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Home My WebLink About0467 PUTNAM AVENUE - Health 467 PUTNAM AVENUE Cotuit A = 038 - 011 TOWN OF BARNSTABLE"' LOCATION L4(49 P 07 NA ft Ail C SEWAGE# Ao 1 ct r A 15 7 y. VILLAGE C 0TU V "r ASSESSOR'S MAP&PARCEL . t) ,--INSTALLER'S NAME&PHONE NO. GAPr w`D C- 6'n►Z'r7-?&J9eS' 47,77 2T51-J SEPTIC TANK CAPACITY + < LEACHING FACILITY: (type) (size) yg: x NO.OF BEDROOMS QGt,kiED D-130V N63 OWNER AP(ZI® 'REPtwe.EA e.fuCS "ry D-9cvi iFa.aa4. sby PERMIT DATE:_� 4 d U 1 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 C A1?E-LJ l i71✓ G—tJ-rtEAM-!�fEC f- PUTMAM AN rc A-1 Q_1 A 3'A-(, A-2 = 3Z° w 36' A.3 7 �►3° 13.3 y 4-1oC.° Pt � A wy sti:6° iC, a LITTLE Ro . kug 141410:46p p 1 Commonwealth of Massachusetts { Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 467 Putnam Ave. Property Address Lawrence Caprio Owner Owner's Name information is required for every Cotuit MA 02635 8-12-14 page. Cdy[Town State Zip Code Dale of InsP ecfion Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form_ Important:When A. General Information filling out forms ��uuutuunr on the computer, ��a r1. use only OF the tab ��'7 th .. ... key to move your Mkt' i 1. Inspector: �� ' ya``�= • cursor-do not :• •'•yG use the return James D.Sears =�: JAMES •�' Name of Inspector 'm key. 5EARSc CapewideEnterpr•Ises,LLC _ =*:. �y Company Name l'••, RTIf .` 153 Commercial Street I N SPS '��O`� Company Address rerrnnnnI"��--- Mashpee MA 02649 City/Town State Zip Code 508477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority —+a - 8-12-14 spectors Signature Date The system inspector shall submit copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. r 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. /, rsns•yr3 Tmeso sr f speeion Form:Su ace Sewa a 113�sal System•Page 1 or 17 . Aug 141410:47p p 2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments- ' 467 Putnam Ave. Property Address Lawrence Caprio Owner Owner's Name information is required for every Cotuit MA 02635 8-12-14 Pa9e• tY ci /Town State Z Code Date e of Inspection B. Certification (Cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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: B -S em Condition ally nal , ly 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): 15ms 3113 Title 5 official Inspaclion Form:subsurface Sewage Disposal system•Pege 2 MIT Aug 141410:47p p 3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r 467 Putnam Ave. Property Address Lawrence Caprio Owner Owners Name information is required for every Cotuit MA 02635 8-12-14 page. City/Town state Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumpslalarms not operational. System will pass with Board of Health approval if pumpstalarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND.(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): distribution box is leveled or replaced r. ❑ 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): C Further Evaluation Is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. I. 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: r ❑ 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 Isins•�1a Tine 5 Official InWecllon Form:Subsurface sewage Disposal System•pop 3 of 17 Aug 141410:47p p 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments N 467 Putnam Ave. Property Address Lawrence Caprio Owner Owner's Name information is required for every Cotuit MA 02635 8-12-14 page. City/Town State Zip Code "Date of Inspection B. Certification (cont.) Z. 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. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool , r ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in W34M is less than 6' below invert or available volume is less than Y2 day flow /o/T t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 4 of 17 Aug 141410:48p p 5 Commonwealth of Massachusetts � } Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 467 Putnam Ave: Property Address Lawrence Caprio Owner Owner's Name information is - required for every Cotuit MA 02635 8-12-14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ® Required pumping more than 4 times in the last year NOT due to clogged or,, obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑- ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is Jess than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ . ® The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15,303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility.with a design flow of 10,000 gpd to 15,000 gpd. n r For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No g ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes".to any question in Section E the system is considered a significant threat, or answered"yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. ISTS•3113 - Ti9a 5 offidal In"'!fi n Form•,54L"mAtA Snma20 Disposal Syd m•Pago 5 of 17 Aug 141410:48p p 6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 467 Putnam Ave. Property Address Lawrence Caprio Owner Owner's Name inforrnation is required for every Cotuit MA 02635 8-12-14 page. Cdyfrown State Tap Code Date of Inspection C. Checklist , Check if the following have been done. You must indicate"yes or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal Flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling'inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Q ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions_ ,T Number of bedrooms (design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CM'R 15.203(for example: 110 gpd x#of bedrooms): 330 tgns-3113 - Tille 5 Official Inspection Fom:Subsurface Sewage Disposal system•Paga s 0'17 Aug 141410:48p p 7 Commonwealth of Massachusetts - Title 5 Official Inspection Form r. Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r 467 Putnam Ave. Property Address Lawrence Caprio Owner Owner's Name information is required for every Cotuit MA 02635 8-12-14 page. cityrrown State Zip Code Date of Inspection D. System Information Description_ _The system is a 1000 Gal.tank D Box and pit Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes 0 No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): 2012-53,000Gals 2013-51,000Gal's Detail: Sump pump? - ❑ Yes No Last date of occupancy: Present Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): canons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ElNo Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3I1 3 The 5 Official Inspecllon Forum Stbsurfece Sewage Disposal System•Page 7 of 17 1 Aug 141410:49p p.8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 467 Putnam Ave. Property Address Lawrence Caprio Owner Owners Name information is required for every Cotuit MA 02635 8-12-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: . Date Other(describe below): General Information Pumping Records: Source of information: 07/ 12 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons • How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ElInnovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval_ ❑ Other(describe): t5ins•3M 3 Title 5 Official Inspection Form:Subsu..race Sewage Disposal System•f aye 9 of 17 Aug 141410:49p p g Commonwealth of Massachusetts Title 5 Official Inspection Form kvww Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 467 Putnam Ave. Property Address Lawrence Caprio Owner Owner's Name information is required for every Cotuit MA 02635 8-12-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: , 1983 Permit # 83-938 / 2014 New D Box and line's in and out of box. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3011feet Material of construction: ❑ cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH 40 Septic Tank(locate on site plan): Depth below grade: 181, feet Material of construction: . ® concrete ❑metal ❑fiberglass ❑ polyethylene y ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 Gal.Precast H-10 Sludge depth: e51ns-3113 Title 5 Official Inspection Form;Subsurface,Sewage Disposal System-Page 9 of 17 i Aug 141410:49p p.10 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Dis g posal System Form-Not for Voluntary Assessments - 467 Putnam Ave. Property Address Lawrence Caprio Owner Owner's Name information is required for every Cotuit MA 02635 B-12-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cunt.) Distance from top of sludge to bottom of outlet tee or baffle 2911 Scum thickness 0 11 Distance from top of scum to top of outlet tee or baffle 12" Distance from bottom of scum to bottom of outlet tee or baffle 18" How were dimensions determined? Asbuilt-Tape 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_): Tank at working level.Tank and covers at 18" below grade. Inlet tee,outlet tee. No sign of leakage or over loading. Grease Trap(locate on site plan): i Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass 9 El polyethylene El 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 t5W*-3113 Title 5 Offidal Inspection Form:Subsurface Sewage Dispose)system•Page 10 0M Aug 141410:50p p.11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 467 Putnam Ave. ' ~ Property Address Lawrence Caprio' Owner Owners Name information is - required for every Cotuit MA 02635 ' 8-12-14 page. Cily/rown State Zip Code Date of Inspection D. System Information (cont.) r Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ meta ❑fiberglass poly-ethylene❑ pol eth i l y y ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: -- — Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches,etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No [sins-3113 r tte 5Offidal Inspection Form:Subsurface Sewage Dbpoaai System Page 11 of 17 Aug 141410:50p p 12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 467 Putnam Ave. _ Property Address Lawrence Caprio Owner Owners Name Information is required for every Cotuit MA 02635 8-12-14 page. Ctty/rown State Zip.Code Date of Insp ection D. System Information (cont.) 