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0050 EAST LANE - Health
50 East Lane Cotuit F A 037 006 G t , A 0 &/a7105 TOWN OF BARNSTABLE Ul°L OCATION �l°D g +- 1� S�4 L A SEWAGE # Q 6 6 -60 VILLAGE lx�*LLk ASSESSOR'S MAP & LOT _ a� INSTALLER'S NAME&PHONE NO.��g`�`'� A, SevZ-e� 5o F-H Y1^ 1 Li d ' SEPTIC TANK CAPACITY 1,560 LO LEACHING FACILITY: (type) (size) NO.OF BEDROOMS L BUILDER OR OWNERC-�- PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by .1 O � v 441-LO I t o4=o ll aC� IJ14 -� 1:XD 41 1-0� F a� Lis I-Z O TO OF BARNSTABLE11 5� ' LOCATION, SEWAGE # i' VILLAGE ASSESSOR'S MAP& LOT J INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY � 00 LEACHING FACILITY: (type) � (size) NO.OF BEDROOMS BUILDER OR OWNER ' PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet _Private Private Water Supply.Well and Leaching Facility (If any wells exist oi, !te or within 200 feet of leaching facility) Feet Edg Wedand and Leaching Facility(If any we ands exist i 300 feet o le 'n ility) . "Feet Furnished by — c � � 4 H5� - l M 4 �. V I��- C I C0►4 A � FEE Board of Health, ���./+'�ST�-"� `�Q' .MA. APPLICATION FOR DISPOSAL S YSILM C®NSTRUCTION ARMIT Application for a Permit to Construct(t�-<epair( ) Upgrade( ) Abandon( ) - Gk�,omplete System ❑Individual Components Location S® r4 �-1.� �A$ ( /q �U& Owner's Name A. ,,7 +V"1a.ekL r' To '�J,-N Map/Parcel# 37 r Address Lot# Telephone# Installer's Name 'Desi ners Name (1� 7 g ,q�.kP-e Sc;r�e S O c.. .Q w Address Address Telephone# Telephone# Type of Building Lot Size O 14A I r_sq.m Dwelling-No.of Bedrooms A (3 1-4 v'®u y`+S o i edeJ rcx,m Garbage grinder (/VO Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures / Design Flow (min.required) —/ gpd Calculated design flow 9 C) Design flow provided t .�G� gpd Plan: Date .� � _ Number of sheets Revision Date Title $ t'fe t Sle// L tk+✓✓ Description of Soil(s) E'e 6s#U' Soil Evaluator Form No. Name of Soil Evaluator 4CO S Tuo'�-' iPLS Date of Evaluation 7 DESCRIPTION OF REPAIRS ORALTERATIONS Q .i 3 / &, The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and furthertfwees to not to=tht in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date g�f Inspections No. d� 1 F yy!! FEE "YX Gl U W9W Of MSC T Board of Health;' 3 APPLICATION FOP, ➢ ISPOSAL SYSTEM CONSTRUCTION PERMIT ` Application for a Permit to Construct(La�epairO Upgrade( Abandon( )'--_ 0•eomplete System ❑Individual Components N Location 50 A +a 5A ST � APE� Owner's NameS«T �- V"1et i To �d t/V ,iip/Parcel# 3'7 _ 6 Address Lot# Telephone# Installer's Name c- Designer's Name cam' g rq,�.kte S�� V C(A"S o cr q k Address Address Telephone# 0 l t- Type of Building / �-� Lot Size / � as aq"'ft.° AG Dwelling-No.of Bedrooms SO A �_O 13 (1 Bet rcx,M Garbage,grinder (NO Other-Type of Building No.of persons Showers ( ),Cafeteria ( ) Other Fixtures /� Design Flow (min.)required) Ll4 gpd Calculated design flow 4/C) Design flow provided *L gpd °} Plan: Date ! �. / :a y Number of sheets Revision Date Title �ytL L&4� Description of Soil(s) - ' Soil Evaluator Form No. Name of Soil Evaluator 46'1' S Q' /0 6 Date of Evaluation 3 U �/' DESCRIPTION OF REPAIRS OR ALTERATIONS `>' /SP �P,l i r rG 3 �'!�✓ CJT 7—w . x' The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and ~' further grees'to not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed 4 Date __J�7/U ' ''Inspections till No. k ,•. t d UO S'� UfJ FEE� �° °^ Board of Health, 'S�t K S��c b �P ' MA. CERTIFICATE Of COMPLIANCE .; ., Description of Work: ❑Individual Component(s) 4 Gurihplete System The undersigned hereby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded ( ),Abandoned--( by. at so- A Nb — CU—CULT has been installed in accordance with the provisjons of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. 9 WS-UucI , dated !U `� Approved Desi n Flow 5 41 (gpd) Installer ✓S-0" l ) , Designer:Y 4,e. /'r--e 5VIVci �y-S(-LFKO/�Inspector: -� Date: /Y The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. U//S��a/�� FEE COMMONWEALTH OF MASSACHUS ETTS Board of Health, &_/'I S+`t y l� MA DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct(L•)-"Repair( ) Upgrade( ) Abandon( ) an individual sewage disposal system at S-0 A f ST �-*q v& o I V`T^ as described in the application for Disposal System Construction Permit No. -Q(R, dated 1/ v Ste. Provided: Construction shall be completed within three years of the date -Ft s p emit. All 1 cal conditions must be met. A Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date � � (�Board of Health 11 A. r_ ' / U Property Location: 50 EAST LANE MAP ID:037/006//1 Bldg Name: State Use:1090 Vision ID:2371 Account#22086 Bldg#: 2 of 2 Sec#: 1 of 1 Card 2 of 2 Print Date:01/04/2005 10:39 G� TR ' iS. Ae07gV PRA' 2«11 °l r�Cx WMAW k = Element Cd. Ch.Pescription Element Cd. Ch.Pescription Style 36 Cottage Model 01 Residential oundation 02 ;Trade D Below Average Stories 1 1 Story Bath Split 10 26 Occupancy - V� .:` Exterior Wall 1 14 Wood Shingle Code Description Percentage Exterior Wall 2 1090 Multi Hses 100 Roof Structure 3 Gable/Hip Roof Cover 3 sph/F GIs/Cmp Interior Wall 1 2 Wall Brd/Wood Interior Wall 2 �I Interior Flr 1 14 �Adj.Base Rate: 9 Interior flr 2 12 BAS 2 e Heat Fuel 4 lace Cost P YB Heat Type 7 Elec Baseboard 1920 . ep Code AC Type 1 None 1978 Jnadj.Base Rate Total Bedrooms 1 1 Bedroom 1emodel Rating Tota]Bthrrris J, fear Remodeled otal Half Baths ep 10 % otal Xtra Fix uncnl Obslnc otal Rooms 3 3 Rooms con Obslnc 16 ath`Style itatus Kitchen Style Cost Trend Factor lep Completeverall%Cond PPrais Val YB Ovr Comment isc Imp Ovr isc Imp Ovr Comment ost to Cure Ovr ost to Cure Ovr Commei Code 16escription Sub ub Descri t Units Unit Price Yr 6 Gde Op Rt Cnd %Cnd _ r Value No Photo On Record AIA Code Description Livin Area Gross Area E .Area 1 Unit Cost Undre rec. Value AS First Floor 542 542 542 0.00 0 Trl /_'....... T:.✓T........ A.....o.