Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0061 PADLOCK LANE - Health
61 Padlock Lane Centerville A= 193-1.87 i ado UPC 12534 ' No.2_3_Rs, 0 1 TOWN OF BARNSTABLE LOCATION PC,.�fU C`( -.4 SEWAGE# X01 A -0-` VILLAGE C er) -e-rV�h ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO.1-Z616 0CWD-06-5 CPrVP- 56b--2 SEPTIC TANK CAPACITY fig b LEACHING FACILITY:(type) (size) NO.OF BEDROOMS ? OWNER PERMIT DATE: 4 ias COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY F 6 ?� t No. ��J C/`� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for Visposal *pstrm Construction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.(01 Ndloc"te (444 Owner's Name,Address,and Tel.No. Assessor113 13s Map�Marcel G� ��y�(�y ( 6 u�v' ! oil lu k 61 HAS K L Installer's Name,Address,and Tel.No.Sa ^3(0- (p/,V1Y'—) Designer's Name,Address,;,,nd Tel.No. arf,),0fCarS,. 33 (?_ntr r#f 0 Type of Building: f Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) /i� f� �� ✓�N Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance.has been issued by this Board f H lth. (� igne 7 __l� Date l Application Approved by Date L �s L Application Disapproved by Date for the following reasons v Permit No. / d y', Date Issued C� - - - --------- —- -------------------------------------- -- -- ------------------------------ No. =r L 9 D-1 M S r f Fee. d THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y Yes � PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS p 4plicatlon for misposal 9ppstem Construction Permit Application for a Permit to Construct( ) Repair(N Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.G1 Owner's Name,Address,and Tel.No. �sc��GC.iE C Mtn P Assessors Map/Parcel C 1i ervo i /Yl c(l( c I i r1 ( VC I H'I Gl t_ 'a ( Installer's Name,Address,and Tel.No.5 3(� 3 3 7 Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building - No.of Persons-,— Showers( ) Cafeteria( ) i Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets f Revision Date Title _ Size of Septic Tank Type of S.A.S. j Description of Soil 1 Nature of Repairs or Alterations(Answer when applicable) e� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the af6re described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance,has'been issued by this Board f H lth. I--7,�/,'), , � � f igne V / ` '�.._ 1 Date !L Application Approved by Date e) Application Disapproved by Date for the following reasons ' i Permit No. �/z/ / C'�L 10;L_ Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V Upgraded( ) Abandoned( )by /j % at ( Q GI C C 1t Lol A J 11 yv)1.1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N /y 0-1 dated Installer 05 To I KP, C C A Si Designer #bedrooms Approved design flow 'r gpd The issuance of this permitshall,not be construed MI_u ke that the system will-f l-nction asj,designed. �%1 / Date Y 1 Inspector -fYT �! 41 ,/ , �9I1 �1, 1A t Y ✓,rjt t -- - ------ ---- --_--/--- ----_-- -_--- -- - _ - _---- - - I ------------------------- No. C) cam- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISIONr BARNSTABLE,MASSACHUSETTS Disposal 6petem (Construction Permit i Permission is hereby granted to Construct( ) Repair( Upgrade( ) Abandon( ) System located at a and as described in the above Application for Disposal System Construction Permit. The applicant"recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided`.Construction must be complTt)dwithi'n three years of the date of this permit. Date L// Approved bye 111E Town of Barnstable Barnstable Regulatory Services Department �" 1 + 3ARNSI'ABLE, Public Health Division FD1AA 200 Main Street,Hyannis MA 02601 2007 SECOND NOTICE Office: 508-862-4644 Richard Scali,Intrim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 2668 April 15, 2014 Caroline A Luongo, TR %Raymond James Trust,NA PO Box 14407 St. Petersburg, FL 33733 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 61 Padlock Lane, Centerville,MA was last inspected on November 20, 2013, by Richard Judd, a certified septic inspector for the State of Massachusetts. The inspection of the-septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: a The tank needs to be repaired or replaced. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF HE BOARD OF HEALTH Th mas cKean R.S. CH O Agent of the Board of Health Q:\SEPTIC\conditionally passed\61 Padlock Ln Centerville Jan 2014.doc 4,'15/2014 Parcel Detail 07- I"� �ET,il3Da'ED S Logged in As: Parcel Detail Tuesday, April 115 20114 Parcel Lookup Parcel Info Parcel ID 193-187 ( Developer Lot LOT 35 Location 61 PADLOCK LANE Pri Frontage 112 Sec Road CONANT LANE Sec Frontage 111 village CENTERVILLE Fire District C-O-MM Town sewer exists at this address No , Road Index 1201 ,gyp Interactive Map a fr e*+ Owner Info Owner LUONGO, CAROLINE A owner C/O RAYMOND JAMES streets PO BOX 14407 Street2 city ST PETERSBURG state FL ( Zip 33733 Country s I Land Info Acres 0.35 use Single Fam MDL-01 Zoning RC Nghbd 0105 Topography Level Road Paved I utilities Public Water,Gas,Septic Location Construction Info Building 1 of 1 Year 1979 Roof Gable/Hip Ext Wood Shing le� Built Struct wall Living 1576 Roof Asph/F GIs/Cmp A None Area Cover Type Style 'Ranch J Wall Drywall �l Rooms 2 Bedrooms Model Residential Floor Hardwood RIn ooms Bath 2 Full (lClick for Building Detail Grade Average Heat Hot Water Total 6 Rooms Type Rooms Stories 1 Story^� Heat Gas I Found Poured Conc. a Fuel ._t tion Gross 3752 V A re a Permit History Issue Gate Purpose Fermi## Amountlnsp Date Comments Visit History http:/fii ssq 12/i ntranet/propdata/Parcel Detai I.aspOlD=13949 1/3 �sH�E r� Town of Barnstable Barnstable Regulatory Services Department + &ARNSfABM '0 °"AM Public Health Division ATfD""AAA 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Intrim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 .1010 0000 2851 1241 January 6, 2014 Caroline A Luongo, TR % Raymond James Trust,NA PO Box 14407 St. Petersburg, FL 33733 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 61 Padlock Lane, Centerville, MA was last inspected on November 20, 2013, by Richard Judd, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • The tank needs to be repaired or replaced. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF TH BOARD OF HEALTH 4_n Thomas McKean,R.S., CHO Agent of the Board of Health QASEPTIC\conditionally passed\61 Padlock Ln Centerville Jan 2014.doc https://tools.usps.com/go/TrackConfinnAction.action?tRef=f illpage&tLc=1&text28777=&tLabels=70121010000028511241 English Customer USPS Mobile Register/Sign In Service Usps.cr Search USPS.com or Track Packac Quick Tools Track Ship a Package Send Mail Manage Your Mail Shop Business Solutions Enter up to 10 Tracking A Find Find USPS Locations Buy Stamps CCoo1po ra 7 TM Customer Service> al uI Have questions?We're here to help. Hold Mail ....... ..... ......... ._.__. Change of Address i Tracking Number:70121010000028511241 I t Requested label is archived. I Restore Archived Details> l I Product & Tracking Information Available Actions Postal Product: Features: Certified Mail'" AAA Ttk STOIC 014W w >, J w �* January 10,2014, _ SAINT eDeliyered 5:43 am r PETERSBURG,FL 33733 - - ......... .....- ........... ......... ....... ...... .......................................... _ . ............ Track Another Package What's your tracking(or receipt)number? ! Track It i LEGAL ON USPS.COM ON ABOUT.USPS.COM OTHER USPS SITES Privacy Policy> Government Services> About USPS Home) Business Customer Gateway> Terms of Use> Buy Stamps&Shop) Newsroom> Postal Inspectors) FOIA> Print a Label with Postage> USPS Service Alerts> Inspector General> No FEAR Act EEO Data> Customer Service> Forms&Publications> Postal Explorer> Delivering Solutions to the Last Mile> Careers> Site Index) 97(/SPS,CCW . Copyright]2014 USPS.All Rights Reserved. https://tools.usps.com/go/TrackConfinnAction,action?tRef=fullpage&tLc=1&text28777=&tLabels=7012101000... 4/1/2014 r - Town of Barnstable Barnstable Oft Regulatory Services Department a;caC j f 4 4 RA"STABLE, 4 , `SS. �° Public Health Division m prED �A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Intrim Director FAX: 508-790-6304 Thomas A.McKean,CHO i CERTIFIED MAIL# 7012 1010 0000'2851 1241 January 6, 2014 Caroline A Luongo, TR % Raymond James Trust,NA PO Box 14407 St. Petersburg, FL 33733 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 61 Padlock Lane, Centerville, MA was last inspected on November 20, 2013, by Richard Judd, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: 0 The tank needs to be repaired or replaced. You are ordered to repair or replace the septic system within sixty(60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF TH BOARD OF HEALTH . Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\conditionally passed\61 Padlock Ln Centerville Tan 2014.doc Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13949 07 a Logged In As: Parcel Detail Tuesday, Decembe31 2013 Parcel Lookup Parcel Info ...... Parcel�93-187 � �- — `" m`� Developer ILOT 35 ID Lot' Pri F Location 61 PADLOCK LANE 1112 I Frontage Sec(CONANT LANE � Frontage Sec Road 111r -, mm---- Fire; Village r CENTERVILLE I District'C-O-MM Town sewer exists at this _ Road 1201 , address No — �� Index Interactive ' u. Map �4 _ Owner Info Owner 1LUONGO, CAROLINE A TR Owner jC/O RAYMOND JAMES TRUST, NA i Streets IPO BOX 14407 Street2 City FST PETERSBURG State FL Zip(33733 Country - Land Info Acres 0.35 Use Single Fam MDL-01 Zoning RC Nghbd0105 Topography Level Road Paved Utilities Public Water,Gas,Septic Location F__._.._..._.