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.): D Box is 16"x1T-38" below grade wlone line out Box is new 8-2014 w/cover at6" Pump Chamber(locate on site plan): Pumps in working order ❑ Yes ❑ Now Alarms in working order. ❑ Yes ❑ No' Comments (note condition of pump chamber,condition of pumps and appurtenances, etc.): "If pumps or alarms are not in working order, system,is a conditional pass. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain'why: ts:ns•3113 Title 5Official Inspection Form:Subsurface sews a DI 9 SPOSW Sysrern-Page 12 of 17 Aug 141410:50p p.13 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4'y 467 Putnam Ave. Property Address Lawrence Caprio Owner Owner's Name information is COEuit required for every MA 02635 6-12-14 page. CdylTown State Zlp Code Date of Inspection D. System Information (cunt.) Type: ® leaching pits number. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: - ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Typetname of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil, condition of vegetation, etc.): Leaching is a 5' precast pit. Pit at 42"below grade w/cover at 14", 32"water in pit. No sign of over or solid carry over. No high stain line. Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert _ Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction, Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Tine 5 Uncial Inspactlon Forth:Subsurface Sewage Disposal system•Page 13 of 17 Aug 14 1410:51 p p.14 Commonwealth of Massachusetts Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 467 Putnam Ave. Property Address Lawrence Caprio Owner Owners Name information is required for every Cotuit MA 02635 8-12-14 page. Crtyrrown State Zip Code Date of Inspection D. System information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): y 15ins•3/13 Title 5 Official Inspection Fcrm Subsulaoe a Ois Sewage Dasaf SYslem•Page 14 of 17 - _ Aug 14 14 10:51 p p.15 Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 467 Putnam Ave. ' Property Address Lawrence Caprio Omer Owner's Name requir eGon is COtuit MA 02635 8-12-14 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately i Eck 13 Li:3 1' 3 Jf 13 . T i5ins•M3 & TWe 5 OHicid. lnepeCbon Foartl:Srmeurfeoa Sewage DivosEtl System•Pegs 15 Or t7 f Aug 14 14 10:51 p p.16 Commonwealth of Massachusetts x Title 5 Official Inspection Form - Subsurface Sewage Disposat System Form-Not for Voluntary Assessments 467 Putnam Ave. Property Address Lawrence Capdo Owner Owner's Name Information is Cotuit "required for every MA • 02635 8-12-14 page. City/Town State Tip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Nv Estimated depth to igh ground water: 101+ 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. 9-8-83 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: T.H.on Design 9-8-83 10'+noFG.W._ Bottom of pit at 9'below grade. Bottom of pit at 1' above T.H. Depth. Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•3n 3 - - Title 5 Official Inspection Forth:Subsurface Sewage Disposal system page 16 of 17 Aug 141410:52p p.17 Commonwealth of Massachusetts' Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'f 467 Putnam Ave, Property Address Lawrence Caprio Owner Owner's Name information is required for every Cotuit MA 02635 _ - 8-12-14 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ? ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 16ina-3/13 Tdia 5 O ficw In3pection Foam StbsLdece sewage Disposal system•Page 17 of 17 PER T A T 10 N C' f SEWAGE NO. V6LLA 1 kkT A LLER'S NA E & ADDRESS t U I L D E R OR A NER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED S D �� l 3� �° � ! a No. ..� FI�s...... v J.......... ".VTHE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 1 (1- d� ......--- ...OF.........�r ,(�./�T1. .-�........................ ` 3 , pphration for Uiipuaa1 Workii Cfnntitrurtinn thrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: -- U� �t!yl....-----. %........ - --�(1..��............ ............................•-------••-•----•---•-••----•...... .f::..�::...... Location-Address or Lot No. :u------------- V...-- ... . ..... ..4.0-.....ja.:2 Z_ Owner ddres. ............................... .. �. `" �f'Y 7/Li/- W e.. /�/1 Installer Address Type of Building Size Lot_�i �._.�1 ....Sq. feet Dwelling—No. of Bedrooms..... ..... ........................Expansion Attic ( ) Garbage Grinder ( ) p`k Other—Type of Building No. of persons.........(o............... Showers (Z_- — Cafeteria ( ) p' Other fixtures�Oi/—Atv..?% Xljv'p/.... ------------------------ -----------•----:..----- W Design Flow............................... allons per person p�r day. Total dai�y flow___._._..._. .. .._._ __...._...._gallons.f. WSeptic Tank—Liquid capacity_.jt_�s�gallons Length_e�'_.(p..__. Width___!�1�..._ Diameter________________ Depth._�._f. x Disposal Trench—No..................... Width--------- _...... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.-...___---/.____-- Diameter.._llJ.. ... Depth below inlet.... f.._._.... Total leaching area..4e ..sq. ft. Z Other Distribution box ( t,�' Dosing tank ( ) Percolation Test Results Performed by........................................7f 2y�� Date..._.._....9__9__.).P� .