HomeMy WebLinkAbout0038 ROSEWOOD LANE - Health +3 8 Rosewood Lane '
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LOCATION �� �o SEWAGE #
VII,LAGE ASSESSOR'S MAP &LOT G�5'
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
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c Commonwealth of Massachusetts
NR Title 5 ®fficial: n' specti®n .�F.oh °° r _
i.�i Subsurface Sewage Disposal System Form "Not.for Voluntary Assessments;z u:lcrtj C "I.
38 Rosewood Ln i+_i ;� et, o*,I C�
-J
Property Address ►, ..�{ ,,�:
Linda Peterson i.1� C�+
Owner Owner's Narr� r.:•t
information is ti
required for every Cotuit F,.�:;y0 h+-�; MA 02648 4-2-21
page. City/Town ,o;, ,, ,�,..:; State Zip Code Date of Inspection
s _w
Inspection results must be submitted on this form. Inspection forms may not be altered in any
Way. Please see completeness checklist at the endof the form.
• � f1 fat+ .f, s .^ ,> �f Jf-�tt1r' S �y':1�,rfit,f� It�„��Ctt.'1ii
A. Inspector Information
Shawn Mcelroy
Name of Inspector, , , . r :_.+ rr �.. ,., , ,, . r„r;�. 1•Etta�r+ ►: r . �•;i ,•r-.., i :_,;
Upper Cape•Septic Services
Company Name
P.O. Box 73 �tt►:rr►rr.f _�
Company Address
East Falmouth in r*i- oV «rivl V0.)MA%, 'ir y! t• . o f.t ;t ,7411-:"02536
City/Town State Zip Code
508-495-0905 S13971
Telephone Number < License Number
B. Certification
I certify that:l am a DEP approved system inspector in full compliance with Section 15.340 of Title 5
310 CMR 15.000 'I have personally inspected the sewa' e``dis oral s stem`atrthe ro eity address listed
( )� P Y� P 9 P Y P P Y
above;the information reported below.is true, accurate and complete as of the time.of my inspection; and
rri !r i - ., . x,^.•� r r ,z. ;. - .< ..
the inspection was performed based on my training and experience in'the proper function and
` '•'r'�`Ti maintenance of on=site sewage disposal sy'stems`.After conducting this inspection l have determined that
the system: .i'ii t,r'a �t lr3t G 3G
if f,oi CAI At'1 I� rfirTl�t:si";ion` iri •Cf1 *7, "' J,x. cA � tl Ajl~ Q
as es
„
rt2: iQ>:Conditional,ly,Passes,., -i,t, "nr.ey 0`,
"wSu `ft*. mc.,'{tr. k'...,+:f't-, " tk<ii Jt :I A)nui7le3nu
i❑ .Needs Further;-Evaluation•by-the,Local ApprovingAuthority•u L,;j fi .coif,}>}ICr j
4. ❑ Fails
tl! .r' it"{2; `� (' � •r. i'rtl.�'.t� ... ^r... .,,„..it..ilf:�G�t�y ii ;t'li'..l:.iQf-.i �c'rir 'If'l;JtitFF:.�if�a:' ii�'�rifi f1 ` .
Q� r i;lf 2;9i s: :.:hf`_illy n31 It i1,itif.}Irlf;: a1:9'I—IF,lit :j
,,..,.E -..t.� ,7 .t,• ,_.4-2-21
nsp c or'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•:x. , a Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 ,
L:
Commonwealth of Massachusetts
;r Title 5 Offidal Iftpe,ct on_ Forte
s 14 Subsurface Sewage Disposal SystemForm--Not.for Voluntary Assessments el
38 Rosewood Ln ;=
Property Address
Linda Peterson
Owner Owner's Name '
information is Co
required for every tuit ! MA 02648 4-2-21
page. City/Town . State Zip Code Date of Inspection
C. Inspection Summary
tr. 1' ,. 7r� ► •r ` «t+, Ji :i rs' _ +; .S ai• i C r, l 0—, A.. i'
• it"1{` :,i `t'
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: �t A• "
System is in good working order with no sign of failure.
f'. .. r r ..gT ..:},�, i.v tC'� t1' `E= tF # � d. 1•' ! y'r � r.
2)i S' tern Conditionally Passes:
❑ tyOne.or more system compon1.ents as described in the ;ConditionaiPass"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. •` r„
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 icomplying septic tank as approved by the Board of
Health.
rt
*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):
":�+;�::1• RI . '!� _:r•� �'r -i .'( t ,fr:si +_'i l J , . 'o. . ..
r j� • ,. �r` Fi 1t Li la.jti.r"' { 1. „ •il.