__ Construction Info Building 1 of 1 Year� `" Roof — Ext 1_ __.__ Built I1979 StructGable/Hip J Wall Wood Shingle Living Area�15 Cover Roof Asph/F GIs/Cmp I Type(None �0,0 � r--------- _.I Style IRanch Wall ID J Rooms 12 Bedrooms "_ ° Int..,,._._____.___._._.. Bath 1_ _._..�.. � .` �4 ff 2 Model Residential 1 Floor Hardwood Rooms�2 Full a , Tan= Heat; Total--- Grade;Average Type•Hot Water I Rooms 16 Rooms Heat r.___ ___. .—... Found Stories r1 Story Fuel jGas ation(Poured Conc. , Gross http://issgl2/intranet/propdata/ParceiDetail.aspx?ID=13949 12/31/2013 I Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form- Not for Voluntary Assessments w„ 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 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:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your 2 cursor-do not Richard Judd I �✓ 13 use the return Name of Inspector key. Moran Engineering Associates, LLC. Company Name VQ PO Box 183 Company Address South Harwich MA 02661 City/Town State Zip Code 508-432-2878 S 19584 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes -® Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority November 20, 2013 Inspector's Signatur j 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 Inspectio or .Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title .5 Official Inspection Form a Subsurface Sewage Disposal System Form- Not for Voluntary Assessments M 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 &Parcel: 187 Property Address Caroline A..Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 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 an information which indicates that any of the failure criteria described Y in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 13) 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): Septic Tank headwall requires being sealed at outlet headwall's unused pipe knockout. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N FIND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh l5ins•3/13 Title 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 w„ 61 Padlock Lane Ceterville MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond JamesTrust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20,.2013 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'h day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 61 Padlock Lane Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A.,Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is St. Petersburg FL 33733 November 20, 2013 required for every page. CityrFown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis 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. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Off cial ;Ins i ection Form . p Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name informrequired is St. Petersburg FL 33733 November 20, 2013 required for every g 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? ® ❑ 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 CM 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): *2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX.14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 page. City/Town State Zip Code Date of Inspection D. System Information Description: *The dwelling contains an isolated living room/den (room contains two doors providing for an isolated room). Number of current residents: 0 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 d 2012: 132 g ( Y g (gp ))' 2011: 227 Detail: Sump pump? ❑ Yes ® No Last date of occupancy: > 1-year Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•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 wM 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 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: 5/30/01 &5/26/98 per Barnstable BOH records. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luohgo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name requinform r on is St. Petersburg FL 33733 November 20, 2013 requiredd for every ersg 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: Disposal Works permit 79-70, Certificate of Compliance date 3-30-79 per Barnstable BOH records. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.9 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: >100, feet Comments (on condition of joints, venting, evidence of leakage, etc.): There were no observed signs of backup or leakage within the basement at the time of the field inspection. A trickle of water was observed entering the system at the time of the inspection. Recommend fixtures be check for leaks. Septic Tank(locate on site plan): Top:25-20", Inlet: 25", Outlet: 20" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1000 gallon. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5'X 4.8' X 49" Flow Line Sludge depth: 3" 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 wM 61 Padlock Lane Ceterville MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name - requir required is FL 33733 November 20, 2013 required for every St. Petersburg page. Cityffown 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 22" 0" Scum thickness Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 24" How were dimensions determined? tape, probe &sludge judge. Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The inlet side of the tank contains a PVC tee (above flow line). The outlet side of the septic tank contains a PVC tee that extends 24" below the 49"flow line. The unused pipe knockout, at the outlet headwall, was rotted out. Recommend resealing the unused pipe knockout. The septic tank did not require maintenance pumping pursuant to 310 CMR 15.351 (1). Grease Trap (locate on site plan): N/A Depth below grade: feet Material of construction: r metal fiberglass ❑ polyethylene ❑ other (explain): ❑ concrete ❑ ❑ 9 i Dimens ons: 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 Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w„ 61 Padlock Lane Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address _Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 page. CitylTown 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: N/A Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins-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 M 61 Padlock Lane Ceterville MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name requinform r on is St. Petersburg FL 33733 November 20, 2013 requiredd for every ersg page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Surface to cover: 30". The box is a D13-5 (21"x 13"). The distribution box contains one inlet line and one outlet line(both are 4" PVC). The box is worn but structurally intact.There were no observed signs of solid carryover, backup or leakage within or above the box at the time of the field inspection. Pump Chamber(locate on site plan): Pumps in working order: ElYes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ 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.): SAS: (1)6'wide X 3.5' deep pre-cast leach pit with 2' of sidewall stone. Surface to top/cover: 36". Surface to floor: 9.9'. The pit did not contain any standing liquid. Interior sidewall staining indicators were observed at 16"above the pit floor. The pit has approximately a 5.6' effective depth as measured below the PVC inlet line pipe invert. There were no observed signs of backup, breakout or hydraulic failure within or above the leaching area at the time of the field inspection. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 61 Padlock Lane Ceterville MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 &Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 A B ST inlet 21 .6 .23.5 ST outlet 27.7' 18.1 D—Box 33.3 23.6 Leach Pit 43.5 r 25.7 • I DECK PATIO A B I � 37.25' I 'Z EXI STI N G GARAGE DWELLING r I � � I ——————— ————— — — PADLOCK ADLOCK LANE SEPTIC AS—BUILT Moran Engineering Associates,LLC. P.O. Box 183 LOCUS: 61 Padlock Lane South Harwich,MA 02661 Centerville, MA 508-432-2878 PREPARED FOR: Raymond James Trust MAP: PARCEL:187 JOB NUMMBEBE R: 1 3-305 SCALE: 1 n_20' A E: 11/25/2013 SHEET: 1 of 1 10 2013 MORAN ENGINEERING ASSOCIATES. LLC. i Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 61 Padlock Lane, Ceterville, MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is St. Petersburg FL 33733 November 20, 2013 required for every g 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: >4.0' below the floor of the SAS. 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: 2/5/79 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: Town of Barnstable GIS web page. You must describe how you established the high ground water elevation: Method 1: per approved septic system design plan: the floor of the proposed leaching pit(El. 88,8 to the bottom of the dry test pit(El. 84.8) provides a 4.0' dry separation distance. Method 2: per Town of Barnstable GIS: Approximate surface elevation at leaching pit: EL. 72.0 +/- Estimated leaching pit floor elevation (-9.9'): EL. 62.0 +/- Ground water contour(range EL. 35 to 40) EL. 38.0 +/- Estimated distance below leaching area to ground water: 24.0' +/- Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts ' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 61 Padlock Lane, Ceterville MA. Assessors Map: 193 & Parcel: 187 Property Address Caroline A. Luongo Mailing Address: c/o Raymond James Trust, N.A., P.O. BOX 14407 Owner Owner's Name information is required for every St. Petersburg FL 33733 November 20, 2013 page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 No.