�-___.. Test Pit No. 1................minutes per inch Depth of Test Pit--- .20.rP____ Depth to ground water....lQ_ -__--___-_. 44 Test Pit No. 2................minutes per inch Depth of Test Pit---%y1...... Depth to ground water.A_/J_.44-^A-T 64- ..__ `_i f�zZ .�'vw1�g0.1 q� 'eacf. `QDescription of Soil_FT,� - 721 1 _�0_.9 _ U 7ITW,Z- VV'7b ..�r....._' ..... W UNature of Repairs or Alterations—Answer when applicable._.............................................................................................. -----------------------------------------------------------•---•--•----------------------....-•---•-----•----------------------------------------------•-------------------------------•--•--........... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLi- 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. •-•-----•-----------•••--------••••-••-•------••-••-•-----•--... ....... ........ ............. Application Approvedotlowing `- �� L Date Application Disappro reasons-............................................................ ......................-•--•_............ _ -•----•------------------------•---------•------•••--•----•-•••---•-•-•-•••--••-••-•••------•---•••-•-•--...---•-••-•--•--•-•-•-•-••••-•---•-•------•---•--••---••. ............................... Date PermitNo......................................................... _ Issued....................................................... Date F j •�t: f No......................... Fins.............................. ° THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...................... ... ...............OF............................... ........ Appliration for Disposal Morks Tonstrurtion Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal r System at: I ................_................................................................................ .....----•--•----...----••--••------._...---•-•-••....._..•-•-••-----••.........---•-............. Location-Address or Lot No. ..............................--•• - .........-....._................................... ..........--.........................................................o............................ Owner Address W Installer Address d Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers � YP g --•-----------------•------• P ( ) — Cafeteria ( ) Otherfixtures -------------------------------•-•--------------•-----•-•••••••-••---••--•••-••••........-••••-•••••••-•••....-•-•...•----•••--•......--••------_._... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ W 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 ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.-..---______-__•--_---- (Z4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 ---••------•--------•--•----•-•-•----••---•......................:........•-----......--------...---......................................................... 0 Description of Soil......................... W x ............................... --•-•------•--•••••••--•••-----••--•---••-•-•--------••----••-•-•-•---•---•--•----------------------•••••-•---•--••••••••-••••-••-••--••-•--•-••-•••-•--------••----•-- 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 TTTLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance ha yb�efi issue by the board of health. / .. .........................--............................................... Application Approved By...:....... .. Date Application Disapprov for e following reasons:----------•----------------------------------------------------------------------............................ -----------------------------------------------•-------------•------•-----•------------------•-----------...------------•---------------------------------------------•----------------------------•--•-- . Date PermitNo......................................................... Issued....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... j' Turrtifiratr of Tompliaurr TIFY That th,} e Individual Se�e Disposal System,constructed ( or Repaired ( ) .. t 2 f.rl Installer at•--••••••..•......•••.••... ............ ..••--......••--•--J-•--•••-....-----•••---•...-----••---------••--•---•.....•..................... X_ .. has been installed in accordance with the provisions of T,7M-.,�f kl! State Sanitary rCpd . ��a°�il�r�ed in the �°� application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................................•-••--••------•-•-•. Inspector.................................................................................... .J T .:QMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No......................... / F .---__......._••-•_-•-•- Dispq4 vf�_AT notnulion " utit Permission er anted _ ---------------------------------------- --•••._............