Loading...
HomeMy WebLinkAbout0099 PINEVIEW DRIVE - Health 99 PINW\6,-k3S COTUIT A = 040 117 s �rz. �^s� � � � 2-53 No. '24 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ,Z PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[pplication for Misposal 6pstrin Construction VPrtuit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. NF Vl iW DLJ2, Owner's Name,Address,and Tel.No. v Q cr K '1 Assessor's Map/Parcel 040 f � C ,r '?>&frN& ow, Installer's Name,Address,and Tel.No. 5de�2` 74-q7$-_3 Designer's Name,Address,and Tel.No. Type of Building: t Z:M 4`vT1� /� Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) h1 gpd Design flow provided ���"} gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) C r- 67X I SEW 6,0 Date last inspected: Agreement: / The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Date Signe J Application Approved by �1 �� Date 1 Application Disapproved by Date for the following reasons Permit No. �-Q d- _y)_ Date Issued o� 1. No. �1 s^! ( 0?1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC 'HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplitation for Misposal �6pstrm Construction 3permit Application for a.Permit to Construct( ) Repair(l Upgrade( ) Abandon(_ ) ❑Complete System Ej'Individual Components s _ Location Address or Lot No. q � �I N� Vi�V✓ IZ, Owner's Name;Address,and Tel.No. Assessor's Map/Parcel 6�� —ti �� (6 %�f 0V,pj t`t> t' Installer's Name,Address,and Tel.No. 506-2 74- q i 57_3 Designer's Name,Address,and Tel.No. IAAS '-jQV66( (ecN,a 2) Type of Building: '�rnpi'`U�1j¢ pan f, Dwelling. No.of Bedrooms \/ )J Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures a Design Flow(min.required) V� gpd Design flow provided k1 A gpd Plan Date Number of sheets Revision Date s Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ���/�, ( rE G' ( I ST I N(T � �`�o A t'A/ 1-E l rV u' P r�r�y r1�-�5 4 - ( Mgt: t U CAT 1 U AI y prr i c`c A"d /r e v'n Date last inspected: �•,� f "�.r e� Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in ti accordance-with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of ' Compliance has been"issued1iy1his Board of Healthy Signe�/"} :fir Date / tt r� Application Approved by i,%` .�4 u,J Ap i� r Date - Application Disapproved by a Date for the following reasons r� f Permit No. 2-0 oL it 0 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate Of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(V� Upgraded( ) Abandoned( )by AN(t-� �- �/M`a­rjZVC1_1040 at ,_. _t -1 `P r RNc !! f 41 1)12 has been constructed in accordance 1 With the provisions of Title 5 and the for Disposal System Construction Permit No. d�Ga i`G r dated Installer �Aly �' lVla ' Designer #bedrooms N//R Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system wil-1<functio =as.designed. Date a/ / , Inspector � A -------------------------------------------------------------------------------------------------------------------------- No. a a -- S� Fee f. l THE COMMONWEALTH OF MASSACHUSETTS f PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *PBtem Construction Vtrmit Permission is hereby granted to Construct( ) Repair(V) Upgrade( ) Abandon( ) System located at ;/ z V V✓ and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. I Provided:Construction must be completed within three years of the date of this permit.i�> Date �1 I Approved by .•� �� „/ t �/ 5 aFt�T� Town of Barnstable Inspectional Services Department Public Health Division MASS. 1639. 6. 