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HomeMy WebLinkAbout0087 STERLING ROAD - Health 87 Sterling Road *, Hyannis A= 268-162 ; r OF Bf TaTABLE ]LOCATION ?-----�---�� •L SWAG ;'# -�- VILL, �nE Grl t C ' t��"5ESSATZ'S:MAP d'i nITY LE '1�AAIII"x"Y Mo CSC BSDROOMSs . i414 �. etvlepn Ile 1Vi�ximum�vjusccdCapurRcfw�cet'4�iletatlacl�ntto�totlLcrti;htn�tH7��r,iltty :._. Iv Q '�l 2Gr S-1, ;4y dull;�is�ci!f��,aiihtng ncatity .(ff�s�y L^iet9s cxis( 901 a seta ac:w)t�tit : tlfle�t of taraeEa.►�r F�c1ni cyf`�Vdlifid ca d L.cac@ tatt �t i¢y(�E uny watI d5 st ' ei. t� feet a ettaliins Puctia C)? y: " �urntshad .. ry�.�..�..�.. ...�.., .. _ . i O � W � a" �l b Q n -c o - -Ar r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is Hyannis MA 02601 1-21-14 required for every y 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 I � ` 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 B. Certification I certify that 1 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 16.000).The system: 4 ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority Inspector's Signature' Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-3/13 Title 5 Official Ins n Form:Subsurface Sewage Disposal System•Page 1 of 17 r. Commonwealth of Massachusetts 1 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 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: System is in good working order with no sign of failure. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired:The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no,,or"not determined" (Y, N,-ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound exhibits substantial infiltration or exfiltration or tank failure is imminent. System will Pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y - ❑ N ❑ ND (Explain below)- t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 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): r ❑ 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)y 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 f Commonwealth of Massachusetts - Title 5 Official Inspection .Fo'rm Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 87 Sterling Rd ' Property Address Philip Laroche Owner Owner's Name information is H anni5 t MA 02601 1-21-14 ' required for every y 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: - s , - El The system has a septic tank and soil absorption system (SAS) and the SAS is within , 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or'!No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or f 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form � Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 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 El El 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not,for Voluntary Assessments M 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is H annis MA 02601 1-21-14 required for every y 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? 0 ® Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of El ® this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) Z% ❑ Was the facility or dwelling tinspected for signs of sewage back up? ® t ❑ '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): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El 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: 1-2014 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203)- Gallons per day(god) „ Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present?.. ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form e Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information r Pumping Records: Source of information: Owner--pumped within last 2 yrs Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenanc 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 co of latest ( Y ) PY inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts r Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is Hyannis MA 02601 1-21-14 required for every H y - 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: 1974--with second leach pit added in 1993 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 24" at tank inlet 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: 16"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 Commonwealth of Massachusetts w Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is re Hyannis MA 02601 1-21-14 wired for eve y a every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" at tank outlet 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts _ Oil W Title 5 Official Inspection Form - W Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 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.): a 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M �~ 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 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 N/A Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑, Yes , ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form =Not for Voluntary Assessments 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 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: ❑ innovativelaltemative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure,`level of ponding, damp soil, condition of vegetation, etc.): Leach pit E had water at working level. Pit F was empty at inspection with stain line at 24"off bottom of pit. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form "s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments say' 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 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.): • F t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Forme Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) - Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately frog f t ` - , , fol ; . . ,3 � f t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments µMW 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 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 20. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Sterling Rd Property Address Philip Laroche Owner Owner's Name information is required for every Hyannis MA 02601 1-21-14 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 I i t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Commonwealth of Massachusetts j Title 5 Official Inspection .Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments , 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in,any way. Please see completeness checklist at the end of the form. Important: A. General Information " When filling out forms on the computer;use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not use the return Name of Inspector key. Capewide Enterprises,LLC. Company Name r� P.O.Box 763 Company Address Centerville Ma. 02632 rermn City/Town State Zip Code (508)428-4028 S14454 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. Lam a DEP approved system inspector pursuant to. Section 15.340 of . Title 5 (310 CMR 15.000). The system: 5 ® Passes. ❑ Conditionally Passes ❑ Fails �- -U ❑ Needs Further Evaluation by the Local Approving Authority c `I 9/15/2008 �- Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approvin '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 t at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ` Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"-section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the.box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank'as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND.(Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008' every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): Fbroken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y . ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions.exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System.will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is.within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes.if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy.of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded-or . clogged SAS or cesspool f ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . - M , 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Arty 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 20000pd- 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 5 Commonwealth of Massachusetts Title 5 official Inspection. Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ❑ Z Pumping information was provided by the owner, occupant, or Board of Health f ❑ ® 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? ❑ Zi Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out?. ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of.scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® , Existing information: For example, a plan at the Board of Health. El ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins-09/08" Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 6 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection D. System Information Description: System consists of 1-1000 gallon septic tank and two 1000 gallon leachind pits. Number of current residents: 2 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 2006:57,000 Water meter readings, if available (last 2 years usage (gpd)): 2007:43,500 Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date 008 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpa) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 87.Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: 9/15/2008 Date Other(describe below): 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? r Reason for pumping: Type of System: ® Septic tank, distribution box; soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of$ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 87 Sterling Road Property Address Phillip Laroche Y Owner. Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 26"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10 feet Comments (on condition of joints, venting, evidence of leakage, etc.): _ Joints appear tight.No evidence of leakage.System vented through the house vents. Septic Tank(locate on site plan): 2' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass _ ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000gallon 5" Sludge depth: J t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 0f 9 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) 2711 Distance from top of sludge to bottom of outlet tee or baffle Scum thickness V. 7" Distance from top of scum to top of outlet tee or baffle _ Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump septic tank every two years.lnlet and outlet tees are in place.No evidence of Ieakage.Tank appears to be structurally sound. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): c Dimensions: . Scum thickness ` Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09/08 TiUe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 10 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for y H annis Ma. 02601 r 9/15/2008 every page. City/Town State. Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): - Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•1111, Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert D-Box not present. Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): i Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 12 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2-1000gl LP ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy dry soil.No signs of hydraulic failure.First leaching pit has been full.Water to invert was 20"to invert at time of inspection.Second leaching pit was dry at time of inspection with a stain line 40"to invert. N Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top.of liquid to inlet invert Depth of solids layer Depth of scum layer -Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 13 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for H annis Ma. 02601 9/15/2008 y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): r 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.): f t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 14 map Page 1 of 2 Town of Barnstable Geographic Information System Parcel Viewer Custom MapIF Abutters Map Size Zoom Out In ry i 1 1 k 1 \ Y 41 \ 1 roc �y r " ............................................ ,........:.............................._..............._..:............................................... Set Scale 1" = 20 I Aerial Photos I MAP DISCLAIMER Coovriaht 2005-2008 Town of Barnstable.MA All riahts reserved. http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=268162&map... 9/15/2008 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for. Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) _ Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of LP 10' 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: As-Built Card ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-000-01 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 87 Sterling Road Property Address Phillip Laroche Owner Owner's Name information is required for Hyannis Ma. 02601 9/15/2008 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist _ ® Inspection Summary:A, B, C, D, or E checked ® Inspection,Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I s, t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 2 MLS �` �� ; J � Page 1 of 3 Listing Summary Listing #20808978 87 Sterling Rd, Hyannis, MA 02601 ' Q Active (09/11/08) DOMICDOM:4/4 $349,900 (LP) Beds: 5 Baths: 3 (3 0) (FH) Sq Ft: 2624* Lot Sz: 12196sgft* Town: Barn Yr: 1974* Remarks 7q ,7 _5 Picture \.1 Report Listing Violation WOW is to say the least about this gem You will feel as if you walked into a home that Martha Stewart decorated. 5 Bedrooms 3 Full baths,Central Vac, and an in law suite on the walkout lower level makes this a great home for the extended family or your summer guests: This gem has been completely renovated from the kitchen to the bathrooms (Marble f �} " Countertops), Plus the exteriorof the Aa�s{f y Additional Pictures C, ,�. p ew9. E "• P hr 7rt lir.N J+l Ul,r It IdPm r ! A- [�•. .uRG .ice . —'----- Pictures.(12) See Map Agent Thomas J Dillon 1 (ID:U2RZ)Primary:508-477-8677 x207 Office RE/MAX Classic(ID:CLAS1)Phone:508-477-8677, FAX: 508-477-2767 Property Type Single Family Property Subtype(s) Single Family Status 13 Active(09/11/08) Town Barnstable Commission Sub Agent Comm. Buyer Agent Comm. Dual Agent Comm. Dual Var Comm 0% 3% 3% No Facilitator Comm 3% Listing Type Excl. Right to Sell Owner Name Philip A Laroche County Barnstable Tax ID 268-162-0-0=BARN Beds 5 Baths (FH) 3(3 0) Approx Square Feet 2624* Sq Ft Source Assessors Records Lot Sq Ft(approx) 12196* Lot Acres(approx) 0.280 Lot Size Source (Assessors Records) Year Built 1974* Publish To Internet Yes Listing Date 09/11/08 All Office Remarks Please Ready Willing and able Buyers for this Deal. Directions to Property West Main to Pitchers to Sterling Listing Page Commission-Other NA Showing Instructions Appointment Req.,Call Listing Office,Yard Sign General Page Zoning RB Year Built Desc. Approximate htto://ceimis.ranmis.com/scri-ots/marais-oi.dll?APPNAME=Capecod&PRGNAME= 9/15/2008 MLS Page 2 of 3 :l Total Rooms 9 Total Levels 2.0 Basement Baths 1.0 Level 1 Baths 1.0 Level 2 Baths 1.0 Level 3 Baths 0.0 Basement Yes Basement Description Finished,Full,Interior Access,Walk Out Foundation Concrete Foundation Width 40 Foundation Depth 34 Fndation Wing Width 0 Fndation Wing Depth 0 Irregular No Lot Depth 0 Lot Width 0 Topography/Lot Desc. Cleared, Level,View,Wooded Association No Annual Assoc.Fee $0 Assoc.Fee Year 0 Garage Yes #of Cars #1 Garage Description Attached, Direct Entry Year Round Yes Separate Living Qtrs Yes Sep living Qtrs Desc Basement, In-Law Apartment Waterfront No Water View No Convenient To Golf Course,Major Highway, Medical Facility,School,Shopping Miles to Beach .5-1 Water Access Beach, Nantucket Sound,Public Beach Description Ocean Beach Ownership Public Street Description Paved,Public Interior Page Fireplace Yes Number of Fireplaces #3 Master Bedroom 15x15 