-•- - ------------- to Construct or,.;R air -Individ Se, - �... ( e":VjsppsalL� ,ysrtem. at No................................................................................................................................... '== Street ' as shown on the plicatio for Disposal Works Construction Permit.,No: _. ........... Dated.......................................... - ----------------------------------------------•---•------ /� r' Board of Health DATE-••---• --•Z• --- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS eosw.390 Fac A4 46671 NE9COMB-RICH, INC., a Delaware Corporation, having an usual place of business at 11PO Gulfshore Boulevard, Naples, Collier.County, Flotida in consideration of NINETEEN THOUSAND ($19,000.00) Dollars grant to LAWRENCE CAPRIO and ANNETTE CAPRIO, Husband and Wife, As Tenants by the Entirety, both of 122 Whidden Avenue, Whitman, Massachusetts 02382 *kx with quitChtittt CDbenants the land imt situated in Barnstable (Cotuit) Barnstable County, Massa- chusetts, bounded and described as follows: WESTERLY: By Putnam Avenue, as shown on plan hereinafter referred to, 125.00 feet; NORTHERLY: By Lot 1A, as shown on said plan, 143.02 feet; NORTHEASTERLY: By Little River Road, as shown on said plan, 142.27 feet; and SOUTHERLY: By Lot 3A, as shown on said plan, 208.25 feet. The said parcel contains 23,100 square feet of land, more or less, an is shown as LOT 2A, on plan entitled "Resubdivision Plan of Land in Cotuit-Barnstable, Mass., for Charles N. Savery, Scale: 1 in.= 40 ft., date 30 December 1957", and said plan is recorded with Barnstable County Registry of Deeds in Plan Book 211 Page 87. FOR TITLE: See Parcel 3 in deed from Charles N. Savery to Newcomb- Rich, Inc., dated December 29, 1975 and recorded with said Registry in Book 2282 Page 107. fFor authority to execute to this deed see Vote recorded with said Deeds in Book 2433 Page 117. COMMONWEALTH OF m EXCISE co 7� '� 1 1J��J N m �J rov-rw4f __ 43. 32 _ P.9.IIa37 1y➢➢�Y@ � i Executed as a sealed instrument this day of 1983 Newcomb- is Inc. BY -ttrarleS N. e the CV. MMVn( zU1th of 'WaSsachusetis Barnstable ss. C -uv''^�'),�� 190 j Then personally appeared the above named Charles N. Savery, President as aforesaid and acknowledged the foregoing instrument to be the free act and deed, of Newcomb—Rich,Inc. Before me, a(lsA "/ /��/IN./ Norm }i461ic t. My commission expires 7/ 19�JfJ { ftL��nLlD NOY 183 L G-L A.T ION S [ WAGE PER VILLA E S7, o// 1 ! lI�STA LLER-'S WA E A ADDRESS R U I L D E R OR MER .. - i ® ATE PERMIT ISS VIE O DATE COMPLIANCE ISSUED No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpIitation for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System X Individual Components Location Address or Lot No. q(orj P uT Ni41Lt AU E Owner's Name,Address,and Tel.No. Assessor's Map/Parcel O3� I G87Vt T 6- 7 AU49 <-O' Ln— Installer's Name,Address,and Tel.No.570$ —4-17 —2S 7-7 Designer's Name,Address,and Tel.No. GA06woc- LLe- 153 S'T Gt4494PL--4�5' Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building PE61(bEYJT t AK, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 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) 12 CP 4_Ecc D -Pc 4 i &A) ti 1,1>LAES f1oya T9&)L �,z��7? L P GT 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 ard of Health o . ![ vngnedl \ Date 10'T Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date-Issued 11t`M �� i No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: W PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,'MASSACHUSETTS Yes 2pplication for Misposaf Epstein Construction Verinit Application for a Permit to Construct( ) Repair 06 Upgrade( ) Abandon( ) ❑Complete System k Individual Components A� Location Address or Lot No. qrg'1 Pv-rN#4k AV 9 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel (-<) T' Li4 W °' 4ptR� bl VT Installer's Name,Address,and Tel.No.S d8 --4-11 -$$7T Designer's Name,Address,and Tel.No. /k Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building j T LA,(_No.of Persons Showers( ) Cafeteria( ) F Other Fixtures Design Flow(min.required) d Design flow provided d gP g P gP Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil 4 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of i Compliance has been issued b oard of Health. ned " Date ' Application Approved by ; Date [/ f Application Disapproved by Date for the following reasons Permit No. Date Issued - - - - - ------- -- - -- - ------- - - - -:-.. -.-----7--.-------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( �) Upgraded( ) Abandoned b ( ) y�'Aj0J!:Ze;1�-�= �- �� (.tee_. at �, t �� t�.r has been con t d' a ordan e with the provisions of Title 5 and the for Disposal System Construction Permit No. d ted Installer 6Q0:34J r)E _ Designer_d J/�� L�Z i i #bedrooms Approved design flow gpd The issuance of this permit shall not be const ed as a guarantee that the system will functio. ass d igne Date Inspector ~_ —�_ ------------------------------------------------- ---- ------ _--------------------- 1(22 �/ jIHE COMMONWEALTH OF MASSACHUSETTS Fee PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS .Disposal *pstem Construction permit Permission is hereby granted to Construct( ) Repair(x) Upgrade( ) Abandon( ) System located at 04,77 Pu7:AAM 4 U c" <_c)7 y i r— and as described in the above Application for Disposal System Construction Permit. 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