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HomeMy WebLinkAbout0000 HARBOR POINT ROAD - Health (3) HARBOR POINT—Cape Cod Village Barnstable HARBOR POINT RD., BARNSTABLE Cape Cod Condominium Village A=352.035 p V r� - 4 ;s r I r i i zz y Akk 54 F c4 STa. "3 t z i �''•�^� tti� to,tSy ag�rj 4�,y�. y,,� t,,. c� as _. ^i'-r a `'^+�' ,, r } ,t' ' . '1� " ' tiY . S �A. � I 4 i Ky ,�,.;-'• �" ^rr x wY Y - ` x + rd: f d" a x� Z M1r�x+`�y,,a. 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RPM s ".�yT3 � �`' •' STV-11`z��,, 5 _ 'r t s� *f��.'' r.d � +T'k ri �'=+a.�t• �;� 'f 'yx�.._ r «yxf. y w . � � ,� `�.t �+ r �'nu"s,`a.``�s�#�"'2.'�a �t���",�;:'� 1'���L�;•� �k�R,+eY�` �}�`�t .,,�"t�'t 'V' �. .'3 d•T P• $ ;='"zt¢k 4'Y .ry`i�" 'f '_ '(t �yr'3 'x' t bAQ f t Commonwealth of Massachusetts kp Title 5 tfiCaG Inspect ®r�f4 �o� F Subsurface Sewage.Disposal System Form-Not for Voluntary Assessments.. Harbor Point Road(system#2) Property Address Cape Cod Village Owner Owners Name <• 'information is Cumma uid MA �02637. .. 05/15M required for. g every page._ CitylTown „ "State Zip Gods : . Data of inspection _- Inspection results must be submitted on this form. Inspection forms may not be altered in any : way.Please see`completeness checklist at the end of the form . � .. Y•t y 4�: y A b ' important., A. General Information * < Y .When filling out y. forms on the ., computer,use <„ only the tab key 1; Inspector to move your Jason P Burnie { Cursor-do not Name of Inspector, use the return key.' Neighborhood Waste Water £ Y Company Name k 350 Main St Company Andress G Yarmouth MA 02673 ' =City/Town State Zip'•Code 508-775-2820 S15011 w '. Telephone Number, w "License Number w B. Certification n h ht i certify that I have personally Inspected the.sewage disposal system•at this addressee d t at t e #7 information reported below is true, accurate'and complete astof the time of the inspe°cation. The inspection was performed based on-my training an experience,in the proper function and maintenance of8n situ sewage disposal systeins.{I,am a DEP approved system inspector,pursuant to Sdetion 15 5l10 b , Title 5(310 CM R 15:000):The systems :77 ® Passes ❑ Conditionally Passes ❑ Falls ❑ Needs.Further Evaluation by the Local Approving Authority 05/15/13 . Inspector re Date'' w The system-inspector shall submit a copy,of fhis inspection report to,the4Approving Authority(Board of Health or DEP)within 30 days'of completing,this:inspection-Af the system is a shared system or has a design flow of 10 006 god 4or.greater, the inspector and the system ownershall submit the report to the appropriate regional office of the DEP. The original should be°sent toahe system owner and copies sent to the buyerjf applicable, and;the'approving authority "*#*This report only describes conditions at the time, inspection and under the conditions of use Vj at that time.This inspection does snot address how thesystem will perforn In the future,under M' the same or differentconditions of use. t5ma'•3/13 ;" � ,,. �' Title 5 Otfidal InspectilFo.m- ce Sewage Disposal System-.Page i of,7 P r y- I J. . Commonwealth of Massachusetts Title 5 ®f ocial Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road(system#2) . Property Address r - Cape Cod Village Owner Owner's Name information is Q required for Cumma uid MA 02637 05/15/13" : every page. Cityrrown State Zip Code Date of Inspection B..Certification (cunt.) Inspection Summary: Check A,B,C,D or /always complete all of Section.D A) System Passes: 1 have not found any iriformation which indicates that any of the failure criteria described' in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: . System.consists of one 2,000 gallon pump chamber and,one 16,000 tight tank.The tight tank has an alarm light that is fully functional and a alarm company is;notif+ed who in turn notifies Neighborhood Waste Water.The alarm is set to go off when the tank reaches 75% Z) P,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(whetfier 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i S Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "< Harbor Point Road (system#2) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaquid MA 02637 05/15/13 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational.FSystem will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static.water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced ❑. Y 0 N ❑,ND'(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND,(Explain. 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 withiri 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments `( Harbor Point Road(system#2) Property Address Cape Cod Village Owner Owner's Name information is C uid MA 02637 05/15/13 umma required for q 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 aseptic 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. 0 The system has a septic tank and SAS and the SAS is within a Zone of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of private water supply well. ❑ The system has aseptic tank and SAS and the SAS is,less than 100 feet but 50.feet.or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are.triggered.A copy;of the analysis must be attached to this form. 3. Other: f D) System Failure Criteria Applicable to"All Systems: You must indicate"Yes"or"No"to each of the following for all inspections; Yes No El ® 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 ool g9 p ® 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' El Z than '/day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System,Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection ®ram Subsurface Sewage Disposal System Form=Not for Voluntary Assessments '< Harbor Point Road(system#2) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaquid MA 02637 05/15/13 every page. Cityrrown. 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: El ® Any portion of the SAS, cesspool or privy is below high ground water elevation. 0 ® 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 equals to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis . and chain of custody must be attached to this form.) The system-is a cesspool serving a facility with a design flow of2000gpd- 0, ® 10,000gpd. The system fails. I have determined that one or more of the above failure El= ® criteria exist as described in 310 CMR 15.303, therefore the system fails.The = system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility'with a design flow of 10,000 gpd to 15,000 gpd: For large systems, you must'indicate either"yes or"no"to each of the following, in addition to the questions in Section D. Yes No ❑; . ❑ the system'is within'400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply' Q the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—IWPA)'or a mapped Zone 11 of a public water supply well If.you have answered-"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. - t5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System form-Not for Voluntary Assessments Harbor Point Road(system#2) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02637 05/15/13 every page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yee..or"no"as to each of the following: . Yes No µ ❑ '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 breakout? ® ❑ 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, 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 15.362(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 28 Number of bedrooms(actual): unknown " DESIGN flow based on 310 CMR 15.203(for example:110'gpd x#of bedrooms):'.. 3,0809pd t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of'Massachusetts Tine 5 OfficialInsctio i=®r Subsurface Sewage Disposal System Form Not for Voluntary Assessments; ug Harbor Point Roads (system#2) Property Address Cape Cod Village Owner Owners Name information is required for Cummaguid MA 02637 05/15/13. l every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: System consists of a 9000 gallon tight tank with alarm Number of current residents: 28-56.; Does residence have a garbage grinder? ❑ 'Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? Ye's ❑ No Water meter readings, if available last 2 ears,usage d N/A 9 ( Y 9 (gP ))� Detail: well water Sump:pump? ❑ Yes -0 No Current Last date of occupancy: Date CommerciaUlndustrial Flow Conditions: Type of Establishment; Design flow(based on 310 CMR 15.203): Gallons perday'(gpd) Basis of design flow(seats/persons/sgftt, etc,): Grease trap present? ❑ Yes ❑ No Ale Industrial waste holding tank"present?, ❑ Yes ❑ No~ t Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No ` Water meter readings, if available: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 0117 i Commonwealth of Massachusetts Title 5 Official Ins-pection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments Harbor Point Road(system#2) Property Address Cape Cod Village Owner Owner's Name information is p required for Cumma uid MA 02637 05/15/13 every page. Citylrown 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: 4/12 11,000gal 5/3 2,500 Barnstable BOH 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: 0 Septic tank,distribution box, soil absorption system ❑ Single cesspool. Overflow cesspool TT Privy ® Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Altemativetechnology. 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. 0 Other(describe): t5ins-3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 8 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road (system#2) Property Address Cape Cod Village Owner Ormer s Name information is Cumma uid MA 02637 05/15/13 required for q 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: System was installed in 1987 and all components were upgraded in 1990 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 28 Depth,below grade.,M.: feet Material of construction: ❑40 PVC Schedule 35 PVC D cast iron.` ®other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting,evidence of leakage, etc.): Ran camera down lines and were ok at time of inspection. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: concrete ❑metal fiberglass polyethylene Ylene oth er(explain) ,- If tank is metal,list age: years . ? certificate) Yes No Is a confirmed b a Certificate of Compliance? attach a co of certi sate ❑ a9 Y p ( PY ) :Dimensions: Sludge depth: t5ins-3113 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 Harbor Point Roads stem#2) Property Address Cape Cod Village Owner Owner's Name information is required for ummaq C uid MA 02637 05/15/13 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 Scum thickness Distance from top of scum to top of outlet the or baffle Distance from bottom of'scum to bottom of outlet tee or baffle How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition,Structural integrity, . liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap(locate on site plan): Depth below grade: feet Material of construction: 0 concrete ❑ metal F fiberglass E! 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.oflast pumping; Date t5ins•3/13 Title 5 Official Inspection-Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r Harbor Point Road (system#2) Property Address Cape Cod Village Owner Owner's Name information is Cummaquid MA 02637 05/15J13 required for every page. Cityfrown 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: F 16"to deck covers to grade Material of construction: concrete 0 metal 0 fiberglass ❑ polyethylene n other(explain) Dimensions: 33'-11"x I VxW-2" Capacity: 16,000 gallons . Design Flow: 3,080 gallons per day Alarm present: Yes, ❑ No 75% Alarm level: Alarm in working order: Z Yes ❑ No 5/3 ` Date of last pumping: . Date: Comments(condition of alarm'and float switches, etc:): Alarm light is functioning.Tank is structurally sound with no evidence of leakage in or out of tank Attach copy of.current pumping contract(required). Is copy attached? ® Yes ❑ No t5ins•3113 Title 5 official'Inspection Form:Subsurface Sewage Disposal System•Page 71 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road(system#2) 'F Property Address Cape Cod Village Owner Owner's Name information is C uid : MA 02637 05/15/13 umma required for q every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locateon site plan): Depth of liquid level above outlet invert Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): y 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.): covers to grade, less than 1 inch scum in tank, 3 floats,-pumps in working order , "If pumps or alarms are not in working order, system is'a conditional pass. Soil Absorption System(SAS)(locate on site plan, excavation not required)` If SAS not located,explain why: N/A pumps to tight tank t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of V Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments: Harbor Point Road(system#2) Property Address Cape Cod Village Owner Owner's Name information is Cummaquid MA r 02637 05/15/43 required for every page. Cityfrown State Zip Code Date of Inspedion D. System Information (cont.) Type: ❑- leaching pits number* . leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑. s leaching fields number, dimensions: ❑ overflow cesspool number: ❑ .,. innovative/alternativesY stem Type/name.of technology: Comments(note condition of soil, signs of hydraulic failure,'level of ponding, damp soil,condition of vegetation, etc.): Cesspools(cesspool must be:pumpod 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 . s. Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 official Inspection Fortin Subsurface Sewage Disposal System Form-Not for Voluntary Assessments. Harbor Point Road(system#2) Property Address Cape Cod Village Owner Owner's Name information is 4 required for Cumma uid MA 02631 05/15/13 every page. City/Town State Zip Code Date of Inspection D. System information (coot.) Comments(note condition.of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): V Y 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-3/13 Title Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Comrnonweaith of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System.Form Not for Voluntary Assessments a Harbor Point Road(system#2) Property Address Cape Cod Village Owner r' Owne s Name information is Cumma uid MA 02637 , 05/15/13 required for q ,. - every page. City/Town State `Zip Code Date of Inspection D. System Information (cost.) i 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 t5ins r3/13 Title 5 Official Inspection'Fonn:subsurface Sewage Disposal System•Page 15 of 17 ' Commonwealth of Massachusetts Tide 5 Official Inspection Form �r o Subsurface Sewage Disposal System Form-.Not for Voluntary Assessments - Harbor Point Road (System#2 Property Address Cape Cod Village Owner Owner's Name information is Cummaquid' MA. 02673 '05/30/08 required for State Zip Code Date of Inspection every page. Cityfrown (cont VAN v-4M �� Is osal S stem:`Provide a sketch of the sewage disposal system,including ties Sketch,Of wages' p System:, to at least two permanent reference landmarks or benchmarks. Locate all wells within 100,feet. Locate where public water supply enters the building. + M , Z_ 7, Ca 3 s ' Q A � • J „ Nra�o►+atk (alCOOaN CDn�'4cs� - 1�pNE"r- n86VtF• �gpJN7 1(6 000 &AL"v -n r TANK W MW b.k,�LONCa� , C14� 14ofis CapecodvillagesystemZ.doc 03I06• Ti s Official Inspection Form:Subsurface Sewage Disposal System Pa' ge I Commonwealth of Massachusetts „. s Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments. . rt Harbor Point Road(system#2) Property Address _ -Cape Cod Village Owner Owner's Name information is Cumma uid MA , 02637 05/15/13 required for 4 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: 11' 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. 11/86 on file Barnstable BOH _ 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:. Well SDW 252/Zone A/water level46.5/.4x12=4"adjustment -You must describe how you established the high ground water elevation: no additional componets beyond the tight tank Before filing this Inspection Report,`please see Report Completeness Checklist on next page. t5ins•-3113 Title 5 Official Inspection Form:SubsurfacaZewage Disposal System'•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection For Subsurface Sewage Disposal System Form Not for Voluntary Assessments yy< Harbor Point Road(system#2) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaguid MA 02637 05/15/13 every page. Citylrown 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 Z System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in.separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 17 of 17 r E, •s, '"e'`� �, �, IT$ I�1T6D PA�C�EAS1t !OREA PRoPISSIONAL L USB02116 (617) 542.5557 P _ - 805TON,AASSACH STREETCH URCH46 : . PN: 180-18-004-5050 � . Jure� 4. 1g90 i Mr, Thoma4 McKean Board of Health Town Hall! i Barnstabli, Massachusetts 02630 x RE: Capj Cod ,Village !. 'Condom iLm AaBn�tAt ri i Dear Mr, cRean: nfo rID o �I� 23 1990 Metter, Dames & Moore is pleased. t i y Supplement�irig our May stBm at the Cape, Cod_.