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HomeMy WebLinkAbout0039 EAGLESTONE WAY - Health w 9 �aglestone Way Cotuit P A = 054 009004 �M oat � U6x' — - ------ - - - --- .- - - - - ---- ---— — —_--_ i r I� �97 TOWN OF BARNSTABLE CV e� . LOCATION rA q qto. SEWAGE # �- 4 fS�—®® _ VILLAGE Q� v ASSESSOR'S MAP & LOT M1 � INSTALLER'S NAME & PHONE NO. 1c,A/y ���fa tfAs- I g SEPTIC TANK CAPACITY O LEACHING FACILITYArype) (13 (size) �, B NO. OF BEDROOMS—PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER , DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: =1 VARIANCE GRANTED: Yes No i. 1 1 _ A6( TOWN OF BARNSTABLE LOCATION SEWAGE # � VI[.LAGE �I ASSESSOR'S MAP & LOT INSTALLER'S NAME& PHONE NO.,—,.l�i� o SEPTIC TANK CAPACITY /6� 71— BSI" LEACHING FACILITY: (type) 19f "ft l� �/�� (size) NO. OF BEDROOMS A BUILDER OR OWNER 6� PERMITDATE: COMPLIANCE DATE: ;�-Separation Distance Between the: ` Maximum Adjusted Groundwater Table to the Bottom,of Leaching Facilit Feet ., Y Private Water Supply Well and-Leaching Facility-(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland a ng F lity (Iffanetland exist within 3 t ac ihty)i Feet Furnish by rwo / •a NIV/ i i_ AsBuilt Page 1 of 1 m- TOWN OF BA.RNSTABLE LOCATION 4g � SEWAGE# VILLAGE ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) t� -�Gw�s 6 �x�� (size) NO.OF BEDROOMS - y BUILDER OR OWNER!S-" , PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leacling Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wedand 'ng Fac'Ury(If an ctlan exist within 3 t i 'ry) Feet Furnishe by / �7 taq!{5fadto V>. L-07 , f- �— http://issgl2/intranet/propdata/prebuilt.aspx?mappar=054009004&seq=1 9/19/2012 DATE : 6/27/0 -_--- ao� aGRTv ADDRESS : 39_Eagle-St one _Way._____ C0tuitLMass--- - - - - ---- - O 0 7 02635- - -- - - -- -- ------------ :. L i On the above date, I Inspected the septic system at the above address, This system consists of the following: RECEIVED 1 . 1-1500 gallon septic tank . 2 . 1-Distribution box . 3 . 2 1000 gallon precast leaching pits . Packed in. 122 " JUL L 8 2002 6 XlOBased on my Inspection, I certify the following conditions: TOWHEOALTBHDEPT. 4. This is a title five septic system. ( 78 Code ) 5 . The septic system is in proper working order ' at the present time . 6. ='Waste water is 47" below the invert pipe . Pit #1 Waste water is 69" below the invert pipe . Pit #2 . SIGNATURE :,- !Fame : Macomber r Company : Joseph-P _ Macomber_& Son , In.c , ccress : Box 66 CencerviIIe , _Ma-- 02632-0066 Phone 508- 775- 3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY ,JOSEPH R MACOMBER & SON, INC. a Tan ki•Cesspooli•Leachflelds Pumped & Installed Town Sewer Connections P'0. Box 66 Centerville, MA 02632 0066 775.3338 775 6412 ; . COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 39 Eagle Stone Way Cotuit ,Mass . Owner's Name: Joyce Ginouves Owner's Address:39 Fag1P Stone Way Date of Inspection: Name of Inspector: (please print)Joseph P.Macomber Jr . Company Name:J.P.Macomber & Son Inc . Mailing Address: Box 6$ 02632 Telephone Number: 508-775-3 38 CERTIFICATION STATEMENT 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 15.000). The system: f 2 �Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails nn g Inspector's Signature. Date: G` The system inspector shal bmit.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. Notes and Comments This report only describes conditions at the time of inspection and under the conditions of use at that) ..—,r i; time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I I Page 2 of 1 1 q OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 39 Eagle Stone Way Cotuit ,Mass . Owner: Joyce Ginouves Date of Inspection: 6/2 7/0 2 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A System Passes: 1 have not found any information hick indicates that any of the failure criteria described in 3 10 CMR 15.30 r to 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: rt h1D 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. N0 The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. 