Loading...
HomeMy WebLinkAbout0035 JENNIFER LANE - Health 3 5 Jennifer Lare Hyannis - _ -- -- 0 ° }I ° { ° Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: When filling out A. General Information C r forms on the J I J 3 computer,use `-s, 1 only the tab key . Inspector: _._ a: to move your DOUGLAS A. BROWN "�E O ��� cursor-do not use the return Name of Inspector ~I y -- key. DOUGLAS A. BROWN INC CID Company Name P.O. BOX 145Cn Company Address CENTERVILLE MA 02632 mod"' City/Town State Zip Code 508-420-4534 S 14297 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 10/16/08 In a I'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. II Title V Inspection Form.doc•08/O6 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '( 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: SYSTEM ONLY 3 YRS OLD VERY LITTLE USE B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if.a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced t ❑ obstruction is removed Title V Inspection Form.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owners Name information is HYANNIS required for MA 02601 10/16/08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a 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. Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS rey uired for MA 02601 10/16/08 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well"*. Method used to determine distance: '*This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Title V Inspection Form.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page,4 of 15 3 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS reg uired for MA 02601 10/16/08 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® 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. Title V Inspection Form.doc•0a106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form - Not for Voluntary Assessments '< 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. Cdyfrown 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)] Title V Inspection Form.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. City/Town State Zip Code Date of Inspection 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 Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): 07-96/08-104 Sump pump? ❑ Yes ® No Last date of occupancy: CURRENT Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) I Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? . ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): Title V Inspection Form.doc•06l06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. Cdyrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: 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) ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): _ Approximate age of all components, date installed (if known)and source of information: I INSTALLED IN 2005 ACCORDING TO AS BUILT CARD y Were sewage odors detected when arriving at the site? _ ❑ Yes ® No Title V Inspection Form.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS reg uired for MA 02601 10/16/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 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.): Septic Tank(locate on site plan): Depth below grade: •5 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: 1500 Sludge depth: TRACE ' Distance from top of sludge to bottom of outlet tee or baffle +..r Scum thickness 0 F Distance from top of scum to top of outlet tee or baffle, ,i Distance from bottom of scum to bottom of outlet tee'orbaffle ' How were dimensions determined? WOODEN POLE ' Title V I+spection Form.doe•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 'e 35 JENNIFER LN Property Address w DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every 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.): TANK IS VERY CLEAN AT THIS TIME Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene El other(explain): r Title V Inspection Form.