-Villag the. rap Jars to the wastewater collection sy have S s (CCVC) are coutpleta, The house c a ea f iour Officeeen repaired•an CondominOM ineor (Mr, ,Jeffrey Doolittle) G inspectedlby an PnB . evious letter, the groundwater has. risen aigriifiC8xlCly duet our , r actions were at. least partiall . Aa stated(in P action of repair recent ra'nstoYms. Almost half of the hous� conn recent ed1by the' high groundwater during Mr. Doolittle's insP g to these ounections. No significant water was observed owing ' tanks From these hous fl !Lpto the � Mr. Doolittle also aor►fYrbted°that all the.new house Connections ar'' connect14s. } k tjght: I The cast iron bolt -doom manhole frames and covers have been installed: if , atter, Flea$a you ha4 any questions on this m call myself or Ka1ly Whalen o this offi�e. i Very trill yours, * DAMES & MOORE A Pro ss onal Limited Par'tnsrs'hiP ' I Pi Lo(nbardo, As.soeiatal. ak I , cc: Mr. Anthony Sapienza., CGVCA Mr. Thomas Mullen, Barnstable DPW Glen Wood, ,Esq: , McGregor, :Shea & .Doline?v h:\.\18039\Qa2\],titters\boh.txt i OFFICES WORLDV IDe 350 MAIN STREET TEL: (855)775-2820 WEST YARMOUTH, MA 02673 FAX: (508)778-9628 ' . Septic Service Pumping 508-775-2820 Installation # eNeighbO.,�IOOv . I Bill To: Cape Cod Village, Customer: Cape Cod Village 3004 S Hill St ; Contact: + Roger Bacon Arlington VA;22202 Job site:. Harbor Point Rd Cummaquid MA 02675 Phone: Email rwbacon1@aol.com Neighborhood Waste Water Services Inc proposes to furnish all the materials and'perform all the labor necessary for the completion of: ' 2013 Septic Servicing Schedule Pump septic from (2)-tight tanks on a per call basis.+ 'Tight Tank sizes:Large Tank is`20;000 gallons, Small Tank is 900.0 gallons. Cost: .15-per gallon pumped In the event of an emergency call for service from the Cape Cod Village Answering Service, no Neighborhood Waste Water technician will respond.unless a member of the.Board has been contacted and has approved service to'be completed. . Neighborhood Waste Water Services Inc.Contract Terms and Condition Late fees, Liens and Costs of Collection: By signing below, l hereby agree that this document is a written contract of even date enforceable under Massachusetts law between Neighborhood Waste Water Services Inc and the customer listed above, a mechanic's lien pursuant to M.G.L. Ch.254 may be based upon this contract to secure the payment of all materials and labor furnished hereunder and incorporated in the real property. 'Payments not received within 10 days of invoice due dates pursuant to this contract will result in an additional charges of 1.5%'per month(18%APR)and customer will:be responsible for all costs of collections including but not limited to reasonable attorn.ey's fees incurred.in the collection process. Respectfully submitted by: Mark White Date: December 1.7, 2012. The above prices, specifications, and conditions are satisfactory and are hereby accepted, You ar'e authorized to do the,work as specified. Payment will be made as outlined above. Accepted By: a , 1 Commonwealth of Massachusetts Title 5 Official Inspection For,, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road (system#1) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA . 02637 05/15/13 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 completeness checklist at the end of the form. Important: A General Information When filling out fortes on the V computer,use 1. Inspector `J . only the tab key to move your Jason P Burnie - cursor-do not use the return Name of Inspector return ; , key. Neighborhood Waste Water Company Name 350 Main St Company Address Yarmouth MA 02673 100 City/Town State Zip Code 508-775-2820 S15011 Telephone Number License Number -- B. Certification ; I certify that I have personally inspected the sewage disposal system at this address anoithat 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 cxi sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340:of Title 5(310 CMR 16.000).The system: ®Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 05/15/13 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the.system owner and copies sent to the buyer, if applicable, and the approving authority. "*'`This report only describes conditions at the.time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official inspection F. :Subsurface Sewage Disposal System Page 1 of 17 I - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< Harbor Point Road (system#1) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaguid MA 02637 05/15/13 every page. Cityrrown 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: System consists of one 9000 gallon tight tank.The tank has an alarm light that is fully functional and a alarm company is notified who in turn notifies Neighborhood Waste Water. The alarm is set to go' - off when the tank reaches 60% 6) System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by .the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y,"N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old'or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank.as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System.Form-Not for Voluntary Assessments Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name E information is Cummaquid MA 02637 05/15/13 required for every page. Cityrrown State Zip Code Date of.Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cost.): ❑ Observation of sewage backup or break out or high static water level in thedistribution 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): El broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed El 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•3113 Tifie 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �< Harbor Point Road(system#1) Property Address Cape Cod Village Owner owner's Name information is required for Curhmaquid MA 02637 05/15/13 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cunt.) 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 asses if the well water analysis, performed at a DEP certified laboratory,.for fecal Y p Y ry 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 El 2 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 El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow !Sins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection For Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is Cummaquid MA 02637 05/15/13 required for every page. Cityrrown 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: ❑ z 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 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 and chain of custody must be attached to this form.] ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. O 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 16,000 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 lf.you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-3/13 Title 5f Official.Inspection Form:Subsurface Sewage Disposal System•Page 5 or 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaquid MA 02637 05/15/13 every page. Cityfrown 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? E ® 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. El ® - 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): 16 Number of bedrooms(actual): unknown DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 17609pd t5ins-M 3 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments " Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA I 02637 05/15/13 every page. City/Town State Zip Code . Date of Inspedion D. System Information Description: System consists of a 9000 gallon tight tank with alarm Number of current residents: 16-32 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage N/A g ( Y 9 (gpd))� Detail: well water Sump pump? ❑ Yes ® No Current Last date of occupancy: Date Commerciallindustrial 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaguid MA 02637 05/15/13 every page. Cityrrown 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: 4/12 9000gal Barnstable BOH 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 Q Privy, ® Shared system(yes or no)(if yes, attach previous inspection records, if any) Innovative/Altemative 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is Cumma uid MA' 02637 05/15/13 required for 4 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known)and source of information: System was installed in 1987 and all components were upgraded in 1990 Were sewage odors detected when arriving at the site? ❑ Yes 0 No Building Sewer(locate on site plan): Depth below grade: 52" feet Material of construction: ❑cast iron ❑40 PVC Schedule 35 PVC ®other(explain): Distance from private water supply well or suction line: N/A feet Comments(on condition of joints,venting, evidence of leakage, etc.): Ran camera down lines and were ok at time of inspection Septic Tank(locate on site plan): Depth below grade: 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) .Q Yes ❑ No Dimensions: Sludge depth: t5ins-3113 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 usetts Commonwealth of Il�assach Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is Cummaquid 'MA 02637 05/15/13 required for every page. Cityrrown State Zip Code Date of Inspection D. System .Information (cont.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to.bottom of outlet tee or baffle How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,.evidence of leakage, etc.): Grease Trap(locate on site plan): Depth below grade: feet Material of construction: concrete 0 metal `❑fiberglass E polyethylene ❑other(explain): Dimensions: - Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 10.of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is Cumma uid MA 02637 05/15/13 required for q 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: 35"to deck covers to grade ,. Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: 18'-7'x11'x9'-2.5" 9000 Capacity: gallons Design Flow: 1760 gallons per day Alarm present: ® Yes ❑ No Alarm level: 60% Alarm in working order. ® Yes ❑ No Date of last pumping: 4/12 Date Comments(condition of alarm and float switches, etc.): ' Alarm light is functioning. Tank is structurally sound with no evidence of leakage in or out of tank "Attach-copy of current pumping contract(required). Is copy attached? ® Yes ❑ No t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ' Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is Cumma uid MA 02637 05/15/13 required for q 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 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.): Pump Chamber(locate-on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: E] Yes 0 No* Comments(note condition of pump chamber, condition of pumps and.,appurtenances, etc.):. ` *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS)(locate on site plan, excavation not required): . If SAS not located,explain why t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road (system#1) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaq uid MA 02637 05/15/13 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type ❑ leaching pits 'number: ❑ 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.)` Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert , r Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of grouridwater,inflow ❑ Yes ❑ No t5ins•3113 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 Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaguid MA '02637 05/15/13 . every page. Citylrown 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-3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is umma uid e'MA 02637 05/15/13 required for C q every page. Citylrown 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 a t5ins•31113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 A✓fig 1 r t k r '"4�Y _....--...—.__....____.._ ommonwealth of Massachusetts , Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments. 1 v Harbor Point Road (System# 1) Property Address Cape Cod Village r Owner's Name rmation is uired for Cummaquid MA 02673 05/30/08 very page. CitylTown State Zip Code Date of Inspection f D. System Information cons. Y (cont.) 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. SF'Pr-ia rwNv� P -rAmiL SEY Ac4o cat Pr= &V . 2 u o R. v - w . y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 'Harbor Point Road(system#1) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaquid MA 02637 05/15/13 every page. Cityrrown 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. 1 fleet 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 on file Barnstable BOH Date _ ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-'explain: ElChecked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: Well SDW 252/Zone-A/water level 46:5/.4xl2=4"adjustment You must describe how you.established the high ground water elevation: no additional componets beyond the tight tank Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins.3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection .Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Harbor Point Road stem#1 (system ) Property Address Cape Cod Village Owner owner's Name information is q required for Cumma uid MA 02637 05/15/13 every page. CityITown 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 eitherdrawn on page 15 or attached in separate file t5ins•W 3 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 ti,f '7 yra"k'r -- 6t f . .. I = tDN.4L Ll*. ^�ER D PAgTS3Lip M A PROFESS r y� �� �►3�- 542-5557 i CHUSTTS 02116 (617) T N MASSA CH STREET,90S t� ; 46 CHUB e � 2 {• ... 180:8-004-505 ! �rtP-21 q, y.; 1990 1 vpa, ens 4, J McKean j Mr. Thomas i Board of health Town Halll 02b30 Barnstable, Mgs achuae tts i RE: ' .. C;9PI Cod Village ' r+.,,.r�nmi[Liam A e enr{Rt�Ori, i Dear Mr, r�cKeen,= leased to inform yob i Dames & Moore is. p our May 23, 1990 letter, system at the Cape Cod Villas ,upplemenin� wastewater collection y that repairs to the com late, The house connections have been repaired an GCVO) are P Doolittle) of our office: I Condomini s ineOr (Mr• Jegfrey inspacted.by an fin$ nif ioantly due t' Ay stated�in'our .provious letter, the B roundwater has risen sig artiall� Mr. Doolittle's 'insPgction of repair �nsto:Cma. A�-most half of trei ousa connections were at a&s recent rah roundwater dun g aubma:ged;by the high8 co these oMactions.. these house iflican� wa ter was Observed f e11 the lowing into the tanks Frain No sign Doolittle also confirm that. . new house connections ar i • connecti4s. Mr. right, I o1e frames and covers have,been installed. . ' Tha cast . ron bolt-dov,-n marsh Whalen of base ca11 myself oi: Kelly 1 if yo u ha�e airy questions on this matter, p ` this Very trult yours., DAMES & m�ORE .. P . A Pro sstonal L"_mi'ted Partt►srshi I Pio Lo hardo, PE,' I Asso�a`ata ' Anthony Sapienza CCVCA� cc: Mr. Barnstable DPW Hr. Thoatas Hullen,McGregor, Shea & Doliuer Glal Wood, Esq. , I I \boh.txt h;\.\1$038\Q02\letters - - 1 ' f 350 MAIN STREET TEL: (855)775-2820 WEST YARMOUTH,MA 02673 FAX: (508)778-9628 Septic Service Pumping: h 508-776-2820 Installation Bill To: Cape Cod Village Customer:. Cape Cod Village 3004 S Hill St ' Contact: Roger Bacon Arlington VA 22202 Job site: Harbor Point Rd Cummaquid MA 02675 Phone: Email: rwbacon1 aol.com Neighborhood Waste WaterServices Inc proposes to furnish all the materials and perform all the labor, necessary for the completion of: 2013 Septic Servicing Schedule Pump septic from(2)tight tanks on a per call basis: Tight Tank sizes: Large Tank is 20,000 gallons, Small Tank is 9000 gallons. Cost: .15 per gallon pumped t In the event of an emergency call for service from the Cape,Cod Village Answering Service, no " Neighborhood Waste Water technician will respond unless a member of the Board has been contacted and has approved service to be completed.. Neighborhood Waste Water Services.Inc.Contract Terms and Condition Late fees,Liens and Costs of Collection: By signing below, I hereby agree that this document is a written contract of even date enforceable under Massachusetts law.between Neighborhood Waste Water Services Inc and the customer listed above, a mechanic's lien pursuant:to M.G.L.Ch.254 may be based:upon this contract to secure the payment of all materials-and. labor furnished hereunder.and incorporated in the real property. Payments not received within 10 days of invoice due dates pursuant to this contract will result in an additional charges of 1,5%per month(18%APR)and customer will be responsible for all.costs of collections including but not limited to reasonable attomey's fees incurred in the collection process: . Respectfully submitted by: Mark White Date: ' December 17, 2012 The above prices, specifications, and conditions are satisfactory and are hereby accepted.-You are authorized to do the°work as specified. Payment will be. made as outlined above. Accepted By: , - y-.... '�.©.14 . Cd Per Commonwealth of Massachusetts dL i So� Y . Title 5 Official Inspection FormS� _ o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M Harbor=Point R System# 1) f isIs-, Property Address Cape Cod Village Owner Owner's Name information is Cumma uid MA 02673 �05/30 8�"• required for q every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. important: _When filling out A. General Information forms on the computer, use 1. Inspector ' O only the tab keyto . , cursoremov do not our Brad J. White `3 Name of Inspector car: use the return p key. Bluewater Company Name N , 350 Main Street CD Company Address West Yarmouth MA 026 3 1e"0/ Cityrrown State. Zip Code (508)775-2800 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: -W ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 5/30/08 Inspector' Ignature ' Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Capecodvillagesystemt.