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HomeMy WebLinkAbout0024 PEN LANE - Health 124 PENN LANE, CENTERVILLE A= 193-205 C No. 42101/3 ORA D a ESSELTE 1o% (o O Q O O N V e TOWN OF BARNSTABLE LOCATION 1,aIV f SEWAGE# VILLAGE CC n V[1 v+11 r, ASSESSOR'S MAP&PARCEL 0 93 INSTALLER'S NAME&PHONE NO. ,SFFgKihs% &C4V4T.''n SEPTIC TANK CAPACITY 1600 LEACHING FACILITY(type)C)H.IDr00 C k Gm�e,S (size) 3,Y e 1 3 NO. OF BEDROOMS 3 OWNER (�nxy 6,9&IaSO PERMIT DATE: to-)I- a,0 I COMPLIANCE DATE: 1"5Q6 Separation Distance Between the: , Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility N,A Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) N. Feet Edge of Wetland and Leaching Facility(If any wetlands exist within �� 300 feet of leaching facility) Feet FURNISHEDBY_®(��h�n�-C � � va as �q �� 3� � � ., ,.y:, ti � y �a;����� Tt?W T OF. B 1STABLE 1 jXST J,, R's NARK&PHONE NO., oa 0 Ps — Ooo � e,o ,No.cep"B15MOoms.......�.. BUIL'ER cast®'mmN r—� 5ePamtioli �srt��t�i c'l�� eta tXza, iV�Axfmuml��ijustedUtoUt��lwatet'!'abletati�cJ3attotnufJi,s�iGhtngl��u,ility :.. ..�,;:w:�. Cr,�� Iya4c; ' o9u►$uOOY�` u id Le ching Facl tty a�l+;riel9s cxisb am e9t�oc w9than�A(I feet oi'taitctuo�Et�ility) ..�........ al . act i of Jet and aid Leachin�v sicA9tty( spy wct9nn ex9se ultf�ixi,� 0 fe u lena9iing 4uctliry) s a ;t No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ Yes PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS 01pphta.tion for 30ispo8AY 6pstgm Cunstruttiun i3erm t Application for a Permit to Construct( ) Repair( ) Upgrade Abandon El Complete System ❑Individual Components Location Address or Lot No. Zy 2 mot! t (/t `-' Owner's Name,Address,and Tel.No(:;,Ia-;,C,1-1 V So Assessor's Map/Parcel /9 3— ZO-'5 ®/9'Z/ Dv..5,0 L.D cf� Installer's Name,Address,and Tel.No.SlJ -Y3Z- Designer's NarrW,Address,and Tel.No.I cam__ �;f_--Z Type of Building: Dwelling No.of Bedrooms Lot Size © ! Ac.sgr4— Garbage Grinder( ) Other Type of Building /Ze S, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '3 gpd Design flow provided ,3 O e gpd Plan Date 0 C-%. / G^Co- / Number of sheets Revision Date ®Cs'. 2 2 of Y Title ,gl u e4A Or— 04 CuSy &i . RXA! L, 4i/ Size of Septic Tank ,4O �J-1'�C, Type of S.A.S. ) - Ct , QA5­5.✓9U.S Description of Soil C", 5 T 0_'Ur Nature of Repairs orAlteratious(Answer when applicable) �,�Ggj0� G�/ l✓ �`t�/'�/9 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 he Environmental Code t to place the system in operation until a Certificate of Compliance has been issued by this Bo of He lth. Si Date �� oP F Application Approved by Date Application Disapproved by Date for the following reasons Permit No. D 0 j - o�/ Date Issued o �� No. Fee UU THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLE, MASSACK SETTS Yes 2pplication for jBispoBal *pstem Construction Permit Application for a Permit to Construct Repair Upgrade Abandon Complete System 0 Individual Components Location Address or Lot No. Z 4(//6e AJ 4-4j,) C r v��-� Owner's Name,Address,and Tel.No<;,,2ti r q ti�v So /�/LAlfc 5/y02a ram. Assessor's Map/Parcel /9 3— 205 Qa Installer's Name,Address,and Tel.No.So • S/32-5 CGS Designer's N�ddress,and Tel.No. GA)o� �l A Sp':Effr",j Type of Building: ) i Dwelling No.of Bedrooms Lot Size 0 .2,1 AC. s Garbage Grinder( ) Other Type of Building /'2e S, No.of Persons Showers( ) Cafeteria( ) Other Fixtures `t Design Flow(min.required) 3 O gpd Design flow provided 7 3 0, 6, gpd Plan Date O G 1 /�� 2 r�i��/ Number of sheets Revision Date 0 G Title q/1L 10C,1 J C)/- p?aJ'o S c o_v si . �o�\2�'P�.�4-e / , Size of Septic Tarik /00 o �J-�7 C, Type of S.A.S. Description of Soil tic/ 'j T--0 4 Nature of Repairs orAlterations(Answer when applicable) 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(Lo the Environmental Code artd not to place the system in operation uritil a Certificate of Compliance has been issued by this Board of He lth. S i Date } Application Approved by ./ , Date Application Disapproved by Date for the following reasons Permit No. a/l/ - L/O y Date Issued !a/;?J --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certifiratt of Compliance THIS IS TO CERTIFY,tha the On itosa Ti tem Constructed( ) Repaired Upgraded( ) Abandoned( )by � v at QA D& r\ rl kP1 V,V IN' has been constructed in'/accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. d��-y u V dated t Installer SOt a k A^P vn Designer #bedrooms j Approved design flow v Jgpd The issuance o�f�thhi/�permit shall not be c nsst-ruu a as a guarantee that the system w'fl file sction as designed. /� d Date /L/'/;� 76/-/ L �1)r Inspector . l / " 1 --------------------------------------------------------------------------------------------,---------- --------------------------------- No. U 1b(" L 0 I( Fee 1 OL' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal 6pStem Construction i3Prmit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at rk INQ. c Q �( Y V 1 , i and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three ears of the date f this o t s permit. P Y Date I U /2 3 ky Approved by �7 41• (L ,r, V Town of Barnstable ofs"E r°►+,, Regulatory Services o� Thomas F. Geiler, Director EaxMsrABM - 9 MASS. Public Health DIVIS1011 •� s639 ��'°Te139 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: l l' Sewage Permit# 9-D Q Assessor's Map\Parcel_��� Designer: Installer: .