- Cd7 Gd'f 9d7 Property Location: 50 EAST LANE MAP ID:037/006/// Bldg Name: State Use:1090 Vision ID:2371 Account#22086 Bldg#: 2 of 2 Sec#: 1 of 1 Card 2 of 2 Print Date:01/04/2005 10:39 _ w . SMAN,HAROLD K JR ublic Water Description Code Appraised Value Assessed Value 1057 RAMONA ST Level as 1 Paved S LAND 1090 167,100 167,100 801 eptic SIDNTL 1090 130,100 130,100;arnstable 2005 Data,M ALO ALTO,CA 94301 - ti .. .. Additional Owners: ther ID: Plan Ref. Tax Dist. 200 Land Ct# er.Prop. #SR VISION ���Ol Life Estate DL 1 Notes: DL 2 IS ID: 2371 1 ASSOC PID# Totall 97,200 297,200 Rai M SMAN,HAROLD K JR 8260/288 10/15/1992 Q I P 145,000 Yr. Code Assessed Value Yr. Code I Assessed Value Yr. Code Assessed Value ASTORE,MARYANTHY 8216/108 09/15/1992 U. I I A 004 1090 142,000 003 1010 95,000 002 1010 95,000 ASTORE,CHARLES L 4669/230 09/15/1985 Q 1 124,000 004 1090 89,100 003 1010 73,300 002 1010 73,300 ARRETT,JOSEPH R&ANNE 4089/348 09/15/1985 U I 48,000 1 INS,ROBERT D 14531096 Q 0 ASTORE,CHARLES M-792 8216/108 U I 1 A Total:1 231,1001 Total: 168,3001 Total:1 168,300 _, •'SS This signature acknowledges a visit by a Data Collector or Assessor YearTvpe Description Amount Code Description Number* Amount Comm.Int. Appraised Bldg.Value(Card) 0 Appraised XF(B)Value(Bldg) 0 NBHD/SUB NBHD NAME STREET INDEX NAME TRACING BATCH Appraised OB(L)Value(Bldg) 0 /A Appraised Land Value(Bldg) 0 Special Land Value 0 1 Total Appraised Parcel Value 297,200 Valuation Method: O Adjustment: 0 Net Total Appraised Parcel Value 297,200 r . , '• ...... ,,. ,, . _ •�. .. K .mow�- ..' , Permit ID I Issue Date Tvpe Description Amount Insp.Date %Comp. Date Comp. Comments Date Type IS ID Cd. Pur oselResull • 9/11/2002 PT 00 eas/Listed 9/11/2002 PT 00 eas/Listed 10/20/1999 MF 10 3rd Visit-2nd Notice Left 6/18/1999. FS- 00 eas/Listed 6/18/1999 FS 09 2nd Visit-1st Notice Left WHO B# Use Code Description Zone D Frontage De th Units Unit Price I.Factor S.A.IS.O. 1 C.Factor ST..Idx Ad'. Notes-Ad' Special Pricing Ad'. Unit Price Land Value 2 .1090 RF 2 0 SF 0.00 1.00 5 5 1.00 0105 1.00 0 Total Card Land Units: 0.00 ACI Parcel Total Land Area: .92 AC Total Land Value: I Property Location: 50 EAST LANE MAP ID:037/006/// Bldg Name: State Use:1090 Vision ID:2371 Account#22086 Bldg#: 1 of 2 Sec#: 1 of 1 Card 1 of 2 Print Date:01/04/2005 10:39 G"'Q3ww' u'N.-9, ST : tCT1�0 �':- •x Element Cd. Ch.[Description Element Cd. Ch. Description Style 3 Colonial Model 1 Residential oundation 01 AS[321 Grade Average Stories 2 Stories Bath Split 11 Occupancy Exterior Wall 1 14 Wood Shingle Code Description Percentage Exterior Wall 2 1090 Multi Hses 100 Roof Structure 03 Gable/Hip Roof Cover 03 sph/F Gls/Cmp Interior Wall 1 D5 rywall Interior Wall 2 Interior Fir 1 12 Adj.Base Rate: teripr Flr 2 Heat Fuel 4 Y` Cost YB A eat Type 7 Elec Baseboard 41 1920 ep Code C Type b 1 Noe 1972 nadj.Base Rate otal)3edrooms 3 � Bedrooms, F lemodel Rating otalBthrms 1 �� j'j ear Remodeled UST FUS ofal Half Baths 1 .�m � ep% 16 16 BAS 1 Total Xtra Fixtrs uncnl Obslne Total Rooms 6 Rooms con Obslne Bath Style tatus 8 41 Kitchen Style ost Trend Factor US 41 /o Complete 2 Overall%Cond pprais Val YB ep Ovr Comment disc Imp Ovr disc Imp Ovr Comment ost to Cure Ovr ost to Cure Ovr.Comme, Code Description Sub^Sub Descri t� UB JUnits JUnit Price Yr `Gde Rt Cnd oCnd Wpr Value No Photo On Record Code Description Living Area Gross Area E .Area Unit Cost Undre rec. Value AS First Floor 688 688 688 0.00 0 US Upper Story 738 738 738 0.00 0 UST Utility Enclosure 0 128 45 0.00 0 Tit (:rncc/.iv//onco drone 1-47.61 1.S54 1.471 Property Location: 50 EAST-LANE MAP ID:037/006/// Bldg Name: State Use:1090 Vision ID:2371 Account#22086 Bldg#. 1 of 2 Sec#. 1 of 1 Card 1 of 2 Print Date.01/04/2005 10:39 SMAN,HAROLD KJR ublic Water Description Code Appraised Value Assessed Value 1057 RAMONA ST 1 Level as 1 Paved RESLAND 1090 167,100 167,100 801 epticRESIDNTL 1090 130,100 130,100;arnstable 2005 Data,Al S'Q� ALO ALTO,CA 94301 - ,� _ ����,q� dditional Owners: ther ID: Plan Ref. Tax Dist. 200 Land Ct# er.Prop. #SR VISION Life Estate DL 1 Notes: DL 2 GIS ID: 2371 1 ASSOC PID# Totall 297,200 297,200 .,.. S h.� rt�__A}` _: W�am ,� fI�JP(���: ItB, rt, � A FIE �. __ . _.. ,_ �_�_za SMAN,HAROLD K JR 8260/288 10/15/1992 Q 1 145,006 Yr. Code Assessed Value Yr. I Code Assessed Value Yr. Code I Assessed Value aASTOjRE,MARYANTHY 8216/108 09/15/1992 U I 1 A 004. 1090 142,000 2003 1010 95,000 2002 1010 95,00( ASTORE,CHARLES L 4669/230 09/15/1985 Q 1 124,000 004 1090 89,100 Z003 1010 73,300 2002 1010 73,30( ARRETT,JOSEPH R&ANNE 4089/348 09/15/1985 U 1 48,000 1 INS,ROBERT D 14531096 Q 0 ASTORE,CHARLES M-792 8216/108 U I I A r : 231 100 Total: 168 30 Total. 168,30( To tal 0 r}M ;Y } This signature acknowledges a visit by a Data Collector or Assessor Year Tvpe IDescription Amount Code Description Number Amount Comm.Int. Appraised Bldg.Value and F(B)Value(Bldg)X NBHD/SUB NBHD NAME I STREET INDEX NAME TRACING BATCH Appraised OB(L)Value(Bldg) Appraised Land Value(Bldg) 167,10( Special Land Value { 1 Total Appraised Parcel Value - 297,20( Valuation Method: C �~ Adjustment: Net Total Appraised Parcel Value 297,20( Permit ID Issue Date bpe Description Amount Insp.Date %Comp. Date Comp. Comments Date Type IS ID Cd. Purpose/Result B26505 05/02/1984 AD 25,000 01/15/1986 100 CO 9/11/2002 PT 00 eas/Listed B26505A 05/01/1984 AD 0 01/15/1986 100 CO ADD"N 9/11/2002 PT 00 eas/Listed 10/20/1999 MF 10 3rd Visit-2nd Notice Left 6/18/19,99 FS 00. eas/Listed 6/18/1999 FS 09 2nd Visit-1st Notice Left T it '�,t ,, T B# Use Code IDescription Zone I D IFrontaze Depth I Units Unit Price I.Factor S.A. S.O. C.Factor ST.Idx Ad'. Notes-Ad• Special Pricing Ad•. Unit Price Land Value" 1 1090 RF 2 1 0.92 AC 170,000.00 1.07 5 5 1.00 0105 1.00 167,10( Total Card Land Units:1 0.921 ACI Parcel Total Land Area:P.92 AC Total Land Value: 167,104 Town of Barnstable DIME, Regulatory Services Thomas F. Geiler, Director * BABNMBLE, y� MASS. ,e Public Health Division i IL ArEDMAtA Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Sewage Permit# M9 Assessor's MapTarcel 3 CC,,57�— Designer: y V t/ Installer: 'las4A,4 �tUZ tL N , Address: � 7 ,�" Address: S l � � C_ On &LC.,-Las issued a permit to install a ate) (installer) septic system at_15'n ft{ 3 !E&S - L4A based on a design drawn by (address) dated 12 j G j O q (designer) ZI certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. 