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is 4 required for Cumma uid MA 02673 05/30/08 every page. Cityfrown 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: �Mill.. System consists of one 9,000 gallon tight tank. The tight tank has an alarm light that is full functional and a alarm company is notified who then in turn notifies Bluewater. The alarm is set to go off when the tank reaches 60%. 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 Capecodvillagesystemt.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form Not for Voluntary Assessments Harbor Point Road S stem# 1 ( Y ) Property Address Cape Cod Village Owner Owner's Name information is p required for Cumma uid MA 02673 05/30/08 every page. CityTown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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: y 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. Capecodvillagesysteml.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts W Title 5 Official inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M Harbor Point Road (System# 1 Property Address Cape Cod Village Owner Owner's Name information is Cumma uid MA 02673 05/30/08 required for q every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 ❑ ® 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 El ® than %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. Capecodvillagesysteml.doc-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet 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. Capecodvillagesysteml.doc-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 Commonwealth of Massachusetts F Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form- Not for Voluntary Assessments Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is Cumma uid MA 02673 05/30/08 required for Q every page. Cityrrown 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 E ❑ 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 El 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)] Capecodvillagesysteml.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is Cu_m_ma uid MA 02673 05/30/08 required for _ q ' every page. Cityrrown State Zip Code Date of Inspection. D. System Information Residential Flow Conditions: Number of bedrooms (design): W 16 Number of bedrooms (actual): Unknown DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Oil- 1,760gpd 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 Y P system inspected? ® Yes ElNo Seasonal use? Z Yes ❑ No Water meter readings, if available last 2 ears usage d l.�ELLwA'� N/A 9 ( . Y 9 (gP ))� Sump pump? ❑ Yes ® No Last date of occupancy: Current 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: Last date of occupancy/use: Date Other(describe): Capecodvillagesysteml.doc•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA' 02673 05/30/08 - every page. Cityfrown State• Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Pumped after inspection I Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: -� 4,500 . gallons _ How was quantity pumped determined? Sight tube on truck Reason for pumping: Check tanks structural integrity. 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): Approximate age of all components, date installed (if known) and source of information: System was installed in 1987 and all components were upgraded in 1990 Were sewage odors detected when arriving at the site? ❑ Yes ® No i Capecodvillagesysteml.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 I Commonwealth of Massachusetts W Title 5 Official Inspection form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is Q required for Cumma uid MA 02673 05/30/08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): VIP 52" Depth below grade: feet Material of construction: ❑ cast iron ❑ 40 PVC Schedule 35 PVC ❑ other(explain): NP Distance from private water supply well or suction line: N/A feet Comments (on condition of joints, venting, evidence of leakage, etc.): Building sewer is in good condition. No evidence of leakage Septic Tank(locate on site plan): Depth below grade: 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: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How,were dimensions determined? Capecodvillagesystemt.doc•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 every page. Cityrrown 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.): 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 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: 35" Material of construction: +�- ® concrete ❑ metal ❑ fiberglass El polyethylene ❑ other(explain): Capecodvillagesysteml.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M Harbor Point Road (System# 1) ' Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: 18'-7"x 11' x 9'-2.5" Capacity: 9,000 gallons Design Flow: b. 1,760gallons per day Alarm present: ® Yes ❑ No Alarm level: Alarm in working-order: Z Yes ❑ No Date of last pumping: --R After Inspection Date Comments (condition of alarm and float switches, etc.): Alarm light is functioning. Tank is structurally sound with no visible`evidence of leakage in or out of tank. "Attach copy of current pumping contract(required). Is copy attached? ® Yes ❑ No Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Capecodvillagesysteml.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 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: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching.galleries number: ❑ leaching trenches m 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.): Capecodvillagesysteml.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 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.): Ca ecodvilla es steml.doc•03/08 . Title 5 Official Inspection Form:Subsurface •Sewage Disposal System Page 13 of 15 P Y 9 Commonwealth of Massachusetts w v Title .5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owner's Name information is Q required for Cumma uid MA 02673 05/30/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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. 1 Locate where public water supply enters the building. 4,eco SGPRa'T'ANlf� . 0 t-A Ntc sEr .Ruw ear a. 6 L l� fl . t7 tal Y Capecodvillagesysteml.doc•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 A� DU Z-t - R.()A-0 Commonwealth of Massachusetts M F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM Harbor Point Road (System# 1) Property Address Cape Cod Village Owner Owners Name information is q required for Cumma uid MA 02673 05/30/08 every page. Cityrrown 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: 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: I�c� Date T� ❑ 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: Well SDW 252/Zone A/ Level 46.8'/Adjustment.9 x 12" = 10.8" You must describe how you established the high ground water elevation: System consists of one 9,000 gallon tight tank. There are no additional components beyond the tight tank, no distrbution box and no s.a.s. System located in area for well SDW-252/Zone A/Level is 46.8'/Adjustment.9 x 12" = 10.8". Site plan indicates groundwater elevation @ 11' below grade. Capecodvillagesysteml.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 j I _ ,_ r - , - -- - - I t I I I i I I , ' ! j , , i 1 1 I ' "I , I � I I I ........... -- — - — — — — — — F I _ � ! i I t I - __ _ __ ._.I _ _ _ _ _ i I . ti , — i— . _ r , I r I , , --�-- I i i I I i ! f I I� T n- ! �(—D_�C2'— C�•Ili t�_e��y.. .."-l--(� _ _�A VI—. _a_ I __ S --- j , ' ' + I --+"-__ ' 1 I t `� I I I I I AA ' _ iI✓�� }y�� �;,�y,}�rr,�� I �r•��,, .��/^� ' I I I ; I� 1 � � I— ! - I- ___.._ I -.. -. _' I ' ' - -_ __. .-�.�..�!•�T�_o� "-""-SJ V_ I _�� -4'_'r VG�G'_�u�Cv �_�.✓.._-_-i- �_ I i j i � I I I I GII�E' [-{=��L�.FG t�---- Cr�O��4u.q►� AL �[.u 1� J 1 I I I - I I i I , ' I I I , I ' ------ -------- ---------- i I j I i .. ........... ---I - - I - - I r� x ORA PROpgS$tON.4L tlltlT6D PARTNEfiSH1P 46 CHURCH STREET,BOSTON, MASSACHUSH TTS 02116 (617) 542-5557 j FN: 180?8-004.5050 j i June 4, 1990 I i .I MT. Thomas McKean Board of Aealth . Town Hall ; Barnstabl4, Masgachusetts 02630. i RE: , Capp Cod Village (;LUdMj tium, Ass_ . s cia..i<i_4 'I Dear Mr. 4cKean: Supplementing our ray 23, 1990 letter, Dames & Moore is pleased to inform yot, that xepallIirs to the Wastewater coke house connecllection mtions have been repaired, at the Cape Cod lan Condomini+ ms (.GCVC) are complete. The of our office. inspacted�,by an engineer (Mr, Jeffrey. Doolittle) As stgte�i lin our ,previous letter, the' groundwater has risen significantly due t recent rainstorms. Almost half o£ the house connections were at least partiall; aubmergediby the high groundwater during Mr. Doolittle's inspection of repair to these o-Slneationa, the tanus rthess No significant water was observed 'flowing e11 the new hoes oonnection pare connections, Mr. Doolittle also confirmed tight, � she cast Ihole frames.. and cover's have been installed, ron bolt-down man If you ha�a any questions on this matter, p lease call myself or Kelly Whalen a this offi6. very trul yours, DAMES & MORE A profss�onal Limited Partnership I Pio Lo bardo, P,E, Associata y_jW\j a cc: Hr.IAnthon'y Sapienza, CCVCA Mr. IThomas Mullen, Barnstable DPW Glen Wood, Esq. , McGregor, Shea & Dolinar I h:\.\18438\002\letters\boh..txt { Qrr Cry WOALDWIDE .......... I - i, 1 74 'ram ;• 50 ' P ' 8,0-i4 . Coe`y t � - Commonwealth of Massachusetts Title 5 Official Inspection Form 77,�/� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5W4 Harbor Point Road (System#2)> Property Address Cape Cod Village Owner - Owner's Name information is Cumma uid —� required for g MA 02673 05/30/08 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. Important:When filling out. A. General Information forms on the computer, use 1. Inspector: only the.tab key to move your Brad J. White cursor-do not Name of Inspector use the return key. Bluewater Company Name 350 Main Street Company Address' West Yarmouth MA 02673 City/Town State Zip Code (508)775-2800 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 f C":: d_. ❑ Needs Further Evaluation by the Local Approving Authority 5/30/08t Inspectors Slgnat Date c-n rV The system i pector shall submit a copy of this inspection report to the Approving Authority(Board of Health or EP)within 30 days of completing this inspection. If the system is a s: -red system or ' has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the re0ortto 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. Capecodvillagesystem2.doc•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 Commonwealth of Massachusetts . W Title 5 Official Inspection Form. , _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaguid MA 02673 05/r 30/0 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: pZ 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: has ern an )an alarm light that-is full functional u nd a alarm er-and one 6 0 gallon tight tank m co pany s notified who-then-in ton n Y notifies Bluewater. The alarm is set to go off when the tank reaches 60%. 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 Capecodvillagesystem2.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System^Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4M ,.•''� Harbor Point Road (System#2) - - Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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: 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 mahner 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. Capecodvillagesystem2.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 every page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 El ® 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 clo89ed SAS or cesspool p ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® 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. Capecodvillagesystem2.doc=03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form =Not for Voluntary Assessments °M Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is required for q Cunima uid MA 02673 05/30/08 every page. Cityfrown State Zip Code Date of Inspection B. Certification (Cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® 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 .and chain of custody.must be attached to this form.] ❑ ® The system is a'cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ER The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with A design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet 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. Capecodvillagesystem2.doc•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 C05/30108 every page. Cityrrown 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?- El ® 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? Z ❑ Were all system components, excluding.the SAS, located on site? Z ❑ 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)] Capecodvillagesystem2.doc•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts r Title 5- Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information isequired for Cumma uid MA 02673 05/30/08 every page. CitylTown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 28 Number of bedrooms (actual): Unknown DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 3,080gpd 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 Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage N/A 9 ( Y g (gpd)): �1-ll��(' `�l Sump pump? ❑ Yes Z . No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 MR 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 e r Water meter readings, if available: - Last date of occupancy/use: Date - Other(describe): capecodvillagesystem2.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System,Form Not for Voluntary Assessments Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: s Pumped after inspection Was system pumped as part of the inspection? ® Yes ❑ No If yes,�volume pumped: --� 9 500 allons How was quantity pumped determined? Sight tube on truck Reason for pumping: Check tanks structural integrity 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): 4 C Approximate age of all components,.date installed (if known) and source of information: ---� System was installed in 1987 and all components were upgraded in 1990 Were sewage odors detected when arriving at the site? ❑ Yes ® No Capecodvillagesystem2.doc-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is Cumma uid re uired for q MA 02673 05/30/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 281, feet Material of construction: ❑ cast iron ❑40 PVC Schedule 35 PVC ❑ other(explain): . Distance from private water supply well or suction line: N/A feet Comments(on condition of joints,Venting, evidence of leakage, etc.): -epm- Building sewer is in good condition. No evidence of leakage Septic Tank(locate on site plan): Depth below grade: 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 r Dimensions: Sludge depth: < Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle. Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Capecodvillagesystem2.doc-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts W Title- 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 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.):. 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 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): � 6 ----W 12" Depth below grade: Material of construction: ® concrete ❑ metal El fiberglass ❑ polyethylene ❑ other(explain): Capecodvillagesystem2.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts M - Title 5 Official Inspection Form _ - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is q required for Cumma uid MA 02673 05/30/08 " every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont Tight or Holding Tank(cont..) 33'-11"x 11'x 9'-2" Dimensions: Capacity: 16,000 gallons 3,080 Design Flow: gallons per day r Alarm present: ® Yes ❑ No Alarm level.' 60% Alarm in working order: ® Yes ❑ No Date of last pumping: After Inspection Date Comments (condition of alarm and float switches, etc.): - Alarm light is functioning. Tank is structurally sound with no visible evidence of leakage in or out of tank. *Attach copy bf current pumping contract(required). Is copy attached? ® Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): k 4 Pumps in working order: ® Yes ❑ No Alarms in working order: ® Yes ❑ No Capecodvillagesystem2.doc,03/08 Title 5.0fficial Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts' W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaquid MA 02673 05/30/08 every page. Cityrrown State Zip Code Date of Inspection r D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is in good working condition..Both pumps are functioning. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ 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.): Capecodvillagesystem2.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owner's Name information is required for Cummaquid MA 02673 05/30/08 every page. CityTTown State Zip Code Date of Inspection D. System Information (cont.) 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, 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.): Capecodvillagesystem2.