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 8302 January 12, 2021 US BANK TRUST NAT ASSOCIATION TR 7114 E STETSON DRIVE STE 250 SCOTTSDALE, AZ 85251 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 99 Pineview Drive, Cotuit, MA was inspected on 12/23/2020, by Michael T Bisiencre, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Septic tank baffle needs to be replaced. • The distribution box is rotted and needs to be replaced. You are ordered to repair or replace the septic system within one year (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH P omas cKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mail ing\Conditionally Passes Letters\99 Pineview Drive Cotuit.doc Town of Barnstable • f:BARNSI'ABLE, 639. ,�� Inspectional Services Department prfD MP'�a Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box is above the outlet invert due to an overloaded or clogged SAS or cesspool ❑ A portion of the SAS, cesspool, or privy is below the high groundwater elevation ❑ A portion of the cesspool is located within a Zone 1 to a public well ❑ A portion of the cesspool is located within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool ❑ Any "conditionally passed systems" (broken cover, relocation of a pipe, relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) 0 ER 4,,kl Repair deadline: G(' Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments i 4 y ' 99 Pineview Drive ` V� Property Address US Bank Trust ,r Owner Owner's Nam information is Cotuit MA 02635 12-23-2020 j required for every page. City/Town State Zip Code Date of Inspection r � 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. Imngoutf rms A. Inspector Information ( 15004P filling out forms on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return Company Name key. 52 Rivers End Road reb Company Address Teaticket Ma. 02536 City/Town State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ❑ Conditionally Passes 3. , ® Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails �12-Z-2(020 I spector'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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts T Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is Cotuit MA 02635 12-23-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 c� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is Cotuit MA 02635 12-23-2020 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: "*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: This 4 bedroom home has an H-10 1000 gallon septic tank and an H-10 D-Box feeding three 500 gallon leaching chambers with 4 feet of stone At the time of the inspection no visible failure criteria was found.. But the baffle is missing from the septic tank and the H-10 D-Box has serious decay. 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 r c Commonwealth of Massachusetts - 'Title 5 Official Inspection Form 1' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. 0 ® 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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 11 of a public water supply well t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments In � 99 Pineview Drive v� Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: 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? EJ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form � a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments « � 99 Pineview Drive V Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. 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): G plus PD Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: - Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: In 2019 30,000 gallons were used and in 2018 25,000 gallons were used. Sump pump? ❑ Yes ® No Last date of occupancy: 2019 Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts re Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is Cotuit MA 02635 12-23-2020 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: — t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �n 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is Cotuit MA 02635 12-23-2020 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known) and source of information: a new leaching was installed in 2001. Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 32"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. town water feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts M1 p Title 5 Official Inspection Form �- Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is required for every COtUIt MA 02635 12-23-2020 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 2411 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene El 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: H-10 1000 gallon Sludge depth: 5" Distance from top of sludge to bottom of outlet tee or baffle Baffle is missing 1 Scum thickness Distance from top of scum to top of outlet tee or baffle Baffle is missing Distance from bottom of scum to bottom of outlet tee or baffle Baffle is missing How were dimensions determined? sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I recommend the new owner put the septic tank on a maint. plan with a local septic pumping co. basest on the future use of the home. At the time of inspection the liquid level was at working level and the baffle was missing. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments >r 99 Pineview Drive v- Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I 8. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts 1. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments >r n 99 Pinevilew Drive Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8: Tight or Holding Tank (cont.) 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 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): At the time of the inspection the liquid level was at working level. But there is major decay in the concrete. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 c� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive v— Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 c� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive V Property Address US Bank Trust Owner Owner's Name information is Cotuit MA 02635 12-23-2020 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection the leaching was dry and no visible failure criteria was found. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts 'Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive L Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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 i t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. 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 i I/ a t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts *Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments v- 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 14 plus feet 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: augered a hole at a lower elevation and shot it with a transit. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 c Commonwealth of Massachusetts 'Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments >r 99 Pineview Drive Property Address US Bank Trust Owner Owner's Name information is required for every Cotuit MA 02635 12-23-2020 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 TOWN OF BARNSTABLE LOCATION yl/ _al IY✓/. SEWAGE # !1'00/ - VY-5 VILLAGE �'Q rV r ASSESSOR'S MAP & LOT 0510-//7 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /000 LEACHING FACILITY: (type)--'?'S46�6V/ ce/6111 (size) ?-T X /3 NO.OF BEDROOMS Lt B[JMDER OR OWNER 14 G./OAb-6S PERMITDATE: 7--0/ - 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 � - r , w ` � chi 9 p ..-. � h£ .s ,L� - - i� - . "fit ._ ���(�( 7 L� .,� 1 � � �n� i CERTIFIED MAIL#7015 1730 0001 49902939 Town of Barnstable Regulatory Services Richard Scali, Director , IIaRNSrABLE ,�� Public Health Division �fC MPy A • Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 23, 2017 Marshall &Benjamin Lopes-Pogue 99 Pineview Drive Cotuit, MA 02635 A4 "Z� NOTICE TO ABATE VIOLATIONS OF TOWN OF BARNSTABLE CODE The property owned by you and located at 99 Pineview Drive, Cotuit, MA was inspected on August 23, 2017 by Town of Barnstable Health Inspector Timothy B. O'Connell, R.S., because of a complaint. The following violation of the Town of Barnstable Board Code was observed: A53-2 Storage of Garbage and Rubbish: Garbage and rubbish was observed to be over flowing in a large dumpster near side of house. You are directed to empty the dumpster located on the side of this dwelling. Clean all trash and debris around this