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18
Commonwealth of Massachusetts ,
f Title 5 OfficiaL I fspec$i®fi Fdtm-�
i�► Subsurface Sewage Disposal System Form---Not for•Voluntary.Assessments
!cT
7_` > 38 Rosewood Ln
Property Address
Linda Peterson
Owner Owner's Name +,
information is required for every Cotuit - a ! ;.' MA 02648 4-2-21 Ji'v
page. City/Town ' ri, State Zip Code Date of Inspection
C. Inspection Summary (cont.) tt �' :!".: �11�'` y %•l .,w ;ate .�
2) System Conditionally Passes (cont.): w 'v�,•',.
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
t? , t1. r. # �,.,`•')1 Jr 'T'/'i"f.' :,.{ Y„ ;s r U Kj�
pumps/alamis ,Tare repaired: I 1 -
•' '. , 1t Two.w l��xri:. _t ie ll...'"..•Ta IKY� ,T. x". i i I4,11ET CW L,.�ct�VU lie !L',A ri:.)iio! .�
4
r:x�T•;t';r Y�� ....y ..'f•i .r,t , fs�tx� t:`_.'' ii� .. ":+ ,-:',#41£.i.' ,r:.•tj ?- ;:"� t-p :'fit I:% i4 -+ ext 'XPA r
❑ 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 broken,
of'Board of Health): " '' " `"Le r•,t r
ti<ttl-)tt'. i a1: is ,�! ? 1 '{:x•i r=? h] . .•tL r x►[.• ishi
El '"} 'a broken"pipe(s)'are replaced' ''r' ` "#'F ="'0�Y�.�ON: ❑tND(Explain below):
%I - -' bsra t' r : focn s removd "❑ Y `❑N
ND (Explain below):
_. .• �, .n, t' " - S✓ --.'' f. ��r..' f, � max, r '
❑ distribution box is leveled-or replaced " ❑ N-` ❑ ND (Explain below):
.. ` . :t, :t,... ,�s 7' T _ . `� . . F ,,. •fly,i .,,i� t1�f+� s!. ttw It . -:�";:.i ;,°° .,? :ctt''I'i•
f:+ i. t.'-!!1 ' '.i ,{i t,i 'Y ' f I`7� '7 rhi t(1 i xf S]r-r• t' t'>�rtis')'�.it .Il` ar,` :ttlf#til+:1
Ntrt. x(T i �?�4`.r 3t( ir-rl i a t:; t;
❑ 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`fiealth,`safety or the enviro`n`ment.'"-`'`''
a. System will pass unless Board of Health determines in accordance with 310 CMR
16.303(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• :,, y: H Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18
Commonwealth of Massachusetts
,'7 Title 5 C fficial. lnspec$oon Forte
l��
r t':
,�� Subsurface Sewage Disposal System Form =Not for,Voluntary�Assessments
38 Rosewood Ln - -
`r Property Address
Linda Peterson
Owner Owner's Name
information is required for every Cotuit MA 02648 4-2-21
page. City/Town State Zip Code Date of Inspection -
C. Inspection Summary (cont.)
❑ Cesspool or privy is within 50 feet of a surface water-
.
�.,. , 1.... .. , l rF. ' 1. , 1.,{k ,
El Cesspool or privy is wittiin 50 feet of a F_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:
1 -:•�- -visa-=
❑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:
t
4) System Failure Criteria Applicable to All Systems: ,•,.
You must indicate "Yes" or"No to each of,the following for all inspections.,
Yes'-,, :No _ _
Backu of sews a into facility or.s stem com onentr due to overloaded or
p g 11 y y,�, :pd .
❑ ® 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
Commonwealth of Massachusetts
fY Title 5 01"Ticial lnspection,"-Fo'-r"m'-",, ;-,,
%i Subsurface Sewage Disposal,System Form=Not foriVoluntar_y Assessments;-
38 Rosewood Ln
Property Address %If
Linda Peterson
Owner Owner's Name
information is Cotuit - z
required for every Moi MA 02648 4-2-21
page. City/Town State Zip Code Date of Inspection
C. Inspection Summary (cont.) "i,V'1 4.,j,
j.! .4), System Failure Criteria Applicable toAll Systems: (cont.) • 11
,u-.Yes No. ti., -i -iL q3�)Ipiirij(f,9,zjP p io :.j 1,t,11 o
iquid IeVel in the'd i ribution box above outlet invert.due to an overloaded
It or:clogged �§AS'6r"c'es's'po'o1` tiv jr, �J.U "'; If 0 •JJA'A
Liquid depth in cesspool is less than 6" below.invert or-available volume is less
f L4 El_4 0 r. I �'- . -j I UP, t LA _j
thah""!�da�flo'w' �" "�l "'_ "J - ,
Required pumping more than 4 times in the last year NOT due to clogged or
El 0 obstructed pipe(s). Number of times pumped: '1'-' ,
dt".!5p "o L":c , 10 -,Any portion,of-the SAS; cessppolior,privy is below high ground water elevation.