114 OF ORLICE G. (In aller's Signat " o gY q A (Designer's Sig a re) (Affix Designer's Stamp Here) PLE:1SE R ,"ruRN TO BARNSGABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF CO NIPLIANCE WILL NOT lit: ISSUED (Writ BOTH THIS FORM AND AS-BUILT CARD ARE RF:CF:IVI:D BY'fIIF. 13:1RNS l':1B[.F. PUBLIC HEAL;f11 DIVISION. THANK YOU. Q: I lealdvSeptic'DcsiS.ncr Catitication Forin 3-26-04.doc oFT"E rWyti Town of Barnstable Regulatory Services BAMSTABLE, * Thomas F. Geiler,Director MASS, gab,, i639• ,0�' Public Health Division rFD MA'S A Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Harold K. Alsman Jr. Date: September 21, 2004 1057 Ramona Street Palo Alto, Ca. 94301 NON-COMPLIANCE WITH STATE ENVIRONMENTAL CODE TITLE V. Several months have passed by since you have been ordered to repair your"failed" septic system located at 50 East Lane, Cotuit You are reminded that you are ordered to hire a professional engineer to design a replacement septic system and to hire a licensed septic installer to:replace the system on or.before November 1, 2004. You may request a hearing before the Board of Health if petition requesting same is received within ten days. Non-compliance may result in a non-criminal ticket citation of 100 dollars. Each day's failure to comply with an order of the Health Agent shall constitute as a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean,R.S., C.H.O. Agent of the Board of Health CC: Board of Health Ino_engineer pim oFI"E A Town of Barnstable T Regulatory Services BAMSTABLE; * Thomas F. Geiler,Director MASS. Public Health Division ArfD:��a -- - Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Harold K. Alsman Jr. Date: 4/29/04 1057 Ramona Street Pala Alto Ca. 94301 NON-COMPLIANCE WITH STATE ENVIRONMENTAL CODE TITLE V. The septic system owned by you located at 50 East Lane, Cotuit was inspected on, 8/25/99 by Joseph Macomber, a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: - Leaching pit main house is in hydraulic failure. The cesspool for the cottage was:;in'.hydraulic failure. Our records show that the system has been in a failed state for more than two years. You are ordered to hire a professional engineer or registered sanitarian to prepare;a plan of proposed replacement septic system component(s). This plan is to be submitted to the.-Town of Barnstable Public Health Division Office (Regulatory Services, 200 Main Street, Hyannis), within (90) days receipt of this letter. The plan will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title V. You are also ordered to upgrade or replace the septic system within six months (180) days of your receipt of this letter. " Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. You have the option of requesting an adjudicatory hearing pursuant to 310 CMR 15.422 Failure to comply 'th this order will automatically result in a public hearing scheduled before the Board of Health. PER ORDE BOARD OF HEALTH Thomas A. cKean, R.S., C.H.O. Agent of the Board of Health CC: Board of Health 1:/fai1ed_septic_)etters r , Septic Inspection Information :#:::::::::::: 8/25/1999 #':::::::: :::::::::::: [�yy� 037 006 •fi? 0 4::r{ J1[1J3 ,ft:t:: 50 FEast Lane ::::<:::i::' •1:6CiMY:: —771 COtUIt Joseph Macomber tiEtsart> Leaching pit for main house is in hydaulic failure.Cesspool for the cottage is in hydraulic failure. �pG�,9 p�pp DATE: 8/17/99 -�- - --G--- PROPERTY-'-:ADDRESS:_ 4,4• East Lane____ {�Cotuitt ,,_Mass . _________ FAILED 0 QT6V ,N ---- On the above date, 1 inspected the septic system at the(oAjjress. This system consists of the following: 3 1999 ►� �'1 . Main House . 1-1000 gallon septic tank . o2 . 1-Distribution box.3 . . 1-1000 gallon precast leaching pit . 4 . Cottage . 1-6 ' x6 ' block cesspool . Z' Based on my Inspection, I certify the following conditions: 5 . Main house has a title five septic system. ( 78 Code ) k; The leaching pit is. in hydraulic failure . Must be upgrade ' 7 . Cottage has one block cesspool that is in hydraulic failure' This must be upgraded. Y. 8 . Both system" are in failure .Must be upgraded . SIGNATURE:f _ Name:_,l L Macomber J_r�______ Company: Jose2h_P. Macomber_& Son , Inc . Address:— Box—66 --- --------------- Centerville , Ma . 02632-0066 Phone:___508_775_3338_______ THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY • rOE P. MACOMBER & SON, INC. Tanks-Cesspools-Leachflelds Pumped & Installed Town Sewer Connectlons x 66 Centerville, MA 02632-0066 775-3338 775-6412 r ` COMMONWEALTH OF MASSACHUSETTS 1Vj EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292.5500 TRUDY c0 Secret ARGEO PAUL CELLUCCI DAVID B. STRU. Governor Co:n.ws.s:o SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM PART A CERTIFICATION NopertyAdaress: 44 East Lane NamoofowrwKen Alsman &Linda Scott Cotuit ,Mass. AddraasofOwner: 10bl Ramona Street Data oflntpecoon: 8/17/ gee h P.Macomber Jr , Palo Alto CA 94301 Na me of Irupettoe:1ptaase Print) P I arcs a DEP approve<l system Inspector pursuant to Section 15.340 of Tide 5 (310 CMR 15.000) comwyNarrw: J.P.Macomber & Son Inc . taas7usgAddrass: Box 66 Co-nrQ=-ville-,Mass . 