'A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: ,(� Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: W 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 I , ND explain: 2 Page 3 of I I OFFICIAL. INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Propem• Address: 39 Eagle Stone Way _ Cotuit ,Mass . Owner: Joyce Gi notivPG Date of lospectioo: - 6 /97117g C. Further Evaluation is Required by the Board of Health: _,UQ 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 wbich will protect public bealtb, safety and the environment: A[ 0 Cesspool or privy is within 50 feet of a surface water Cesspool or privy is witbin 50 feet of a bordering vegetated wetland or a salt marsh 2. S*Nstem 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: L) 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 I of a public water supple. 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 feet or more from a private seater supple well•• Method used to determine distance 1� 'This s\stem passes if the well water analysis, performed at a DEP cenified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that faciliry and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are rriggered..A copy of the analysis must be anached to this form. 3. Other: r 3 Page : of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWACE.DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 39 Eagle Stone Way Cotuit ,Mates . _ Owner: joyrP Gi nnnves Date of Iospection: r; l�,—??T02 D. System Failure Criteria applicable to all systems, You must Indicate "yes" or"no" to each of the following for all inspections: Yes ^o _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or pondvtg of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in e dism. ution box above outlet inven due to an overloaded or clogged SAS or cesspool ��(p-001b (j �y 16 IFIl<' I Liquid depth in.ta44ioaLis less than 6" below invert or available volume is less than 'h day now !�/Rcquvcd pumping more than 4 times in the Iasi year NOT due to clogged or obsrmcted pipe(s). Number f times pumped '. //Any pomon of the SAS, cesspool or privy is below high ground water elevation, V Any ponion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _ Any ponion of a cesspool or privy is within a Zone I of a public well. any ponion of a cesspool or privy is within 50 feet of a private water supply well. Any ponion of a cesspool or privy is less than 100 feet but g7eater than 50 feet from a private water supply well with no acceptable water qualiry analysis, jTbis system passes If the well water analysis, pert,rmed at a DEP certified laboratory., for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from (hat facility 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 cop)- of the analysis must be attached to this forma (Ycs'No) The system fails. I have determined that one or more of the above failure criteria exist as described in )10 CMR 15 )0). therefore the system fails. The system owner should contact the Health to de(ermine 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 now of 10,000 g.pd to 15,000 gpo You must indicate either 'ycs'' or"no" to each of the following: !7Te following criteria apply to Large systems in addition to the criteria above) yes n0 the system is within 400 feet of a surface drinking water supply system is within 200 feet of a tributary to a surface drinking water supply Y 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 !f yoc nave answered "yes" to any question in Section E the system is considered a significant threat, or answered yes" to Section D above the large system has failed. The owner or operator of any large system considered a s:en:ficans threat under Section E or failed under Section D shall upgTade the system in accordance with 3 10 CMR :04 The system owner should contact the appropriate regional orrice of the Department. 