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 JENNIFER LN Properly Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. Cdyrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) 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 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.): BOX LEVEL NO LEAKAGE Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Title V Inspection Forrn.doc•08/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: NO OBSERVATION PORT Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 1-22.5X20 ❑ 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.): Title V Inspection Forrn.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Title V Inspection Form.doc•08/08 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent.reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. " 37 z - 3O �5 3LI '13 I ' I7� I z I? 3 " 2LI 'N ! k •( r Title V Inspection Forrn.doc-08= Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 JENNIFER LN Property Address DAN WOOD/J GROUP Owner Owner's Name information is HYANNIS required for MA 02601 10/16/08 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to ground water: AT LEAST 5' 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: Title V Inspection Forrn.doc•08/06 Title 5 official Inspection Form:Subsurface Sewage Disposal system-Page 15 of 15 7 — ' TOWN OAF BARNSTABLE ' LOCH .GNN �/�/t/ �! SEWAGE #2605 S Jq VILLAGE ASSESSOR'S MAP& LOT 70 a. 33 INSTALLER'S NAME&PHONE NO. i�///�r!'I SEPTIC TANK CAPACITY LEACHING FACILITY: (type) aZ.EACIV ai i 4 BF-(10 (size) NO. OF BEDROOMS MILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation'Distance Between the: ' —Maximutn 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) C Feet Edge of Wetland and Leaching Facility(If any wetlands exist Within 300 feet of leachingfacility Feet Furnished by i f � _ t r. � � 1 J r No. goo Fee!_) v *, THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASS ACHUSETTS 01pplication for Mi5po0a[ �&pgtem Com5truction Vertu Application for a Permit to Construct(/Repair( )Upgrade( )Abandon( ) E)Complete System El Individual Components Location Address or Lot No. �s Owner's Name,Address and Tel.No.P Assessor's Map/Parcel . Q etc Installer's Name,Ad ress,and Te o. ,.. Desige .�d�r� dLTglrD` S 42 C�E jQRY,tLA1Vy 1LWNJTH, IA CRQ0W Type of Building: Dee ^--f r,�` Dwelling No.of Bedrooms Z,_ Lot Size Z 3 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow -z•Z® gallons per day. Calculated daily flow gallons. Plan Date c Number of sheets L Revision Date i iv-- Title Size of Septic Tank Type of S.A.S. os=� Description of Soil !E�;b%� Nature of Repairs or Alterations(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 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by t :s Boardof Heal r-- Signe Date Application Approved by Date Application Disapproved for the following reasons Permit No. ao ^ —53 Date Issued /0 .''�'. ti•z\ _ ♦ • t• '!1 mT �F '.y'�..,,--rj' .. `�. r .,x �l,,'r�-+' .., 'p'.,-«.r r. �•.. � -84"Rq/;•a...w. o., Fee ,�,• .� I - ems' , THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: i PUBLIC, HEALTH DIVISION -TOWN OF.BARNSTABLE, MASSACHUSETTS Yes 01pprication for 3Diq; ogal *pgtem Construction Permit Application for a Permit to Construct(V�Repair( )Upgrade( )Abandon El Complete System ❑Individual Components Location Address or Lot No.' Owner's Name,Address and Tel.No. Assessor's Map/Parcel � Installer's Name,Address,and Tel.No. ;,'Desi EAST FA MOUTH,MASSACHUSETTS 02536 9 . /kj-0C-L) s~ 1%�//�S ,{ !i ut 508/540-2534 Type of Building: / f Wi Dwelling No.of Bedrooms- Lot Sizem sq 'ft. J Garbage Gender( ) Other Type of Building No. of Persons .2.1 Showers(`i ) Cafeteria( ) i Other Fixtures Design Flow •�-2 go gallons per d'ay. Calculated daily flow z!:5rz gallons. Plan Date Number of sheets Revision Date � �� gi 0�0 Title, 1 Size of Septic Tank Type of S.A.S. 4; -•, Description of Soil ` r �t + Nature of Repairs or Alterations(Answer when applicable) o Date last inspected: Agreement: `The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- ?