02632 Taleptsorse Number: CERTIFICATION STATEMENT 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 Inspection. The Inspection was performed based on my training and experience In the proper function and maintenance of on•slte sewage disposal systems. The system: _ Passes Conditionally Posses Needs Further Evaluation By the Local Approving Authority Fails �y Inspector's Si4rsature: Date: t;1j, The System Inspe r shall submit a copy of this Inspection report to the Approving Authority (Board of Health or DEP)within thirty (30) days o 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 own, flail submit the report to the appropriate regional office of the Department ohfnvironmental Protection. The original should be sent to Trm system owner and copies sent to the buyer, If applicable, and the approving authority. NOTES ANO COMMENTS i revised 9/2/98 PaeelofII L� Pr,nl.0 on R.cycl40 v,(xr r SUBSURFACE SEWAGE DISPOSAL SYSTEM IrWSPECIION FORM PART A CERTIFICATION (contirwed) Property Address: 44 East Lane C o t u i t ,Mass . Owner Ken Alsman & Linda' Scott Data of inspection: 8/1 7/9 9 INSPECTION SUMMARY: Check A, B, C, o/ A S A. SYSTEM PASSES: ' 1 have not found any information which indicates that any of the failure conditions described In 310 CMR 1-6.303 exist. Any failure criteria not evaluated are Indicated below. COMMENTS: 'Leaching_pit for main hougp i R i n hydraitl i r fai 1 iirP _ rP4CP0n1 for thA C-Otter—is in hyd-r-Nuli-6 faAl r-P J B. SYSTEM CONDITIONALLY PASSES: A_ 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. Indicate yes, no, or not determined(Y, N. or NO). Describe basis of determination In all Instances. If "not determined", explain why not. The septic tank Is metal, unless the owner or operator has provided the system Inspector with a copy of a Certificate of Compliance (attached)Indicating that the tank was Installed within twenty (20) years prior to the date of the Inspection: or the septic tank, whether or not metal,is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is Imminent. The system will pass Inspection If the existing septic tank Is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed In the distribution box Is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval of the Board of Health). broken pipes)are replaced obstruction Is removed distribution box is levelled or replaced AVV - The system required pumphirmore than'fourtimes a yeardus to broken or obstructed pipe(s). The Tyvtem wi timw— Inspection If(with approval of the Board of Health): - broken plpe(s) are'replaced obstruction Is removed revised 9/2/98 Page 2of11 1 f�l SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 44 East Lane C o t ul t ,Mass . Ownw: Ken Alsman & Linda Scott Date of Inspection: 8/1 7/9 9 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 the public health, safety and 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•PRQTECT THE PUBLIC HEALTH.AND SAFETY AND THE ENILROKfiMENT' 0 Cesspool or privy is within 60 feet of surface water /9 Cesspool or privy is within 60 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPUER.IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: f 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. 40 The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 60 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coiiform bacteria and volatile organic compounds indicates that the well Is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance_(approximation not valid). 3) OTHER Cottage ,31em. eac in Dit is in hydraulic a3 ure . revised 9/2/98 Page 3ofII r 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSizEGTION FORM PART A CERTIFICATION (continued) Property Address: 4 4 East Lane C o t u i t ,Mass . Owner: Ken ,Alsman & Linda Scott Data oflnspection:8/1 7/9 9 D. SYSTEMIAILS: Yo must indicate either "Yes" or "No" to each of the following: --6-== I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes„ No Backup of•sewage component due Ko an overloaded or-cbgged•S,A8�,or•ceaspod. -�•--'• ' Discharge or ponding of effluent tothe 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. -r jhr Liquid depth in cesspool is less than 6" below Inver for available volume is less than 1/2 day flow. ZRequired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped L. X1 Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for -coliform bacteria, volatile organic•compounds, ammonia nitrogen and nitrate nitrogen. - E. LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No t/ the system is within 400 feet of a surface drinking water supply the system-iswit�ia 200 feetofa EributarYtoasucfaoadnnlcir►gwatersupply - --- 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) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further inforinati I revised 9/2/98 Page 4of11 f I i i c1 i SUBSURFACE SEWAGE DISPOSAL SYSTEM If4$PtC N FORM PART B CHECKLIST Property Address: 44 East Lane C o t u i t ,'Mass . Owner: Ken Alsman & Linda Scott Date of Inspection:8/17/9 9 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes Now Pumping information was provided by the owner, occupant, or Board of Health. -None of the system-cornpooants havel�ean pusnpedWar- Jeast. oawe" aadtbe'system hasbaeaascaiaing+AmmW flow rates during that period. Large volumes of water have not been Introduced Into the system recently or as part of this inspection. As built plans have been obtained and examined. Note If they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. ZThe system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. _ All system components,excluding the Soil Absorption System,have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions,depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System orrthe site has been determined based on:- Existing information. For example, Plan at B.O.H. _ Determined in the field(if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)) _ The facility owner.(and.ocr�paats,if differaW from-eiwnW)AUaraprnyided,with fnfnrmntion;Dn thn prn,'nnr malntonnn.