Level: First Floor Mstr Bdrm Features Tile Floor Bedroom#2 OxO Level:Second Floor. Bedroom#4 OxO Level:Second Floor Foyer OxO Level:First Floor Living/Dining Combo No Living Room 13x2O Level: First Floor Living Room Features Cathedral Ceilings,Fireplace,Skylight Dining Room 11x12 Level: First Floor Kitchen 11 x13 Level: First Floor Kitchen Features Fireplace,Granite Countertops, Kitchen Island,Tile Floor Family Room 11 x1 5 Level:First Floor Other Room 1 OxO Level:Basement Other Room 1 Type Bedroom Other Rm 1 Features Fireplace, Private Master Bath,Sliding Door Other Room 3 OxO Level:Second Floor Other Room 3 Type Loft Floors Hardwood,Tile,Wall to Wall Carpet Interior Features Interior Balcony, Linen Closet,Mud Room, Pantry Exterior Style Contemporary Style Description Contemporary Pool No Dock No Exterior Features Deck, Porch,Prof. Landscaping httn://ccimis.ranmis.com/scripts/miaraisni.dll?APPNAME=Capecod&PRGNAME= 9/15/2008. MLS Page 3 of 3 1 ' Roof Description Asphalt Siding Description Clapboard Mechanical Heating/Cooling 3+Zone Heat,Natural Gas Water/Sewer/Utility Private Sewerage,Town Water Hot WaterMater Heat Natural Gas Legal/Tax Annual Tax $3309 Tax Year 2008 Land Assessments $218300 Improvement Asmt $265100 Other Assessments $19600 Total Assessments $503000 Annual Betterment $0.00 Unpaid Betterment $0.00 To Be Assessed Unknown Mass Use Code 101-Single Family Title Reference-Book 1493 Title Reference-Page 858 Land Court Cert# 11111 Underground Fuel Tnk Unknown Lead Paint Unknown Asbestos Unknown Flood Zone Unknown The listing contract has not yet been validated by MLS Staff. Denotes information autofilled from tax records. Information has not been verified,is not guaranteed,and is subject to change.Copyright 2006 Cape Cod&Islands Multiple Listing Service, Inc.All rights reserved Copyright©2008 Rapattoni Corporation.All rights reserved. Generated:9/15/08 10:49am t,f —4/...;, 10 ranrnlc nnm/crrintc/marnicni r1119APPNAMR=C i.neccd&PRGNAME= 9/15/2008 f• WOW is to say the least about this gem You will feel as if you walked into a home that Martha Stewart decorated. 5 Bedrooms 3 Full baths,Central Vac, and an in law suite on the walkout lower level makes this a great home for the extended family or your summer guests. This gem has been completely renovated from the kitchen to the bathrooms (Marble Countertops), Plus the exterior of the home has been freshly painted. Enjoy those cool evenings around one of the 3 Fireplaces and enjoy the breeze and view from your deck or sun room. Enjoy a leisurely stroll to the beach Or Kennedy Compound. This house is priced to sell as it is $150,000 under assessed value and will not last. If you area picky buyer, then this home is for you. COME SEE NOW f�-' \�� �.---..--`-'J�- � �, - - - 1--lo, 4� — " , , A r c A C'o 1,.r 7" Co. a e h etra 1�• �1 7 iNa4 j4�a ;;..b •---•--- Fps..../... .................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® PF HEA TH 1. ...� .._-------OF..... .4... . . .. ..---------- -------- ,� Aliptiration -for Uiipniittl Works Cnomitrurtion Vrrufit. Application is hereby,made for a Permit to Construct (/--)*,Or Repair ( ) an Individual Sewage Disposal S stem at 4i / ffo,gSr ys ( •............... .y G L cation-Address or Lot o. X/- a Gf/ /ir✓ Tai✓-- fi x t� iYti µ ec../ J e ddress alG ' i/ l co b ( ��c� yzf_�n• �en�ec. -------- -••-•--•-•------'----•---•1--- -- Installer Address dType of Building Size Lot-A.�.4_'7-E.....Sq. feet aDwelling—No. of Bedrooms__..--------_�f-----------------------Expansion Attic 4(b) Garbage Grinder (Y) p, Other—Type of Building ----------------_____---____ No. of persons_.-___--."_-__-__.___--_-.-- Showers ( ) — Cafeteria ( ) 0.4 Other fixtures ................................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity------------gallons Length................. Width........:-----. Diameter---/---------- De,,tli_.j"_--"----- xDisposal Trench—No. ..__._.l___.__. Width.__... . ______ Total Length-------------------- Total leaching area.__ __._._._..__._sq. ft. Seepage Pit No----------/-------- Diameter_�_'`!': �-- Depth below inlet_.._._____.___ Total leaching area......f--------sq. ft. z Other Distribution box,( Dosing tank) 1'I '—' Percolation Test Results Performed b /1� !lu.C-- __ 9� ----------------- Date--- Y--- C - v ,_- - a Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-----1.2------.------ w' Test Pit No. 2................minutes per inch Depth of Test Pit____________________ Depth to ground water...----------------- ----------------"--- -"---------------"----------------------_....-•--•--•---------------------------------•--................................................. Descriptionof Soil C e1R•ae5 � --------------------------------------------------------------------------------------------------------- x W ------------------------------------------ ----------------------------------------------------------------------------------------------- ------------------------------------------------------------- UNature of Repairs or Alterations—Answer when applicable-----------------------------------------.----------------------------------.....____-.--_.--.... -------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------ ....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been jfstled by t board of�alt �O y Signedr. _ . . �� ------------------- ------------------------------- Date Application Approved BY-------- --- ---__----••-----•-------•- �- - -. ..