-......70_...._ 2 d ii Fres..........-- --..._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH B Town OF Barnstable pplutttinn fnr 4:45pnntti Marks Tan,5trurtinn Frrmit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: _.Lot #•,35_Padlock_Lane Centerville MA 02632 .........- - ..._......---......_.-- Location-Address -•._..•..••.••.•......................_.2_._.-_.._.._-•......—....._._-...__..__.—.—.-___•---_ Suffolk Realt Trust Lnc rta. ............. ----- — _ �'----.... ---•-......_.._............ --•--••----'---.:_--Box-_308 Centerville MA 02632 Owner r—..---•-- a _Kevin_Hickey Carriage_ Lane nad... zBarnstable (p Installer ................... _........ d Type of Building Address U Size Lot.....-15,.000 Sq. feet Dwelling—No. of Bedrooms. two -------_Ex anion Attic n '-•1 No. P ( Garbage Grinder n W Other—Type of Building .ranch No. of persons_---_-2............... Showers 2 ( g Other fixtures --•- ( ) — Cafeteria (n� W Design Flow_.._..--..110.........................gallons per person per day. Total daily flow----------Septic Tank—Liquid ca aci 1000_ gallons. P 9 P h- • - gallons Length Width.- Diameter---------------Depth--_-----•-__•--- Disposal Trench—No.................. Width-................ Total Length-------------------Total leaching area_------•-----------sq.ft. 3 Seepage Pit No----•------•---.._. Diameter._..._............. Depth below inlet----..-•--_.•.-----Total leaching area..................sq. ft. z Other Distribution box ( ) Dosingnk ��jy n Test Results Performed by... 2(g( �,t,Al- Percolationr/Y!� -S, _ 2 Pi p-•---. Date---L------7-;._7� - .I Test Pit No. 1-------___------minutes per inch Depth of Test Pit.__..__144" Depth to ground water..___APA Test Pit No.2--------------minutes per inch Depth of Test Pit----------- Depth to Y P ground water--•--••-•---•---•---•-- - -----••----•-------------_.-..----.-----•-----.------------- Description of Soil._..__ ---------._....._......•.--otr__ 24!'.. loam subsoil - _....... - 4 - ----- --- . 60m sand ...................... _- - "__-_ " mediu - ---------------------................................--..............-•- d - 60r° - 144^ fine sand -- � afore of Repairs or Alterations—Answer when applicable......................... - 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 further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of healt4. SIke. e 1..__... �---/- Application Approved B �lw!/�. . .. _Date Y - --7{: .......................� Application Disapproved for the following reasons______________________•--------••••--_,---••---_ Date Permit No...................................._.._..._._.-- Issued-._3•._. �_® --7 Date ............ ........-.....-- Daze THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........T.olm...................OF............Barns.table......................----•-••--•-----... r o T'Ortifiratf (91inaph anrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired ( ) by..............................••-K ev3 I• ? i-c-k&l __....._.._...__._....._._......... ---•--•--••----------- Installer at---------------Lot-4---3�-->kau3ocl -.. -:er�tet'� , 1- --------0-2b3---------•---- _ 79-------------- has been installed in accordance with the provisions of TIT `>of iYhe State Sanitary Cod as descrilSed 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. 3 (J - Inspector.- DATE------------------•------.---..._...-•--•-------------�--..-........ ................ ........................................... 1 THE COMMONWEALTH OF MASSACHUSETTS 1 BOARD OF HEALTH �S . ....... ......T.O.w.n................OF........Rasnstalbe............................................ No......................... FEE........................ BisvnsFal a1rh-q Tnn.5trat tinn Prrntit Permission is hereby granted...:.....Rev.# Hickey to Constructl(t` ) or Repair ( ) an Individual Sewage Disposal System Lot # 35 Fadlock Lane IN Centerville IqA .. .. ... �.... as shown on the application for Disposal bi'orks Construction.P o.. 14/� ➢oard f FIealt6 DATE-- - �- � '....................................... o ". FORM 1255 HOSES & WARREN. INC.. PUBLISHERS L0_'CATtor� J �y SEwA G E -E.RMiT R0. D e ' ,L j f VILLAGE I N S T A LL.ER'SJ NA-ME A ADDRESS BUILDER DR OWNER ®'ATE PERMIT ISSUED „ ; 7F- DATE COMPLIANCE ISSIiED � 4:, tp b f48liP'R-�'�Cf�� � q 10 00 -E-4Ei �Assur/> wG.tj O y?ri 14_9 �9 _ ja„J L O; j/ / 00 a�� ^��41 U t�V' TES 7- HC �z.3o p 1, I° RES U/-7 PER T O w',1'REc DPTE: /2127/7, SCALE. c 5 TOb,//V A/ATER 1.5 AVA/L/-78LE /NS'P N'l./rn/7/`IUI`7 BUILDING SETZ319CK REOUIREMEN7:5 F/eO/./T 20• S/DE. /o " R-EFi',e /O ' DRlvEL./'9Y NOT TO HE LOCf -rED P� C?POSED Z3F_ T'�GONIS OVEIE' SE G./E r2/9QE SYSTEM UNLESS DES/G'-: FLO.IN' _s'30. G.