� R c+te of Compliance has been issued by this Board of Healtpl ^` Signe Date '-- - ''Application Approved by Date /0 Application Disapproved or the following reasons _ Permit No. Ply� - s: L Date Issued 4o -�2 I - us` -------------------------------------- i COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance r~ THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(X)Repaired ( )Upgraded( ) Abandoned( )by at a ✓► has been constructed in accordance with the provisions of Title 5 and the forbispos System Construction Permit No. _ dated n -�/ Installer f Designer The issuance of this perrru,Sh m not be construed as a guarantee that th syste f s designed. i Date / Inspector No._ 2 6/0 6--- Fee I --THE•COMMONIii'iiEAL'i H-Oiy PriASSACHUSETTS -- - PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ai!5pozaf *pgtem Congtruction Permit Permission is here'y granted to Construct( �Repair( )Uan g_ - � ad An( f� p do 'aTCSystem located � ) and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this perrru Date:_ _ Approved by I . l _ - Town of Barnstable Regulatory Services • Thomas F.Ge7er,Director • a�xr�rears t 639. Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&D'esi er Certification Form MA ii-- z�� —►Z 1�- ]Date: Designer: : TES Installer. f�SSU�►.u `�i �11� VI. .. Addy--ss: 42 CANTERBURY LANE EAST F'AIMG- ,uecceruiISEIISoaa3B Address: 8/540-2534 50 �j On_I O -Q S `r It I / was issued a 't to install a (date) (i�_Ilei l t� septic system at 3 rV_VatT—'!,:I17' LA N 1 based on a des; drawn by -' (address) ,' o z .1 _ dated -- (d— esign�r) c > I cer+ -, *t,-* the septic system referenced above was installed substan ' y according to the design, which may include minor. approved changes such as 1aLerallocation of the distribution box and/or septic tank. _ -- Germ' '' �+ the septic system referenced above was installed with major changes (i.e. great;,. 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 as-built by designer to follow. BRUCE G. cs PHY Sta1r^r'S Slgnature) v NUR o.749 JSTE��� S"AUTPO 01, (Designer's Si ) (Affix Designer's Stamp Here) PLE,'_77 --TJRN TO BARNSTABLE PUBLIC.HEALTH DIVISION CERTIFICATE OF COMPLIANCE WELL NOT BE ISSU1 -Uhfl'IZ .'$ I'.�s ffi 7FORM ASJD AS BUILT CARD T ARE RECEIVED BY THE BARNSTABLKPUBLIC HEALTH DIVISION THAI`r{ V U. 0: HenlrhJSeptic/Desiper Cati6cation Form . X �. o i /•i '1 1, .71 kip Al \ 1'� yy�e��ts'1k r f /r 'f.3• ', 'i ti aY 1y,�f�'�, ' �••• ��� �!'. c ,, :fi'�Q�;fir '��' , �i;, " •'�� .. . i ��-��a4� f , ' .. •'ter /;: :..• .�j�� i --------------------------- Al t� r q o vo - N LAW OFFICES OF ALBEIT J. SCHULZ WILLIAM CHARLES PLACE 7 PARKER ROAD OSTERVILLE, MASSACHUSETTS 02655-2034 TELEPHONE(508)428-0950 FACSIMILE(508)420-1538 ALBERT J. SCHULZ MICHAEL F. SCHULZ aschulz@schulzlawoffices.com mschulz@schulzlawoffices.com October 13, 2005 Town of Barnstable Board of Health 200 Main Street Hyannis, MA 02601 RE: Jennifer Lane Our File: 21562 Dear Sir or Madam: In connection with the applications of Daniel C. Wood for building permits for Lot 5A (41 Jennifer Lane), Lot 6 (49 Jennifer Lane) and Lot 28A (50 Jennifer Lane), I enclose copies of the following instruments: 1. Deed Restriction for premises at 49 Jennifer Lane dated September 1, 2004, recorded in Book 18997, Page 312; 1 / 2. Revised Deed Restriction for premises-at 41 Jennifer Lane,,dated October 7, 2005, recorded in Book 20362, Page 238; and = a � 3. Revised Deed Restriction for premises at 50 Jennifer Lane, dated October 7, . 2005, recorded in Book 20362, page 241. -_ -" • These restrictions have been reviewed and approved by Thomas McKean. , If you have any questions, please do not hesitate to call me. Sincerely, s c-� ry( r•' —i Albert J. S z 1F AJS:cg ;=; Enclosures �.; ;•, cc: Daniel C. Wood e , r� Bk 20362 Po238 -71924 a: 10-13-2005 of 03 = 18o 21562-37.res REVISED DEED RESTRICTION WHEREAS, Jeffrey Pepi is the owner of a certain parcel of vacant land located at 41 Jennifer Lane, Barnstable (Hyannis), Barnstable County, Massachusetts (hereinafter referred to as "Premises"), under a deed from Dorothy E. Scott, dated October 17, 2003, recorded in Book 17813, Page 95, which said land is shown as Lot 5A on a plan of land recorded in the Barnstable