•��f SubSurface Disposal Systems. i i I revised 9/2/98 Page 5orii i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION proportyAdro":44 East Lane Cotuit ,Mass . Owner: Ken A1smaN & Linda . Scott Date ofon8/17/99 FLOW CONDITIONS RESIDENTIAL: Design flow:]ZQ__g.p.d./bedr ✓l� w,v .0,56, � y�1'l9 Number of bedrooms deser, Number of bedrooms(actual):Total DESIGN flow Number of current residents Garbage grinder(yes or no): Laundry(separate system) ( as or If yes, sopacate Inspection,required --. Laundry System inspected or no) Seasonal use(yes or no): Water meter readings,if available(last two year's usage(gpd): Sump Pump(yes or no):-A& Last date of occupancy: COMMERCIALANDUSTRIAL: Type of establishment: Design flow: d ( Based on 15.203) Basis of design flow Grease trap present: (yes or no) Industrial Waste Holding Tank present:(yes or no) ,� Non-sanitary waste discharged to the Title 5 system: yes or no)1V/1 - Water meter readings,if available: Last date of occupancy:_", OTHER:(Describe) Last date of occupancy: VAL GENERAL INFORMATION 1 PUMPING RE DS and so ceeoof' Iormation1 f"/ i /. System p mped as part of inspection: (yes or no) If yes, volume pumped: allon� Reason for pumping: o TYPE 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) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other A XIMATE AGE all gom�one�,n�ts�,,d,�to installediif known)-and source of•information: Sewage odors detected when arriving at the site: (yes or no) i revised 9/2/98 Page 6or11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPE07110N FORM PART C SYSTEM INFORMATION(continued) Property Address:4 4 East. Lane C o t u i t ,M a,s s . Owrwr: Ken Alsman & Linda Scott Date of Inspection: 8/1 7/9 9 BUILDING SEWER: (Locate on site plan) � �J1�� /) �.�� �� .� ��✓t��/� 6/i Depth below gradely1wo C:E Material of construction:_cast iron 1/40 PVC_other(explain) Distance froVnvate water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of hakage,-etc.) Joints appear tight No Pv; dpnrp of •I npl nSe S&TIC TANK: y (locate on site plan) Depth below grade& Material of construction:-&!!�lconcrete.?&metal,04 FiberglassAJA Polyethylene.VAother(explain) If tank is(petal,list age&A. Js.age_confumed by Certificate of Compliance 44 (Yes/No) Dimensions: Sludge depth: _ Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness:_ Distance from top of scum to top of outlet tee or baffle:_ Distance from bottom of scum to bo of outlet tee or baffle: How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or-baffles, depth of liquid level in relation to outlet invert, structurallntegrity, evidence of leakage,etc.) Pump tank every 2-3 years After uupgradP ) Tnl Pt R Outlet tees are in nl acp Thp tank ; g gtrt1rtnrg1 1 y onnnd 2pd ohQ.ao GREASE TRAP: (locate on site plan) Depth below grade: Material of constructionconcreteeV? metal4•FiberglassNAPolyethylene J!�2other(explain) Dimensions: 44 Scum thickness: loy Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffler Date of last pumping:_ V Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet Invert, structural integrity, evidence of leakage, etc.) rease trap is not present ' i revised 9/2/98 Page 7of11 er SUBSURFACE SEWAGE DISPOSAL SYSTEM INSWi,TION FORM PART C SYSTEM INFORMATION(continued) Property Address:4 4 East Lane C o t u i t ,M ass . Ownw: Ken A1smaN & Linda . Scott Data of kwwwd—: 8/1 7/9 9 TIGHT OR HOLDING TANK"(Tank must be pumped prior to, or at time of, inspection) (locate on site plan) Depth below grade: Material of construction-Ah9 concrete4�Lmetal�4Fiberglass,(�gPolyethyleneo_pther(explain) AM Dimensions: Capacity: gallons Design flow: gallons/day Alarm present Alarm level: Alarm in working order:Yeser4j� NgA0 Date of previous pumping:_ AJA Comments: (condition of inlet tee, condition of alarm and float switches,etc.) Tight or holdi R tankq are not prPRPnt DISTRIBUTION BOX-Z (locate on site plan) Depth of liquid level above outlet invert: Comments: (note-if level and distribution is equal, evidenoe of solids carryover, evidence of leakage into or out of box, etc.) Distribution box has one lateral .There is evidence of solids carry over No PyidanrP of leakage ihtn nr niit of the hox PUMP CHAMBER-A&,e- (locate on site plan) Pumps in working order:(Yes or No)NO Alarms in working order(Yes or No)"�w Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) ump cliamber is not present . revised 9/2/98 Page 8of11 I \f; SUBSURFACE SEWAGE DISPOSAL SYSTEM,INSPtCTION FORM PART C ``' SYSTEM INFORMATION (corrdnued) Property Address: 44 East Lane C o t u i t ,Mass . owner: Ken Alsman & Li.nda Scott Date of Inspecdort: 8/17/9 9 SOIL ABSORPTION SYSTEM(SAS):I/— (locate on site plan, If possible:excavation not required,location may be approximated by non-Intrusive methods) If not located, explain: Type: leaching pits,number: leaching chambers,number: leaching galleries,number:, leaching trenches,number,length: leaching fields, number, dimensions: overflow cesspool,number: Alternative system: Name of Technology: Comments: 37mK hA 6V b aKlmi' mote condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.) Loamy sand to sand Roth c ,c1 ems ar® Tsa>�n i-= ' " '� in be , tipgraded to clit! new 95 code . Add new leaching area and n an or the cottage . This will be a sshared system. (locate on site plan) Number and configuration: ! _— Depth-top of liquid to Inlet Invert: Lt&r JAVIli Depth of solids layer: Vq Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: QA inflow (cesspool must be pumped as part of Inspection) 0 Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of,vegetation, etc.) PRIVY: (locate on site plan) Materja13 of construe on: Dimensions: Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation;etc.) Privy e revised 9/2/98 . P2ee9of11 SUBSURFACE SEWAGE DISPO$AI, YZT.EfA INSPECTION FORM PART .. SYSTEM INFORMATION(con*Ki 0d) Proq.MA1kk—:44 East ,Dane Cotuit ,Mass . 0wrw; Ken Alsman &. .Linda Scott Dou or trap—don: 8/1 7/9 9 SxETc i OF SEWAGE DISPOSAL SYSTEM: Include tlos to at least two permanent reference landmarks or benchmarks locate all wells within 100'ILocsto whore publlc water supply comes Into house) t� 0 /11 revised 9/2/98 Pete10ortl SUBSURFACE SEWAGE DISPOSAL SYSTEM�INfiPECTION FORM PART C SYSTEM INFORMATION(continued) Property address:4 4 East Lane C o t u i t ,Mass . Owner: Ken Alsman & Linda"Scott Data of kupecdon:8/17/9 9 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date wabsite visited Observation Wells checked Groundwater depth: Shallow Moderate Deep _ SITE EXAM Slope Surface water Check Cellar Shallow wells i Estimated Depth to Groundwater/-.'r Feet Please Indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record _ZObserved.Sits(Abutting property, observation hole, basement sump etc.) determined from local conditions Checked with local Board of health Checked FEMA Maps _to-Checked pumping records f Checked local excavators, Installers -Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) Used water contours map . Gahrety & Miller Model 12/16/94 revised 9/2/98 Page 11 of 11 •w..n r�rnl•rarr-rr an�mr•ntn.rl.na+nr�rgnT+wlnrr�rR'ennn nam,i..n.