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 I ` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Harbor.Point.Road (System#2 Property Address Cape Cod Village Owner Owner's Name information is Cummaquid MA 02673 05/30/08 required for State Zip Code Date of Inspection every page. CitylTown ft-(cont.) VAN isposal 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. o� ;tr z of - x 3 4 w (M AO►+a e rrANL y v M4 .2 pvo &A,kL a r N Qa r P C►+A►ree"f L' Tit 5 official Inspection Form:Subsurface Sewage Disposal System Page 14 of 15 CapecodvillagesystemZdoc•03108 ' Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M Harbor Point Road (System#2) Property Address Cape Cod Village Owner Owners Name information is Cumma uid MA 02673 05/30/08 required for q 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: feet Please indicate all methods used to determine the high ground water elevation: �J Obtained from system design plans on record —'—Q' If checked, date of design plan reviewed: I �SfO .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: too Well SDW 252/Zone A/ Level 46.8'/Adjustment.9 x 12" = 10.8". You must describe how you established the high ground water elevation: —�- System consists of one 2,000 gallon pump chamber and one 16,000 gallon tight tank. There are no additional components beyond the tight tank, no distrbution box and no s.a.s. System located in area for well SDW-252/Zone A/Level is 46.8'/Adjustment.9 x 12" = 10.8". Site plan indicates groundwater elevation @ 11' below grade. w e I CapecodvillagesystemZcloc-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15.of 15 ' I I ; I I I : ; t , i - - i - - - I 1 I - t , � i t I I. _ i I { I t t - i --- - --- - � 14,1 �._ - r- ..- __ _ I kAWCA, - --- : I 1 I ��3 Q�i i V� �_ t_ H-c.. 'cF-t-0_�I_ OcliP�1(�W:�►-TY�2 - - -- - 1 , I f 71: ,7-- - -. --I - I y i . -------------'-- i - ARE A PRC)fUSi0N.4LL1StITBD PARTVERSHIP I .> 4 _ I 4o CHURCH STREET,BOSTON, 2�tASSACHUSEI'r$ 02116 (617) 542.5557 PN: 18o387 D4.5050 Jura 4, 1990 i Mr. Laith Board of Town Hall ; i Barnstabl4, Massachusetts 02630 RE: Capp Cod Village 1 Dear Mr, r�cKean:i Moore is pleased to inform YO4 Supplementing our May 23, 1990 letter, Dames & Irg to the �rastewater collection systai� at the Cape Cod Viliag that rape, The house connections have been repaired an Cond•omini�s (CCt�C) are pornpl9te• of our office . inspacted!hy an �ngina�r (Mr'• Jeffrey Doolittle) ioua letter, the groundwater has risen signifiaan.' tia11; As stated lin our ,prav action of repair scent ra nstorms. Almost half of d eing aDoolit la's '-aspt least p hou r roundwater u g aubmargedby the high g to these minections, rito ,,cant water was observed flawing at all connectio>{�s• A2r• the n8W house co nnection oaro No signif ' Doolittle also oonf`�rmed th tight• I I a ole frames and covers have been installs . ='ha cast ron bolt-down m nh If you ha�e any questions on this matter) Please ca11 myself o� Kelly Whalen o� this offi�e. i Very trul yours, DAMES & MOORE ' A Pro ss�onal Limited PartnsrshiP pio Lombardo, P,E• Assaciate� a1�JW\jA cc* Mr.I Anthony Sapienza, CCVCA I .I Thomas Mullen, Barnstable'DPW r n Wood, Esq. , McGregor, Sgea. & DolinOr GleI h;\.\18038\00�\letters\boh.t�ct i QFFIcr$ WLIRLD`VIN .... -... ..T. F 1_1 y r. 1 74 rat= 5 0 310 CMR 10.99 Form b oEOE Fib•No• SL 3—212 4 ' N �o` tTo be prowoso by 0EOEI Commonwealth �°� Barnstable f Cry Town of Massachusetts Appicanl Cape Cod Village Condo ro rw• p 1079, Order of Conditions Massachusetts Wetlands Protection Act . G.L. c. 131, §40 TOWN OF BARNSTABLE BY—LAWS, ARTICLE XXVII From Barnstable Conservation Commission Cape Cod Village To Codominium Association Same (Name of Applicant) (Name of property owner) c/o Tony Sapienza Address 5 Lincoln Street Address Same 7riington, mA. Map Number I52 Lot Number 035 This Order is issued and delivered as follows: D by hand delivery to applicant or representative on (date) XM by certified mail,return receipt requested on June 14 , 1990 (date) This project is located at Lot #35 Harbor Point Rd. , Cummaguid, MA. t The property is recorded at the Registry of Deeds in Barnstable r Book 1 s r10 15 5 0 page 211 Certificate(if registered) The Notice of Intent for this project was filed on May 05, 1990 (date) The public hearing was closed on May 22 , 1990 (date) Findings The Barnstable Conservation commiaai nn has reviewed the above referenced Notice of Intent and plans and has held a public hearing on the project, Based on the information available to the Commission at this time.the Commission has determined that the area on which the proposed work is to be done is significant to the following interests in accordance with the Presumptions of Significance set forth in the regulations for each Area Subject to Protection Under the Act(check as appropriate): ❑ Public water supply Flood control ❑ Land containing shellfish ❑ Private water supply Z Storm damage prevention ❑ Fisheries X® Ground water supply )Q Prevention of pollution ❑ Protection of wildlife habitat Total Filing Fee Submitted $5 5 . 0 0 State Share $15 . 0 0 City/Town Share VA.fee in excess of S25) Total Refund Due S CityRown Portion S State Portion S ARTICLE 27 Only: ('h total) (1/1 total) Q public Trust Rights ❑ Agriculture M< Erosion Control ❑ Aquaculture ❑ Recreational Q Historic ❑ Aesthetic Effective 11/10/89 5.1 y r Therefore,the$arnstable Conservation. Co zission.%reby finds that the following conditions are Ef necessary,In accordance with the Performance Standards set forth in the regulations, to protect those inter, ests checked above.The Cn=_ ' asinn orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced above. To the extent that the fol• lowing conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent.the conditions shall control, General Conditions 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory mess• ures.shall be deemed cause to revoke or modify this Order. 21, This Order does not grant any property rights or any exclusive privileges: it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state or local statutes. ordinances, by-laws or regulations. a. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: ' (a) the work is a maintenance dredging project as provided for in the Act: or (b) the time for completion has been extenced to a specified date more than three years. but less than five years. from the date of issuance and Cosh that Cate and the special c,rccrostances warranting the extended time period are set forth in this Order. 6. This Order may be extended by the :ssuing authority for one or more Periods of up to three years each % upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this protect snail be clean fill, containing no trasn, refuse, ruboish or de• bris, including but not limited to lumber, backs. piaster, wire, lath, paper, cart^.card. pipe, tires. ashes. refrigerators, motor vehicles or pans of any of the foregoing, 7. No work shall be undertaken until all administrative appeal periods from this Order have elacsed or, if such an appeal has been filed, until all proceec:ngs before the Department have coon completed. B. No work shall be undertaken until the Final Order nas coon retorted in the Registry of Oeecs or the Land Court for the district in wnich the land is locate.. within the cnain of title of the ailected property. In Me case of retorted land, the Final Orcer snail als; oe noted in the Reti:stry's Grantor Index under the name of the owner of the land upon which the proocseo work is to be done. In the case of registered land, the Final Order shall also be noted on the Lana Court Can:ficate of Title of the owner of the land upon which the proposed work is to be done. The recording !nicrmat;on shall be suomitted :c the Co%mission on the form at the end of this Order prior to ccrnmencement of the work, 9. A sign snail be dsplayed at the site not less than two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Quality Engineering, ReNumoer SE3-2124 •• 10, Where the Department of Environmental Cuamy Engineering is requested to make a determination and to issue a Sucerseaing Order, the Conservation Commission shall be a art ail n p y to a agency proceedngs ano hearings before the Oeoartment. 11. Upon completion of the work descr.beo herein. the applicant shall forthwith recuest in writing that a CerUfiCate of Compliance be issued stating that the work nas been satisfactorily completed. 12. The worK snail conform to the following plans ano special conditions: | / ^ ' SPECIAL CONDITIONS -- CAPE COD VILLAGE CONDO ASSOC. -- SE3-2124 � PLANS: ' Title: Site Plan Dated: May, 1990 - | Signed and stamped by: Unstamped, unsigned by Dames & Moore On file with: Barnstable Conservation Commission 367 Main Street , Hyannis, Ma. 02601 - (508) -775- 1120, ext . 140 Finding: | � � 1 . ) The Commission finds the isolated wetland adjacent to the � shuffleboard court to be recovering from a cutting violation in the summer of 1989. The extent of the wetland is found to have increased � since that date, while the wetland flagging has not been revised in kind. The Commission will continue to observe with interest the regrowth of this wetland ,, � 2. ) The tight tank system is not regarded as a long or even mid-term . e g an sys e - � solution to the accomodation of septic waste at the site. � � � Decision: 1 . ) Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein , Genera] Condition number 8 (preceding page) shall be complied with. 2. ) It is the responsibilty of the applicant , owner and/or successor(s) to ensure that all conditions of this Order are complied with . The project engineer and contractors are to be provided with a copy of this Order and referenced documents before the commencement of construction. 3. ) The work limit for the project shall be 3' off the most northerly-located tank , and 10' off the two larger tanks. 4. ) All areas disturbed during construction shall be revegetated immediately following completion of work at the site. No areas shall be left unvegetated or unmulched for more than 30 days. This approval is contingent upon the approval by the Board of c~Health of the subsurface sewage disposal system. 6. > The Conservation Commission, its employees, and its agents shall � ^ � , - have a right of entry to inspect for compliance with the provisions of � the Order of Conditions. 7. ) At the completion of work, or by the expiration of the present permit, General Condition number 11 shall be complied with. ' � � � � � ' � G Issued By Barnstable Conservation Commission Signature(s) This Order must be signed by a majority of the Conservation Commission. 14th June 90 On this day of 19 , before me personally appeared Eric Strauss , to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed.deed. October 28 , 1994 otary 'c My commission expires The applicant,the owner,any person aggrieved by this Order,any owner of land abutting the land upon which the proposed work is to be done or any ten residents of the city or town in which such land is located are hereby notified of their right to request the Department of Environmental Quality Engineering to issue a Superseding Order, providing the request is made by certified mail or hand delivery to the Department within ten days from the date of issuance of this Order, A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and the applicant. Detach on Dotted Line and Submit to the Issuer of this Order Prior to Commencement of Work. To Barnstable Conservation Commission (Issuing Authority) PLEASE BE ADVISED THAT THE ORDER OF CONDITIONS FOR THE PROJECT AT ti FILE NUMBER SE3-2124 HAS BEEN RECORDED AT THE REGISTRY OF ON (DATE) If recorded land, the instrument number which identifies this transaction is If registered land, the document number which identifies this transaction is Signed Applicant 4 c� Daniel S. Greenbaum VG�t'C `�eQ�f CCO�l, Commissioner GDZE _AX !l✓�i, ✓IfaBBQdw""OT Y47 Gilbert T. joly Regional Director RE: NOTIFICATION OF FILE NUMBER DATE: May 18, 1990 WETLANDS/ BARNSTABLE This Department is in receipt of the following application filed in accordance with the Wetlands Protection Act (M.G,.L. , Chapter 131, Section 40) : APPLICANT: Cape Cod Village Condo. OWNER OF LAND: Same Association ADDRESS: 5 Lincoln Street ADDRESS: Arlington, MA 02174 PROJECT LOCATION: Harbor Point Road - Lot 35 This project has been issued the following file # SE Although a. fil_e # is being issued, please note the following: No file # will be assigned to this project until the following missing information is sent to this office to complete the filing in accordance with/the Act: PLEASE RETURN THIS FORM WITH REQUESTED INFORMATION. (1`) Notice of Intent (1) Locus Map ( ) Fee Transmittal Form ( ) Title 5 Plans ( ) Appendix A Documentation (1) Plan COMMENTS: Only one of each submitted, require 2 of each. 310 CMR 10.99 Instructions for Completing Notice of Intent. Application has been forwarded to the Waterways Licensing Program to determine if a Chapter 91 License is required. ( ) Please forward a copy of the Notice of Intent to the Army Corps of Engineers for Sec. 404 review (Call 1-800-362-4367 for information. ) Project may require a Water Quality Certificate. Applicant is advised to contact the DEP Division of Water Pollution Control (1 Winter Street, Boston, MA 02108; Tel: (617) 292-5673) for forms and further information. ISSUANCE OF A FILE NUMBER INDICATES ONLY COMPLETENESS OF FILING SUBMITTED, NOT APPROVAL OF APPLICATION. JJS/jt cc: Conservation Commission ( ) DEP Water Pollution Control-ATTN: J. Perry ( ) U.S. Army Corps of Eng. , Reg. Branch ( ) Building Inspector (x) Board of Health ( ) Coastal Zone Management Original Printed on Recycled Paper M -� To: _rn McKean, Barnstable Board of Health ltt Tom Mullen, Barnstable Department of Public Works From: pilexander C. Blair, 115 Harbor- Point Road Frank W. Gibson, 149 Harbor Point May Y,, 1990 Re: Cape Cod Village First, as residents of Harbor l-_•ir#I_ Road we thank '.l3f#_t for the opportunity you arranged for us to meet with you the representatives of the Cape Cod !','`i llt3ge i'-4sL;i_cii;i}fir# and Pio Lombardo, their- engineer, ,and Glenn Wood, their attorney, on Wednesday, April 25 to discuss the current situation 'sherith regard to the Village's septic, problems and to explore the possibilities for a long terns solution. We believe. it 'shitas a `'fiery productive meeting. We pope that both you and the representatives of the `:''illira�g_e recognize ze that it'e, as neighbors, wish sh o do what f e can to help the ''Village solve its problems. Our onlh disappointment is that Mr. Bryant Firma n of the state DEP did not attend as scheduled. This is a major disappointment as our discussions, though productive, were quite involved. the believe that it will he difficult for any of us, individually and/or collectively, to recreate for Mr. Fi.rmin, through memos and/or minutes, the sense of urgency which h we arl agreed was necessary to effect a viable solution for the Village. Though you agreed to allr_a„, the villa age to utilize its temporary holding tanks and pump fcar- ,het another "final season" (provided all the requirements uir errient•J set forth in Mr.. s sc ea n''_ memo are i:Lsriiplied with), we slope that Mr-. Firr€iin s_lear ly understands the conditions, agreed to by all of those present on April 25, which governed your granting this extension beyond your previous deadline for the termination of the Village's "temporary solution." Specifically, by assigning the s'villa=fie and the abutting Harbor `Poins neighborhood a high priority for analysis by the town-side sewage 8 needs program, you anticipate that the town :still 3::rsa=,r;' by the the o the year y „ lai„ treatment pit system :htili be needed _d to serve ve I h re .�=':Ii �� aJ r e�i o�,i i � e�itr##e3i _;�_ ii ii i r ee.�}?3� 3 =3' , i� stlf l t i this i _ { determines 3�a�rtsiar r-�+Jin. area. #f I_tlic au,#a�li�=°l= 'r€fT a3 „r_1giasr;ial.. treatment e_ system i s zit'J1r equir red for the entire area, it •,iy is agreed b, all { pr-e•;Yn+ that the "r ound systeri l," proposed iiy Clan on & 3 lour e and pr previously accepted by the board of health and the department of public: works as a viable solution to the requirements of the. Village, be implemented immediately by t! a Village i order t i the Village e ♦ for its L•� l�, 'r s 3 3 i a� r i : r-s��=r .+� allow l;�'':ti the ;f s s s al�L. !l� �l�ss?r-# s i it i+_:; 1991 season. As approval by the DEP will, be required for implementation of the mound system, it also was agreed b, all dpr'�' er,t tt�a�t a� reevaluation i Damon �w. llloi - proposed i i e ! ,e� r} iIi}-Id r. i_. e-P� b the DEP ih7 wr• . ii w>•:�f �:,Jrl Vi# 1': i _�r '�~ }:3 i�Fa L¢ti- aJ ii#�,iii •J �:#j::1-more- ._r # •#. •_t: _��` ii V•'. �,ti�3J i. L to 11-11c-'Kean ai i d P-11'U'l I e 1-1, -P a ge 2 We trust that steps- are be-Hnq taken., as volunteered tiq Mr. L - he cl�fe und. rstand- the u.nanimous. a g r m n Lot-nbardio, to insure t1ha-4 L LCI L ee e-t It i -Ii I' of all who attended April 25 meetinq that the " nound s., e t ) y. I . r, .4st -m" 'a It work and (b) should be approved as soon as possible. We I ook for to the V I I I dge'---,- comp]iance, as per t1r. McK.-an's directive, with reqa,,d to the tightening of the tanks, the installation of standpipes, 11 - I he - - -!!- I ease - indpipes, the surfacing 0 ti-e road, etc. as this si-ould ease sr-Ime of the tensions that have reqrettablq, but understandably, been caused between neighbors. One additional point. Although the flagging of the area abutting I fan', "s apparan-I i-las-ifi�—,,;on as a %vetland is primarily the main fan', and I L W �Dlll L-OLI I under the jurisdiction of the Conservation Commission., we ;hush to reiterate here, for the record, that this so called wetland apparently is the result of construction work undertaken b!4 several of thi--- Village residents, rather than the result of An Act of Nature. As this current lack U.