County Registry of Deeds in Plan Book 602, Page 84; and i WHEREAS, Jeffrey Pepi has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit from the Town of Barnstable Board of Health and to obtaining a building permit for the premises; and WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to issuing a permit for the installation of a septic system on the premises and authorizing the issuance of a building permit for the construction of a single family residence on the premises requires that the agreement for the restriction on the number of bedrooms in any house constructed on the premises be recorded with the Registry of Deeds. NOW, THEREFORE, Jeffrey Pepi does hereby place the following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. 'The premises may have constructed upon the lot a house containing no more than two (2) bedrooms, unless an innovative/alternative ("I/A") system is approved by the Board of Health, in which case a house containing no more than three (3) bedrooms may be constructed on said lot. 1 . 1 21562-37.res This restriction shall continue in full force and effect until such time that construction of a residence with greater than two (2) bedrooms, or three (3) bedrooms if / alternative/ / ("I/A") an alternative system is approved by the Board, is allowed as of right. THIS RESTRICTION REVISES AND SUPERCEEDS THE RESTRICTION DATED SEPTEMBER 1, 20049 RECORDED IN BOOK 18997, PAGE 308, WHEREIN THE PREMISES WAS INCORRECTLY DESCRIBED AS 37 JENNIFER LANE. IN ADDITION, PARAGRAPH 1 HAS BEEN REVISED TO INCLUDE THE RI T Innovative/ A,'�O CONSTRUCT A 3-BEDROOM RESIDENCE IF AN / �/ /ALTERNATIVE SYSTEM HAS BEEN APPROVED BY THE BOARD OF i HEALTH. For title of Jeffrey Pepi, see the following deed: Book 17813, Page 95. Executed as a sealed instrument this�_day of October 2005. Jeffrey Pepi 2 _ i iz`�`a•44 'x's; »��� h c Aar' � 'A L:T,. ►r ew y F 3A' " iYr v' " ..,..,..�.xaw"` 4ieF u. ..aLLiFB;•^ a b. *;' _ c P ��.'.:.,7 21562-37.res COMMONWEALTH OF MASSACHUSETTS Barnstable County On this day of October 2005, before me, the undersigned notary public, personally appeared Jeffrey Pepi, proved to me through satisfactory evidence of identification, which was Wr 5�r-k - rssucd driv«'s )I c-c-vi sc to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose. of ublic Cheryl K.GruensWrn My commission expires: Notary Public My Commission Expires:02123✓07 3 �`t �.`J t1-• .� ,;. ;fix ,�,;. 16 B k 20379 PS 257 73238 r 10-19-2005 a o9 = 44a 2156249.res CONFIRMATORY DEED RESTRICTION WHEREAS, Melbourne K. Nickerson and Jeffrey G. Pepi are the owners of a certain parcel of vacant land located at 41 Jennifer Lane, Barnstable (Hyannis), Barnstable County, Massachusetts (hereinafter referred to as "Premises"), under a deed from Vivian Walton, dated April 8, 2004, recorded in Book 18515, Page 172; and .WHEREAS, Melbourne K. Nickerson and Jeffrey G. Pepi, as the owners of the premises has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre- condition to obtaining a disposal works construction permit from the Town of Barnstable Board of Health and to obtaining a building permit for the premises; and WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to issuing a permit for the ins tallation stallation of a septic system on the premises and authorizing the issuance of a building permit for the construction of a single family residence on the premises requires that the agreement for the restriction on the number of bedrooms in any house constructed on the premises be recorded with the Barnstable County Registry of Deeds. NOW, THEREFORE, Melbourne K. Nickerson and Jeffrey G. Pepi do hereby place the following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. The premises may have constructed upon the lot a house containing no more than one (1) bedroom. This restriction shall continue in full force and effect until such time that construction of a residence with greater than one (1) bedroom is allowed as of right. I i l _w 21562-49.res THIS CONFIRMATORY RESTRICTION CORRECTS AND CONFIRMS THE DEED RESTRICTION, DATED