�+as+A•n .rt'•'•�-.�.•:rr-''.+..r•-I TOWN OF Barnstable DOARD OF HEALTH ,SUBSURFACE SEWAGE DISPOSAL ,SYSTEM INSPECTION FORM - PART D .- CERTIFICATION ��•Tf'1R•'.•::t—T.111t�.tTra.�1►11'.f.�1T1rlRTfIA,IT'��t7T{ITR•�RfT�Y"IR,�AfI�1-AAT•!'f•Ti ATn I -TYPE OR PRINT CI-EARLY- PROPERTY INSPEC7'ED STREET ADDRESS 44 East Lane Cotuit ,Mass . ' ASSESSORS MAP, DLOCK AND PARCEL # OWNER' s NAME Ken Alsman •& Linda Scott PART D - CERTIFICATION 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 State EIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( 508 ) 790 _ 1578 R CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and complete as of the time of6inspection . The inspection was performed and any recommendations 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 : System PASSED The inspection iihich I have conducted has not found any information which indicates that the system fails to adequately protect public health or Lhe environment as defined in 310 CMR 16 . 303 , Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. Sys tea^ FAILED* 0 The inspection which I have condlcted has found that the system fails to protect the i-iublic 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 �� � One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the I30ARD OF HEAL1'1I: * If the inspection FAILED, the owner or'"O.perator shall upgrade ' ayste within one vear of the date of the inspection, unless allowedorthe requiredm otherwise as provided in 3.10 CMR 16 . 306 . partd .doc 15- 00 THE tMMOf1iWEALTH OF MASSACHUSETTS EAR�D \OF HEALTH -------- --------_-T-ownOF..k........Barnstable-----------------------------.....---------- Appliration for DW 'at Workii Tonstrnrtion rrmit f, Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual Sewage Disposal System at: .........East Lane. -Cotuit.,... 026)5........ ....................•----- Jose h R. BarreLc Lion Address 4701 Falmouth A �. f°'Cotuit, MA 02635 --•--.....k?-----•----_..............•-•-• -••-•----•-•......-----•••--_._.._ ....•-•••••---•-----••........_......--- --............•--•------•-----...._•-•---•---- a A & B.Cesspool___Service, Inc. 128 Bishops Terrac9s, Hyannis, MA 02601 -• --•.................... --------Adddres-- resss.---------------•------ ......._.._......._.. Installer Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.............3__.._....---_.._..._-.--..Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons-----------2-------------- Showers ( ) — Cafeteria ( ) A, Other fixtures d . --•----------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 04 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W Disposal Trench—No..................... Width....._._.....---.. Total Length.................... Total leaching area.--____._•--....___-sq. ft. x - Seepage Pit No--------------------- Diameter..............-. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by............................................................. ............ Date........................................ Test Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •---•------------------------------•----------------------...•••... --------- .-..-•--- •--------............................................................. ~ ® Description of Soil...............Sand................................................... .................................................................................... W c, W ----•--------------------•-------------------------------------•------•------•---------••-••-•••--•------•--•-•-----------..._.....--•---•---••------•-----••----•----•-•-•-------------•---•-•------... UNature of Repairs or Alterations—Answer when applicable...1n,5ta-lla:ti_on___of a___1_,OOQ-_g31-.•_.-SePtic ta.nk......d-box... ...pr'e.'Q.ast......stone...packed-_-leach pit.................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned furtl r agrees not to lace the system in -� operation until a Certificate of Compliance been issued by th, bo d o Sig ..... ............. 11./0618� Application Approved By........... .•-•----•-•--•-------•-••------•-• ...........11,86Y84 Date Application Disapproved for the following reasons-------------•-••----•-•-----------•------•-----------------------------------------------------------...•.....-- ......................••••--•---•..................-------•-•-----------••------......-•-....•-•••-•••-----------------------------------...•-•-•-•-•------------....-_....------------------•-•---•--•- Date 8 - 10i 11/06/8 Permit No.............. ._ Issued.........................•........... - Date i� ................. .......... ...... ..................................................... ......................++... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................Town..........OF........B.arutable.............................................. Trrtifirate of Tomplianrr THIS IS TO CERTIFY, That the Individual Sews e Disposal System constructed r Re red ll byA & B Cesspool Service, Inc. 126 Bis�ho-ps Terrace, Hya nis , W01 Inst er at........ ast lane, Cotult, MA 02635 _.- 'oseph Barrett ------. ----- ---••... ......... ........ •--••-•. --.---•- ------•-- has bin installed in accordance with the provisions of T], F 5 of The State Sanitary Code as1 V do the application for Disposal Works Construction Permit No.............01-3.................. dated------------------------ ib................