4 I Page 5 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Properry Address: 39 Eagle Stone Way Cotuit Mass . Owner: Joyce inouves Date of Inspection: 6 7 0 Check if the following have been done. You must indicate 'yes"or"no"as to each of the following: Yes No/ r 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 (lows 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 componen(s,.e�uding the SAS, located on site Were the septic tank manholes uncovered,opened, and the interior of the tank insP ected.for the condition of the baffles or tees material of co nstruction, 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: + i Yes no/ _ ✓ Existing information. For example, a plan at the Board of Health. r Determined in the field if an of the failure criteria ( y a related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15.302(3)(b)) } . 5 Page 6 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:39 Eagle Stone Way Cotuit ,Mass . Owner: Joyce Ginouves Date of Inspection: 6/2 7/0 2 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): l Number of bedrooms(actual): DESIGN now based on 310 CMR 15.203 (for example: 1 10 gpd x q of bedrooms):40/4=4V���� Number of current residents: ZA04 Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no):�O (if yes separate inspection required) Laundry system inspected (yes or no): Seasonal use: (yes or no): AAD Water meter readings, if available (last 2 years usage (gpd)): 2000-209 , 000 gal lons=572 . 61 GPD Sump pump(yes or no):� gallons=890. 41 GPD Last date of occupancy: COMM ERCLAL/INDUSTRIAL Type of establishment: Design now(based on 310 CMR 15.203): N gpd Basis of design now(seats/persons/sgft,etc.): Grease trap present(yes or no): Ao Industrial waste holding tank present (yes or no):1//9 Non sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy/use: ,tJA OTHER (describe): .di4 GENERAL INFORMATION Pumping Records , Source of information: 14m� 4 Was system pumped as pan of the inspection (yes or no): If yes, volume pumped: _gallons •• How was quantiry pumped determined? .040 Reason for pumping: TYKE OF SYSTEM _/Septic tank, distribution box, soil absorption system L& Single cesspool VA Overflow cesspool ALM Privy /vbShared 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 TjA Attach a copy of the DEP approval AVOther(describe): Appr ximate aoe of all components, date installed (if known) and source of information: I� LtII i9�� Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of 1 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Add ress39 Eagle Stone Drive Cotuit ;Mass . Owner: 6/27/02 Date of Inspection; Joyce Ginouves BUILDING SEWER(locate on site plan) F Depth below grade: yI / Materials of construction: cast iron / 40 PVC 4/pother(explain): '4� Distance from private water supply well or suction line:/��y'' Comments(on condition of joints, venting, evidence of leakage, etc.): Joints appear tight Mo evidence of leakage The system is vented through the house vents , SEPTIC TANK: Zlocate on site plan)1f70AyyA. dl� Depth below grade: Material of construction: /11IncreteA/d metaLlJofiberglas of eth lene �d .G� other(explain) p y y If tank is metal list age:4/Q Is age confirmed by a Certificate of Compliance (yes or no),e-e(attach a copy of certificate) Dimensions: /40 � v 67-7 / J�- � Sludge dept : �� Distance from top ofsludge to bottom of outlet tee or baffle:, Scum thickness:,ZGPG Distance from top of scum to top of outlet tee or baffle:l,�f�ly, . Distance from bottom of scum to bottom of outlet tee or bae� � How were dimensions determined: rQ, //0�/ Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): Pumped the septic tank ever 2-3 years . Inlet & outlet tees are in placcA The tank is structurally sound and shows no evidence of leakage . GREASE TRAH( (locate on site plan) Depth below grade: Al,*f Material of construction:,Wconcrete4,0 metaWO fiberglass polyethylene-Wother (explain): /14/9 Dimensions: 1411.01 Scum thickness: Distance from top,of scum to top of outlet tee or baffle: //X Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: , Comments(on pumping recommendations; inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): Grease trap is not present . 