- . of drafinaqe could I!]rivr- a negative effect upon any all uure -.-ems r-i ft S!4"Zt designed for the removal of septaqe.. we urge that the steps necessary to rectify this unnalT ural high water table be approved and implemented as soon as possible. Yciurls in no od filth, Copies 413: o L 0 Charles U. L, U I yuh, Pr—i--ent, Cape rod V'I I agr- -soci at',on 0 Pi o L o-mba rdo!, D-jt-ne,---. & t-1 o ore r -- -:- Lion Ce forr:�rarva4 mrni- sion F ry - �f No..._�V:.29 Fxs., .. ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratilait for Disposal Works Tonstrurtion Frrmi# Application is hereby made for a Permit to Construct ( ) or Repair (-11(t) an Individual Sewage Disposal System at: I .....PkGs r.&n1 : .. ��14?tillq��.�.GS1j...................•....... ................---•----.............----------•----------------...-: _cation-A dr s o�j Lot No. ........ ....��C1� 1 1 i?rLsLl9 071 1 [J JX!c. ...TfCq E,l.(2W1441c _GGI ............................. /� o Owner n+ �- fA�d�dres t a I!_ _�i�n S.Q. IY(G.�w.. r¢? a.._SvAk� _Lcr_Y_�nA_u.............................` Installer Addres ..-- Type of Building Size Lot____________________________Sq. feet U �-t Dwelling=No. of Bedrooms....................._-----------___________Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons-----_--_-_••_______________ Showers — Cafeteria A'' Other fixtures -------------------------------- . w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------. Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter----___.-.__-____-_- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-� Percolation Test Results Performed by..................................................................-...... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--__-_-__-_-___•.-.____- a ---------•--------------•----•-•--------•----------------........---------------•------...-•---.............-----------------------------•......-•••-........ 0 Description of Soil................................................................................x w ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U ture o ep irs or Alterations—Answer when applicable__.1� C._D.h PC_ __ Qn �_ io>�5----E�sl�ec .-(�y____________________ Agreement: c/ The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance hias been issued by the board of health. Signed ------ ---#7. ..jy?r--------- Application Approved By ..................�0- a�� ---------- ------ ----tj 3- /-&---- Dare Application Disapproved for the following reasons- ........................................-----------------................. -- ------------------------------------------------ -------------- -- ----------------------- ------ ------ ------------ ------------------------------------------------------............................................................--- --------------------------------------- a 1 Dare PermitNo. .. --------_------- Issued --------------------------------------------- ---------------- Date No.... .» / Fxs. ....._..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE i.F . Appliration for Disposal Works Tonstrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair (- ) an Individual Sewage Disposal System at: II II cc�gyr oirlt�aac{ (I�mt r utd 06d ado ocation-Address Lot No. {' � �50CLCS�{dYL 4r Gly C•Q GP.WIu(.� U.l Owner /►/� 4� ddress `..nco 350....................................... .pJ25 ��lrYLiG U`t a Installer Addres d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms________________________________ _Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria a4 Other fixtures .................................. W Design Flow............................................ per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity____________gallons Length--------------_ Width................ Diameter................ Depth................ Disposal Trench—No_____________________ Width.................... Total Length.........._......... Total leaching area...................sq. ft. Seepage Pit No--------------------- Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY....................................................................=----- Date........................................ Test Pit No. I......._........minutes per inch Depth of Test Pit____________________ Depth to ground water........................ 44 ' Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ itsf'i --------•-------------------------------------•-•--------------------------......-•-----------------........................................................Description of Soil = V .-•-----•---•----•----•--------•••---•...•--•----•-•-•---•---•--•----------------•----.......---------...----------------•-----------------------------------------._...._...--••-•-•-------••--•----- .- ----------------------- ----- Pg cat Qr @on c b y V mature o{y tR`epairs o�j Alter`at_ions/G Answer when applicable_________________________ _______________ n.. l��e.____V_.______:__________.. �...Oi2 �pG.rc1 . /�•�riQ7W Agreement: The undersigned agrees to-install the aforedescri6ed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Com fiance has been issued by the board of health. ..........-- p `�M 4 Date Application Approved B ...............—v �--.c'....'`-"--�-------------------------- ------------------------------------------- .....— ' ��..-. Q PP PP Yv ► Date Application Disapproved for the following reasons- -----------------------------------------------------------------------------...................................................... ............................................................-------------............---.......................................---....------------......................--.... .............-- ................. . - + Date PermitNo- -----------c �� s ;9---------------- Issued ----------- ----------------------------------------------- -- -- I, Date THE COMMONWEALTH OF MASSACHUSETTS �1 BOARD OF HEALTH TOWN OF BARNSTABLE Terti tra#e of 101ontyltttnce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( — ) bysut b--------------CP, ...------------------------....------------......-------------------------------------------------------------------------------------------------------- l Insmlle, at .....................)i_l?- ' y00�....... !!>� .............V..,................................................. has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....... .. ....... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------------- ---------- ------- -------------------------------- --------- Inspector -..............................---- .....--------------------------------- -- 0 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No C FEE� �c� TOWN OF BARNSTABLE V. r - ................. Disposal Works Ton#rttrtinn rrutif Permission is hereby granted..............4•,-- 't�'1 t 44 --------------...----..._........_...------------._._.....-•-•---.._......---•--- to Construct ( ) or Repair (qy) an Individual Sewage Disposal Syst atNo............H �=l' 'S-------Ae'r—� ._..��!--_-'-_______ = --- s •------------•----•-------•_______________•----------__-___-___----___ Street g as shown on the application for Disposal Works Construction Permit No.'1'-), _ Dated.......................................... ............................ - -)------------------------------------------------------_ �DATE.................. �° 90................................. Board of Health FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS L Y114el Daniel S.Greenbaum _ - O Commissioner �Q Gilbert T.Joly 029..47 DEQE (508) 946-2800 NOW IS THE DEPAMMENT OF ENVIRONM&ITAL PROTECTION RE:. NUI'IFICATION OF FILE NUMBER. DATE: October 27 , 1989 WETIA?,NDS/ BARNSTABLE This Department is in receipt of the following application filed in accordance with the Wetlands Protection Act (M.G.L., Chapter 131, Section 40) : AppTTCANT: Cape Cod Village Condo OWNER OF LAND: Same ATTN: A. Sapienza, Pres . ADDRESS: Five Lincoln St. ADDRESS: Arlington, MA 02174 PRQTECr LOCATION: Harbor Point Road The project has been issued the following file # SE 3-2040 Although a file # is being issued, please note the following: 310 CMR 10 . 28 No file # will be assigned to this project until the following missing information is sent to this office to =rplete the filing in accrondance with the Act: PLEASE RE= THIS F01V WITH THE REZUE= INFORMATION. ( ) Notices of Intent ( ) Locus Maps ( ) Plans ( ) Title 5 Plans ( ) Appendix A Documentation C3V'1'S: ( ) Application has been forwarded to the Waterways Licensing Program to determine if a Chapter 91 License is required. ( ) Please forward a copy of the Notice of Intent to the Army Corps of Engineers for Sec. 404 review (Call 1-800-362-4367 for information) . ( ) Project may require__a Water Quality Certificate. Applicant is advised to contact the DEP Division of Water Pollution Control [1 Winter Street, Boston, NIA 02108; Tel: (617) 292 5673] for forms and further information. ISSUANCE OF A FILE NU11BER INDICATES ONLY CU IP=NESS OF FILING SUBMI'ITID, NOT APPROVAL OF APPLICATION. JJS/ re cc: Conservation Commission ( ) DER Water Pollution Control-ATIN: J. Perry ( ) Building Inspector ( ) U.S. Army Corps of Eng., Reg. Branch (x) Coastal. Zone Management (x) Board of Health Original Printed on Recycled Paper L No**... .......... Fps.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...................... .!'..............OF... .4?. !^...5...61� r Appliration for Uhipaii alb Works Tonstrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair X an Individual Sewage Disposal Systesn�t .... V..... -- tion-Add�s �i a ��.......® /.�v....... t-No ;....... -:AA- ••--..... a or 44-0 I1 ................ w!.........._ _......... ..........._......_......_................. OwAlm r A dress ...................................� �.°I r '^ .7j. 12 ,.,, r� -----•_.. .... t Installer Address t; Type of Building Size Lot............................Sq. feet U Dwelling'—No. of Bedrooms.......................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............. No. of persons........................--.. Showers Cafeteria Otherfixtures -----------•••-••-••-••--•-•-•-- •••....••••••-••••••••--•••••••-••••...•--•-----•-•-•-•..:.......-•--••--•••--•-•---•--...-----•---• W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 14 Septic Tank—Liquid capacity-------------gallons Length................ Width................ Diameter.................Depth................ ` Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area...............T....sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 111 Percolation Test Results Performed bY.......................................................................... Date........................................ t ,aa Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ tl Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x -- ............................................................................................................. 1 ODescription of Soil... f.••---- ---•-------•----•-•----------------------------------------------------•---------------------------._.._...._-•-••• 1 x ------------------------------------- ------------------- ---------------•---•---........ U Nature of epairs or Alterations—Answer when applicable----. .._e...._ 'e �- :.--_ Zz'_. ......—f`. 4 ear -�.�4� - i�dG �G Agreement: la/a v .L 2 The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL% 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Sign Application Approved By..... - --------- --- --- --=C •--•-• © �1 Date Application Disapproved for the following reasons--------------------------------------------------------•--------------•---------•---•--•...........•-•••---•-••. ........--•----------•----------•-----------•--•--------------------••-•--••-----.....•...-------•----....-----•---•-----•------- ---------............................................................. gDate PermitNo.... 1..------- .9-------------------- Issued_....................................................... Date ap 1:1. Ole, ' No.. ....... Fps.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 61 ............ Applirattiun for Disposal Workii Tomitrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair Y an Individual Sewage Disposal .System at: y.,;AtY.... ��,...o c�'v t Lo�ationJA�ddf�s • or Lot No. �� ..`..........�',�.f :..t�...f/...................... �G .�.74.G Ovs�l vt v w 4 y^n hn m �Cr r -• Wa O T Address .V ........ . ......... ....� . Installer. J Address Q Type of Building Size Lot............................Sq. feet :U Dwellings—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ...................................................................................................................................................... WDesign Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length.............•.. Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length........_........... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 17 a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-__---.______.___ --__. Ii, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ODescription of Soil... IV...... 4: ................................................................................................................. x V ..............................................................-................................................................................................ ..................................... ----------------------------------------------------------------•-----•-•--------------•-•------......--------=------ U Nature epairs or Alterations—Answer when applicable.____-...�...... evd: _ Agreement: .0 v L. e, a The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned fur leer agrees not to place the system in operation until a Certificate of Compliance has been issued by the board/of health. _ Sig coil = Application Approved BY •--•---------- -........... • .••• •-• •........ .. Date Application Disapproved for the following reasons------------------------------------------------------------------------------------••--•-----•---•••......_..... C ..............••----•--••---•--------••---•-•••-•-X•••f•-•...••-•-••-•••-•--•-•--........-•••--......._......__....-•--•------•-••-----••.....••--------••----•--••-----------.._ ......-••-•-•--- Date F� Permit No....0...L_....- �1 Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... ...QF......✓........... ...................................'. ' ........................... (9rdifirate of Toutplitanrr THI,& IS�iO CERTIFY,phate Individual Sewage Disposal System constructed ( ) or Repaired (�) by.. .......•••• J --.-•-------------------------•----.--••------•---.--............._..-•-•-•--- / ��// nstaller at - t� _._�c��----•�-•--•.....-•--•-.......... ?'v!I `...'' has been installed in accordance with the provisions of l.!" 5 of The• to Sanitary C d's des in the -_ application for Disposal Works Construction Permit No...... _%_~ _., _ dated-----j. ... ................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARAN EE T AT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................... ....... ................................ Inspector........................................................................... ....... t 1 THE COMMONWEALTH OF MASSACHUSETTS ! (� > ---5 BOARD OF HEALTH LO No. S! -'._ ''" .................OF.. '''.�'....'.. ..a. �' ... FEE........................ Mops 1 rks 11 nstrnr�ion anti# Permission is hereby granted........ t"' .I ..........--•--••----� --`=-�-�------•---•°----------------•----•--...------..........--•----•--- to Constr ( _ ) or Re an }dividual Sewage isposal ystem at No...... -AP.`�....`•-'.'-)........... / n n v�i-•v----- J ---•-•••------ ------------ . ......... Street Q as shown on the application for Disposal Works Construction it No.(... t d...: . ........... ... . ' .......... . .. ....Tz'-'�IZ. ...... ' ......••...-•-•• DATE. Board of He Ith i FORM 1255 HOBBS & WARREN, INC., PUBLISHERS j ASSESSORS MAP NO:, � - �} � �, PARCEL N0: `5-, No......................... � � Fizz.............................. r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH r -.............._0F... -^- "".� Appliratiuu for Uiipugal Works Tumutrurtiurt jhrmit Application is hereby,,kiade for amit to onstruct ( ) or Repair ( ) an Individual Sewage Disposal syst t . .. ------ Location-Address or Lot No. ...............».....................................--.............................._.... _....................----...-----•--._.............................. .......... •- r caner A ss 66 a •_••••-•••.............. `--••-----••-•---•--••-_..o-.....----...•--•--•-- ---------•---- ter" t:.- ✓fir .w , y u p Installer Address d Type of Building ,�{�ize Lot............................Sq. feet U Dwelling—No. of Bedrooms---- ._ ...............................Expansion Attic r ✓J� Garbage Grinder �Pq Other—Type T e of Building No. of persons............................ Showers yP g ---------------•------------ P ( ) -- Cafeteria ( ) � Other fixtures .......................•------•---•••••••••-••-•-••••.•••••••...-••••••••-•-•••••••-•------••--•-•••-••••-•-•-•-_... ..