_... _ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE *� SY ILL FUNCTION SATISFACTORY. DATE....................`111.......-----`8 Inspector.. -��_-------------------------------------------------------------------------------------------------------J No.84-•_101 ' Fss. ....ilt©0.._ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................... olfw-fioF............Ba. stable------------------------------------------.-- Appliratilan for Disposal Works Tonstrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: --------East 4s...Cq:tu1tjL---M...... 2635......... --•------•---------•----------•--•................ Joseph R._-Barret tion-Address 4701 Falmouth Ave:`,N�Cetuit, MA 02635 - ..__... ( ................•--......-----....------------. -............._. owner 128 Bishops.Terraeesy •._ annis, MA 02601 w A & B Cesspool_ Ssrvice Tne. H,y ..... ............. .................... ......................... Installer Address Type of Building Size Lot............................Sq. feet U DwellingNo. of Bedrooms___........_ .Ex anion Attic Garbage Grinder— P ( ) g ( ) W`4 Other—T e of Building No. of persons 2............... Showers YP g =--------------------------- P - ( ) — Cafeteria ( ) dOther fixtures -------------------------------------------------•----------------------------...--------•----------------------------------------------------------- w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------------------- Diameter.__......1.......... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) �-' Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water--___--______.__._._-__. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Q+' --------•-----•---------------------------------------------------------------------------•-•................--•-------•----------------....._......--•---_.. 0 Description of Soil..............Sand................................................................................................----------------•-----------•-•---------------- x W U Nature of Repairs or Alterations—Answer when appllcable_instal.latlon of .. 1,.OQO gad,„ svgtic tank.$....d-nbox..and..a._Is.QQQ---gall=..pre:ncastp.... tone.._paoked---1.0a h...pit-......... ......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code—The undersigned fur! r agrees not�tolace the system in operation until a Certificate of Compliance been iss ed by the bo rd � �% — .............•••-•--------•-•••--- 12 06 84_..._.__Sig / 1 11 Oft 84 Application Approved By_..... � _ -:__ Y „ -----1•------------- Date Application Disapproved for the following reasons-........-....................................................................................................... --------------------------------------------------•-----•---....----•------••-----------....--•-•-......_--------•--.......------•-•-----••---•-...----------------------------------------•------------ Date Permit No.----.......8� Ol?•--------------------- Issued------------ 11 .06/84 Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................. 4IK7C1............0F.....Bad'1StAble....;........................................... Tntif iratp of Tnntpliatta THI Is TO CERTIFY, T at the ndividual S wlge Is osal Sy tem constructed ( ) or R fired b .& .$S Cesspool Service, Inc-` 1W$ Bishops-- Terrace, Hyann3 s.................................... 4661 In Iler at East pane, Cotuit, MA 02635 Jaoseph Barrett . --... .-•----. -----• -•-- -•--••------------------•--....-- -----------......---------------- has been installed in accordance with the provisions of T4LF 5 of The State Sanitary Code WOW.... .................. n the application for Disposal Works Construction Permit No-------_...jQ1-a................... dated__..-___._......... __O.../-" ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE .1 :� ........4 4............................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 84- .................Town.............OF..Barnstable........ $ 15.00 No......................... . -----------.................. FEE..--- -•-•-....0 Disposal Workii Tnnfirnrtuan rrntit Permission is hereby granted-.A B ggsspool Service! Inc....... ............................ to Construct 1 orkRepair an In ivid wage Dis osal System 1 �d a1 S t IanA 02 - J�seph Barrett at No.----Ea'$------ CoC �.. • 5 . . ----------------------------------------------••......._ 'Street Q / as shown on the application for Disposal Works Constructio Permit A.... t_�!a_.. Dated...11�A6—8..'................ 11/ /84 Board of Health _ DATE................................................................... ............. FORM 1255 A. M. SULKIN, INC., BOSTON 1 40-8 112"+/- 5 2x8's Q I G.O.C. 1 I i I A A7 o I m o I � REPLACE EXIST.WDW-- 101 EXIST. EXIST. --GLOB— --- - L HALLBATDNG15TING l\J ROOF TUBi 5"WR I ' EXISTING C15TING BEDROOM co g a BEDROOM 10'-7•. 13'-4• I " gEXISTING w I BEDROOM RENLOS S O C . B v4 - 12'-I 1'H V-7 MOVE DR. uwc G� I L---------_ © I NEW O REPLACE EXIST.WDW5 REPLACE EXIST.WDW5 CHASE cv REMOVE WDWS NEW IW S1 I 7 N { I a I 7'-8 1/2' + W'S®I G•O.C. 1 0-1 d' SECOND FLOOR PLAN r 1 PROJECT: REVISIONS: DATE: 0212112005 DRAWING#: p MM 4284219 FAX(500)4264295 g O D E N ADD 1 T i O N SCALE AS NOTED 0 SO EAST LANE COTUIT,MA DRAWN BY: ARCHITECTURAL INNOVATIONS TITLE: A3 7 '°°"'S'0"OFa°"E7*R SECOND FLOOR PLAN AND ROOF FRAMING P.O.BOX 2056.CONK.MA 02635 i 49'-1 1/2' 1 13'-1 112' 2T-T' 2'-8 112' 2'-8 1/2' 2'-8 112' 2'-8 112' 5 112, 5 112' 5 112' 5 112' 5 1 2' S2 N NEW aNEW SCREENED PORCH `T o_ DECK O Tom'"S'-' GI G'-1 112' 1 2-3 112' 5'-0' 4'-2- DOOR CU � NEW GAS F.P. FILL-IN O REPLACE NEW WDW EXIST.WDW EXIST.WDW N CENTER'N DINING Tl�N ZV New 2'G".GG' DN — 'T m o BATH in O NEW aR . i[l 3 F EXI5TING r DONaI KITCHEN d PANT io 1a-11•.'B'�3• ®® EXPANDED ® EXI5TING LIVING ROOM d a REF. =15L-_D 1 DINING s'-la. la'-I r. REFINISH WOOD FLOOR � zo . _ REFINISH 3 N F, 3'-6 3/4" 4'$ I/2' 3'-6" _ WOOD FLOOR r- v EXISTING. � N N MUD RM. ��ai o _ �S < - a'-I•. s•-e• EXISTING REMOVE UP . 