWNER \ $AMI. �N PARCEL 89 TOTAL LEACHING AREA: 1,200.0 SQ.FT. 30" 68.50' \ \ 6 126,033 S.F.t TOTAL LEACHING CAPACITY: 888.0 'GAL./DAY REV. DATE BY APP'D. DESCRIPTION \ ` $ 71 x2 C-1 Loamy Sand \ LP e a 72, 2.5Y6/2 PROPOSED SEPTIC SYSTEM UPGRADE 66" 65.50' PROPOSED INSPECTION PORT WITH \ 71x2' / \1,' NOTE: PREPARED FOR: 0' T GRADE TYP OF 5 5 EFFECTIVE LEACHING AREA OF 4.80 SF/LF OBTAINED FROM THE AccEss Box o ( > / P q12 GEORGE BARTLE17 a DEPARTMENT OF ENVIRONMENTAL PROTECTION APPROVAL LETTER / \ "MODIFIED CERTIFICATION FOR GENERAL USE" ISSUED TO M-C Sand ADVANCED DRAINAGE SYSTEMS, INC. ON OCTOBER 3,2003(LAST \ / 2.5Y 616 LOCATED AT EXISTING LEACHING PIT TO BE \ / MODIFIED JUNE 30,2009). TRANSMITTAL NUMBER=W000052. C"2 (loose;5-10%gravel) PUMPED AND FILLED WITH CLEAN PROPOSED 1,000 GALLON SEPTIC TANK 1160 PHINNEY'S LANE COARSE SAND (TYP OF 2) \f CENTERVILLE, MA 02632 f I EXISTING DISTRIBUTION BOX TO BE ABANDONED CONSTRUCTION NOTES: SCALE: 1 INCH = 20 FT. DATE: NOVEMBER 18, 2009 --� 130" 60.1 T 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP LkA 0 10 20 40 80 FEET EDGE OF EACH SEPTIC SYSTEM COMPONENT. No Mottling, Standing or Weeping Observed PREPARED BY: 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE RESERVED FOR BOARD OF HEALTH USE o cc�c ,cwILL �"� JC ENGINEERING, INC. LOCATION OF THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS PLAN. U anL 2854 CRANBERRY HIGHWAY o 4180 REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF SOILS EAST WAREHAM, MA 02538 f� r_ PLAN ARE 1NOT CONSISTENT WITH TEST PIT DATA. SITE r H 508.273.0377 3. ENTIRE PROPERTY 1S LOCATED WITHIN AN APPROVED ZONE 2. - ` SCALE: 1"=20' , ) � � Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.1716 - I I li Z _ O I � I I E , � -DRIV RAVE _ Q c,� I t G � o . — -,f•, .._. ••-- M M -/ rr SECTION UNDER GRASS SECTION UNDER PAVEMENT I f 3.3 cD _ N CO tD cD N O _ -__ _ x _K _ ' �x _ _ rc-x �x _..x � _ x__ x x x x G 1.8� x x _ Q, o a cn E— N cD LINK (b FENCE CHAIN - A r OMIT TOPSOIL WHERE Wwo I OCCUR rvo GRASS s, O N r --x61.6 r- RESURFACING W � � 0 cD 1 O USE. 6 SELECT GRAVEL V Z � co AS REQUIRED 00 1 to x N - - Y & SEWAGE DEPTH . I ,:, :._. - _ RNSTABLC HIGHWA Z r� TOWN OF dA A 8� t � -:�••-,:.::--•..:.-_;-:.:-.._� Z J � TO • . I ...�.... _...-�-.__• 14• W 6 TOPSOIL :,• ..; W - r 0 r�: 5 I / ,1 i :• W C'3 --- .: . . . .. �.- O - 6 GRAVEL , •,. .. .•. .. ... . . - 12 SELECT GRAVEL (T0 BE Z co) _ W — — — 6 ', PAID FOR UNDER .ITEM ( OF rn Ln I H SECTION 0J II50) J W r, -- ,. _ - a--- -- - ---t.r - u7 _ Z Q� M N 00 cD M Z v n N I O tp M 1 N _ _ W N �. AIV F _ , W D G E 0 PA V E M E NO Str4GE t ) ti �- E N T _ U r- ♦�//�� N M _ V/ �- d u ) O ti : N 1n to . . f� 0 PINE INS �7 10 P NE I 12 P x — — COMPACTED 'BACKFILL (EXCAVATED 4 PINE -� �PUc Soh �O '►/�nE Pi,o C BORROW AS OFS �P� _ _: SfOnc1 M!-� �-ro�n� w/Goose N��/c /r�SeC/ .Sc/`�Crl c MATERIAL OR c _ I 2�} q�s �' D aq,.o Doc 1 -! r- i ) bu 1/ 4r .. _. SPECIFIED) LIMITPAY M ApL - AT TOP OF n8WIDE PAVED 12 ) WATER SERVICE BIKE PATH . Q JOd WJ � pa0y vCONT 0L NAILUNDLR GROUND 3� I z J - . ELECTRIC SERV CF _ ELEV. 58 .8 3 /-'* �/� G an . . 6 r MiN 3 6 MIN _27 141 L � / o � z P z OR DON � a v LEW o r 69 o Q' r•-- BLG. 5 4co 3 3 2 O _ ,. F. THOROUGHLY COMPACT. ;W a a � o ra � I Q . W .