�L j/✓ A4-eo DES/G-IV LORDING /S USE'D. p20POSED LEf?CI-/' A,eE/� SEPT/C SS/STEM COn/S7r2UC7/0N S5HI91-1- c O ,eO /IIQSS. ENVIeOn/MENTRG PERCOL �T/Oti T �' I NFO M T vDE = D.97-ED .TUGV 6 /977 7-OJ,,/A/OF <S'9RN 5:ABLE HEALT 1 2EGUL 9T/ONS. SILL ELEV.TO 8E Top OF �,�,�>T-, T y.P/ Fo uNDAT/on/ /�/O S C r9 L E FJ,eE_.9 / .EL6V = /O/,D /MYEi-2Vi0U5 COVE Y MANHOLEe COVE,e To EXTE'VD TO 7-0 F?E b'F/,'7 W/TN/N I' OF F/N/SHED GAP19DE R.pry/ /A-'F /L r,c"yT//J M/N/MUM 1 /O' ✓ 57-oniF 2' OF 7- 24"COVER5I f D/ST. ,�- L✓ySt/ED BOX i� 2/'"w.vc ALL F)R 4 D/'j F/R7ER �F r ^ WE F P/TCH FLOW L/NE p/TC I / /o"MW. / E' r4/n P! CN q4. F007/ /$' 4FOr /M/n/ 2, %4roor GALL/Odp _. /NVE2T —9C..S/ C�� L.Ff1 C 'TONE 93117 GALLON /vvE.eI Fes;• /= SEPTICa-k-. W.9TER7-/G NT, /NVE97- [_ /N VE R7- /✓O ZO'N//A//M UM `Z CZW77114771EDPLOT / /..:/ /A/ JJ•�'88.8 i=',C�O;.i:',:i", ', .'i ',E.� c KONALD s LOC AT/ O/\/: CEn/7",eXV/[L- o naniva SC'9L,e / 30' DFHTE /ziq/7'9 ++iueD ^I 13 2 E FE 2 E NC E: S E/r`/C-,' LOT 3 s- fI9 SH04✓N ON /a PL f7/�/ R E C 0.2 ZD E D //V T'/-/E 8FJ rHt3LE COUNTY C'EG/STey O/F DEEDS [r4N� �OunZT sL�GY/ON L.C. P a $8sG7A �o�,�4k-!!.�/�/� F O/e //ZL/>y SEPTIC T/q N K T O a C f? st�/'ct'��, � ���G T�/ / �i/✓/ /MUM O F /O /_�C7!•" F O C/N. �eorgE Cow CO. T/ON F7ND L_Ef) '!/ j iT L E f-/C/-I!,'V G P --,S' i-0 3 E. f7 P12c C CER7 � � TN�lT THE lco 1/I.' 9;/O� u /_ tiES H,ti r) S C Tip N '_�;,:. SHO h/.-7 r;n_/ 7 I /-5 PLf�N l S I- O C/4 �O FAO.J :?(J'v'D <7/./ Ti-IE ,E c7i/nJ D r9.5 .SHOW'N HE�EO// ��- j -- i9n✓ rF-' 7 ;7 ODES' CONFOPM Df7T 7...-`, T H F: 7..U:'L D l//G S E 7 8 f� ,k R Q U he,E -- F_ lv'.ti OF�R1�5T/�L3Lf' - map Town ,of Barnstable Geographic Information .System Parcel Custom Map Abutters Map Size ® ■ zoom C Viewer !I r R .,: 81.57 2.56 $f X 78.45 4 .78.01 11 n f �a T . n ' t -..... —.vim•"+' •..., .�' =� - ���� .. _ �. 7, r • - IS ti i f IR )d 3 Fey Set Scale 1" = 63 Aeri I Photos v I MAP DISCLAIMEF Copyright 2005-2010 Town of Barnstable, MA All rights reser BarnstableMA vl.2:4748 [Production] http://maps.townofbamstable.us/arcims/appgeoapp/map.aspx?propert),ID=l 93187&... 11/29/2013 L- 0,'CAtION SEWAGE PERMIT NO. VILLAGE I N S T A LLER'S NAME i ADDRESS MSA Pe U I L 0 E R OR OWNER DATE PERMIT ISSUED � ws.. 7r= DATE COMPLIANCE ISSUED � � 7� d �r t of, �,� • tNI VA 3� Ate - chP., ��s � cis sf'P�l1� "',ION W PERMIT N . L� CAr SEWAGE E MIT 0 14 t- 3 S VILLAGE INST��A// LLER'S NAME i ADDRESS B U I L D E R OR OWNER -S7jA—,00Jk DATE PERMIT ISSUED 2 -5- 7y DATE COMPLIANCE ISSUED r . f �.,� 0 26 ,. n �� M �- � � � � M r-:�, Nj`�-. -_ d d No................_....... Fps.. ...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH H Town Barnstable........... ..........................O OF..................... �t Appliration for Rapa,ial Works Tonstrnrtiun pamit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: .... _Lot # 35 Padlock Lane Centerville,___MA•.___._02632 Location Address or Lot No. Suffolk Realty Trust P.O. Box 308 Centerville MA..__ 02632 --- .... --•-• --.... ...._ _... ........••- Owner Address Kevin Hickey Carriage Lane Barnstable ..-•----•..........................•-•-------......................----------••......-•-------••-• -------•••--------------•-----•--•--...............................---•----•-••......---•--....... Installer Address Type of Building Size Lot------- 5J_000-....Sq. feet Dwelling—No. of Bedrooms......_two............................Expansion Attic (no) Garbage Grinder (no) aOther—Type of Building ........... No. of persons......2................... Showers ( 2) — Cafeteria (no) Otherfixtures ------------------------•------•-------•--------------•-•...--------••--••-----•--•-------....-••---•......----......--•-------------................ W Design Flow...........110.........................gallons per person per day. Total daily flow..........330 gallons. WSeptic Tank—Liquid capacityl 000_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 ( ) Dosingnk ( G.t. -Al,�'� Percolation Test Results Performed by.._. dz2_. . . ...... .....�r. _A_.._._..,_. z7�__7X. :. Test Pit No. 1.......2......minutes per inch Depth of Test Pit.......144'! Depth to ground water------none...... GXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-•......................••-------•----•-••--•-•-•---------------........------•---••-•••••---.....•---•--•---••-•-•-----........----...........------_•---- Description of Soil.........................................0": - 2411 loam & subsoil ----•••••-•...... . . . . ---••--•-•-------••••••--••-••-•...................•--_----•- 24"'____-___60'.______medium sand W ........-•-•-----------•--•-----....-•----•..............................60��. _ 1441, fine sand --------------- ---------------------------------------------------------------------------------------------------------------------------------------------------•--•-......