3 BREAKFAST FA5T. TH o O z 1a-1•. B'c O <I © O iv © NEW TILE FLOOR - O CENTER IN DINING I REMOVE EX15TING WALL Z~ NEW W O ©z O ADD GHASE •.••-.• AND WDW NEW UDER POST NEW PLUSH STL.BM.ABOVE W8 35 P05T O Q UNE OP E 5Tv2ND PLR. $i OZ J � o { 4'-4" 4'-1" 5'-5 3/4" 6'-I I" I,T6'-1 0 112' 7 4'-7 /W' CLPS. b vow O NEW Ek W . NEW— �lS OA DQOO PATIO) N 101.23'-1 NEW 3' " I51-10112" (SEE OWNER FOR RNAL DE51GN) PORCH O <:D \`_-�` �� STRUCTURAL POSTS 7 . / STEP 16'-IO" FIRST FLOOR PLAN 7 ( PROJECT: r REVISIONS: DATE 02/21/2005 DRAWING: FAX(509)428 4295 B O D E N ADD 1 T 1 O N SCALE: AS NOTED —_ 50 EAST LANE COTUIT,MA DRAWN BY: - ARCHITECTURAL INNOVATIONS ADM90N0FA/DV7ERPRLSE%p4G TITLE: •� � . .111-W FIRST FLOOR PLAN ol w ► _ edl�0 _ c - Ir YGH c.l L�• IIS?H Jr� x-oo. 2 aS oo al 1 , -! 3'-4Yz• � 1 .. G.-U IOC-®M � `NN.�GED^$ • - S•D•3C. 21'-8•• RND 7tA 203�o AND ryJ Zo3tp-3 I v.t�sr' c��,t.t•n o•.f 1 ftNo r.47-54L-7- F(A x Aav TW 28�IG-Z .. I T-9'x8•- ?.c- vJaw o.� IR Z.p" �C BAST E�E�LATo�I. II I .etyma o�� i I I ANo Tv4 2•-o.x�.-o.• •zyYb _ ---. SAs-.1 - ' $oDEnl Cc'rY-iC•-,t So'3 =�tST �-r( � wPPrfOVEO By: ORA—By owrE: 3 to o 5 REWSED G *,"G HU"BER 1 S� ' i i (HOUSE 150A) NEW FOUNDATION ELEV.= 102.0' 20' MIN. (COTTAGE /50BJ NEW FOUNDATION �— 10" MIN. 4" SCHEDULE 40 ELEV._ 101.5' P.V.C. CONCRETE COVERS MIN. PnrH 1/8 PER FT. 2"LAYER OF CLEAN OUT 1/8"-1/2" CONCRETE COVER WASHED STONE � EL=100' 6' MAX 6 MAX B MAX � B' MAX 4" CAST IRON PIPE w X. OR UAL MINIMUM l � CLEAN SAND PI7 H /4 PER FT FLOW _ N L/NE EL-98..0' (PROP.) o 1 o0o O o000 - ( 10" INVERTS M/N. 14" --2 0' 7040 oo° o0000000000 - 995 LEVEL °o° o ooC3C3C3 oo0 EL.-___ ADD CAS INVERT i 6 SUM °° °° o 0 0 0 0 0 0 0 0 0 0 INVERTS BAFTZ9' -98.25 INVERT INVERT o° o 0 0 0 0 CO 0 0 .o 0 0 =95.3 EL.=9e. EL.= 8 o' EL.=97 75' _ 4. 4 _--5 _ -- 3 500 CAL LEACHING CHAMBERS DISTRIBUTION -s' GALLON EL.=g�: 12.8' X 33.5 TRENCH FORMATION 15 00 SEPTIC , TANK BOX o, ?1'J BE WATER TESTED SOIL ABSORPTION IF MORE THAN ONE OUTLET O b PLACE ON 6" S7OAW 1-1/2" 3/4" T SYSTEM (SAS) t� DOUBLE WASHED S719NE PROFILE of ' NO OBSERVED WATER TABLE (811312004) EL=_89 4'- SEWAGE DISPOSAL SYSTEM NOT TO SCALE OBSERVATION HOLE 1 ELEV.= PERCOLATION RATE SB MIN/ INCH AT _46_"- INCHES DEPTH HORIZ TEXTURE COLOR M077 OTHER 0-10" A LOAMY SAND 10YR 413 SOIL TEST 10"--24" B SANDY LOAM 7.5YR 516 DATE OF SOIL TEST: 911312004 _ 4"-48" Cl COARSE SAND 10YR 616 PERC. SOIL TEST DONE BY: EDWARD A. ---STON -- & SOIL EV----- 8"-132 C2 MEDIUM SAND 2.5 Y 714 NO WATER ENCOUNTERED GENERAL NOTES 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN OF -BARNSTABLE____ RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. DESIGN CALCULA TIONS.' 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO (3 HOUSE 50A) WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" NUMBER OF BEDROOMS . 4 EXISTING (I COTTAGE 50B) 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN GARBAGE DISPOSAL NO 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE TOTAL ESTIMATED FLOW GAL DA Y W FT. OF RIVES OR PARKING AREAS. INSTALL O DA Y x 4 BR. 440 / U UNDER OR WITHIN 10 .. 11 AL BR __ USED � G ) 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL (3) 500 CAL LEACHING CHAMBERS BE MORTERED IN PLACE. 2.WITH 4' STONE ALL AROUND 16' X 33.5' PROPOSED SEPTIC TANK CAPACITY 1500 GAL 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH SOIL CLASSIFICATION .. 1 DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO DESIGN PERCOLATION RATE < 2 MIN./IN. OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR • NOTIFY YANKEE SURVEY 24 HOURS PRIOR EFFLUENT LOADING RATE . . 74 GAL/DA Y/S.F. IS TO CALL DIG- SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS TO INSPECTION LEACHING CAPACITY (AREA X RATE) 454 GAL/DAY PRIOR TO COMMENCING WORK ON SITE. (33.5X12.8X. 74)+(33.5+33.5+12.8+12.8)X2X 74) 454 GAL/DA Y 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. 8) PARCEL IS IN FLOOD ZONE-__"(�:_-_-_. 9) LOT IS SHOWN ON ASSESSORS MAP _37_ AS PARCEL 6------- SHEET 2 OF 2 J,� 53793SP t4 • ASSESSORS . � COT . LOT 37=05 MOSSWOOD 7.1' ,; _ 2 CEMETERY S57 00 35 W 83. 79 - - S57 00 35 W 85. 02 Locus C.B 1 TODD WAY (FNDJI rrrrrrr..r'49.3'.rrrr.rrr. �� I TREE 7T7 rrr,rrrrrr, r,rrr,r.� a A rrrrrrr...•....,..rrrrrrr I. BE SAVED � Q' Irr/r/Ir.I rrrrrrr. O rrrrrtrrr#50A:rrrrrrr1a I TREE 7C7 (20' PRI VA TE WA Y) "" .... - BE SAVED r..r.rr.,........:.,r,rrr rrrrrriiiir.rrrrrrr... SAVE CEDAR I PARK SEP. SEYSM 7V BE SA VE lLLED W/SAND AND/OR� SPRUCE RE,vovED _ o I COTUIT �j�ELG� E.S. BuiLo \� BE voVED �I I' sAva o 0 / i7REE 7YJ� ti l \BE SAVED \/ � I I 0� I I(`,ya1j I I 1 � i 99. r,r..rrrrr to �' { � I y 3.4';:;:;;::;; o�s�io CJ COTUIT W ,,.rrrrrrr � soq 48.7 A LOCUS MAP BAY � d$cy2O F / C.0 rr rrrr rr 1 /TREE 7v - r rrrrrrr CLEAN BE SAVED ell ur PLAN REF 2211125 p I l / ly 218 NED �! DEED REF 82601288 EAMI Oti C6SS IN917 � ASSESSOR'S MAP- 37 PAR. 06 rMlJO OAK ti F/LLED W/SAND �'- _ 10' ZONING.• „RF" I 1 � \ �� SETBACKS.• o �l � WELLHEAD PROTECTION DISTRICT 1 BUSH►v i o I N �"' ASSESSORS B SAv o i 1 o ``�I C,4 1`' LOT 37-07 ASSESSORS I I I fop ;i `� i SITE AND SEPTIC PLAN LOT 36-22 , , J L--' I 10' �(' 'LOT 3 8' 128 LOCATED AT. #50A & #50B EAST LANE LOT 2B lu COTUIT, MA. our WOODS PREPARED FOR: 1 94 1 I POSITIONS ROBERT & MARY JO BODEN 100.4' I-► OF �15 B PINE N __-- I f ,_B,9000M SCALE: 1 "=30' I O I T� _ 1/1 r0F ra-' s 144.7' �� pgIVE �. Of ' RaP I DECEMBER 29, 2004 BRUC€ ��,, I W 1 ' . "� �`1�t7 _ W A.M. 37 REV -� G. MURPHY y I ► W ,�/ I PAR. 6 REV s►h&AAAA® No. 749 ".. r, I AREA=40221_+S.F. �P0 of M46. ®v r CISTER I I / I WOODS I REV go`'�P�G'sT'gco9cyGJ®® •9'V/rAa\p. I� co W �o o STEPHEN ® YANKEE SURVEY CONSULTANTS J. y ® �. 85. 02' 1 85. 02' DOYLE ib �s UNIT 1, 40B INDUSTRY ROAD � ® I s' m --—---- off'TRA vl Lls'v war - -- , (FAD) P. 0. BOX 265 c Q ® (FNDJ 1 ---- 7' "E 170, 04 � �c �BENCHMARK MARSTONS MILLS, MASS. 02648 N56°4 45 TEL 428-0055 FAX 420-5553 TOP OF NAIL EAST LANE 100.0' (ASSUMED) IF SHEET 1 OF 2 J#53793SP JF/GM