SEPTEMBER 11 2004, RECORDED IN BOOK 18997, PAGE 312, WHEREIN THE PREMISES WAS INCORRECTLY DESCRIBED AS 49 JENNIFER LANE INSTEAD OF 41 JENNIFER LANE. For title of Melbourne K. Nickerson and Jeffrey G. Pepi, see the following deed: Book 18515, Page 172. Executed as a sealed instrument this )� day of Octo 2005. Melbourne K. Nickerson Jeffrey G.'Pepi COMMONWEALTH OF MASSACHUSETTS Barnstable County On this itday of October 2005, before me, the undersigned notary public, personally appeared Melbourne K. Nickerson and Jeffrey G. Pepi, proved to me through satisfactory evidence of identification, which were �cch� to be the people whose names are signed on the preceding or attached document, and acknowledged to me that they signed it voluntarily for its stated purpose. Notary Public Cheryl K.Gnmstem Notary Public My Commission Expires:02/23/07 My commission expires: Bic 20a79 F's262 -Cr-7324i) . 10-19-2005 a rj9 4 ov COMMONWEALTH OF MASSACHUSETTS Barnstable, ss. Probate & Family Court . Docket No. MELBOURNE K. NICKERSON and ) 05E0077GC1 JEFFREY G. PEPI, JR., ) Plaintiffs ) VS. ) VIVIAN WALTON, ) �V ) Defendant Z JUDGMENT attached All persons interested having been notified b/w, and in accordance with an Agreementf-er-Judgment, dated September 27, 2005, between the Plaintiffs, MELBOURNE K. NICKERSON and JEFFREY G. PEPI, JR. and Cynthia M. Bourget, Esquire, as Temporary Guardian of the defendant, VIVIAN WALTON, as authorized by decree of the Barnstable Probate and Family Court entered on September 22, 2005, in ILI, Docket No. 03P-143 6-GC2, it is hereby W a. ORDERED and ADJUDGED that the deed from Vivian Walton to Jeffrey G. Pepi, Jr. and Melbourne K. Nickerson, dated April 28, 2004 and recorded in the O Barnstable County Registry of Deeds in Book 18515, Page 172, is rati ed and confirmed. N QOctober 2005 4 +BUF.WPY ATTEST: REGISTER F 1 Bk . 203 r"9 Pa 2-59 �73239 10�-19-200 5 a 09 2 440 21562-37.res CONFIRMATORY REVISED DEED RESTRICTION WHEREAS, Jeffrey Pepi is the owner of a certain parcel of vacant land located at 35 Jennifer Lane, Barnstable (Hyannis), Barnstable County, Massachusetts (hereinafter referred to as "Premises"), under a deed from Dorothy E. Scott, dated October 17, 2003, recorded in Book 17813, Page 95, which said land is shown as Lot 5A on a plan of land recorded in the Barnstable County Registry of Deeds in Plan Book 602, Page 84; and WHEREAS, Jeffrey Pepi has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit from the Town of Barnstable Board of Health and to obtaining a building permit for the premises; and WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to issuing a permit for the installation of a septic system on the premises and authorizing the issuance of a building permit for the construction of a single family residence on the premises requires that the agreement for the restriction on the number of bedrooms in any house constructed on the premises be recorded with the Registry of Deeds. NOW, THEREFORE, Jeffrey Pepi does hereby place the following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. The premises may.have constructed upon the lot a house containing no more than two (2) bedrooms, unless an innovative/alternative ("I/A") system is approved by the Board of Health, in which case a house containing no more than three (3) bedrooms may be constructed on said lot. 1 w 21562-37.res This restriction shall continue in full force and effect until such time that construction of a residence with greater than two (2) bedrooms, or three (3) bedrooms if An alternative system is approved by the Board, is allowed as of right. THIS CONFIRMATORY RESTRICTION CORRECTS AND CONFIRMS THE REVISED DEED RESTRICTION, DATED OCTOBER 712005, RECORDED IN BOOK 20362, PAGE 238, WHEREIN THE PREMISES WAS INCORRECTLY DESCRIBED AS 41 JENNIFER LANE INSTEAD OF 35 JENNIFER LANE. For title of Jeffrey Pepi, see the following deed: Book 17813, Page 95. Executed as a sealed instrument this day of October 2005. z Jeff ey Pepi . I 2 ` 21562-37.res COMMONWEALTH OF MASSACHUSETTS Barnstable County On this IW day of October 2005, before me, the undersigned notary public, personally appeared Jeffrey Pepi, proved to me through satisfactory evidence of identification, which was oJn� -/,j54c d pt c-h4 r e lI cc)�S r to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose. I of' ubll Cheryl K.Gruenstem Notary Public My commission expires: My Commission Expires:02/23W 3 G'+ st ' J=o 1 33 � •1 i ' . . .. . . .., . . .. . .. - - .. ...... .. .. . - - z._.. .. .. , ..... ._ - ... .. ,4. .. r . .. .. ... . .. _ • :. r.