dumpster. These violations must be corrected within seven (7) days of your receipt of this notice. You may request a hearing before,the Board of Health if written petition requesting same is received within ten(10) days after the date the order is served. Failure to comply with an order will result in a fine of$100.00. Each day's failure to comply with an order shall constitute a separate violation. joPEmR ORDER HE BOARD OF HEALTHas A. McKean, R.S. Director of Public Health Town of Barnstable Q:\Order letters\99 pineview 8-23-17 No. —t#y 3 Fee +� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for Miopomf 6p$tem Congtruction Permit Application for a Permit to Construct( air( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. q 7 ln/:-:: /,:w 4 Owner's Name,Address and Tel.No. Assessor's Map/Parcel p Z�d /� "� Zo_ _F e i Installer's N;n ,Address,an Tel.No. G/'�1—dly`i Designer's Name,Address and Tel.No. Jos e1 ., 'Y Type of Building: Dwelling No.of Bedrooms _ Lot Size sq,ft. Garbage Grinder( ) Other 'Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Natured of epairs or Alterations(Answer wh n applicable) ui17- y ' s"dam! z-- 0/2v� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this oard of Health. Signed f'I/ Date Application Approved by _ Date 72" 6 Application Disapproved for the following reasons Permit No. JVI rqq 3 Date Issued �9 —o � I Fee SI' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes �f PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 0[pprication for -Miopogar *p$tem Con!5truction Permit Application for a Permit to Construct( air( )Upgrade( )Abandon( ) O Complete System ❑Individual Components } trC Location Address or Lot No. q? /h115 //:4v 0VrZ.Owner's Name,Address and Tel.No. >a��r/ L a!o-ems' Assessor'sMap/Pazcel Cy 1/Q // + ,'�;"�"�' /1 y C / V� Z Installer's Name,Address,an Tel.No. L/97-d 1 y f Designer's Name,Address and Tel.No. Jos c,d/i d� l��ti" Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other. ' ,Type of Building - No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank / Type of S.A.S. Description of Soil; , Nature•of epairs or Alterations(Answer wh n applicable) ( rO 6V15-115 Date last inspected: Agreement: � The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this oazd of Health. j Signed _ Date Application Approved by Date b- T 7-0`t Application Disapproved for the following reasons t Permit No. Za)/ Date Issued (9 Z 7-0 THE COMMONWEALTH OF MASSACHUSETTS (r Sep (jp--6v�, BARNSTABLE, MASSACHUSETTS cba Ls, Certificate of Compliance THIS IS TO CER71FY, that the On-site Sewage Disposal System Constructed(,_/ repaired ( )Upgraded( ) Abandoned( )by . OJ cf l a-G/3•yGvvs at 9'�! *I//,0 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. "IN 3 dated ''7 7 0 Installer locr-,y yU_- Designer o.S /fQ The issuance of this e shall not be construed as a guarantee that the syst fun t signe ��i' Date / '�� Inspector = ——���—---—---------------- ——— 0�6 �17 No. Fee —S--df THE COMMONWEALTH OF MASSACHUSETTS vT y 9 PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 1Wi!5po!6ar *pgtem Con5truction Permit Permission is hereby granted to Construct( pair( )Upgrade( )Abandon( ) System located at i&I/=- //uJ /4 vl 5 _a71 /T and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must b completed within three years of the date of this p Date: Approved by l/6i99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF S1<ETCI3 .ktiD .APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) o.T hereby ceairy that the application for disposal wor,�s construction permit signed by me dated (, !�7 7 p / conce.