7 Page 8 of I I OFFICIAL INSPECTION FORM —`NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:39 Eagle Stone Way Cotuit ,Mass . Owner: Joyce Ginoouves Date of Inspection: 6/2 7/0 2 TIGHT or HOLDING TANK4&Ve_(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: _AA+ Material of consrructi�: �concrete 4y—metal fiberglassN/4 Polyethylene•f/� other(explain): Dimensions: AIR Capacity: A) gallons Design Flow: AA gallons/day Alarm present (yes or no): Alarm level: ,4 Alarm in working order(yes or no): Date of last pumping: AJA Comments(condition of alarm and float switches, etc.): Tight or holding tanks are not resent . Q Q P DISTRIBUTION BOX: Zif present must be opened)(locate on site plan) Depth of liquid level above outlet invert: _ Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box has two laterals . No evidence of solids carry over , No evidence of leakage into or out o t e box . PUMP CHAMBER(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is not present . 8 Page 9 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTA RY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM_ PART C SYSTEM INFORMATION(continued) Property Address: 39 Eagle Stone Way o ui ass ., Owner: Joyce Ginouves Date of Inspection: 2 / SOIL ABSORPTION SYSTEM (SAS): �/ (locate on site plan, excavation n tf;quired) 2-1000 gallon precast eac ing pits packed in �2 stone . 6 X10 Min ; If SAS not located explain why: -Le6a-t ed-;—See�PARP 10 Type ype eaching pits, number: - leaching chambers, number. O NA leaching galleries, number: leaching trenches, number, length: Q /VO leaching fields, number, dimensions: ,Vooverflow cesspool, number: Q innovative/alternative system Type/name of technology:/2/�e j;le Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Loamy sand to sandy loam to fine samd . No signs of hydraulic. failure or ponding . Soils are dry . Vegetation i . CESSPOOLS�/a (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: D Depth-top of liquid to inlet invert: A�i9 Depth of solids layer. Depth of scum laver: Dimensions of cesspool .4114 Materials of construction: 10119 Indication of groundwater inflow(yes or no): Comments (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Cesspools are not present . PRIVY'd 4&, 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.): Privy is not present 9 Pagc 10 of I I OFFICLA-L INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORIrtATION (con0nvcd) P,CPtrry Acdrel,: 39 Eagle Stone Way otu1 , ass . 0 w o c r: Joyce G—17ru-rv-e-s �Ilf of Inlpaclioo; 7 2 SK—rTCH OF SEWACE DISPOSAL SYSTEM hov'Ot I Ik(Ich of the '(wit( 61PoI11 Imcm Inclvd(ng Ilct to III al Icatt twopormancnc rcfcrcnce Idnvnukl o, Ocn�NnUkI LO<Irt . 011 � iihin 100 fccl, LOc11C what pvblic waicIMI y ply cntcrs the bviloinj. SIT y CIO A, V 3 10 Page 11 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 39 Eaglestone Way Cotuit ,Mass . Owner: Joyce Ginouves Date of Inspection: 6/2 7/0 2 SITE EXAM Slope Surface water Check cellar Shallow wells r .. Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record - If checked, date of design plan reviewed: y e sObserved site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: AM Checked with local excavators, installers-(attach documentation) esAccessedUSGSdatabase-explain: h t t p ; 11town , barnstable.ma . us You must describe how you established the high ground water elevation: Used ; Gahrety & Miller model . 