�:.- .. tj j' . V`J,:' . . . - i..: �. _n 11-4 : .. . .•, .. - - - u „_. _.t . : . . . ^ t - �.+ , .. r. �: :.. ,.: . .. . ! p.. '�. .., - ;:: % .. ,. r. .. ,t. .. .. .. .t "�C .: .,, ,. .. :5:, , . . . r w . f ... '..::. '.4,. v, ..._ ..;._. .. - . .: - .. '' - - - . . : . . ' - .. .. - _ I. .. :. , - , :+.,.; I - _ ;: ::: -- - ;'�. _ �,••. .. - !s . .. _ t CUt:4 :'�:. '. ., . 4. . .. .. • .:.. _ .. i .. l: .. _ E• 1. 4. - t. :.Y, 1 ! Pi::: y} - . I i i y:. ...,.,.r .. ..,: _ ..,,.. - ' ..C'•' z. . :: .. r. ._ - __ - - _ - .. .i:pt.:.IZ.: .'7re.' ':Cc,�:a`tawa-..^. 'atti•=.� ... • ' . ., i __ .. - .. .. ; _. Or _ -. -�1' .. �.' 1... .., .., .: , 4. - . . .1 .T.I. I I ... .. M1... .. I. 4. - - .. .: .:� . 1 Ix . '�' _ .. , , , -. I .. .• ._ i _ _ . . . - _ li ... . : ' .. : �. _ r • 4. . ,�� . . jv,., . . . ..I � . .." . :�� . . . � . .- .. , ... . . . . .. 1. ;n: _ : ��"�� :. �k' :f:4 I.is a• :Z ^T ":1'. ' _ 1 • '. i K yyyy EfEt'E'D'YAG` . J .i� 'S'• 1..:.. . .. .. 1. .i:¢.e'�.:f• ^-':fit•?�:' . .. _ ._ . ..- .. .. ... .. .: ___ _ _ _ ._ .._ —_ __ ._ _ _ — _: _ .. ._. .. 4. , _ 1 .... ..,. I. .. - .,.,< - `,-•r" -..._ -: .a .., ... .,... ...,c, .., .. . . _ .. .. ' a: +A_ ,¢.: :.6 : .:=•.. .. eft _-..__-...�_......... ........._. - gc 11 _ t• . .. ; F',. ' - - 4 ::..... .. _ :. . . .. � . . . :- .... .. rr.• r•n,. is. �: , . .. - - r.. .. .. 1. �,*,,., t I: , F. . ..r 4 . , .. _ :y '•' _ .. �.<,`_7 v' 9.-• - 'ra o• . . . ..- - '._ i. .._ :ti .,:. .., .: - t : .: - _ 1. , + ... ... - y .. . _ I. ..- ., .': - �: a ro ..., -.I. % Y �_ . .- . , : . a. I . tin ;,.. a. Ali 12 f...., .. -- _ :,. + .. 'D L ; _ I . yyfn ... ZC•EdE. ... . . ... .. ...:, ., a .; _. .44'. .� `-1. ... .'. 1 - -. ... .... .. _ -.. ... .. .. .. _. _ ..fir,•'`.' n`r" .. c Ill .•. .. .. .. .. _ r _ ... _. . . ;:I _ _ . 6'GY52IIDALC .. ♦ . ... .:. .....,. .. . .. �W... - . .f -•w ... Ig ...- '.r. ..., .. 4 % ,. ,,-, .. f., .. Wit._ r. y. '`.:,:. :La's,•• 4. R it tw - :,,-. a i148- - -::- ; �� �. c 'v 7..- -1 .4 _.. - .3, .i f ,a� I. .. ice... • �V., :.i '�. ..,/ -}. r. Vr. ;.fir 'w;:, r.. J. n., Id 1 a �' !�l ^ev 7 r. d E%v a. .:e `` r V< iJ 't iy;: �: - - "mot'' ti.. _ � s b ,;c .:w� .s^ .=?4 :! r C. is r - C.- yl• / . S. �5 s2 :f�• _ �. r' . iw. ,� i i .14 kya t`:: y., 5 1 :E �tf: 4 6PP .. „ - y f: �-i~e�' - E'er t - 1,; _ i r..' v._ ... s; r 5 .t .. _ -Rye\�_ r�. Li,u {:..: r; : _ ti f{•i ., . . . . , . . :j_; .�_;:: t 1 all- 1.4 ' r. ,�. -. .. - :r - 1 .. .. .. ". f•::Y•'i_'y.:. . j. �al i /..• ..:: Y 'lv:•w _ - .. ... a.... J— ,.!. .. ... l 1 : , 339 -- -- - - .. _.._-._-.1- DBL 4. r.�- `.. - .. .., ... - f , -.. )� ';. . c .1.1.-�.-II.'.aII!+..�.."'... -..�'�.I.....�,-. ,.'.,'.I,.'...... .- . - . .—�. .. ., . ..I... I --... * .. . .. . I .11 I I . I-........ :.....I.-�.......,,.I.,�,w....-� !.,.-,....-..:..�.i t.-.,�....'-.-.:....-,-.,-....-:. ...-.,.......�%.,. �.—" .-..- ,:.-..�-,--.,. :. ',..�.'---.---.,�.."..,,.:..,,.0,. --�..:..,,.-.,.r..",;.O,�.!,:,�.-...-,:_....-,.,1-....1..1�.-. �I CST:FLCOIL.VLdEf1 ' . .. 'tti%" r. �.r >. .. x.. is t .. - :. ._ " '. ... . ....:... ... ..: .. ,. _. f...c,,,:.. . .. ,,•r�.. . .. .,.. •.:.... •vi:'-ei n' "i;VS .:3Y.�S!. .�IYi:' P.!►ea,.�.,.�;. .a+E'i`:tly.•1-,iWftoUF .. ,..If t �': _4 iaL'°.. .,R, >�t,+�ml`,3xals ,.f.� -f i �,. .,.r •., 1 ( i?.: n k'i' lii !: -' t: ► a Ea:. .,...:.I.,*,..:.�.��...1.-,...........I.,,.-....-:!I:.::..w.:...�....-I*....�...;.....,...:.;...,-'...-��,�...-i:;..—."*..I...�..".....:._-!l,..I.k.,'.,:-.�..1.....---�''..-....I..s;.:...!.:...!:......l� .,..."....I..-!.:;-.".....