^tina the property located at 1�19 T` of-e V i94 #111-c CoTyl T meets all of the following criteria: ?jT'ne failed system is conne^ed to a residential dwelling only. Trie:e are no commercial or business uses associated with the dwellins. <-/T'ne soil is classined as CUSS I and the percolation rate is less than or equal to 5 minutes per inch. • There are no wetlands within 100 fee:of the proposed septic s+se n �nere are no private wets within 1:0 feet of the proposed septic s+sern There is no increase in flow and/or change in use proposed T"nere are no variances requested or needed. • The bottom of the proposed leaching faclity will not be located less than Eve feet above the ma-cimum adjusted undwaier table elevation. (Adjust the goundwater table using the Frimptnr me;hcd when applicable] • tf the S.A.S. will be located with 250 feet of any vegetated wetlands. the bottom of the oroposed leaching facility will not be Iecated less than fourteen (14) feet above the ma:yumum adjured zmundwater table t!(r+ation, Plea.se complete the following: I -k) Too of Ground Borate =:�r+auon(using CIS informauon) - 7l B) G.w. Elcvadon -the 1,LA2(. ;i;h G.W. Adjusunea 3 D - -_RE`i CE BETWEEN a,and 360W� f (Sketch proposed plan of s+ste:n on back]. q::uai[h ioidc-.-i 17 po4' o 7 v 0 �i I z,�.an � �` 3.:xbx '�2 ` :�zz3.^oa-�' T'^MCY`.'•i" aL,..:.y.... 13A�5 r + a- »--q. b •s�,�, 'r s7 S �^Tn e�gCT SO r I `i 4-W-o� "$ l— 5MM ^r.W..."."a,y G �., '+_ � ..,. 'Ef ,—`'.i, r...z -.'.-''�--`-:-.. o-.."sstss '"a�...>^ •�.�+'-4-e�a—`" "�'r^ -�z � - �w ,,i 1 {�, ,.f.- ,c� �+-` T�WI��F BARNSTABLE G �`` � zt ,� LOCATION 9 /1'I V SEWAGE 1FwI//�. # Q01 4'y- VILLAGE (fDry!1 ASSESSOR'S MAP.*LOT'DyO^//1 .` INSTALLER'S NAME&PHONE N0 :28 y7 2 Jas�iP� 4� /34 �0os SEPTIC TANK CAPACITY /000 . LEACHING FACILITY: (type) Z/ (size) X /3 NO. OF BEDROOMS 3 © y. e�s BUILDER OR OWNER Pkorl Z o"e-&S PERMITDATE. 4:, 7"O/ COMPLIANCE DATE. Separation Distance Between the: Maximum Adjusted GrqundwaterTable.to the Bottom of Leaching Facility Feet. Private Water Su 1 Well and Leaching Facility If any.wells PP Y, g tY ( , co Feet: .facihty) . Edge.of Wetland and Leaching Facility(If any wetlands exist Within 300 feet•of leaching facility Feet Furnished by . t - .. •L T�A z l c4 Flow- l P►(A't viOEA ) `Z-)rc Col;x1 - M4 rS. J /9 - Vr L O C A TJON . ACE PERMIT NO. f 0,1 IAJ C, VILLAGE co; INSTALLER'S NAME i ADDRESS S `161,� ® U I L D E R OR OWN ER /-5 31e91- �Xls DATE PERMIT ISSUED DATE C O M P L I A WC E ISSUED — Q W, 0 gee Lot w THE COMMONWEALTH OF MASSACHUSETTS ` BOARD OF HEALTH ........... ...........TOW1V--....OF:.....8ARNS.TABLE.................................................... Appliration for DWpos al lgorkii Tonstrnrtinn ami# Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: PineviewDrive.c.._Cotu :t.r.... ................. ...............................................49............................................-- Location-Address or Lot No. Dennis Star Const �, ,ox1... Qmpaay:..... 24 ...C�rjeat... P.and,:.D �ve.r-_-5:..._y.�, ,}�_,--• Owner Address a Spero ' eo17. idis.--------•-•-•--•................................ .... ................ ---___----•---- Installer Address �►"' Q Type of Building Size Lot..23 t 12 -- Sq. feet Dwelling—No. of Bedrooms..... Expansion Attic ( ) Garbage Grinder ( ) Other—Type of BuildingRe5.ideIlticll No. of persons.......b................... Showers ( ) — Cafeteria ( ) Q' Other fixtures ----------------------------•••• . w Design Flow............ ......................:----gallons per person per day. Total daily flow--------- 30............................gallons. WSeptic Tank—Liquid capacityl•r.00_9allons Length.J-Q..fi... Width.....5_!...... Diameter................ Depth._6-.3-•-•-• x Disposal Trench—No........15.......... Width.................... Total Lenith.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq.-ft. Z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by....Rob.1Z.t..E_.....RAY.Mond..................... Date_._._lII/6./_.8.3............... as Test Pit No. 1.....2_........minutes per inch Depth of Test'Pit... 44_'.'........ Depth to ground water...NO-ne.......... Test Pit No. 2................minutes per inch Depth of Test`Pit.........ie _:___ Depth to ground water........................ •••• -••-•-... •••---•.....---•....---•••••••••..................•-•--••--••-------......................................................... 