�� Address: Address: on d. �� was issued a permit to install a a 3 / �� ly �� (da e) (installer) septic system at 2`i� C' '4. c"t/t.Cd'�based on a design drawn by (address) . dated esigner) I certify that the septic system referenced above was installed substantially according to a include minor approved changes such as lateral relocation of the e design, which m pP the Y gn� distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF A�Igs� o. DAVO �y B. staller's Si a MASON ' v No.1066 gNiTAR�P esi ignature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. I Q:Health/Septic/Desiper Certification Form 3-26-04.doc Commonwealth of Massachusetts / U L'evt W Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �qM 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 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. A. General Information 1. Inspector: I Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number 9 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 8-19-14 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. i *System:rhasr2,H .1.0 Leach pits in the driveway. �r„ I v I t5ins•3/13 Title 5 Official Inspection Form: ubs ace Sewage Disposal System•Page 1 of 17 i tl Commonwealth of Massachusetts Title 5 Official Inspection Form j Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ® One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): System has H-10 leach pits In the driveway. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts ` W Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville (VIA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form ` Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface_water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D? stem S Failure Criteria Applicable to All S Y Pp stems:Y 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 Y2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts 1 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 24 Pen Ln ;r Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed.at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis 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 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection D. System Information Description: 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 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 7-2014 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day Y(9Pd) 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 W Title 5 Official Inspection Form " Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Pen Ln M Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Within last 3 yrs Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance 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-3f13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form " Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 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: 1979 with second pit added in 1980's Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 14"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: 8"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: 1000 gal Sludge depth: 12" t5ins-3113 Title 5 Official inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 -- I Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �^M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts T Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Good condition with no sign of back-up from pits. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts = u Title 5 Official Inspection Fora r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 . 8-19-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pits in good condition with stain line in second pit at 40" below inlet invert. 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 i i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °7M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is Centerville MA 02632 8-19-14 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately �. ,s f ,p [ a jI 1 I t5ins•3f13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 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: 16' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at 16'. 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 F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 24 Pen Ln Property Address Gary Caruso Owner Owner's Name information is required for every Centerville MA 02632 8-19-14 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 3Lo5 / " Barnstable Town of Barnstable Bar, Regulatory Services Department AFAMNwaj 639. Public Health Division m �1� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL 4 7012 1010 0000 2851 4327 September 4, 2014 Gary & Patricia Caruso 145 Lake Shore Road Boxford, MA 01921 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 24 Pen Lane, Centerville, MA,was last inspected on 08/19/2012,by Shawn Mcelroy, 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 system component (leach pit) is located beneath the driveway. It is unknown whether it is constructed of heavy duty loading(H20)which is designed for vehicular traffic. When it is unknown whether or not a particular system component which is located beneath a parking area or driveway, is H-10 or H-20 (for example: a leaching pit is located beneath a paved driveway without an accessible steel cover to grade and there are no records on file indicating whether the system component is H-10 or H-20), the system shall also be deemed as a"conditional pass". In this case,the seller must make potential buyers) aware of the "conditional pass" status, the unknown construction of the septic system component(s), and its safety concerns. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH t--�At 01 - mamas McKean, R.S., CHO • Agent of the Board of Health Enclosure: Copy of Town of Barnstable Policy: H10 Components...No.2012-005 Q:\SEPTIC\Conditionally Passes Ltr\24 Pen Ln Cent 20I4.doc r Town of Barnstable P# Department of Regulatory Services / aARNSTABM Public Health Division Date /s 59.� 200 Main Street,Hyannis MA 02601 prFo�s J� �l Date Scheduled Time Fee Pd. Soil Suitability Asse sment for Se is o t� Performed By: IJICV Witnessed By: (1j LOCATION&GENERAL INFORMATLONS Location Address a q - Lix Owner's Name Ct-,V1y e. _ I Address iy/J��(�/�!<,SXs Assessor's Map/Parcel: N,\4f let (�3 "0. 2- Engineer's Name� � m� NEW CONSTRUCTION REPAIR ✓ Telephone# Sj0 —�O V4 bZ Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) �L1 q �s t L/ Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pi ace Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment fl. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ p PERCOLATION TEST Date' Time Observation Hole# Time at 9" 11 Depth of Perc Time at 6" Start Pre-soak Time @ q Time ff%6") End Pre-soak Rate Min.Rnch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\S EPTI C\PERC F ORM.DOC DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel O- JA © 23 I DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sail Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate May: / Above 500 year Flood boundary No /A es Within 500 year boundary NoI/` /Y/ es Within 100 year flood boundary No q// Yes_ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervio erial exist in all areas observed throughout the area proposed for the soil abso tion system? If not,what is the depth o nat ally occurring per 'ous material? _ Certification Q 1 certify that on to ` (date)I have passed the soil evaluator examination approved by the Department of Environ ental Protection jay tha the above analysis was perfor ed b me co istent with t uired training,experti nd erie ce d c ibed in 310 CMR 15.017. Signature DateLl �O Q:\SEPTIC\PERCF ORM.DOC a Page 1 of 1 Crocker, Sharon From: patty caruso [carusosix@yahoo.com] a Sent: Monday, December 07, 2009 3:20 PM few To: Crocker, Sharon Subject: Fw: Gary Caruso/Meeting ----- Forwarded Message ---- From: patty caruso <carusosix@yahoo.com> 2_0/0 To: sharon.crocker@town.barnstable.ma.us Sent: Mon, December 7, 2009 3:17:57 PM Subject: Gary Caruso/Meeting Dear Sharon, This e-mail is regarding our conversation at 2:30 on December 7, 2009. As I had stated, our son is, having surgery in New Hampshire the day of the meeting which is scheduled on December 8, 20009. We were unaware of the meeting until you called today. We would like to ask for a continuance involving our property at 24 Pen Lane in Centerville. `You had informed me that the next meeting will be on January 12, 2010 at 3:00. We would like to attend the meeting on that date to discuss the issues surrounding our house. Thank you very much, Patricia Caruso Gary Caruso cell# 617-212-2651 I 12/7/2009 1 .. X/O�%n6 J 11/09/09 To Whom it May Concern. I respectfully request a hearing with the Board of Health so that we may discuss/resolve any issues pertaining to the property located at 247Pen Lane, Centerville, MA. I look forward to meeting with you. Thank you for the opportunity to discuss this matter. Sin ely, Gary Caruso 15 Curtis Road Hampton Falls, NH 03844 --� s V a o --"'603-580-2883 -` Cn C 617-212-2651 n N W CX7 rn W -c,&J xc a � d I " Certified Mail#7008 3230 0002 5177 8582 Town of Barnstable ,.� Regulatory Services �* ptcRN't1'AstL, vd MASS. $ Thomas F. Geiler,Director O zGSq. a�'a Public Health Division Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 October 30, 2009 Gary A. Caruso 15 Curtis Road Hampton, NH 03844 NOTICE TO ABATE_VI.OLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION, THE STATE ENVIRONMENTAL CODE, TITLE 5. The property owned by you located at 24 Penn Lane Hyannis,MA was inspected on October 22, 2009 by Timothy O'Connell, R.S. Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration of the Town of Barnstable. The following violations of the State Sanitary Code were observed: 105 CMR 410.300 and 310 CMR 15.00: There were a total of five (5) bedrooms observed in this dwelling; two (2)were observed on the first floor, two (2)were observed on second floor and one (1) within the basement. However, the existing septic system (permit# 95-1679) was not designed for(5) five bedrooms. It was designed for three (3) bedrooms. You are ordered to correct the violations listed above within six (6) months of your receipt of this notice by pulling any required building permits (if applicable) You are ordered to remove two bedrooms from this dwelling by removing entrance doors and by opening all door-way entrances to each room to minimum of five feet wide openings. This will bring the total bedroom count down from (5) five to the appropriate (3) three as designated by your septic permit You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each days failure to comply with an order shall constitute a separate violation. ,-PER OV.DER THE BOARD OF HEALTH Thomas A. Mc ean, R.S., CHO Director of Public Health QAOrder letters\Housing violations\Rental ordinance\24 Penn lane cent a Page l of l (Zrrocker, Sharon From: patty caruso [carusosix@yahoo.com] Sent: Monday, December 07, 2009 3:20 PM To. Crocker, Sharon Subject: Fw: Gary Caruso/Meeting ----- Forwarded Message ---- � ) From: patty caruso <carusosix@yahoo.com> ,,jd To: sharon.crocker@town.barnstable.ma.us Sent: Mon, December 7, 2009 3:17:57 PM Subject: Gary Caruso/Meeting Dear Sharon, s This e-mail is regarding our conversation at 2:30 on December 7, 2009: As I had stated, our son is having surgery in New Hampshire the day of the meeting which is scheduled on December 8, 20009. We were unaware of the meeting until you called today. We would like to ask for a continuance involving our property at 24 Pen Lane in Centerville. You had informed me that the next meeting will be on January 12, 2010 at 3:00. We would like to attend the meeting on that date to discuss the issues surrounding our house. Thank you very much, Patricia Caruso Gary Caruso cell# 617-212-2651 �. (Z ✓ 12/7/20.09 4 ` 11/09/09 To Whom it May Concern. I respectfully,request a hearing with the Board of Health so that we may discuss/resolve any issues pertaining to the property located at 24 Pen Lane, Centerville, MA. I look forward to meeting with you. Thank you for the opportunity to discuss this matter. Sin ely, Gary Caruso 1S Curtis Road Hampton Falls, NH 03844 o 603-S80-2883 617-212-2651 C). w r-- rn rkz aIzea 5 Certified Mail#7008 3230 0002 5177 8582 CT-= ,; Town of Barnstable Regulator Services BARNST,1[3M Regulatory ! M.ABS. a moo i6 � All Thomas F. Geiler,Director . ArFO Public Division b is Health Division Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 50 - -8 790 6304 October 30, 2009 Gary A. Caruso 15 Curtis Road Hampton, NH 03844 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.0004 STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION THE STATE ENVIRONMENTAL CODE TITLE 5. The property owned by you located at 24 Penn Lane Hyannis,MA was inspected on October 22, 2009 by Timothy O'Connell, R.S. Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration of the Town of Barnstable. The following violations of the State Sanitary Code.were observed: 105 CMR 410.300 and 310 CMR 15.00: There were a total of five (5) bedrooms observed in this dwelling, two (2)were observed on the first floor, two (2)were observed on second floor and one (1) within the basement. However, the existing septic system (permit # 95-1679) was not designed for (5) five bedrooms. It was designed for three (3) bedrooms. You are ordered to correct the violations listed above within six (6) months of your receipt of this notice by pulling any required building permits (if applicable) You are ordered to remove two bedrooms from this dwelling by removing entrance doors and by opening all door-way entrances to each room to minimum of five feet wide openings. This will bring the total bedroom count down from (5) five to the appropriate (3) three as designated by your septic permit You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. I. -ER"O."ER THE BOARD OF HEALTH Thomas A. Mc ean, R.S., CHO Director of Public Health Q:\Order letterMo6sing violations\Rental ordinance\24 penn lane cent 04-02-1998 03:38PM CENT DST FIREDEPT 5087902385 P.02 / r A.jann aliptit,auvu w HJt.7ar r ist; ui=pcumrCrrr. Fire Department retains original application and issues du:piicate as Permit. r C- / rixe Wey-wea.— Moog,*,/ cam* �xeuantron APPLICATION and PERMIT Fee: $10.00 for storage tank remcval and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148. Section 38A, 527 CMR 9.00, application is hereby ma6e by: 7Owner Tane(pieass print) George Hamrah X AddPen Lane Centerville MA 02632 Sveer C1ry Rare —ZIP Company Name Enviro-Safe Corp. Co, or Individual Enviro-Safe_ Corp P" Prha Address P_ 0. Box 304, Sagamore beach MA Address Prim Prfnf Signature Signature (if applyingfcr=ermit) IFC1 Cartirier Other Z IFCI Certified = , =# Other Tank Location 24 Pen Lane Centerville StoarAddmss Tank Capacity(galicns. ;C 1000 gallon Substance Last Store: #2 fuel Tank Dimensions(diar-Lf x length) Remarks: 7Firmsporting was.a —Enviro-Safe Corp State Lic. # �C329 s waste mane' E.P.A.# Approved tank dispcsai'rerd J Turner Salvage Tank yard# 002 Type of inert gas Tank yard address u Lynn, MA City Centerville - CI or Town FDID# (��4� Permit# Date of issue April I 1998 Date of expiration April. 14, 1998 Dig safe approval nurnber 981103673 Dig S fe ToU Free Tel. Number-800-322-4844 Signature/Tiile of Of5c-- ranting permit 2Tg 1,f jzf,�, �Q After removal(s)send For-. =?-290R signed by Local Fire Dept.to UST Regulatory Complies Unit. One Ashburton Place, Room 13101, Boston,MA -M-03-1618. FP-292(revised,W961 TOTAL P.02 - /11 1� iL c.� 1 S t— � C� Cad g�- `�" ��� �� �� � t TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATION Date to "��' ° Time: In Out ( d 3d T Owner �t���0 Tenant — I ►�- Address Address °2 Ll ��1'v►'L t �+ 3 MA Compliance Remarks or Regulation# Yes O Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation l 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal Ju 16. Sewage Disposal 3 11' 9 $— (� 7 17. Temporary Housing /✓ 18. Driveway Width G rr©f�� c� ►a vE'" C3) . �( 19. Number of Tenants Observed PART II M 37. Placarding of Condemned Dwelling;. Removal of Occupants; Demolition Number of Bedrooms Jt Number of Vehicles Allowed (max) a Number of Persons Allowed (max lQ)titiN Person(s) Interviewed Inspector. If Public Building such as Store or Hotel/Motel specify here Town of Barnstable . Barnstable Regulatory Services Department 94, 039. Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX- 1;0S-7Q1LFZl1d Thnm A X4,W an ('T40 CERTIFIED MAIL# 7014 1200 0001 0358 0161 September 4, 2014 Gary & Patricia Caruso 145 Lake Shore Road Boxford, MA 01921 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 24 Pen Lane, Centerville, MA,was last inspected on 08/19/2014,by Shawn Mcelroy, 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 system component (leach pit) is located beneath the driveway. It is unknown whether it is constructed of heavy duty loading (1120)which is designed for vehicular traffic. When it is unknown whether or not a particular system component which is located beneath a parking area or driveway, is H-10 or H-20 (for example: a leaching pit is located beneath a paved driveway without an accessible steel cover to grade and there are no records on file indicating whether the system component is H-10 or H-20),the system shall also be deemed as a"conditional pass". In this case,the seller must make potential buyer(s) aware of the "conditional pass" status, the unknown construction of the septic system component(s), and its safety concerns. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Conditionally Passes Ltr\24 Pen Ln Cent 2014.doc . Town of Barnstable Barnstable *IME T yP`° Board of Health j j * BARNSTABLE, * 200 Main Street,Hyannis MA 02601 039. �m 2007 ATED MA't A OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. BOARD OF HEALTH MEETING RESULTS Tuesday, January 12, 2010 at 3:00 PM Town Hall, Hearing Room 367 Main Street, Hyannis, MA I. Hearing — Housing: GRANTED A Gary Caruso, owner of 24 Pen Lane, Centerv�Jle, Map/Parcel WITH 193-205, hearing requested by owner in regards to violation letter CONDITIONS dated October 13, 2009. The septic calculation showed it only was built as a three bedroom (and probably the other room was a den originally-as frequently was done. The Board voted to approve the property as a three bedroom with the following conditions: 1) open the doorway of the room in the basement to 4 feet or greater, 2) record a Deed Restriction as a three bedroom, and 3) supply the Public Health Division with a proper copy. Postponed Until B. Philip Sheinis, owner— 6 Uncle Willie's Way, Hyannis, February 2010 Map/Parcel 292-307, requesting variance from ceiling height. II. Hearing — Septic Failed (Cont.): CONTINUED A. Michael Santos, owner— 26 Bishops Terrace, Hyannis, UNTIL FEB 2010 Map/Parcel 251-215, septic failure. The Board requested a letter be sent notifying Mr. Santos that the Board requests his presence at the February 2010 meeting, otherwise a decision will be made at that time without the benefit of further input from the owner. The Board would also like to know how many bedrooms are in the property. The Board voted to Continue to the February 2010 meeting. CONTINUED B. Rosanie Joseph and Severe Philogene, owners — 33 Stetson Street, Hyannis, Map/Parcel 306-055, septic failure (continued from November 10, 2009 meeting. Ill. Variance — Septic (New): Page 1 of 2 BOH 1/12/10 s UNITED STATEs 1pj Sjj; s�9 IE h !'1. ` 4 �M;+�� ;z:,7;w3':�a� __:xr�;. ... ..�"l�,,t �`.f. a. •w>::..�+.. '.'�4:i ��"'"a..,,�,,,,�,.�' • Sender: Please print your name, address, and ZIP+4 in this box • �� Town of Barnstable s�� Health Division ' 200 Main Sheet Hyannis,MA 02601 I Hiiii il'I J"!L I 11)IM I1111111 i 1111HI ii i J11li 11 Ail 1i1 ilil SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sig nat / yg item 4 if Restricted Delivery is desired. G%" " !` C pE ent ■ Print your name and address on the reverse X v/ Addressee so that we can return the card-to you. B. Received by(Printed Name) C. D to o Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item 11 Yes If YES,enter delivery address below: ❑No Gary A. Caruso 11 5 Curtis.Road Hampton,NH 03S44 3. Service Type A"Clrtifled Mail ❑Express Mail ❑Registered ach@tum Receipt for Merchandir, ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) p'Yd 2. Article Number 3230 2002 5177 8582 4 (Transfer from service labeQ PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 Certified Mail#7008 3230 0002 5177 8582 ,a IKE Town of Barnstable Regulatory Services F?;A BLE, yQ` "ASS. Thomas F. Geiler, Director N I W, nio—C,_�_n>j pra"` Public Health Division ' Thomas McKean, Director C� ^ 1z v 200 Main Street, Hyannis, MA 02601. Office: 508-862-4644 - Fax: 508-790-6304 l Octo r 30, 2009 Gary A. Caruso 51 15 Curtis Road " Hampton,NH 03844 NOTICE TO ABATE VIOLATIONS OF 105 CMR.410.000 STATE SANITARY CODE II-MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION THE STATE ENVIRONMENTAL CODE, TITLE 5. The property owned by you located at 24 Penn Lane Hyannis,MA was inspected on October 22, 2009 by Timothy O'Connell, R.S. Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration of the Town of Barnstable. The following violations of the State Sanitary Code were observed: 105 CMR 410.300 and 310 CMR 15.00: There were a total of five (5) bedrooms observed in this dwelling; two (2) were observed on the first floor, two (2) were observed on second floor and one (1) within the basement. However, the existing septic system (permit # 95-1679) was not designed for (5) five bedrooms. It was designed for three (3) bedrooms. I You are ordered to correct the violations listed above within six (6) months of your receipt of this notice by pulling any required building permits (if applicable) You are ordered to remove two bedrooms from this.dwelling by removing entrance, doors and by opening all door-way entrances to each room to minimum of five feet wide openings. This will bring the total bedroom count down from (5) five to the appropriate (3) three as designated by your septic permit You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall . constitute a separate violation. 4.ORDER THE BOARD OF HEALTH Thomas A. Mc ban, R.S., CHO Director of Public Health L Q:\Order letters\Housing violations\Rental ordinance\24 penn lane cent �- � TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date �-�'" ° Time: In )0 0rD Out f'0!3d Owner CtiJLw►�O Tenant 5"t— M c Address ► -I`'�` Address q Re" A Compliance Remarks or Regulation# Yes O Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 3 9 S— 1P0 17.Temporary Housing ►✓ 18. Driveway Width 19. Number of Tenants Observed o2-- � ►4 t Z-S 4A ` PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Jt Number of Vehicles Allowed (max) 1 67 Number of Persons Allowed (max Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date ' 001 Time: In )0 ` Oro Out r 0 1 _3d Owner CtMJ1�0 Tenant ` LlAddress Compliance Remarks or, r C, Regulation# Yes iNO - Recommendations 2. Kitchen Facilities 3. Bathroom Facilities ` 4. Water Supply 5. Hot Water Facilities ` ' ) 6. Heating Facilities 7. Lighting and Electrical facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service i 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 3 9 S - ((0 17.Temporary Housing J✓ � r 18. Driveway Width t CI) IIDft 0-) l�-v�{� (3) 19. Number of Tenants Observed c — c(49,y PART II P-A 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE LQCATIGN SEWAGE # ✓ '�� P LLAGE / e- A/SSESSOJR'S MAP&LOT/��-"�� INSTALLER'S NAME&PHONE NO. ���GO / SEPTIC TANK CAPACITY LEACHING FACILITY: (ty ®14V1 e 9Q'�AIL'�/ NO.OF BEDROOMS BUII,DER OR OWNER �qG7 PERMITDATE: 6—/6/ 122�� COMPLIANCE DATE: Separation Distance Between the: r Maximum Adjusted Groundwater Table and Bottom of Leaching Facility �Q 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 1"r Feet within 300 feet of leaching facility) Furnished by 40 , r ' r r AU) � U No.------1-2 "' 40 F�a.............................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Apphration for Uhnp ml Workii Tomitrur#ion rantit Application is hereby made for a Permit to Construct ( ) or Repair (b4 an Individual Sewage Disposal System at: --------------------------------------------------------------------------------------./---------- ................................................................................................. Locat' ddre s or Lot No. - - o�/�, t4'C-4 96 C C.ZdV O ner Address vll � Installer Ad ress Type of Building Size Lot............................Sq. feet Dwelling— No. of Bedrooms--------------------- -----------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons.-.._---_--____-.--_-----.- Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------ - W Design Flow.:............. ----------------------------- per person per day. Total daily flow....__.:--____ -36___..__.........__gallons. WSeptic Tank—Liquid capacit/-OPP...gallons Length________________ Width.-._-._- -.---_ Diameter......-._-___-__ Depth................ x Disposal Trench—No. .. .................. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No---------_el--.-_- Diameter--_-._l0.___--- Depth below inlet......6.-......... Total leaching area..................sq. ft... z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by--_------------ ..................................................... Date.................................... " Test Pit No. I________________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........................ ...........................-...........................................................................................:............-........................ . ODescription of Soil......................................................................................................----............................................................... U ------------------ --------------------------------------------------•-----------------------------------------------..........•-----•-----•. VW ------------- ---------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------- Nature of Repairs or Alterations—Answer when a plicable.....� ...___ .. l d Ct'?D.:_ LV4-94+ . Agreement: i rAA The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental de —The undersigned further agrees not to place the system in operation until a Certificate of ComplianceAhee6nis/s - t board of health. Signed - ------- ------"----- ------------------'----------------------- �--------------------------- A lication A roved B pp pp y ........:... - - ...--------------------------------------------------------- ... �i Da Application Disapproved for the following reasonr: -------------------------------------- = ------------------------------------------------------------------------ --- -. ` - -.....----�- ...--.... ....--- No. -..."...-- Issued .........Permit . Dace 1�r3- No....l 1 FEB.............................. " THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn for Diitipoiial Works Towitrnr#inn Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (15� an Individual Sewage Disposal System at: ... ` y /?fin!nJ e-,4 J r t , ---••--•---...-•---...--•-•-----••-----------•-- ------------------------------•---------...•.-------•--•------'----------•---...."--"•"•----•- Loran n/-: ddre s. ,, J (',/ / /� ( �/� --�j� .....'_- —^�i' £tt�'t 7-�P —+i�. —=-_-_v- or Lot Nv�/ � --------------•----._...._. ....... .. Owner _ t �'f • Address i y ..:_._ � a M LlS - ,.� ----•-----------------•-•-----.....�------------------------------------------------------------ -------------------- --- -- ----•---------------•--•...M Installer Address UType of Building / Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures -----------------•---------- -------- - W Design Flow.................. S__-___________--gallons per person per day. Total daily flow_.____..____._.�-3 6_._.. ---------------- WSeptic Tank—Liquid capacity/0P---gallons Length---------------- Width________________ Diameter................ Depth............:�. x Disposal Trench—No. .................... Width.................... Total Length..------------------ Total leaching area--------------------sq. ft. y Seepage Pit No--------...1------ Diameter------- �4..------- Depth below inlet------G_f......... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by............_............................................................. Date........................................ Test Pit No. I----------------minutes per inch Depth of Test Pit____________________ Depth to ground water_____....-._._______-_- fi, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water.............._......... --------------------------------------------------------------------------------•------•••......-•------•---_--•- ....................................... O - - Description of Soil............................................................................................................ ........................................................... U ----------------------------------------------------•------------------------------------------------------. ---------------....------------....------------------------•------------------•-•••......-- W UNature of Repairs or Alterations—Answer when applicable.___._ .__..__�_----- •••( %.1-.h..... l-+; r/ «i Agreement: S`'S i M The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Vde—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has' een iss ed the board of health. ... �Signed ......//....... ... ......../..---- -/---- -- 120 . :wwM 'f�'fI"�"j�lf/ _ Dare Application,Approved By ............. I .. 't Application Disapproved for the following reasons- -------------------------------------------- ....-------.-...-----........----------------------------------------------`------- ---------------------------- -- ---------- ---------..- ..... -- ---------------------- Permit ... "�' t ._.......-- Issued -_--.-.. '� P�" ��............................ Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,_'j.477 hat the Individual Sewage Disposal System constructed ( ) or Repaired (�) by ---------------------------------------------- 4<).. .. - ('N_STrt,.✓c r"7.u�J-------------------------- ----------------------------;---- at ........... . .... -_..... . ........... 