Any portion of cesspool or privy is within 100 feet of a surface water supply or
-f -VV
in utar 1 '� 6�.water"t'.b "y toga e wa er suppiy.
Any portion of a cesspool o�yri��,is within a Zone I of a public water sup
10, . ply
I �
well.
i[E L 0 des; p�vy is Within 50 kny p"ftidn"6f a Poo fiet of a private water supply well.
Any portion of 6 cejssf'pool,o'r' priv'y.is'less than 100 feet but greater than 50 feet
from a private water supply We; II'w'_it_K 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 servinga facility with a design flow of 2000 gpd-
:41W )dj Ic -b'do " 01'""" . .v 61
1 0 gpd. "
-"! . ,, ".I'E.-I ,.;pit
n)J'A,rl,.l IL ir, !4:r1fjfj-�j1 4. ., I
The system fails. I haVfe#.de-teirml'ih'e'd'-that one or more of the above failure
ea in'310 6MR 15.303,therefore the system fails. The
0%,Z 1"11 0; P. 0 [T.(,Il ttf-4i. .,,)system owner-should contactfthe Board of Health to determine what will be
ru-klz 4lnecessaryjo correct the failure",i, In
5) Large Systems:To be considered a large system the system must serve-a facility with a design
flow of 16,006 gpd to'1175',006 gpd. 4,
tr. ?I ri'_ For large systems,tyou must indicate either,:'yes" or,"no",to.each of the following, in addition to the
L
I 6,lquestions.in'Section!C:4.-t--,jr,,,,;,
Yes No
El El the system is within 400 feet of a surface drinking water supply
El D the system is within 200 feet of a tributary to a surface drinking water supply
El El 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.,7126/2018 r 3 t - _ Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18
cam'° Commonwealth of Massachusetts
pit' Title 5 Officisi i nspection,Fo ' ,
f
l► Subsurface Sewage Disposal Systern Form Not.for,Voluntary Assessments i. t ,
-
� _ ; 38 Rosewood Ln
Property Address
Linda Peterson
Owner Owner's Name
information is required for every Cotuit MA 02648 4-2-21
page. City/Town . State Zip Code Date of Inspection
C. Inspection Summary (cont.) i V: .Jj1*!(
If you have answered "yes"to any question iri SectionC.5 thelsystem 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.
Z,..
6. You must indicate`"yes"'or"no"for each of.the following for all inspections:
Yes' No f., r , . , r
El., Pumping information was provided by the owner, occupant, or Board of Health
� ® Were any of the system componLJ ents pumped out in the previous two weeks?
® ❑ Has the systemi received normal flows in the previous two week period?
r_ Have large volumes of water been introduced to the system recently or as part of
this inspection?
�® - ,E] Were as built plans of the system obtained and examined? (If they were not
available note as"N/A) _ f
'® 0 Was thelfacility or dwelling inspected for signs of sewage back up?
'® El 1i 0 Was the site inspected for signs of break out?
. _ a •. r. i 'y r i.. j '. t'
Were all system components ezcluaing 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?
0 = Wasthe 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:
Ov-
❑" `® Existing information: For example, a plan at the Board of Health'.
ff 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)]
IL I
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18
' Commonwealth of Massachusetts
Title 5 O'l"g'acael Inspection_ Forn1 .,r
?'I I Subsurface Sewa a Dis osal System Form-Not for Voluntary Assessments„•. P
9 p Y rY
38 Rosewood Ln
Property Address .„ ,• .
Linda Peterson
Owner Owner's Name •s•
information is :c
required for every Cotuit 5 Ne"'? MA 02648 4-2-21
page. City/Town o.' + . State Zip Code Date of Inspection
D. System Information
1. Residential Flow Conditions: .z� : ; ;,d . 111 %Ut tO 1"4;; -; w
Number of bedrooms (design): N/A N u m ber,of,bedrooms(actual): 4
DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): N/A
Description: - r r,-,,it-' -' ., �+r,2 w 3• .�..
- 1
Number of current residents: , 'j� ► �,xr,ir • :;Gcz ,l,' lti.