0 Description of Soil..._Subsoi I...medium-• x send-;........................................................................................................ w U Nature 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 TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by th oar o e a ..ed•- . h• .h........ ...........••--- ---- -•-• Application Approved By......•-r1lowing ... ............................................................. -•-- Date Application Disapproved for easons----------------------------------•-•--------------------------•-----------•------------••-••-•--•••......_-•_... -•-••............................•----------•---------------••-------------•----•-------...._.......----•--------------•--•---•.....---•-••-•-•-•••-•--•••-•••---•-••--•••••-••--•••--•-•••-••••--•----- Date PermitNo......................................................... Issued....................................................... ' � Date No................_....... FEs...$4 0 •0 0...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN.....OF....... ARNS-TAH.I�E Appliration for Disposal Works Tonstratrtiun "(rrntit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: Pineview Drive, Cotuit.....mA............. ---------4.9............................................. ................__...__._.........•-... ....... - - Location-Addresg or Lot No. .Dennis Star Construction Company_.- 24...Crea....pQnd..Drive.* Mp, Owner Address WSpero Theohari di.s .............................................Same_......................................... Installer Address U Type of Building 3 Size Lot...23,_125+ Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building Residentia............................l No. of Persons.......................... Showers ( ) — Cafeteria ( ) Otherfixtures .---•••---------------•••••-•-••-••--------------••---.----------••-----•-----------------------------................--------........------•--.--••-- 55 W Design Flow............................................gallons per person per day. Total daily flow.........330...........................gallons. WSeptic Tank—Liquid capacity.l rAPAllons Length._10_.6.. Width......5_...... Diameter................ Depth...6.A.._.. x Disposal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosin tank ( ) a Percolation Test Result Performed by... bert__E . Raymond_____________________ Date......I0f 61$3_.________..._ Test Pit No. I................minutes per inch Depth of Test Pit...144........ Depth to ground water ..NOne---.---. 44 Test Pit NO. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 _ .....1.. ............................................................._...................................................................... . p Sulisoi.....medium sand. Description of Soil............................................... ........•--- x c, W x --••------------------------•-----------•••--•----•--------------------------------•----------•--•-•-----•------------------••---------------•--------------•••-••-•-•-•......----------......---....... V Nature 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 ITS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... .......................... Date ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons:--------•------------------------------------------•------------------------------------------------....._---- ......................................•-------•---------•--•-••••--•--•-•--------•-•••-----------....-•---•-•-••.........-••••••---•-------------------••------•-----------------------•-•------------- Date PermitNo....................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................TOWN....O F.......BARNS TABLE ..................... ..................................... Trdifiratr of 19outpliFanrr HIS IS 0 CERTIFY, That the Individual Sewage Disposal System constructed ( X) or Repaired ( ) by Spero T?eoharidis of 24 Great Pond Drive, South Yarmouth. --MAI Lot 49 Pineview Drive, Cotuit, IWsachusetts, at ---------- ------------•----.........----• -------•----•-----•---------------------------------...