91....------- .1--------- ---------- --------------------------------_------- has been installed in accordance with the provisions of TITI, of .he t to Environmental Code a escribl�l in the application for Disposal Works Construction Permit No. F - .- �'�. dated ..► d"°'�� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. . DATE.............. .� -------------- Inspector .................... --- ....-� �•,._�..-. p THE COMMONWEALTH OF MASSACHUSETTS l ( 20,5'— BOARD OF HEALTH TOWN OF BARNSTABLE FEE.._ ............ Uwposal Workii Tnnotrudinn "rrmit _ Permission is hereby granted.................... .____.._._ :.h_vJ,S _�_... to Construct ( ) or Repair (,K) a�n/ Individual Sewage Disposal System at No. ��f � ._... rJ ---;.._.. _f 1.........................I C ---------------- -- Street as shown on the application for Disposal Works Construction fle mrt I�o�__ .___..�.!___�__/._*1-ated._._ .__..�.� ....._. ,C Board of Health . DATE.. ...... /! n �' / FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA M" Ulm XW gg'; ME ty� 'T 2 WIN", NIP" I ANONZ M Vi, v*Ka MR AYA WO P"41 V— Aq. al , 1 " ) S'V., fr i l'irk;AN 'ill Mg"''.,�jSV?., '"�o '�x�� 1a�t'a'',f� 't'.' i'Y 3 sgq't�,;3���,1�`X {y"a'�'t�'d':"1.v+f+ , �u+�t��ts,�'".�- ,, r R. w. LEM 0q..", gy 6NO-1 a "30 Dh- AE mp 'f X, -1 gyn- "WN !I-v-'X 'N' LOW% AIR +'a. r d a�ptt�3.Y,. ro�s`��� ' .a} +x fie,, ,( d �5�. t+ - .yr f l �,�p 4 r 3'�p 1� q,yr� *7 vio� �py„�� nm aw to R p Pat �KT-41AW J, Rl gwv B"At! §tjho WAR, ggg PORN lu� y 7 L'®_ C•A<; ION SEWAGE PERMIT NO. �a /-7 VILLAGE / INSTA LLER'S M i ADDRESS c - B U I L D E R OR OWNER DATE DATE PERMIT ISSUED . - 7 DATE COMPLIANCE ISSUED r - � O (YOUsue Fimic THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF....... .................... Appliration for Uhipugal Works Toutitrurtion ramit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: PQ . ....... Loc' -On.�TYe's orLot o.ZCA ........ ............................ Own Z Address.. — ................................. e-- / Installer Address Type ....Sq. .. . of Building Size Lot... ....Sq. feet 6 a Vcj Dwelling—No. of Bedrooms._..........................................Expansion Attic (.4/ Gatbage Grinder0 Other—Type of Building A4 _e6K2__t-—----- No. of persons...........7.............. Showers (,-2) — Cafeteria J14tj P4Other fixtures ------_---_------------------------------------------------------------------------------------------------------------------------------------- Design Flow... .................gallons per person per day. Total daily flow...........41 �...................gallons. 1:4 Septic Tank—Liquid capacit/i7d.a..gallons Length................ Width.._.._...._..... Diameter____.._......... Depth................ Disposal Trench—No..................... Width.................... Total Length..................._ Total leaching area....................sq. f t. Seepage Pit No.--________________ Diameter.............._..... Depth below inlet.................... Total leaching area.................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) "4 . Percolation Test Results Performed by.. Date........................................ �4 )�W Z_ ...... --------------- Test Pit No. 14..?!:�..minutes per inch Depth of Test Pit.. ------- Depth to ground water...... Test Pit No. 2��h_aiinutes per inch Depth of Test Pit.._...!!......_.. Depth to ground water..........d......... .............................................................. ....... ... ....... .......... . ----------- --------*------------------------ ..........*.T-A.� 0 Description of Soil.................................................... if ------------ ------"--------------------------- jX_j. ............................... —iArjaL., ....... --------------------------- .........16.......... *..... .72 ... ....................................................................................................................................................................................................... U Niture 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'-ITTIE 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 h h. 4C, A ...... ......... .... Signed------. .... ........ ...... ..... Date ApplicationApproved By................................................................................................. ........................................ Date Application Disapproved for the following reasons:............................................................................................................... ...................................................................................................................................................................................................... Date PermitNo--------------------------------------------------------- Issued... .................... Date No. _................... V Fss...............�. ...... THE COMMONWEALTH OF MASSACHUSETTS ..N BOARD OF HEALTH ...............OF....... t11.? ,n-• f , ..t,.,L............................. Appliration for Disposal Morks Tonotrurtion thrutit Application is hereby made for a Permit to Construct.,,( or Repair ( ) an Individual Sewage Disposal System at: ' ........... ... . . Gt s3: 6.3 . (" / Location-Address /, or Lot No. .? ieA�/.; _!r_!s ✓, -t r t ". _..._ !�a e(^.ram-_..... C . .L .9__G.C_ /•', _ - �, .....••. •••• ownn t,1 Address ov .. Install-- Address ,Type of Building fs+' Size Lot.__ .. ! ---I....Sq. feet Dwelling No. of Bedrooms..........r: .................. .....Expansion Attic Garbage Grinder PL4 Other—Type of Building p ( ) ( ) fp.%. ' -_____ No. of ersons__.______._7______________ Showers — Cafeteria CLIOther fixtures ...................•----._._._......._..__...--=--•--••-••••••-•-- W Design Flow._ ....... .................gallons per person per day. Total daily flow............... ....................gallons. WSeptic Tank—Liquid*capacity =%t!%...