--••••-•-......--•-.-•---- V Nature of Repairs or Alterations—Answer when applicable-............................................................................................ -------------------------------------------••------------------------------------------•----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1Z 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 healt Si ed---- Kit. ....... ' _Date Application Approved BY . -- ------ 7 : Date Application Disapproved for the following reasons:-------•------------------------•--------------------------------------------...------------------------....._. -----------------------------•------------...-----•----------.......------------.......-•----•------•----.._..----•------------------------------.......--------•-----------------------------------••••. Date Permit No. Issued_._3_ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........Town T.oWn..................OF............Barnstable........................................ (9rdifiratt of Tootpliattr THIS IS TO CERTIFY, That the Individual Sewage Disposal System„constructed ) or Repaired ( ) . Installer at...............Tat•-#---35-•�adlock...Lane-----Ger+t2r-v} ,- • ----------0263-2----•---------- �t�om ►�p-- -------- has been installed in accordance with the provisions of TIT 5 o7 e State Sanitary Cod6as`descrilfed in the application for Disposal Works Construction Permit No______ _______________________________ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL 146T BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.. .. v . 7 - Inspector..../....... -•-••••'•=•--=---•-••----••-----•--•-•••=- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .7 . .............Totim................OF�........Bar-nstalb-e........-......-....... ............ No......................... FEE........................ Disposal Works Tonstrurtion rrottt Permission is hereby granted - Kevin Hick ---------------•--•---.........--e y-•.---•-••--......-•-••••••----••-•---•--•--•-•••-••---•-.._...._.....--•--•••....--•.` ...------ to Construct # ) or.Repair ( ) an Individual Sewage Disposal System at No.... ....35 Padlock Lane � Centerville, RA 02632 �►� _-,,` Stre as shown on the application for Disposal Works Construction;P, _______ _______.." #,...` ---------------- -----••-•--•••••••---- •• •---•----- .: ..• •......._•--•-•--- '` Br oa d of Health DATE------^� u y '---------••----••-•----•--•-------..... ,, FORM 1255 HOBBS'& WARREN, INC., PUBLISHERS No........ ........ Fim .................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 19 Town OF......Barnstable ................... .. .................. ................................................................................. Applird"fivu for Dispatial Marks Tomitrurtion "amit V Application is hereby made for a Permit to Construct (X ). or Repair an Individual Sewage Disposal System at: Lot # 35 Padlock Lane Centerville, MA 02632 ... ................................................................... ................................................................. L eitt yl�re,s St or Suffolk R rust P.O. Box 308 &nkervilles MA 02632 ......................... ................................................... .................................................................................................. Kevin Hickey 0,,,r Carriage Lane Add'e'barnstable .......... Installer Address U Type of Building Size Lot......j..5-rQ()G-----Sq. feet Dwelling—No. of Bedrooms......_t.Wo............................Expansion Attic (no) Garbage, Grinder (no) 04 Other—Type of Building r.anC-h............ No. of persons...._.2.................... Showers (2 ) — Cafeteria (no) PL4Other fixtures ..................................................................................................................................................... Design Flow..........J.JD..........................gallons per person per day. Total daily flow..........3.30..........................gallons. WSeptic Tank—Liquid capacitj..00Q..gallons Length................ Width....__._........ Diameter.___.._..._..... Depth............._..Disposal Trench—No..................... Width..._................ Total Length.._..........._ Total leaching area........--..........sq. ft. ... Dept I leaching Seepage Pit No..................... Diameter._._.f ...... ;r Other Distribution box ( ) DosingjW94;(X.l0V1nlf( Percolation Test Results Performed by......................................................................... Date_...---------.............--........... Test Pit No. I.......2.......minutesper,ihch Depth of Test Pit.......144Yt.. Depth to ground water.....tl()Re....... 44 Test Pit No. 2................minutes per inch Depth of Test Pit...........