-- Application Disapproved for the following reasons:..............._....1 -------------------•-_-_--------------------------•---•-----------_____-----_____------- --•-•--..___..--•-•---••-•--•--------...-•--••------••---------•----._.....-•-----•-----..--•-------•---•-----------------------------------------•-------------------------------------------------- Date PermitNo.................................................._------ Issued........................................................ Date ,. - -;'� a -•.. No.-- Fa$............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD F H E A T H Appliration for IM-4p iial Works Cnonstrurtion Vrrulit Application is hereby made for a Permit to Construct (Kor Repair ( ) an Individual Sewage Disposal System at: .................................. -------------------------••--••---.._..--•-------- Location-Address or Lot No. H -2` --------------== s�sf/i�Y....._ - ddress °w C d/✓Si_. .... dl-V. U. 36 cJe�iUa vet �1 t e evil e Installer Address �! Type of Building Size Lot4.4_ .....Sq. feet _.-Ex ansion Attic 0(b Garbage Grinder �` Dwelling—No. of Bedrooms-------- P 7t� .) g ( ) Other—Type of Building _- ___________________ No. of persons-------------------------- Showers (" ) — Cafeteria ( ) a Other fixtures . ---------------------------------------------------------------- W Design Flow...........................................gallons per person per day. Total daily flow............................................ W Septic Tank—Liquid capacity------------gallons� Len h................ Width........ ------- Diameter---------------- Depth---.----------- . x Disposal Trench—No. .................... Width_....... ------- Total Length................... Total leaching area--------------------sq. ft. Seepage Pit No.......Z........... Diameter..a�._._A..k._ Depth below inlet____________________ Total leaching area-------.----------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by-- __`r-_w4_.c:.__../Iv if 9_42.X................ Date.!V�`�/7`_�.--.__-—-__-_---- . / Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water----- ,2_-_--„f---- lz, Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----....-•--------------------------------------------------------------------------------• --=-......----•-----•-------•----•-•-----------••-•--------- D x Description of Soil----- -U-4)..._C019 59 !g1Y --------------------------------------------------------------- ---------------------------------------------- • -----------= ------ W ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------=----------•---- VNature of Repairs or Alterations—Answer when applicable..............._-----------------_---------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------:-:.:...-_...._•....._....._...Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System iii accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place tfie system in operation until a Certificate of Compliance has been if sued by'tU board of h alt Signed-,__L------- - -------- 4:;- k . ---------------------- s ........----Date-•--• -•- Application Approved BY--....-� ate ..... - '�- ; Application Disapproved for the following reasons:....................... ------------------•---....--••-•--------......_......-----•-•----.....-----...... y ------------------------ Date y PermitNo.......................................................... Issued---- / . . ..---•------•�- C Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH ..................OF... ; �rdif ira#r of Toutphaurr THI IS TO CERT That th dividual Sewage Disposah System constructed.( or Repaired ( ) by ! , + :. Installer • has been installed in accordance with the ovisions of Artic ey of The State Sanitary Code a describ -in the application for Disposal Works Construction Permit No._r.-------,--� _..dated . -2. .��.. T THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A"GU ANTEE THAT THE SYSTEM WIL F CT ON SATISFACTORY. DATE.......... . . ------ .......................:.......:....... Inspector-- ----------. ----------------------- ..............--. THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH ............:. ...../�?w/l�j...OF....... FEE No.. ... ..r ... isrrtti Irktrr atrr�ti / j..4.,, - Permission •s -r -- by granted-- ----- .......L.. d ..... ---0-----------------------•-------------------------------------•-= to Con str ( R air idual ew D' posal stem at No..- = s� tT as shown on the application for Disposal W6rk- onstruction P No-- _. ___- ___ .' ed___- -- - ----•- ------ {/�-�/ -• ------------- oar d o .Health�4 f DATE . -- G :_ FORM 1255 HOBBS &.WARREN. INC...PUBLISHERS TOWN OF BARNS ,,"LE Y LOCATION gam/ Sler1il?o --Roorl SEWAGE #93-,30 VILLAGE �JQh��;� ASSESSOR'S MAP & LOT<?, 6�?-/602 INSTALLER'S NAME & PHONE NO.&rkI6 i SEPTIC TANK CAPACITY Q Q /Y, LEACHING FACILITYAtype) per, 54 C J (size) (o ' Y .)0 ' NO. OF BEDROOMS 3 PRIVATE WELL OR PU �WATE BUILDER R OWN Qr-O C DATE PERMIT ISSUED: 2 /0 9 3 DATE COMPLIANCE ISSUED: G / VARIANCE GRANTED: Yes =No - �X. _ �_ -�, _ � _ f c, V d 6''_ `� �, v � �. . . s f r `... J � 1 io % Ih� .(y AP ;a I � LOT 12;22 59,, ° rCVHP47'IOPJ 0.0 l � I pg-o'P'/L 4-:� CPO I e Ui1ril P'::�Lbqf? CoMs ° t 41YD s,5S 7' Pt i L"�j /000 6194. oN Z//Y/71/ i o ® �. \�e6 o' I