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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1L...9`__...minutes per inch Depth of Test Pit____j_.�- Depth to ground Water......... ? . Test Pit No. 2.:: !_minutes per inch Depth of Test Pit......!_'__.......... Depth to ground water............el.__.__... ................................. .......................................................................................... Description of Soil----------------------•----------•------....._..--------•---;;..---------------- �-�a-:�----== '--`=-- S`•�. .-------•-•--._......--•------------- _ w U -•• ;% ----------- ---------- -------------------------- -------- ------ ---- .. . �'�' ` r �::__.'--''�_ — W -- . U Nature ofARdparps or Alterations—Answer when applicable..............................._................................................................ ..•--_.. Agreement: y w The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT:.,, 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......./ ". .... ........ ' ... f... :.....!_ � Date ApplicationApproved By..... ,....-•---....-•--•--•-••--.........-••---•-•••- .._..•- ........................................ Date Application Disapproved for the following reasons________________________________________•___________________•______________________-_-__......_________.-_..._._ .........................................•---•---...-------------•-----•--------........---••--------•----•----••--•----•--•---•••---••••---•--•--••••••-••----•----................................... Date PermitNo... ......................... Issued....................................................... Date - -"` r t THE COMMONWEALTH OF MASSACHUSETTS �BOdRD OF HEALTH ........y�l..!i 7)..............OF.....LL��.�t .t .d; ! �.'...1.�.1:..�.:�..L ................ Ter ifiratr of; Toutpli anrr THIS IS TO CERTIFY, That the jIndividual Sewage Disposal System constructed (.� or Repaired ( ) Installer at............�._............. ..-•-•• -`✓ ° �j� c-, ." 1 t < t f . has been installed in accordance with the provisions of _ 5 The State Sanitary Code as described in the application for Disposal Works Construction Permit No 7y__:__:� 7______________ dated-----y/-2_��..6.---- ------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL440T BE CONSTRUE® AS GUARANTEE THAT THE SYSTEM WILL UNCTION SATISFACTORY. — ..2 DATE............. ,Z 4•-•- ------------------------------------------ Inspector........ =�{. .............. THE COMMONWEALTH OF MASSACHUSETTS �J BOARD OF HEALTH I./ .?............OF.... 1:.1. 1 -: r ,::;`�..... _.-............. d't/ :..-/.. FEE... Disposal Works T otr ion rrutit Permission is hereby granted......... / p� ---.- - -•- = ........................ to Construct � or Repa�ii,,,( ) an Individual Sewage Disposal stem s' atNo Q..... .... = ._ ._.... ----••••---------- ------- Street as shown on the application for Disposal Works Construction ,Per • No____ ____________ ated.._J-1_------y'7J�._..._.._. +� � ...... "t-- •• --._._...-•••--•••_••--•. Board of Health DATE-----J't------ �----....(------•--------............................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 3�1 f_ f f E �y C T 9 , G e , 0 w , ' r� -t` r:: !. �'r �+'��1fi, �y,�..� .. y!1 *, '. ] y y ,. � ♦ s T, r i � .�: � : .- � •��, _� 4jlTf �� e ^ �/^","_ �'/F h �fey+. �� � Na 44 NO 44 Are ID 40 Ye r ... -) t .' ✓S�r f c' c c .11'-E Z f 0 W z>s3r i ip IAIS IW,( A// tj V i-I 734/14,wA�r;,- r2a,�q c k L�Mkjo'J-7�5 y t a-' 0K'�y�!T� ." �•. � , �' f'YVT -�'+�.�r'G�'..z, 4.._ S _pi, , ,) j._.�^'� �4y��7 y�Z�y 25{6.r f l:' :117 4 -4!ln� • f +4`'��,b 1++' '3 ?�.A Ahi�•aw.`f. a a'� c '.y„ {' .*C .. F`'1� ry �" ,.yam�J''� ��+�• /� J � y,yy✓'; �y �J 4'�t �'+ �/� .yam J� p y _ �l�.s rr..�'/-' �'vJ�/•�».� •J�� '�w#�"f fi R+w .7.�T',- • •.�.r .,—rl l + :/ iLr(,l`.•f' f l"�Y' �q, r 1F l�'y\yr!' !'"M" "' i •.f `s r _ _ a• v .} .�r�y'�, y,'+�f+w• 7 I �,/� ` S, 'r' •1 :1 '4 v ,. ' G,.4•'.'• .� �'kr'l sA-• ! �/ {-/ �7 � � �fV' Y,' ��•. .7►.�' t, f?'*+'"���d F•.-. - _ ` '. 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I� ti D} \ inv.a _6;'c'rush�d �3 Z`� v -D Y`o \ � y �� cja/, t sfon base inv. e% inia/. a fic fan �.3: / { l7 inv. e/. - �� --- • "! �t'o „crushed„stone , b0.se.,•. disf. inv. /. �.9- /G- "`*_ ground wafer f-o L/e elev. 4 bo#oM fes-/ hole- a/ev _ SEWAGE- SYSTEM PP-oF/LE -- /lot fo sca/e its l �\ 111:7 k O ! \ "i LD C S/G'N 0197-109 --3 AI MBE/e OF BEDROOMS : T ST H L o G GApSIgi /SPOSAZ_ TEST OATE / C)UN/T /U h� T0Tfi EST/Mf�Tar3 FL W Gt//TNESSEO GAL./812.IDAYx _ PE-PCOLAT/OA! 12ATE :"� Z- M/AZ /NCH ,/ ) R EQ• SEPTIC TAA,/k CAPACITY: O GaL. J'-�IOL E I HOLE P- /��' e� --6'k "f �`\ tgcTUAL SEPT/C TANk Siz E : l � GAL. e/.= 7O,Z 4 e- EAcHARE- , /A/G A�2E AJT.S :.s � Z 23.s 2 GAL. ,r � �� ► �a���l 70 \ 7Z + B®TTaM _ I ; c 7 707-AL LEACHING CAPACITY_._ I ► 33a. GAL. lt� (o Yj l b8 C)� ,� . \ l� i2ESEP-VE LEACH/NG CAP /TY GAL. ra 9� AJOTEs 5 r� s / Z�e- L i2 T/ TLL=�----- ! � ALL W0�2/�MANSH/P ANO MATE2/ALS 1` SHRLI. GD/VFO12M To .E./? LE � J 9 AND THE To%VA/ OF � RULES AND e E G UL P T/OV S /Z F0�2 / ' SUB SURFACE O/SPOSAL OF l SAiV/ TART- SEWAGE. �� l 2� GOMPL/BINGE WITH ZOA//A/G R&GULATICIMS Aq/ E D �0 BE DETE2 BOJNG IJVSPECToP / C0MfV7ISSIONER. /ST�A/G AiND F/IVAL GRADES SHAL L �E O ! MAN ESSENTJALLY THE SAME, - T7�E ,Lo� I1TE APP/eovED :.q D UT t� a 17'� -c���cc.�r►� �� cSF WEQ /�/VAS•�' �S�'�/C � B D. O F H E A L T H _ B�2_7r\(S � c cis c �,�/E A IO2 70 10A1 AGENT �S P Li P2 POSED G Ow ST)e UcT1oIU z a 5 L o c A T l o A/ : Iti-� C 1 GvS S /TE Of PLAN �' EFE�eE /vcE : 4 v d �� S c 0./e : /" D • S C A L E : S Sh�OLI>�l./ Q A T C— : Z D� ��t1t�k OF�qs�� Y LEGEND / o c z DAVID B. y U ' e iS-h S of e%V. - O.O MASON m O �yP' existing conf-our = - —— =- — — l�,/D cSV2VE / / Ifa.1066 a - 4tfp• prop. fin. Spot e%V. - o. o r� GJ� / /Tl �'• Y'/� e/��' �/Y `��IsTEP� prop. fin. contour = o 0 i L o c AT I oN MA -test ho/e location c,p��} j z W SCALE: /N = wo ��© ' /�c3Z �s�� • r_,