--•--••- W Design Flow.... ...) •....................gallons per person per day. Total daily flow--- .....................gallons. WSeptic Tank—Liquid capacity------------gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ff. Seepage Pit No--------------------- Diameter........... Depth below i e Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.. -----------•---------------------•-•---•--•••••_... Date a Test Pit No. 1____•-..______-minutes per inch Depth of Test Pit.................... Depth to ground water.......... r q Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil...._ ____ _ _ y_ __�{ �......... x u__ �__ —- -------------- •-•------.-... U Nature of Repairs o Answer when applicable................................................................................................ ---------------------------- -------------------------•--•-----------------•--•--•----------..................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of ii`I :a p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until.a Certificate of Compliance has been issued by the board of health. Signed -_ - !• J' Application Approved By- --_ •�t__i!............. Date Application Disapproved for the following reasons:............................................................................................................... --•-------••----------•-•-•---------------•-•----- ------------------ Date Permit No....31MV-67------------------------------- Issued..-..y &ngre----- �------------ Date t No. -- Fn'$c..`.s'........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Applira#ion for Biipnstal Works Tonstrurtinn Prrutit Application is hereb iade,for a.-Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal. System-yat� s. •.:---fj r, _ t� '�G- Location-Address or Lot No. ......._......---......................•--.........----•--••---.........._................... ..---•------••--•----•--•--••------•--............................... ........................ / owner InstaLer Address U Type of Building J 6 Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attie Garbage GrinderA�51 aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures .-------•---••• •-------------------•-•-•--••-.....••---••-•-•------•---••••-•--•••------•-•---••-•••......---•• ................................... Design Flow.., ...�........................gallons per person per day. Total daily flow--- ._!".1_ ......................gallons. WSeptic Tank—Liquid"capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlIq................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank Percolation Test Results Performed by..............................- -----------•---- Date........................................ a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water________ ........ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..__....._.._...._........................ Ri - -------------—---•----••------ ------------.-----------•-•-----Description of Soil.... VC--- 1 _ r ' n'� ? = �' t `:^:='� (xj 4� c:__-. -------71 ... ---------------- ----?------ - �` � r ...._....---- '-- == '................ r' -- ............................................................ U Nature of Repairs or Alterations—Answer when applicable..............If_______________________________________________________________-_.___.__.._... --------------------------------•--------------------------•------------------------........----------------...----------------------------•-------------------------------------------.............-•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTLE' 4 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss-ed by the board of health. Signed---- 6 —Ll ems,, vv�. s �a = ...V212Y� Application Approved BY '� - - -------------- Date Application Disapproved for the following reasons:..............................................................................................................- •------•---••-•••----•-••-••-•-•----••--•••--•----------••-...-------•••--•-•-------•-.....------•••-•--•-•--•-•--•-•-•-----••--•----------•------••--•--•----•--..................................... Date Permit No.2-�1-=.Y/�------•---•-•------------•••---- Issued-.. w r t'.•. y} ................ Date THE COMMONWEALTH OF MASSACHUSETTS �I BOARD OF HEALTH ........... Cwrrtifiratr of ( omplitanrr �H!S�n_f O CER IF, , That/the Individual Sewage Disposal System constructed ( ) or Repaired Y�_�� �1 at............... ............. r_ R-.__ .`:�..... ��-9, _: . ........................V..... �.,r, r- }i��.i.,/ � � - �r................................... bf has been installed in accordance with the provisions of T111.6 j The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH Y Jy, ........... ........................ ....... .OF..f .. ....."':.....`................................................ O"O I Dispasol Mprk.5 Tn #rt �n rrnti# � � Permission is hereby granted..__, �r_............_..•.............___ to Construct ( ) or Repairs(i� A Individual S wage Disposal System No ....��/ Street as shown on the application for Disposal Works Constructio ermrt No. 7'_`�!6__ Dated.._7� �...: y�. �- � .. c, --------.----------------------------------. DATE....---_Uhe r....�y j--f1�. .................................. Board of Health . FORM 1255 HOBBS & WARREN, INC., PUBLISHERS C � � AQ ASSESSORS MAP NO: PARCEL NO: 3 � � No.._......���..i Fx$. 7 ............ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH • ---..OF.......... , ..............................................•---.......... Appliration for Disposal Works Toustrurtiun rnmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Se e i posal System at: ......... -•[ ¢��-••-• � .. ............. -------------------------------------or' ----•----..... ------. -- ocat• Ad s ` - .0 .B_.. � - �.�. � a.�_►�.r. ^-- /fad'..............................A.� r_s�Y► Iap of n"r � f .. ........................ t, Ownez r Addres a. Installer Address U Type of Building Size Lot_ Sq. fee Dwelling—No. of Bedrooms..... --__-_..-_--•_--•-__-__-Expansion tic;, b ge Grinder aOther—Type of Building ------------ ------------- No. of persons............................ Showersvl, Cafeteria a O , Other res ✓ -1 •-- Design Flow... :. _ g p p.._ ..f�'.p_. _____._gallons per person per day. Total daily flow.._...?.E_'__�____________________ lons. W Y l� WSeptic Tank—Liquid capadtv,/da.i?,.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width_____....._._.__... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter... t' Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) D (ing tank ( ) aPercolation Test Results Performed by •----------------------- Date Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water----______ PLf Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...........2b....... a Description of Soil..........:.... `a. ------------- ------- - -•-----•------------•-••-----------------•. -------------------•-------••--- ----•------••. ---.. .....- --- U Nature o�ReDairs or Alterations—Answer when applict le...____..��4._�. '_�__.....,1___ _ _ _. _.,.ate � . . .- -Sa--ram• .. -- •---�---- -y. ........fay--t�� ----�-�+•-r4.5---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of I L i.% p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss by the board of health. 1 Signed ' ...--------••-•--------•--• /Da .. Application Approved BY �`-'�"�= ..fir /._..._. fApplication Disapproved for the following reasons:--------------------••---•-•---------------------------•------•-----------------•----------------------••-.-•--- ----------------------------------------------------------------------------------------....------------------------•------- P Date it No...S�_.7-----•--•---•-------•--.......... Issued-.....:&v`�.......y)-D-�-••---•--- Date j • DU 3 ....... /Z Fus...7S.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ._...................OFJ-'f.-'. ............................................................ ,Apure#ion for Disposal Works Tontrnrtion rumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sep e D sposal _ System at: r� . iJ ! '............................. �- ,t o 4 ' ,-Addr ss (//// ` !' or. LohNo.. "1 �.... !3i.... v _� t✓7 rn .:J v`1 f-"��- ---•---•----J .✓..----------• '�+--- •---• t w } _--./., .-- ---- .. = Owre Addres Installer Address d Type of Building Size Lot.. .......................Sq. feet Dwelling—No. of Bedrooms.--" ........................... ExpansioonnlAttic, � , G. bage Grinder aOther—Type of Building .....-.-.-j............... No. of persons................................................. Shower — Cafeteria Othe _ roes .--- / 1`/ .......................................--------•--•---•--...........-•-----------------"-•---•-•"•----------...•....._.... `� Ions. W Design Flow.......-,.;:::.-.•._r�._ ''_..___gallons per person per day. Total daily flow..... ..................................gal WSeptic Tank—Liquid capacit)p/!f.f_:_:..gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter__''J� i4l.. Depth below imlet.................... Total leaching area..................sq. ft. Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed b ........................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water----------- .....:Z_ (a, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........... 1...�..._ 3 -- ....--•.............••----"----....--------......------•-----•-•-----------------.....---•--------------.....----•------........---. ODescription of Soil........... ---� ......................•---•------•---•-----••----------------------•----------------•-••••----'•••-•----•------------....-----------'. �4 U -------------------- --•-----------•'•----••---••---------•...----------------------------------••......------••-•-------------.....-•-•-------•---------------------------------------------•""""-""". F=l x = e, V Nature o airss}^brr Alterations—Answer when applir ble......... - �?_. _: `'.��__---- L d Agreement: The undersigned agrees to install the afor edescribed Individual Sewage Disposal System in accordance with f J. ; the provisions oT i, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. z// ^� T / Signed ............ ........................................................ tf �L / ,p Application Approved By.. ,....................................... ------- g�-....... Date Application Disapproved for the following reasons:__...---•----...'-••--------------------•--------•-----•---•-------------------•---•"--"----"""-•'••--"--....... --------------------••-------•--------------•"--•----------...----------......------•-----•-•---...............---.........--•-•-•----••-------•-----------:"•---•----•--------••....-"---""•----------" • •_ Date Permit No... �...---------------------•-----------. Issued-.-..S&�=Q----------y�-�7.•......•_. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH µ Trrtifiratr of Toutplianrr THIS IS-Tj0 CERTIFY', That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) y --•-. -- - --------------------------------------------•-•--•........---- i at...... ��-.-..�,'.. -----� --- I tau ---•-----••---•-------- �.- . - ------------------------------ has been in ailed in accordance with the provisions of TiTIE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated---------------------------..................... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUE® AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD, OF HEALTH BYO... FEE....................... Dillpo,sal3morksi Tontrur#ion rrntit Permission is hereby granted-..,. .. .- s '� u. - ----"- . "" to Constn4cv-,( ) or Repair. a dividu Sewage'Disposal System ,-------------- , at No L' -'�1y-1 n ( 1+ ,� ..cs». ^j!Z?.i'.._:jZnn._.n-.�T-..-`Lfj�'+�1/'�C' --^-•-- Street as shown on the application for Disposal Works Constructio Permit No.�27..V 7..,Dated;T !A_C�..-Z.V a.�;� g .....-_. .... . ---------------•-.------.----...-•--..---_ .................................. Board of`Health FORM 1255 HOBBS & WARREN. INC., PUBLISHERS i k 4P 83-: 5 Lincoln St... Arlington, Ma. 02174 1 March 3, 1987 J. Lal._L' Lj Ms. Diane Boretos Conservation Administrator Town of Barnstable 367 Main Street MAR 5 1987 Hyannis, Ma. 02601 Dear Ms. Boretos: As I mentioned to you during our phone conversation of February 23, 1987, I am acutely aware of the severity of the situation at my property .at the Cape Cod Village Condominium in Cummaquid. Thus, I have scheduled a meeting with you at the Conservation Commission office to include the CCVA consult- ing engineer, Peter Sullivan, the Public Health officer, Dale .E9s &, .the Sewer engineer, Walter Jacobsen, and other members of the managing board of CCVA. This meeting shalfhtake place at 3:00 on March 11, 1987. With reference to .your letter and the Orders .of Conditions, I believe that condition 12 has been met and condition 20 has been met if it is referring to the plans of relocation submitted with the application. Condition .17 has not been complied with because of the difficulty of designing a 'suitable septic system. At such time I will endeavor to comply with condition 21. Please be advised that at the time of the initial .hearing in 1983, the Con- servation Commission was aware that a design for an entirely new septic system had been started. However, none of us could have forseen the ensuing difficulties and delays. I have enclosed a record of our efforts over the last years and a copy of the plan showing the location of my cottage. I trust that our meeting on March 11, 1987 will be the start of a mutually satisfactory conclusion to this process. Sincerely, Anthony R. ,Sapienza t . P `.�042r 998` 186 RECEIPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) b s'M/4 Douglas M. Lange m stgegt WMtier Street P.O.,State and ZIP Code a Cambridge, MA 02 Postage $ ui * Certified Fee 1-67 Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to whom and Date Delivered z cm Return receipt showing to whom, om Date,and Address of Delivery T a TOTAL Postage and Fees $ m 1.67 U. c Postmark or Date co M E February 27, 1987 `o U. N a STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST-CLASS POSTAGE, ti CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front) 1. If you want this receipt postmarked,stick the gummed stub on the left portion of the address side of the article leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier. (no extra charge) 2. If you do not want this receipt postmarked,stick the gummed stub on the left portion of the address side of the article,date,detach and retain the receipt,and mail the article. 3.If you want a return receipt,write the certified mail number and your name and address on a return receipt card, Form 3811,and attach it to the front of the article by means of the gummed ends if space permits.Otherwise,affix to back of article. Endorse front of article. RETURN RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee, endorse RESTRICTED DELIVERY on the front of the article. 5.Enter fees for the services requested in the appropriate spaces on the front of this receipt.If return receipt is re- quested,check the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make inquiry. � / .oar f� PM `MAR x, 5' 1981 Town of Barnstable Board of Health 367 Main Street a - Ln Hyannis, MA 02601 u your `J Rt/iB�.P.JJQtA}1�F �.T9�1 uC` f'ty ii- {j g�� Zip (.cede, APaiimt, lNu�� bor t3 Gerr�ea, Uwve � MAR a�C � 1 . r 1 ;�: . � . �� � \� \ f t .�� �\ 9 �rF' � y � ,� +i e. + � t.y j'3 �. �y �� } '� i ..h ' ~ S' ' 1 � � � �� i �� _ � ...y� (. ��<S� F -- .. .... _ _ ... - - i � �� s,tr r� ,4Q^t. fir; •--a-°° __; P M O _. 1 t 'MAR 5. a Town of Barnstable Board of Health 367 Main Street Ln ;. Hyannis, MA 02601 a Ln t U.S.G.P.O.1984-4146.014 PS Form3800, Feb.i982 o O wm om' N �r `° °m (�O 0 7"w ,a �: m W ton FL El io, n g.. :coo y a m CD,�i" ,may • rn m4 .� go CD 33 m: v r M. _. n G c•. C �-+ CD >ON I . k eJ Ael Q� o �E�Zaf4f72e/?,���/2(A.Cf S. Russell Sylva Commissioner AadadwAeAl 623.E7 91s7-�23�, �xG 6M-6,-4 June 15, 1987 This Department is in receipt of the following application filed in accordance with. the Wetlands Protection Act, Qeneral Laws, Chapter 131, Section 40. ("the Act"): Name Mr: Robert Yawitt \ Address 65 Arnold Road, Wellesley, MA 02181 Owner of Land Same City/Town Barnstable Location Harbor Point Road This project has been ,given the following Wetlands file number in accordance with the Act SE 3-1635 ( ) The, following information is missing. and must be forwarded to this office for a canplete filing in accordance with the Act: ( ) Locus Maps ( ) Notices of Intent ( Plans ( x) Wetlands Regulation 310 CMR 10.27, 10.28 should be reviewed priZ to hearing by Conservation Commission. v The plans for -the 'sewage disposal system appear not to meet the requirements-of`, �--- Title 5 of The State Environmental Code. Review with the -Board of Healtty_ (. ) Application has been forwarded to the Licensing and Permits Section to determine if a Chapter 91 License or Permit is required. A decision regarding Chapter 91 jurisdiction will be issued by the Licensing and Permits Section. ( ) Detailed Notice of Intent Form 3 must be submitted. ( ) PLEASE RETURN THIS FORM WITH REQUESTED INFORMATION. Notices of Intent will not be kept on file longer than 6 months. Issuance of a file number indicates only completeness of the file and not approval of the application. JJS/re cc: Conservation Commission ( x) Board of Health (� ) Coastal Zone Management ( ) Water Pollution Control. ( ) Building Inspector .F1 l V V • exW6� S. Russell Sylva �AIt9 Commissionerner 623. 