-_..._... Depth to ground water_._.................__._ ..............................................................4.............................................................I................................. 0 Desci tion of Soil........................................Ot�...M �p 24!!-------1-Gam--&---subw)-14........................................................... .................................................................24!!-.-----L----6.0!!......ined-ilm...san-d................................................................. .......................................................................601!----—---144Yj-------flne---sarnd.................................................................. .U. Nature of Repairs or Alterations—Answer when applicable....__......................................................................................... ..................................................................................................................................................................................................... Agreement: The undersigned agrees to install the ajoredescribed Individual Sewage Disposal System in accordance with the provisions of'TTLE, 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_ oard of health. � . �-I-- ce Si ......... 4 27 Date ApplicationApproved By........ ..../............................................... ............................;/ ........................................ Date Application Disapproved for the following reasons:................................................................................................................ ........................................................................................................................................................................................................ Date PermitNo......................................................... IssuedL....................................................... Date ca IWA!F,o/4.)l o TEA p/ 7 elk ,F .O `• TEST ' H a�E � � .30' 97 4 Tl: lo0. /eES ULTS PE/e 7-0 wN /eEeoreDS 1)P7-E . /2107178 y TO 1..//V k/ATER /S A VA L E /A/SP. M/A//1`!U/-I BU11-Z) AIG , 5ETB,09Cx REaU/ RE/'-7EA/T.S Ile A/ s/D F- 1 R) V'eEWAY tIOT" - -reD OE• I- --F-z: PROPOSED BEDROOMS � 0VH)e SE �•/€ ;P.9a S,S/S. EM UNLESS DESlCT',/ G/-9L�D�y M H-.ZO DES/ GN C.O/9D!/ lG /S USE-Z) . pR4P4SED LEJ90f-/ J9P-Ef9 19, of SY57",- /-/ CbNS?',E'UG'T/ ON 5H,43L1 PEJCCOL �7T/OIL/ TEST p/V F O ,�'M T O /`%/.�S�'. EJV 4/!� O�.!M E/V TA,�. ku Pl O Ta E Y- D A T E ?. .TUL.y / /9 77 FNb .7'Ol�/A/ OF /e ES(JL TS M/ti/ /�V C H .9RN.57"�9�L.E f- Ei91- 7rA4 teEGC/I. RT/ PA49. SILL ELEV. TO 13E FT. i913DVE )OD. M J il/ G Fa UJdDA7/UJ�I �219DE f�jgoVe 1 E,9C'H /V O Y EG Ef/ /p/0 /J`'/PEiE'V10U.5 COVE2 1\4,9lVHOLE4CovER To ExTEND TO To 7'�2EVENT F/n/ES WITHIN /' 4F F/N/SHED GrE'F�DE F,epM /NF/L�,eAT/N� rr MU STONE 2 Or' Xg„Ta�,. c o VE,e Wl9S!-/E D s7oNE y 4r'CA / •BOX �JRDUND rr /f�J. �t Y ry DJ� WATER R e /0/, �'/TeN FLoW CJN� MJA/. p/rc /F 7 /o"•t IAI, ., %4.' Foor -fIAJ P/7cN �00 _Y_ >tiiN �, /4'lF oor 62, GR L L OJAI - _ 3r1. 9Z.S/ ( esT-nJ� � - 7 GAI-LON INVERT, CA P190 / ry - ,s Fjr2O UND S,�P7-/C 7'r�NK <Wf}7'E,2 I AI V--,e T /N VERT Y U -4- /2 M!N �2 9� L E�C� H x . (JV VE,Q7- �8 GA e B AGE 4' ,� Jnl D/5T. TO M19x . � GROUND k/�ITEA cELEV. P407 PLRAJ � rtOrvaLD�y�, ARTHUR $ C ,9 1- ,E GIVTORD F'S S_ OG✓N �F�tstE��o y 0A/ ,Q ADD FAN C co,eD L D . /N Tf/E 8Fa•�AJ- ��'Vrra�- , Ti9�3E CavNTY �EGIS�-,eY 0,4= DEEDS G/4NL3 C�?r1QT' ,���'J�`iOiV L. C. P, eat��5�3?''� �o•n�ll •�� /t�' O/e S'EF'T/ I � 4 < 7 ME fUl Me`H O!/F /O' )`RO/-I T/ o N 4 J /D E� e P FO 7U-S eO� a LO� r4 N.D,9- 7-S -ro n E A/- s e �'�-~�1�' ,"'� C� U '7" /i', /'',1� 1-3 S. /M U/"I 0 F / O' F� o r! . PRoPEPTy CE T / may TNAT 7-NE ND S ,EPT/C 7-AA-1 ..J/-/'O W JL/ OA/ Tip ! P L fa /�/ /.5 ©L C/'9 G- T O UND /9 7�/O/V OA-1 7-HE GROUND /9 s5 s NO WAJ 1--1E)eEoNcEc-icl ,gAJD 7'�//i9T > T OOE'S CphlQ.E'/�-I ; ~i tt`;^7IY �; r! DATE T! T,L E fiT P-7 — — — _ — — �5 /-/7"S C3 ict- —rye ��� '� Z, /9 �p �% � •�.�sF►ti�°` —D F/TE 8 p A ,2 D U�' �-� E�/..T/-% Z)Fq 7- 6 )e'E.G. 'L"q ^./T S L./ R V,65 V 0 AE! Fq C A N T f I TOWN OF BARNSTLE 5 LO CD E 8 z _ o a CO w � _ .� a o N N N � 6t-IOfa cV G> r a B'-5!S" 25'_lOo 20'-998° - 6'_99g° ^ U •� a II C �'-0 x<'-0 N -0�!3($4) 9 . LVI. Beam CL r J LL 7L : � u)33adroom 2Dining Room ! itchen Gara a M� OW W m =U3 -j azHHI P 4 3� ------------ r 7'�° Bedroom 1 Bedroom 3 Livin Room m j m 9 Y Q 1 , N Clcr- :1 _�jj 7 Q .a. PL . Point Load o .. Provide Solid c ntinuas bearing on Curt z Z c� LL = LL 71'-0° 2-'19/16"14'-836" 2-101/Vo' Q IL J 16'846" < H U W E- 2 U ' tr I f 1