� '�. WITH RAM OR , I _ 7 24 I D: Aces L � s: PNEUMATIC TAMPER +p 0 4 SEAMED0 W VILLAGE Fxjsf, N Iwo RIM SEWER M.H.56.80 I. d INV. 18 PIPE OUT-43.74 0� Q /71�C . ._.. . & �, o Ti 7"0 � d h o ao Ir, In o Z O SHEETING PAY LIMIT FOR LEDGE 't.' OI �/ L "t' Ql . i / Z ENCOUNTERED ,. . . . .. .. . ...• . .. ,. p R _IF ENCOUN7E E ts7 (D � � . • .. .. S REQUIRED Q U 1 E O ti In 5� .. t4A 3 MINIMUM THICKNESS)( TYPICA L TRENCH DETAIL.� - Q NOT TO -SCALE { �i L e v� a/or Corrrrec%d •. .. A h h PL N � A/4 oar° .1 • l. 4 , SCALE 0 GENERAL NOTES 1. Location of all utilitie s and subsurfa ce structures ore from. . surveyand .record f the town n so and utility corporation �Y 'and are considered a imot h r / P� a bat as to sizean I location a are • d , and a indicated on • these drawing s to gi ve bidders a n 9 9 general idea of -,existing 9e crndit co nditions st /4 0 L.. •�- - 0 be investigated / ��� � sell at ed b 9 y the bidder. It is understood pnd a reed each 9 that ch bidder e will not o rely e upon•,._.---�_ _ ;, Y Po these drawings for such _ __ __ informal_ 9 ion but that that -- tx bu each rider - _ shale make @ ex G► 1 G exa minations t ; �? •�• a ion/ s in the e fi eld ieh d vari ous available b by e methods e and. . hod sh obtain in formation from re cords,utility corporations s a1 Y Por one and individuals cis to the I Of all location subsurface t e structures. 2: El evations evn t ron s are base d on U.S:G.S. D.. alum I of 1929 Mbrr Sea Levee Elevati on/,/"'� / Y I�, 00 3. c The Cont , ractor shall-c n . o fin�3 his rations ape and actrvrf res for constru O Gran pu rposes ores ._ within the P street lines _ , ,�aosem@nt land n ht f s, g o wa s. Such lines and y . Y property,Imes ._ are token r Pe Y from subdivis ion Ions street eat outs on > approximate oY d assessors'mo ps and ore • only. _ d o cis hi �' Y Wee fh er r of /c/ L h /� 9 9' , . Se e Specifications for.b bo ring n to inform �o 9 9 atron. NOTES 1 Where THE ` ere th CONTRACTOR MUSTS a new . .SUBMIT THREE -COPIES OF SHOP sewer cro ss" over or within 12 in ches else of existin g n ut4titr eS (except 4 lJ�e• 9 water P a er main s where 18 DRAWINGS inch A INGS FOR-THE TIGHT es is required TANK FOR APPROVAL PRIOR ) a concrete r _ directed. cradle shall be used as _5 7 TO INSTALLATION ' 3�2F/VG_O U�2 TION EM E /V A : s. t is most 5 important that hat 2 the � THE TIGHT e proposed I HT'' TANK' SHALL ed se I L BE MADE -0F PRECAST CONCRETE P Po war line O CRETE be located n rrLtnirn ium of � O rf'I 0 feetwater : . _ O from e /'O n,BO r � � a �4 /� Y morn also 10 � USA ��A,E'.�I 2E'Gfeet from � NU _ Y WITH o an utility TH A MINIMUM STRENGTH F Y e where possible.0 5000 PSI AT 28 DAYS.:. Y Pa Po bie. m 7. A dro p pi pe > A P shall P be 3 P rout O / L G DESIGN d UT E I LO provided � ADI for NG SHALL o 0 L $E TO WITHSTA P sewer ND APPROXIMATELY entering a manhole of on ei I inches or more evotion of 24 O e above.the m difference invert. Where C 15 ens the differ FEET OF, FART COV ante in el :H COVER. THE .TANK MANUFACTURER evatron betwe , en the in a comity se invert,is r and the e ma nhole hl I oe m veil is less than Inch", the SHALL . , invert Q LL SUBMIT WITH , should H THE . SHOP DRAWING STRUCTURAL be filleted t o prevent solids deposition. ! � O Q C MPU A T TIONS SIGNED BY A MASSA CHUSETTS REGISTERED . . t3. _Th@ locati on f o w es chi m n s and d se rvice c e eY Conne ctions one sh all be oc cur PROFESSIONAL alai E NGINEER I D N AD IT O rI N THE TA dEngineer. Y 1E TANK SHALL determined e rued in the field b the Y S// C /'7 AC Sh4 f QrCn �n e /3 vf�o 2 A f / WITHSTAND :TYPICAL 'AASHTuo `1 O HS20 44 LOADING. i 1.1 9 - W • The Coat r act r 0 shot co _the D _i II , 4 Safe 1 o e n THE TANK Center 1Barnstable3 � P G✓ r v SHALL 9 8 BE W 00� t WATERTIGHT 322'I'O M 4 MEET DE E RE 844 REQUIREMENTS. and ,he 4 4 .01/C .Sc O V�nE Pi e � Tom/ one /n �t Water Company at - - o 4 � /7 � eroh P P Y 617 775 0063 atleost 72hours n � ADEQUATE WATER PROOFING SHALL BE APPLIED (including weekends and `C LI TO .INSIDE. holidays) for too 9J Y Pr any excavation. 1 � AND OUT 1 � SIDE OF THE -TANK. AT ALL PIPE CONNECTIONS h >. O p .. 10. Bonn location v 9 son pions ore`a approximate. - . `� r- r 1 BITUMASTIC COAT SHALL BE APPLIED Pp ate. Boren I data ore sh � 50 IED WITH TROWEL. I ref 9 09 own.in profile for � c ° reference only and their locations ° c �c within the profile ore for -- 5 _ convenience h m c m AT OPENINGS USE NON SHRINK CEMENT only. ._ u w • E ENT GROUT FOR FINISH. horizontal an y - m 3 d vertical placement �. C P of the'borm data i A 9 n profile to do not ra P necessaril is 6. PR OR T _ hov Y d I O DIGGING.".CALL- D G A e an relotr u � t T) �/� / /� � _ I S FE, 72 HOURS NOTICE Y on to the profile of °4 CJ L/(J�/�[� �L /"� ! " l �/�LF� P he existing surface or the o NEEDED 9 sewer. � 11. Termi nal Ne w � I Sa nitary Manh ole SMH Y ( ) location " under this contract is 7 restricted ALL EXISTING CONDITION MUST REBORED TO to not more th• ITS ORIGINAL an 5 0 beyond th Winne/ f�' /..�e �/Xrd q>< he s/ Y the lost service cm S � CONDITION AFTE R CONSTRUCTION: 12. Allmaterials ,ode a f-c S used and construction methods adopted shall 8P all conform with the THE CONTRACTOR MUST OBTAIN NECESSARY PERMITS FROM Local Stole n � ) , and Federal Regulations. X j ; THE TOWN BEFORE STARTING THE CONSTRU CTION. I 13. The proposed Posed pipe shall be PVC Po ly o)y Vinyl .Chloride J pipe,SDR mu . . P P 35 and it must be certified t„ l,` o meet the said re uir m B�PVc• S_p. o q e ants OR AS SPECFfED O So I, 14. Necessary"deflection Y and leakage tests g .shall be conducted t n o insure the integrity I 1 of .the Pipe. 9 Y 5 Chimneys shall U y be constructed us ing 6 inch Pi pe,PVC: P 50 �o _ '__v _ _. Pe is. Tre nches ch s e sh all it b e bockfcompacted 'Y i I led and t7. T T wel► / f7� G3/7/ trot to I base rC . P applying the .. 9 course and Y 9 wearing course and it 9 shoal conform Z o m with existing N g conditions'.. I Back fill W fill shall be in layers of 18 Y to 24 inches well compacted t 40 � with the use a Q compactor. �' 17 . All Q i disturbs W d areas shall be restore d to its original condition an following construction. 9 J Q 8. Contractor . JC s Q loll`assume the risk — _' sk of dewatenn rock c 9excavation. G 19 . . T . The Contractor shall .. submit shop drawings for —'P 9 pipe,'manhole man hole fi and cover as directed b the W y Engineer. (n Z 1 _}" Z N Q }- � Z Q 0 '�• W Q , J y O c O c 1 30 v� Q 5 a d W _ � � a e (n W k O PROFILE p o � �• Ll.. , r a p _ H R. l - 40 0 �? SCALE _ VER'T, I - 4 Dw No. SEA-MEADOW VILLAGE LO CUS MAP m MILLER REPROGRAPHICS CO..INC. i I I I