7 947-12S ( x1 686-eS4 June 15, 1987 This Department is in receipt of the following application filed in accordance with the Wetlands Protection Act, .Qeneral Laws, Chapter 131, Section 40 ("the Act"): Name Mr. Robert Yawitt Address 65 Arnold Road, Wellesley, MA 02181 Owner of Land Same City/Thwn Barnstable Location Harbor Point Road This project has been given the following Wetlands file number_ in accordance with the Act SE 3-1635 , ( ) The following information is missing and must be forwarded to this office for a complete filing in accordance with the Act: ( ) Locus Maps ( ) Notices of Intent ( ) Plans ( x) Wetlands Regulation 310 CMR 10.27, 10.28 should be reviewed prior to hearing by Conservation Commission. ( Y) The plans for the sewage disposal system appear not to meet the requirements of Title 5 of The State Environmental Code. Review with the Board of Health. ( ) Application has been forwarded to the Licensing and Permits Section to determine if a Chapter 91 License or Permit is required. A decision regarding Chapter 91 jurisdiction will be issued by the Licensing and Permits Section. ( ) Detailed Notice of Intent Form 3 must be submitted. ( ) PLEASE RETURN THIS FORM WITH REQUESTED II`TFORMATION. Notices of Intent will not ET be kept on file longer than 6 months. Issuance of a file number. indicates only completeness of the Zile and not approval of the application. JJS/re cc: Conservation Commission ( x) Board of Health ( ) Coastal Zone Management ( ) Water Pollution Control ( ) Building Inspector V ��.y c.<..�����i� (LJ/ �i Cam/ /��L(.1G•(,�KiC�/�c�uf/ S. Russell Sylva Commissioner Gilbert T.Joly Regional Environmental Engineer June 10, 1987 This Department is in receipt of the following application filed in accordance with the Wetlands Protection Act, General Laws, Chapter 131 , Section 40 ("the Act"): Name Cape Cod Village Condo. Assoc. , Mr. A. Sapienza, Pres. Address 5 Lincoln Street, Arlington, Massachusetts , 02174 Owner of Land Same o City/Town Barnstable Location Harbor Point Road 41 The project has been given the following Wetlands file number in accordance with the Act SE 3-1628 ( ) The following information is missing and must be forwarded to this office for a complete filing in accordance with the Act: ( ) Locus Maps ( ) Notices of Intent ( ) Plans 9 �(x) Wetlands Regulation 310 CMR 10.28 should be reviewed prior to hearing by Conservation Commission. l system-do-not- show- Title 5 com liance x The lans for the sewage disposal p ( ) g P __ P with The State Environmental Code. Review with the Board-of Healthr. ( ) Application has been forwarded to' the Licensing and Permits Section to determine if a Chapter 9.1 License or Permit is .required. A decision regarding Chapter 91 jurisdiction will be issued by the Licensing and Permits Section. . (. ) Detailed Notice of Intent Form 3 must be submitted.. ( ) PLEASE RETURN THIS FORM WITH REQUESTED INFORMATION. Notices of Intent will not be .,kept on file longer than 6 months. -;Issuance of a file number indicates only completenes_s__of_.the-file_ and not approval of the application: LV/jt cc: Conservation Commission W Board of Health - tight tanks proposed ( ) Coastal Zone Management ( ) Water Pollution Control ( ) Building Inspector A . M . W I L S O N , ASSOCIATES March 10, 1987 Mr . John Kelley, Director Barnstable Board of Health Town Hall Main Street Hyannis, MA 02601 Re: Land of Robert Yawitt Harbor Point Road , Cummaquid (Our file #2.0142. 0) Dear Mr . Kelley: Our office presently represents Mr . Robert Yawitt in the matter of permitting the repairs to his cottage located in Cape Cod Village Condominiums. The structure was damaged during the January 1987 blizzard. We have, to date, obtained an emergency Order of Condition from the Barnstable Conservation Commission to place temporary foundation supports under the structure while a new site plan is prepared to move the building somewhat landward of its previous location. Once site plans are completed a full filing must be made with the Conservation Commission and permits obtained from your office as well . We are, however , somewhat puzzled by your violation notice. As you may be aware from previous discussions, the Yawitt cottage is only a summer residence without heat or insulation. It had not been used since late last fall . Further , the early January storm which knocked the structure from its foundation also severed the building sewer . It is, therefore, not possible that the system servicing the structure could have been. discharging sewage to any watercourse on February 5, 1987, the time of your evaluation. It may in fact be possible that the agent inspecting the area observed a system servicing a cottage other than Mr . Yawitt' s. Further , because of the way the development is set up more than one lot does not use the system in question, although the system does service two residential units . 91 1 MAIN STREET , O S T E R V I L L E , MASSACHUSETTS 0 2 6 5 5 61 7.4 2 8 •1 4 5 0 2 - In any event, the entire condominium association has been attempting to asses their alternatives for septic system upgrading . As you are aware, a meeting to discuss the problem has been set for Wednesday, March 11, 1987. Subsequent to that meeting survey and engineering necessary for permitting will be commenced. It has not been possible to accomplish survey previously due to snow cover . We request that you grant an extension of time to Mr . Yawitt for both design and construction due to conditions outlined above and the need for permitting beyond that of the Board of Health which will take longer than your allotted time. If you have seen the cottage you will know it is not presently habitable and there is no potential for it or its septic system to be used until the Conservation permit process can be completed and repairs undertaken. Your assistance and cooperation in this matter are greatly appreciated . Yours, A. M. Wilson, As ociates, Inc. rlene M. Wi son President cc: Robert Yawitt Bernie Wilber Peter Sullivan 4 AMW27/mg A . M . W I L S O N , ASSOCIATES March 6, 1987 Mr. Douglas H. Lange . l l Whittier Street Cambridge, 11a 02138 RE: 36 Way off Van Duzer Road, Cummaquid, Ma. Dear fir. Lange: The hearing you requested for violations of 310. CMR, 15.00, the State Environmental Code - Minimum Requirements for the Subsurface Disposal of -Sanitary Sewage, will be held on Tuesday, March 17, 1987, at 4:45 P.M., at the Board of Health office, Town . 1-1411, 367 Main Street,,Hyannis, Ma. Very truly yours, .John M...Kellq Director BOARD.OF HEALTH TOWN OF BARNSTABLE JMK/bs , Robert A.:Yawitt Page 2. Non-compliance could result in a fine .up to $500.00. Each day's failure to comply with an order with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH John M. Kelly Director of Public Health " PP_ - Mr. Mrs. Douglas M. Lange 11 Whittier Street Cambridge, Ma. 02138 Property owned by you at 36 Way off Van DuzeMoad, Cummaquid, Ma., was evaluated by Dale Saad, Coastal Health Resource Coordinator for the Town of Barnstable on February 5, 1987, because off-a complaint or on a routine sanitation survey of the,area. Your on-site sewage disposal system was found to be in violation of 310 CMR,. 15.00, the State Environmental Code Minimum Requirements for the Subsurface Disposal of Sanitary Sewage. The following violations were observed: REGULATION 15.02 (General Requirements) (11) Discharge to Watercourses: Sanitary sewage and other polluting water. is- allowed to flow into tidal waters and shellfish beds of Barnstable Harbor. (14) .Type of System; System does not discharge it's effluent to.'a suitable subsurface sewage disposal area. - (15) Drainage; Disposal system is located in an area where surface water accumulates. (18) _Multiple Use-Prohibited: More than one, lot is using the subsurface sewage disposal system. (19) Maintenance: Owner has not kept disposal system in proper operational condition and unit is filled with sand and cover is partially off. East Bone Hill Road has been closed for shellfish harvesting because of contamination from inadequate on-site sewage disposal systems. Your system is in all probability a contributor to pollution. . . l You are directed 'to have a professional engineer submit plans within thirty (30) days of receipt of this order upgrading your on-site sewage disposal system to conform to Title 5 of the State Environmental Code and the Town of Barnstable Health Regulations. Plans for a tight tank may have.to be submitted if a system abating all contamination cannot be designed. After approval of the Engineer's design the on-site sewage disposal system must'be installed by April 20, 1987. If no action is taken in this matter, the Board of Health will consider condemnation of Douglas M.. Lange Page 2: ' the dwellings. You may 'request a hearing before the Board of Health if written petition requesting same is received within seven' I) days after the date order is served. . Non-compliance could result in a Pine up .to $500.00. Each day's failure to comply with an order with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH John-M. Kelly Director of Public Health OF Mr. Robert A. Yawitt 522 San Ignacio, Suite 3 Coral Gables, F1 33146 Property owned by you at 299 Harbor Point Road, Cummaquid, Ma.,, was evaluated by Dale �. Saad, Coastal Health Resource Coordinator for the Town of Barnstable on February 5, 1987, because of a complaint or on a. routine sanitation survey of the area. Your on-site sewage disposal system was found to be in violation of 310 CMR, 15.00, the State Environmental Code - Minimum.Requirements for the Subsurface Disposal of Sanitary Sewage. The'following violations were observed: REGULATION 15.02 (General Requirements) (11) Discharge to Watercourses: Sanitary, sewage and other polluting water is allowed to flow into tidal waters and shellfish bede,of Barnstable Harbor. (14) Type of System; System does not discharge it's effluent to a suitable subsurface sewage disposal area. (15) Drainage; Disposal syste'm-is located in an area where surface water accumulates. (18) Multiple Use-Prohibited: More than one• lot is,using the subsurface sewage disposal system. (19)' Maintenance: Owner has not kept disposal system in proper operational -condition and unit is filled with sand and cover is partially off. East Bone Hill Road has been closed for shellfish harvesting because of contamination from �. inadequate on-site sewage disposal.systems. Your system_ is in all probability a contributor to, pollution. You are directed to have a professional engineer submit plans within thirty (30) days of receipt'of this. order upgrading your on-site sewage. disposal system to conform to Title 5 of the State Environmental Code and the Town of Barnstable Health Regulations. Plans for a tight tank may have to be submitted if a system abating all contamination cannot be designed. After approval of the Engineer's design the on-site sewage disposal system must be installed by April 20, 1987., If no action is taken in this matter., the Board of Health will consider .condemnation of the dwellings. You may request a hearing before the Board of Health if .written petition requesting same is received within seven (7) days after the date order is served. 1 1 1 p%THEtOt' TOWN OF BARNSTABLE j OFFICE OF BAH3STABLL i MU& BOARD OF HEALTH i639. 367 MAIN STREET SEC Y11Y k` HYANNIS, MASS. 02601 Mr. and Mrs. Anthony R. Sapienza 5 Lincoln Street Arlington, Ma 02174 Property owned by you at 301 Harbor Point Road, "Lands End", Cummaquid, Ma. was evaluated by Dale Saad, Coastal Health Resource Coordinator for the Town of Barnstable on February 5, 1987, beacuse of a complaint or on a routine sanitation survey of the area. Your on-site sewage disposal system was found to be in violation of 310 CMR, 15.00, the State Environmental Code - Minimum Requirements for the Subsurface Disposal of Sanitary Sewage. The following violations were observed: Regulation 15.02 (General Requirements) (11) Discharge to Watercourses: Sanitary sewage and other polluting water is allowed to flow into tidal waters and shellfish beds of Barnstable Harbor. (14) Type of system: System does not discharge it's effluent to a suitable subsurface sewage disposal area. East Bone Hill Road, Cummaquid, Ma., has been closed for shellfish harvesting because of contamination from inadequate on-site sewage disposal systems. Your system is in all probability a contributor to pollution. You are directed to have a professional engineer submit plans within thirty (30) days of receipt of this order upgrading your on-site sewage disposal system to conform to Title 5, of the State Environmental Code and the Town of Barnstable Health Regulations. Plans for a tight tank may have to be: submitted if a system abating all contamination cannot be designed. After approval of the Engineer's design, the on-site sewage disposal system must be installed by April 20, 1987. If no action is taken in this matter, the Board of Health will consider condemnation of the dwellings. You may request a hearing before the Board of Health if written petition requesting same is received within seven (7) days after the date order is served. Non-compliance could result in a fine up to $500.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE HEALTH DEPARTMENT J hn M. Kelly Director of Public Health . SeAcol�+ 3'3�s� �P�oFTNETo�` TOWN OF BARNSTABLE OFFICE OF = DAH77TADLL MAlI BOARD OF HEALTH 16Jq. 367 MAIN STREET 0 NOR � HYANNIS, MASS. 02601 March 3, 1987 Mr. Anthony R. Sapienza President of the Cape Cod Village Condo. Assoc. 5 Lincoln Street Arlington, Ma 02174 Dear Mr. Sapienza: You are hereby notified in your capacity as President of the Cape Cod Village Condominium Association, that properties owned by members of the Association are causing a public health nuisance. These properties were inspected by Dale Saad, Coastal Health Resource Coordinator for the Town of Barnstable on February 5, 1987, on a routine sanitation survey of the area. The Department of Environmental Quality Engineering was interested in a follow-up survey of this area. The on-site sewage disposal systems were found to be in violation of 310 CMR, 15.00, the State Environmental Code - Minimum Requirements for the Subsurface Disposal of Sanitary Sewage. The following violations were observed: Regulation 15.02 (General Requirements) (11) Discharge to Watercourses: Sanitary sewage and other polluting water is allowed to flow into tidal waters and shellfish beds of Barnstable Harbor. (14) Type of System: Systems do not discharge their effluent to suitable subsurface sewage disposal areas. (15) Drainage: Disposal systems are located in areas where surface water accumulates. (18) Multliple Use-Prohibited: More than one lot is using the subsurface sewage disposal system. (19) Maintenance: Owners have not kept sewage disposal systems in proper operational condition. One unit is filled with sand and cover is partially off. East of Bone Hill Road, Cummaquid, Ma., has been closed for shellfish harvesting because of contamination caused by inadequate on-site sewage disposal systems. Systems belonging to the Association are contributing to this contamination. Anthony R. Sapienza March 3, 1987 Page 2. The Cape Cod Village Condominium Association is directed to have a professional engineer submit plans within thirty (30) days of receipt of this order upgrading your on-site sewage disposal systems. to conform to Title 5, of the State Environmental Code and the Town of Barnstable Health Regulations. Plans for tight tanks may have to be submitted if systems abating all contamination cannot be designed. After approval of the Engineer's design, the on-site sewage disposal systems must be installed by April 20, 1987. If no action is taken in this matter, the Board of Health will consider condemnation of the dwellings, not allowing occupancy for the summer season. You may request a hearing before the Board of Health if written petition requesting same is received within seven (7) days after the date order is served. Non-compliance could result in a fine up to $500.00 for each owner. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE HEALTH DEPARTMENT.. il-i,r / CPS�LKelly ector of Public Health JMK/bs cc: Natural Resources Conservation Commission 1 '' '° r •,n,Yus-i�IP7 3'a- yer n a•q--a. .. RtT j:-n.•o-. c,. �„ ... _ THE 00MMONWEALTH OF MASSAOR SETTS ORDER ' WETLAND, PBOTEOTION ACT Q.L. OH. 131, B. 40 TOWN OP BARNSTABLE FILE bLBEC .To: Name Anthony R. Sapienza and Priscilla S. Sapienza Address. S .Lincoln' Street, Arlington, Ma. 02174 Recorded Owner PROJECT LOCATION: 6gJ _3g3 CERTIFIED MATT,.NO. Address<,'—Cave C Vi llaae C0 Mini Ha z t Rd • • urmn- aauid�_ Ma. 02637 Title .Reference; Re 249 39 i; ook 23 page 75 3334 172 Certificate (if registered) • and as. shown on Town of Barnstable. Assessors Map # `' Lot REQAADING,: r r Feb. 1983; March 1, 19830 < Notice of Intent dated Nove;nb+er 29, 198 an d• March 29, 1983 ean r :. ate of. Angs Plans entitled "Rough Flan`for Hearing .3/29/83,s/based on. discussion 3/28/83 with sub-COimnittee of.-.Barnstable Conservation Commission", .by Bernard _Aube . __._ _..��. Plans dated =1 5 83 Stamped #nd signed:,;by a v 777777 Apxit 19. 1.983 . THIS ORDER;IS ;ISSUED pN Pursuant to the authority of G.L. Ch. 181 S. 40 the', BARNSTABLE CONSEItVAT SION has considered our 1 N 0 Notice COMMIS.y ce o f Int en t an d la n the area on which the plans submitted therew;th, and has determined that described in the said Act-.The BARNSTABLE CONS RVe done is ATION. COMMISSION t to one or more erenificanf the interests the following conditions orders that are necessary to protect said interests and all work shall be performed in strict accordance .with them and with .the. Nonce of Intent and plans:�dentifed above except where such pans are modified bv, said conditions 1 . 