-.:.:,T%,..::..:-:..:Ii.....-,.:....I'll,....:'�I.Il,.-.:..'"..:I-!...:,...;:.4. ...li..1�,�-.i'..,.II,..f:.1"..�-."-­.....,.�,.i......I,.�"-�i:1.-.1�..I..�....;.,i..-.:-.��1,�:--.�... r; j.i ;J 5e1 I. k, r ` i; . ;el :r' ir.a �� :, t' 4 4 :. ,, ..� . .. .. r.: L.A . . . a . . 1 - .. - - ..`:i.:T.': Ii..Y't:: . t:, I. -'r : :.r:.'; . .•,.' ; . . , . .,1 .l 1 : j i :.:1 :r i?:..: { i '• i ,V. r,:e.. :'.,t.. r i I Y .:j.:., _ ., { t - - 1 . J'.f' f if.. 1 l.':.' , l r i' ii : y-,, %a" 4 5', r i!.' '1' ..tS-~ v. 1.!. !".':'' h' . ti.� :v. . .4, .--.-r_,:S}. ~ .. .. _ .d_ii. l: }-2Sit:;'r+ ::'i' '-¢•:.�:1 ... . �' - ., . :{:' y .�... ! " r T .:''., t:• . x':+ :: �e. 6).'. , .. a ".I +.:•.,: :Y,' .,. .. .. .. + I 'J: .. ... - .. . y, . :',: , .. _ .1 - L. 5 y.' ; ,.1. 4 ,, .•t '' '1 .. itI•' t. I , v 1n t _ < }:, 0 T 1. n ` 4 t y,1. r' ",'j. L"• . ..:.,.;.,..i7:.I-4.--..:...?..:.,.�j".-.I.:...-.:.,...:..-�.,..p.::...�!I.;,...,,....-*.-.....t:.,.-.,.,.-..�....:.0,',-....,.:..,I:.... } Ii '11 c { 'i. I. }( 1'% d :I I a.r :YI .J ~ II I I' -T" ... ' Tj:, t ' L:ti,I J `..,�., ` rl1Ir.. ',. .. ' .. . • ' } ,, 4 . . .. t•:, ..f...': V. •'i:''. 2 1 �:. I ' 1.. .. ... _ h:C,. ;. ;, ;trr.-' i. m fI. : ::;. .:::�: :P... I i 11i , .:L.iL :• , :i .s .I 1. .::..:;: : .� , { 't. 't ( :i' i. 1. I I` 1 1 4 I 1 1 .; ' 1 .t — i Ii •i a.l:jll,• '"111 'l>,. ' 1 'c[.. .:o.' iJ . e , I.!'.�' 1' .ice J.I' .ff`.� 11'' I: j' 1 irr:: ' 1' � ,Y. :i i1 C n Cp , 5k` t Xav ^.�, 1 t I r i.. r I I! + !.. :f r T . .'j: ! 1: X r �J FI . If( t ` I.: l y. +f '-�: r4` I }.. .. A::. r t :� I ;. _j l ..- 4 '" .. �L I i i. . .t K:I,•1• .Y'. ( :. 1 i�,'.• Y - .''ice' Irl'I'{'•.'li.:I.1 :r 'I t , is ''t'f.1 .1•. . . ",*,%,.....*--.i....:":....I..�.'.I.*....":..I:r.-..-q,.,...-��--.....,i..,.--I i...�.: ..,...!,...%..-.-iiI...IIr..�.i!*Ima.-:...Z..:. x A t' ,:9 I +Nr� \. ;y,L .k1 ..._- ...... La I •,� f ::11�i 'II I' 1•l i;l�[1�'RI ;, I. ; . ��� .. j, S s 111 J.: '• ; 1 "\ ,-:.j.[i 'L.;i'i 1.11'il:'w 7jI j ! !1� ! 11 I iit(;:1?Ir:i .1'li:' !'11 �'i ,•,.1;I: Iy a,� "Lr .1 J1 r, ii.l '{� �T' ,. i ti+.. =t:'. .;:' , . I ;, . y.; fr T" •, yl . �rl'I - ,�;. ..,I,I . } , G.,. :I. / ! t'jt r. ,'... , k;i 'l L'.•: ''l.-.• . ':: - . N. .o,.M .".Y. _i . . !rI v 4:., .. I ' Top Foundation Elev 41.6' Vi IV, 7_7' 'S, FFnish Grade EL 40i Foundation Design By others 6" 6" nvv,gz nie. RSM? a nia _ 6`'.I I/11I1111 I, Finish Grade El 39.2' 38.70' ® � 7T17TTl El 38, N e . . 1 8 to i V flashed stone O 2" ??hall • El. 37 6' /'-- INV EL sump 3 EL a.d°d' 3/4' - r r/z' !lashed stone - EL 34.1' INV EL 1O Min. 14"a INV EL 37.80 INV EL El. 37.1' 38.35' Below Flow Line/ 38.10' 38.00 ;8", stare 37. T ,Liquid Ley! 48" Bott, Field El. 37.1' q 4 HOLE DISTRIBUTION BOX . . . .• . ,. , ° PROPOSED LEACH FIELD °d°d d a°•a' °° d °' d a dd d' PRECAST REINFORCED CONCRETE DISTRIBUTION BOX 4• °d ° -.-e• 4' 1500 GALLON SEPTIC TANK Install on a level base 6" Max Max I Minimum wall thickness = 2 USGS Ground Water Adjustment = 3.9' Use (3) Distribution Lines at 0.005 slope Minimum inside dimension 12" Length of Distribution Lines - ZY' equal to each other and at USGS Adj. High Ground Water El. 32.1' 1500 GALLON REINFORCED CONCRETE SEPTIC TANK Outlet inverts shall be e q PROPOSED LEACH FEILD - END VIEW N.T.S. 2" minimum below inlet invert. Minimum Construction Materials Per 310CMR 15.226(2) The distribution lines from' the distribution Tees shall be constructed of Schedule 40 PVC and shall extend a box shall all have Bottom of Deep Observation Hole El z5. T equal inverts as determined by flooding the distribution box to minimum of 6 above the flow line of the septic tank and be on the height of the distribution line Invert after all lines have the centerline of the septic tank located directly under the been sealed in lace. Note: clean-out manhole p Remove all unsuitable material 5' around SAS The Inlet pipe elevation shall be no less than 2" nor more than 3" Invert adjustments shall be made by filling with durable and down to the "C" layer (EI 32.7) and replace with clean nondeforma ble material