__....-------------•----.....--•----•--•---•-------------••••.......................... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary,Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN BARNSTABLE ...........................................OF..................................................................................... $40 .00 No......................... FEE........................ Disposal Marks T-Ronstrudion Vrrmit Spero Theoharidis, . a Permisslon�s hereby granted-----------------------------------•------ 24 Great Pond Dr '----S-...•.-----Y....rm.-•-•-!�.-..MA to Con S1581 (& VIR&Ad n1 bR,�%divi�ttalt&-Aige posal System JII IF at No............................................................................................................................................................................................... Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... .....------•---•-------------•-------•---------...------------....--------...•---......_...._.........._ Board of Health DATE..................•----......---.....--••---•----........ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS r � .' " 2�l`{L � ZKK 6 � Z4 it[o j 3(." ti Cj— a ' C1 v- N 12-� LL S L6 F,z 7 can i r-)-q Zo� �w a _ 3.�. Z p z� dw ' 4 lkc a OW M 11� " • e a e t , !r 9 s7ox . Stiff owl $ tar.'T it Serbs � _ ,..,.�. .. � EI'SG��-7 2A., P' , �►1.i.. t.,. M'tS Aop -r/frcc;pT - • �. Y�• „ t, ,; : : f,; � , M+eS►J tw- s :rwi yWOUi,..aY.040 �rf•C�� .; (1 d ', A,L 1cPT� T1AktK�► v+5'3'21ls eiCW., .pw.)t3 "iytrt S*+a w.L t�E flE'a is F ALM S QED✓E ALA, v.JS.�v T,A3a-AE MIN s '� �w</Efc"T EI,�t/artorJS I ET OF: oc4irl R� t a _ _ 4v D �...L �. ._ } 4 �' ,: `' v ( C) © A ea�l S o� }p' I�Jo B,ocKr Li IT1+i C.ay- 1 D C 2A�Ji . t �. TµE QAttJl*-r f5L6. Qa` NE+�t_111 Mtd,T - J N0rlF:iE .) T p I-i0ek *4c �ySTEM IS NEAT Q Q + o Q CC) CC`-"PL.ET-IprJ Ao-sO Pe,oc2 �0 6.�GF;�t►u�w ,, � c = gA�1,r,�cJ `:J v►.3��5 OT�•�E���SE t�.lo-C�D, A>.� by3t�.*� . h { �---'TEG I 2�lri• Q L,1`/ Q 0 O �i � � �l'7�A1E►.a�TS 'b►'LAL� $E 1w1�TA.L.�-CL'� 11.J • f A4CCr2 LEA►-IC Is., W 1'r + r t T t_ E ZZ7 TYPICAL. pI5T2tbu-rlOt.1 (� �'`� A kh TC) S4C^%-e 0 0 c 0 ) t �.L ® `A..J IT�E'y C1JUE A.SD A,.)y L.taCaL 2L��-E S V1N iCFI MA+y A P��-`J ►.�aTrE t:.sTe6buT-t►J ONO,, ,►uv 4,000 TyPoc..` ocx� Gw+�- tcr.�.1 1. d►ct-►LN ►C Qg6S�,C VA T!Q A./ P/T S ¢�r.s F�r�i, ---- �...�. �.e. S !by AHte►CA4.j c'rEc_r.sT ►3oT `fC7 sc s�E I.bT-,i o ...�E Ca�- Gr Gt UA L -�: Tewy K S Rrc t►J Fca,ClJE O TI.�{{G+IX�N C7J"'� ,czxcotA riaw ,cA7v 0�3�•tY•IT/oNf. 6y: .J4 ),)4 XJT ?A MAtAAOLL-n, -co ti B IEt)a7�1bL� Bo.,4,e& ow Ar,4[.7-y 6oTCo�. Coo C. is 400o rei. bsT gcv-r�c 14JILTAj uiw o Mov.r-me TG �!f Burl? l!P TO )'�.i�it.)'iR"'Z DA>� _ Q{:f d.J' �1+ TOE' Fo� acLcw f�►s�yN art'.a�� F I"I.415K $tAD /F.rL%m tIC TritcIC �11*0 OVflt"dVACM IDA tdWCH1"cl �" PtrxsTo+�# o V. ._ � ' • C4 O' ® O 0 ' ' ` 12"of t►k 1000 b,uL. � • r rltl�KE D dTO+.1r ZolecuJFO[Ge'p CA*JG- ' DIST t�5OY- p _ � O Q O • 'I CjE1p'(1L TA1�! , • p • E1-EV = (o2i2p .16 tSE Lt1/EL 4 $TAO LE J r X TYPICAL 5EWAC7E SVSTIE M P mrtus NoT To Sc.e.LE L,E A CA IN6 IPA h �n 33 it F. � Pear O�tAE+.t�x3[. 5 }a 007 LEG€�c/1� Des/�.Iy ceirEl/�+► . PROP051=D DWE-LLI KiG LOCAT I O" •�Gx � Gq�. /r� / Q �leo�n� ccrvTdut ::�.�,........ q 3 ":�` PROP0 W-0 SE.WAG� OISPGvAL SY�TE.1�( t �t/vM �� aF eEv.�avi+,r a __„___ 71r�0 ,Irxi�r �+" v ,IA <sv �x ---`"�' "- .�•�• ; ilAYrdCSN� LaT -J �1h►G1�IE1�.� L/QtV clrif�L4 6 �' i'L.x+N' /9G�P L�iA Y f_ P��Ct�IG11JbR/ 1lC9T G��Ic�,w6 A�e54 �C'EQ v/tEL> r PCB Zecwesfi,t/G Azc4 Prow/DAD AITZ W- PROPO'�` F-P LLtACW IWCS PIT .4t?PL,IGA.�tT: i►t�.liJ it: - �� ZDP-ca T L 12AVI Mcj^�)Q TKO D�SPOS w1.. . Laoy6 Ent'.an.19IoN ,a V ?AGt AkT .Fawio DeivE S'J9T12.`PC?- :.A"e. ,•� t ► � ��►R.�tQ Uu"h� :1 ��r �. FA L I�.et p l�T h-� . ��a Ss, S iG/E� '� UlES�G IV ROBERT ��xa td)t�)Cz 5) = 37 6PP SiofwAa- Qs SCALAL 4Z1 GPD , > �►5 1�4T1EL�i. LScT 13) Eg$3 1 Uf SE�1�f�' �S,PPLIGA.TI OIL, �.14, PLd 4 OOAVM iw: CHKO OY: Aldo hr: iui#� Mo