77 CONDITIONS 1. Failure to comply with all conditions stated herein, and with all related statutes:and other;regula- tory measures, shall be .deemed cause to revoke or .modify this Order- �.:This Order :does not grant any property rights,or any exclusive.priv;leges, it .does not. authorize any injury t4 private property or invasion. of private rights. . q. 3. This Order does not relieve the permittee or any other erson of the necessity of complying'with al' other applicable federal, state, or local :statutes, ordinances, by-laws and/or regulations.'" Y 4, The work authorized .hereunder shall be oompleted within one. 1 Order unless it is for a maintenance dredging project subject to.(Sect oa 5 ear from (9).t The he aOrder maate of y be extended by the issuing authority for,on or more additional one-year riods upon application to the said issuing. autbontg at least thirty (30).�days prior to,the ezpirat on date of the Order or . its extension Y . « ab, t T S '' '. ' n. CONDITIONS CONTIN[TED FILE NITMHE$ SE 3-948 5. Any fill tised in connection. with this project shall be clean fill, containing no trash, refuse, rubbish or. debris. including, without limiting the generality of the foregoing: lumber, -bricks, plaster, wire, lath, paper, tires,. ashes,. refrigerators, motor vehicles or parts of any of the fore- going. 6. No work may be.oommrneed until all appeal periods have elapsed from the Order of-the Con- servation Commission or front a final Order by the Department of Environmental Quality En. gineering. i. No work aba11 be undertaken until the Final Order, with respect to the proposed project, be; been recorded in the Registry of Deeds for the District in 'which the land is located within the chain of title of the affected property. The Document number indicating such recording shall be submitted on the form at the end of this order to the issuer of this Order prior to commence- went of work. _ S. A sign shall be displayed at the sitz not less than two square feet or more than three square feet bearing the words: "Massachusetts Department of Environmental Quality Engineering.`:. Number BE 3-948 ",,And a copy of this Order shall be available at the site. 9. Where the Department of.Environmental Quality Engineering is requested ;to make a determin- ation and to issue a superseding,Order, the Conservation Commission shall be a party to all agency proceedings and hearings before the Department. 10. Prior to any work being done at the site, all legal advertisingg bills incurred by the petitioner in relation to the Wetlands Hearing held on this project shall be paid. 11. Notice shall be given. to the Bsrnstsble Conservation Commission or Conservation Officer no 12. The existing cottage shall' be moved and., relocated: in` the back of. the_dune, at the - same elevation as in the. original location. V The existing dune shall be removed and stockpiled so that it can be re:-established in its original location, and revegetated, following the relocation of the cottage. 14. The old septic system under the dune is to be pumped out and filled with clean material prior to the re-establishment of the dune. All exist:iz.g Y:il)..1sp at the site ►!hall be removed- f2om the site to an area not a+,ibje:ct to State or local Wetlands Statutes. A single row of stones may be left in place in' :front.of the original cottage location., The area behind it shall, be planted with beach grass', or other indigenous vegetation. 17. A new septic system shall be sited south of the property line, in the common area, out of. the. flood plat The septic system shall be approved by the Barnstable Board.of Hea th, and a copy of the design.and.Board of Health approval shall be,sub muted to the Conservation Commission prior to the' start of. construction. ' 18. Snow `fencing shall be .used during the,wf.nter'`n►onths to lessen the drifting of sand, and to protect the vegetation. 19. All disturbed areas are' to be revegetated immediately following construction. 20. Stamped Engineer's Plans shall be prepared in conformance with the Conditions cited i above. These shall be submitted to, a�s�! +onresac�d by "h czss:_=va'.i�;n C.�,r i 3Si n -& ."lid "Lc Prior to the start of work. y 21. immediately following. completion, the project sh,311 be certified to be as per:these conditions and plans, in writing, to the Barnsta]ble'Conservation Commission by the project engineer who shall be registered in the state of Mass. Upon certification : by the project engineer, the applicant shall forthwith request, in writing, that a - . Certificate of Compliance be, $ssued stating that,the..work has been. satisfactorily, , completed. +a 22' This Order of Conditions is: 'Simultaneously :issued. under Article XXVII of the Town of Barnstable By-haws. Jf 1 ANTHONY D. CORTESE Sc. D JoadeaW R / h 1, Commissioner o2,a�v�e c��Gby�G, a�,IXICPit/l�l�, ../PI��tLl6P.�6 0,2346 PAUL T. ANDERS,ON Regional Environmental Engineer. 947 1, 3-1, 0j-r 680_6'84 Fbbruary 8, 1983 This Department is in receipt of the follawine application filed in accordance with the Wetlands Protection Fact, General La,vs, Chanter 131, Section 4.0 ("the Act"): Hanle A.R. & P.S. Sapienza Rod C 2 "M6 / 0,)-6 3 Y Owner of Land _ Same City/Tovm RarneC bls Location garbgr point Road This project has been given the fol l(xii nC 'lletl ands file nuriber in accordance with the Act SE 3-948 . The following infornaiion is wissinr, and rust be forwarded to this office for a cor,lplete filing in accordance with the T,ct: ( ) Notice of Intent Environrlental Data Forn (:: ) Locus -Map ( ) Plans ( ) The plans for` tie seiiaage disposal system appear not to meet the requirements of Title 5 of The .'fate Environmental. Code for the following reasons(s) : Revie',w `!with the board' of Health. . lac) Coastal Uetlands Re;;ulation 27, 28p 32 should be reviewed prior to heari ng. ( ) A Chanter 91 License or Permit is not required by the !Division of Water,,iays. Application has been forwarded to the Division of llateroays to determine if a Chapter 91 License or Permit is required. A decision regarding Chapter 91 jurisdiction will be issued by the Division of !�!aten;iays no later than It may be a good idea to move the cottage back if doing so. Won't interfere with dune functions. V Zone elevation o +10.5 ft. Issuance of a file number indicates only completeness of the file and not approval of the application: For the Corriiissioner Ale Hobert P. Facan cc: Conservation Corriission Deputy '�'.epional Cnvironirental Engineer Board of Health Coastal tone Planapement WETLANDS PROTECTION ACT MASSACHUSETTS G. L. C. 131 s. 40 WETLANDS PROTECTION BY-LAW Ch. III Art. XXVIII Town of Barnstable By-Laws NOTICE OF INTENT All parts of this form, the attached Environmental Data Form and Article XXVIII Filing Form shall be com- pleted under the pains and penalties of perjury: Incomplete filings may be rejected. CCGG DATE ..... a..irs...e ......`. ...r. :..... Town of Barnstable Conservation Commission 1. Notice is hereby given in accordance with the provisions of Massachusetts Q.L. c. 131, s. 40, and Barnstable- By-Law Ch. III Art. XXVIII that the proposed activity described herein is within the jurisdiction of TOWN OF BARNST LE, (Village v.. .. ... ... ....11...[...> .. _._.._......_....._................. at .. war.b..0-V0 ti �S• ..1... ..�. 1.............. S#,ee�r Assessors Map ..............�...... Lot .............................. Most recent recording at the Barnstable Registry of Deeds, Booky9 Page 39" Certificate (if registered) ........................................................................ /?a- 2. The hand on whic the work is proposed to be done is owned by: NAME�s ' o�y� ( ) `p� 3,�� ��..., ...��'�. �Ca�... ..�.... ADDRESS .......� ! 'D... .L1'...[LCI� .. ! .N/. �. e� 3. The Applicant submitting this Notice is: 13 -1 . 1 '5. . : NAME -+ x .dI.. t �,........ ADDRESS ............................._...................................................-............................................. TELEPHONE .............................._..................�L................ (Optional) The following person is hereby designated to represent the Applicant in matters arisin hereunder: r NAME �'.. !..�1..�.:.'.. . ..... ...I�... ..r...... ADDRESS ... }.' ►�. :. . L.. ..1 ..U.LJO.213 TELEPHONE La. ....... ......... 4. Plans describing and defining the work, included herewith and made a part hereof, are titled and dated: s�4. .6.1:�._.1r1�.d..,�, _A.R.a iex .&A.u.x�.........-�.�....l..l ���.3..�c s���� .........._ G� - r 5. Identical material has been submitted by certified mail as follows: �� Original to Conservation Commission (Date) el&U ,,/„f•,,.)R3., Main Street, Hyannis, Mass. 02601 Three copies to Department of Environmental Qualityf IT]ikiiieeriiig',-`:' Southeast Regional Office Lakeville Hospital 6` ...._._•,,,� ( ) �� 1G�d' Lakeville, Mass. 02346 Date .!�............ !(. astal Projects only send one cop wealth of Massa llivis' cries wich, Mass. JAN 1 4 1983 (Date) .......................................... Page 1 _ (1aa) 2utuu gV11I2IVIR D. TOPOGRAPHY (Please use NGVD) 1. Maximum existing elevation of site. 2. Minimum existing elevation of site. 3. Maximum proposed elevation of site. 4. Minimum proposed elevation of site. dA;Z-T01—t Description of proposed change in topography. /?�-� a-p akrf Ice.al amount of fill to be placed. , 7. Total amount of to be removed a. 9pe})r deposition site act E. GROUND WATER 1. Minimum depth to water table on site (at time of filing) ; 2. Maximum depth to water table on site (at time of filing) 3. Seasonal maximum ground water elevation. F. WATER SUPPLY 1. The source of the water to be provided to the site ,( ce- Gl'u U.SOM�M' 2. The expected water requirements (g.p.d.) for he site 3. The uses to which water will be put , G. SEWAGE DISPOSAL 1. Sewage disposal system (description and location on the te, of system) 2. Expected content of the sewage of -pent.- human waste`pest de detergents, ois, heav m_ tale oth chemicals Gam. o - —Y 3. Expected daily,volumes of sewage H. •SOLID WASTE x 1. Estimated quantity of solid waste to be developed atAAthe site at� ' �l 0 2. Method of disposal of solid waste 3. Plans for recycling of solid waste Page 4 61?- y97-2�O Y 4' G y; c4•r� W- f 2 . �r { �7 F f xr Z.3� • ' y � � $I x "�1'9 &:`4r74 Mws - z 3� l �,•,�,�^,,, �., � tm a �' . VU R 4 ,kklr 5 ' t gl A off. cy P { VaAel� M1 TV ta t: `x« u 41 4��ly� ZI _ t Fint ..e........... . ..... THE COK: PNW&LTH OF MASSACHUSETTS ,SOAR® OF HEALTH - ---::_ QR.=...............:...............................................------------------•---- Application is hereby' inade for a Permit to Construct ( ) ,or,Repair ( ) an Individual Sewage Disposal System at: a Ah4= c zJ.': : s ;`�5:..�..a �......... ....................... .......................................... o tion-Address or Lot No. ...��., N ......` :e... ..► .. ... ................. ....................................................•........... . ..... .... . YAddress....... ...... .. ...................... ........................ ._I`: ....._._............................... Address U Type of Buil �-� J Size Lot.................. .. q- �� _ .. S feet Dwelling—No. of- Bedroom............................................Expa�ision Attic ( ) Garbage Grinder ( ) Other—T e of Building ..................... No, of peisons............................. Showers — Cafeteria Other fixtures ----------- - W Design FIA — • C- _ allons per person per day. Total daily flow...........................................gallons. WSeptic r n,`. �iquid capacity d� gd h.._- Length................ Width................ Diameter................ Depth................ g •, x Disposal Trench—No. :d. ........ Width ....Total Length.................... Total leaching area____ _.,�.---sq. ft. Seepage Pit N6 -................. Diameter...................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Resu Performed l;y.. Date :--'----------- ,aa Test Pit No. 1__.l ........minutes t er inch Depth of Test Pit.................... Depth to ground water_._ ._._--__--.--_-. Gs., Test Pit No. 2................minutes per inch Depth of Test Pit--_-__._-__-___-_-. Depth to ground water........................ ......... _�'.............. O Description of Soil ----------•••- ------f-------------••-•------. W U Nature of Repairs or AfY *ions—Answer when applicable................................................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been sued by the boar of health. Application Approved By.--- --- 7ale7 ' Application Disapproved f or';tlie following reasons------------------------ .................................................................... -------•---------•-••--------------------------------•--•-----------------------•-- ----------------------------------------------------------------------------------- Date . PermitNo----------------------------......................................................... Issued........ . ---1.. ---� �..................... ate l Fix..... .....:................ /> rt THE COMMONWEALTH OF M.ASSACHUSETTS BOAR® OF HEALTH t ............ ........................................................................................ t r for R-sliviial Vorks Toftotrurtion rnmit Application is` hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System"at: 4-4 ' , #r . ...........V_­...................................................................... Location•t n ress or Lot No. ':6}{.-m...u,"_` - _•-• t�^•-�ia� .. :[°�c;< ,.................. t"+w'........... ... . __^_----......................._..__...................----- Owner � - .Address ............. ...... ' ................................... r Address UType of Burl . Size Lot............................Sq. feet �-+ Dwelling.Ni.,' IVo. of Bedrooms.__..- _......_...__Expansion Attic ( ) Garbage Grinder ( ) 'Other—'T e of Building _..._ No. of persons....:....................... Showers — Cafeteria a' Other fixtures - W Design. Flow:`"'_ ___ . gallons per person per day. Total daily flo . _gallons. Ri Septic Tank—:Liquid cap3ci y Le''n'gth................. _Width................ Diameter__:_....................Depth................ Disposal Trench No:: z.? .Width:___. .:=_ Total Length ......:........ Total leaching area.. ' ._.sg, ft. Seepage:Pit No: ,.______ ::_ Diameter _______________ Depth, below.inlet..._:__.___...._.... Total leaching area__.__ ..____....sq. ft. z Other Distribution box•.;(` ) Dosing tank (. ) `-� ..Percolation Test Result Performed by- .._.._..--•______________•••,-----•....._.......--------___-•----••-- Date........................................ Test Pit No 1 minute's per inch Depth of Test Pit____________________ Depth to ground water__°r'"_..__....:._-_._- G� Test•-Pit'No:',2.:.....__.__:_._minutes per inch Depth of Test Pit.....................Depth to ground water__________:____________- ------------•-=-------------------„_,------------------- •-------- _••-••------------ Description of.Soil a� �x -------------------.......................................... U -••--•-••----••......---•------------------------••- W - -- UNature of Repairs or Alterations Answer when applicable................................................................................................ ------------------- ----------------------------------- Agreement The undersigned agrees. to, install the aforedescribed Individual :Sewage Disposal System in accordance with the provisions of Article XI'of the State Sanitary.Code—The undersigned further agrees not to place the system in operation,until a.Certificate of'Compliance•has..been fssued by the board,of health i `. . Application Approved. BY --•-- , ................... Date Application Disapproved for the following rei�sons::: ................... -----------•-----•------------ ------------------- ----- ---------------------------------------------- Date PermitNo:---•-......-•-------•-•............................................................ Issued................... ................................... Date ;', i >.W THE COMMONWEALTH .OF •MASSACHUSETTS BOARD OF; ...........................................O F.......,............:.........................................:....................... �C�rf fire .lf T Imp, trcrr T I IS TO CERT . Y, That the Individual Se1�-,ge Disposal,System constructed ( ) or Repaired ( ) T Y has been install : -: •: ;< �.• r at.__.._ _ ed in accordance with the provislores of 1rticle Hof The State Sf;te itary Code as d scribed n the ' .,:.. .. application for Disposal Works. Construction Permit ��o______________________________ ______ d THE. ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTi81��D S A f��1A68 PITEE TF�AT THE SYSTEM SILL FUNCTION SATISFACTORY. DATE--_.. �.:_ ° . : ...' Inspect .__.�..:._ ' THE COMMONWEALIZWOF MASSACHUSETTS No..... FEE_., . ........... Permission -hereby granted....... 2.P-- - °. _::.:: �''' ._ '� _______-. to Construct ( ) or R r ( ) an Inds' .ri S waage i osal t of No. .. Street ' as shown on the application for Disposal Works.Cons tt uc.tioii .' mt .... Dated,-_._ ..................................... '.. py.{•- Bo dull and of I1e DATE.- , FORM 1255 HOBBS A,e WARREN, INC.. PUBLISHERS '