12/16/94 Ground water elevations above sea level . Used ; USGS_- Observation welldatn Tnnp 199 Used ; USGS - Terhini.ral _hi,l1efin A9-Onn—I P1ntp #9 Anniinl rangpg of n water table elevations . Leaching Pit I :eet Groundwater: Feet Below Bottom of Pit h,GroundwatOr Adjustment..) 8.ft per Frimpter Method Therefore, the vertical separation distance between the botto /I Of the leaching pit and the adjusted groundwaterrtable is feet: 11 `+•rrnr+•-n•r►�•'r- rR.-mr•nTTmrrnr.IItvr.rrr.:•.7e-r!Tarr:++T+•.�rn ns+lZJ*.a'trTP.m'+ .TTnr+- r--r-..-•, -. .' 1 TOWN OF Barnstable LVJARD OF HEALTH 1 T,-T '--'r-S1H1Sl1RFACF 9FWA(;F DISPOSAL SYSTTF�M INN9I) CTION FORM - PART D •- CERTIFICATION I -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 39 Eagle Stone Way Cotuit , Mass . ' ASSESSORS MAP , DLOCK AND PARCEL # OWNER' s NAME Joyce Ginouves PART D - CERTIFICATION r NAME OF INSPECTOR Joseph P.Macomber Jr . COMPANY NAME J. P.Macomber & Son Inc' COMPANY ADDRESS Box '66 Centerville ,Mass . 02632 Street Town or City Stat• E I P COMPANY TELEPHONE ( 508 ) 775 3338 FAX' ( 508 ) 790 - 1578 !'t CERTIFICATION STATEMCNT I certify that I have personally, inspected the sewage disposal system at DrIecommenda his address and that the information reported is true , accurate , and omplete as of the time of :inspection . The inspection was performed and any tions regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Check one : �S stela PASSED Y , The which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 16 - 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form , System FAILED* The inspection which I ° have con Qcted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 , 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form , Inspector Signature Date ne copy of this certification must be provided to the OWNER, the DUYER ( where applicable ) and the 130ARD OF HEAL1'll, * If the inspection FAILED , the owner or"" 'P* erator shall upgrade ' the eyetem within one year of the date of the inspection , unless allowed or required otherwise as provided in 3,10 ChJR 16 , 305 . partd . doc i . . . - - - + � �Kva•ilY�1y�, j low U. P` d I a l N 1 I I I _ 2 4--—`C- —-- i fill - -H�x. 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Map Zone: C Engineers and Land Surveyors Plan Reference: Lot 2 ® Plan Book 465 Page 73 78 North Street, 3rd Floor Deed Book: 15,501 Page: 278 Hyannis, MA 02601 Phone — (508) 771-7502 Fax — (508)-771-7622 Owners: Robert A. & Kellianne Faiella Job Number. 2006-059 Scale 1 = 40' Date 08-27-09 LOT 2 PLAN BOOK 465 PAGE 73 44,046 SQ. FT. 1.01 ACRES N/P JAMES F. & NICOLE D. PICCIOTTO S 74�52.23" E _ � 6,55, N SAS IN FRONT OF BUILDING J SEWAGE # 6-27-02 J N �P SUBSURFACE SEWAGE DISPOSAL W GPOP SYSTEM FORM: 6-27-02 n 0 0 "a, z EXISTING 2 STORY WOOD 39 FRAME o CB/DH FND 0 ti GARAGE 6' 149.23' N 86'01'00" 18.9' N/F SUSAN M. & LARRY F. WHEATLEY M 24'0k24s� CB/DH FND< in GARAGE L, r a 168.96' CB/DH FND tO N 89.53'55" W 7Q Y n m it LA N O (0 4t a N N/F JOHN T. & DORIS G. IL W ;,� TALMA' I co g I N CB/FND o, ;n 0 z I W ZONING DISTRICT: RF I • 0 3 MINIMUM CURRENT ZONING REQUIREMENTS 00 LOT SIZE: 43,560 SQ. FT. c 00 00 o FRONTAGE: 150' z to FRONT YARD SETBACK: 30' o N SIDE AND REAR YARD- SET BACK: 15' I CB/DH FND I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE EXISTING STRUCTURE AND PROPOSED NEW CONSTRUCTION SHOWN HEREON ARE LOCATED IN RELATION TO THE MONUMENTS SHOWN Of AND ARE NOT LOCATED WITHIN A SPECIAL FLOOD HAZARD AREA. THIS PLAN IS NOT TO BE RECORDED NOR IS IT TO BE USED TO ESTABLISH PROPERTY R LINES. �lco9 REGISTERED PROFESSIONAL LAND SURVEY N BAXTER NYE tNGINEERING & SURVEYING DATE oe •2-1•o g 0:\2006\7006-059\�URVFY\worksht\2006-059C—go rage.dwg, 8j97/2009 4:41:26 PM, 1:1, MTM