permanently fastened to the line or granular sand per 310 CMR 15.255 (3), (4), (5). above the invert elevation of the outlet pipe. reconstructing the lines until all inverts are of equal elevation. and (6). Septic tank shall be installed level and true to grade on a level, stable base that has been mechanically compacted and on which Construct a 20'w x 22.57 x 6" Deep 6" of crushed stone has been placed to ensure stability and Leach Field with Three Distribution Lines to prevent settling Septic tank shall have a minimum cover of 9': Two 20" manholes with readily removable impermeable covers 44 ASSESSORS' DATA- gout of durable material shall be provided with access ports - - - 270 124 The outlet tee shall be equipped with gas baffle. / FEMA DATA- ZONE IC" Dunns ZONING DISTRICT- RB Pond 42 O VERLAY DISTRICT WP �b Locus i. BUILDING SETBACKS. _4 b TPI - '1. 35. 7' » TP2 - El. 35. 7' » - - SIDE AND REAR 10' $ 0 „ » ' i' , SUBDIVISION LOT 5A °� Fawsetts A SL 10yr 5/1 6» A SL 10yr 511 6» Pond / REFERENCE PLANS.• „B» »B» BOOK 293 PAGE'26 LS IOyr 514 LS IOyr 514 / / ! SUBDIVISION MODIFICATION PLAN �8 30 36 / r �. OF JENNIFER LANE FOR arc 36" / / - �' R 1g,n2 rn SJ cl PEP 60AND KEMPTON MCKEKSON b „C,,, C' p / / / y" 38 - o _ DATE 11118104 REv 07125105 L.O C U,S' MAP MED. 6 MED. / / If 1_ IOyr 71 SAND 10 r 716 38 "� SAND b � us Note. (E � / 2a • usted HGW Ad usted HGW 44 (Elev. 32.1) (Elev: 321) VP��',� ` N g Remove all unsuitable material 5 around SAS ,50''� down to the "C" layer (El 32.7) and replace with clean Pro ter 90" i (Elegy 28.2) Water 98'" •Q• � d D�� °3- granular sand per 310 CMR 15.255 (3), (4), (5). /i N3� S / /� , a �1 and (6). (Eleo 2779 a�et / \ � �,ea GRAPHIC SCALE 120 120 Dra 600 38 'r�' N 30 0 15 30 60 120 .El. 25. 7 El 25. 7 4 has 6` w 36 �,� 36 se 102'f 2, ° ° :.:, y ; . � .� ( IN FEET ) P# 10,653 USGS Groundwater Adjustment.- rn ,-'19 �1' pie o. ,iy' of a,�:ss�n� i inch = 3o ft. soil Log Zone - D co / Deck ;; • cr o aF ti, Performed By.- Bruce Murphy BOH Dave Stanton Well AIW 230 � � 0 J `.... 1 J 14 C STEPHEN L � Adjustment - 3.9= El. 32.1 x .l 1 t 4e PI a n O f Lan d Date: January 30, 2004 cn 3s e' � � � ::s;:;:>: � � DO',!-.E i� � Phposed iy .::; :- NF a Prepared For.• Perc Rate: C2 ANin/Inch a; g� 1500 Gallon yank o See Lots 4 and 5 for Water o t �� '� Adjustment-Perc Date 01/30104 G, $er� / F�� HOUSE 35 JENNIFE'R LAND' GENERAL CONSTRUCTION NOTES LOT 5A F� / "�` In 21130-1-sq.ft. / 1. All the workmanship and materials shall conform to R E:P Title 5 Hyannis, Massachusetts as BK Top CB , : - OF 41, and the Town of Barnstable rules and regulations for the subsurface Mev. s783' " ;•' ' disposal of sewage. Datum: NGVD.t gRUC , 2. At least one access port over tank tees shall be accessible „ ' �k R Scale: 1 30 Date: August 28, 2004 within 6" of finish grade, with any remaining access ports brought / ;, No'749 �' Prepared By to within 6" of finish grade. `\ 1ya �'0335a° 3e �� p y and Associates „ z Stephen J. Doyle ��` `f J'i` '` N 42 Canterbury Lane, E. Falmouth, MA 02536 3. .All components of the sanitary system shall be capable of �M,�,�: ` .Y withstanding H-10 loading unless they are under or -o thin 10 ft Design Data: - - Telephone: 508/540-2534 of drives or parking. H-20 loading shall be used under or within R 4-_ v 3, 3 B 1. © c k � Two Bedroom = 2 X 110 gpd = 220 gpd Required Flow 10 ft of drives or parking unless noted Plastic equals may be No Garbage Disposal used in lieu of all precast units 4. The exca va for/con tractor shall verify the Iota tzon of all site Use: Le 'e1 0' x 6" Eff/Depth utilities prior to any exca va tion, and shall be responsible for �3a [22.5 '2 0. 74 = 33 Tota Design Flow all matters relating to electric easements 6 22 S 5. Sewer pipes shall be 4" Schedule 40 PVC laid at a min. 0.02 slope. Note: A Bedroom Deed Rest1•istion is Required. 6. Any masonry units used to bring covers to grade shall be Locus Falls Within a Water Protection Zone. mortared in place. 1 10-12-05 Revise Ise Number 7 Finish grade shall have a minimum slope of 0.02 ft per foot. NO. i DATE i DESCRIPTION