Does residence have a garbage grinder?., pjz,sf:) 'I4.1.r r181(1 ❑ Yes ® No
Does residence have a water treatment unit? jVV ❑ Yes ® No
If yes, discharges to:
Is laundry on a separate sewage system? (Include laundry system inspection
information in this report.) a iQ ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonal use? ❑ Yes ® No
Water meter readings, if available (last 2 years usage (gpd)):
Detail:
• ,' ,4 i t4`,,.,:!'_ -'tt' "Rl '° ,1. e,'� r"L`� Y +..Y.f'tir,-�;,..��,I
Sump pump? ❑ Yes ® No
4-2021
Last date of occupancy: � , ,:; ;:�. t�: ,.; t, v Date
` ••"', � 1 -r,,� . �c.1 Date
� . . .tr�,r,1:•�
t5insp.doc•rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18
Commonwealth of Massachusetts
' Title 5 Official Ins ec$ion-Form) -
ICI Subsurface Sewage Disposal System Form Not for Voluntary Assessments
n 38 Rosewood Ln
Property Address
Linda Peterson
Owner Owner's Name
information is Cotuit MA 02648 4-2-21
required for every '
page. City/Town State Zip Code Date of Inspection
D. System Information (coot.) ,
2. Commercial/Industrial Flow Conditions:
•Type of Establishment:
Design flown(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 El No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available: .c -
Last date of occupancy/use: �'. '" `- '
.
Date
Other'(describe below): -?
,.
t
3. Pumping
Records:
ors a Owner---pumped 2
Source of information: p p Y g
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Maintenance
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18
Commonwealth of Massachusetts of=,2 if. : ._:, .• �, :,Y }
Title 5 Offici-alllnspection. Foft' :: �
i�i Subsurface.SewagelDisposal System Form -Not for,Voluntary Assessments t l• >>_
38 Rosewood Ln
Property Address
Linda Peterson s, -4
Owner Owner's Name
information is
required for every Cotuit fVgk MA 02648 4-2-21
page. City/Town -t State Zip Code Date of Inspection
D. System Information (cont.) i a_; 1.01,;1 1, � •: °!1 :, ,' .*
4. Type of System: :rr, ro •ai F
® "hSeptic tank, distribution box, soil absorption system' ..x.c i rG
❑ Single cesspool rcr;,u}fs Itt t 4 Ilgt,;u.
❑,f, idi i �:4•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,undencontract,I1
r'r r`i i ❑ . .-. ; ,!Tight tank.Attach a copy,of the DEP'approval!,V t!—Tc ,
❑ Other(describe):
Approximate'age of all components',date installed'(if known) and source of information:
1977
Were sewage rodors detected When I arriving.at the;site? I,, ca, rt att :LSrY y O! Yes ® No
5. Building Sewer(locate,on site plan):., to -r €,_': 'A MLVJtl'C i"110' q f-rL',t t
3011
Depth below grade: tW`�' "= r, E'n'.�'=feet "
-' r + •t. -A�
Material of construction:
Yt vat!r:r... Frt Z, ',jot61
® cast iron ® 40 PVC ' ❑ other(explain): -
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Good condition.
t5insp.doc•rev.'7/28/2018• n_:," Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18
c Commonwealth of Massachusetts its
Toile 5 Offico'al . lfspectaor Forte
i .0 Subsurface Sewage Disposal System Form -Not:for.Voluntary.Assessments
38 Rosewood Ln
Property Address
Linda Peterson
Owner Owner's Name
information is Cotuit " MA 02648 4-2-21
required for every '
page. City/Town ;. State Zip Code Date of Inspection
D. System Information (cont.) t . _
6. Septic Tank(locate on site plan): .,.„
Depth below grade: - of. I ` '_ _ 24"feet
Material of construction: '
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: . .r.
years
Is age confirmed by a,Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
Dimensions: , 1000 gal
Sludge depth:
12"
Distance from top of sludge to bottom of outlet tee or baffle"
20"
Scum thickness
Distance from top of scum to top of outlet tee,or baffle _ +,
6"
Distance from bottom of scum to bottom of outlet,tee or baffle
1511
How were dimensions determined? �,,f Tape
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tank is in good condition with baffles installed and no sign of leakage.
t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18
f
r Commonwealth of Massachusetts
Title 5 Official•. Inspectiofi - drm
1.1 Subsurface Sewage,Disposal-System Form.-Not-for Voluntary Assessments. ;:ru. 1,1: > i~
38 Rosewood Ln
Property Address ,1,,r- t tr,,
Linda Peterson
Owner Owner's Name
information is
required for every Cotuit MA 02648 4-2-21 r"
page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.) tt ,�. :�f� 1,
7. Grease Trap (locate on site plan): .1+>i�, ,; ,k r�nit�;. r' rrt i
Depth below grade: feet •
Material of construction:
❑ concrete ❑ metal ❑ fiberglass •,,❑,polyethylenes^,;; ❑ other(explain):
-{ •V ..wofi4. ."L+ i• ., r,i r iVtJial+ + j 4i, -. t•
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
r f _ Date of last pumping:.,4,, , i., ,r:�-��r . '�,, , i .;i�tr, r +r > i
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)7 `i ' ,J'
i
Vu �+r !"a.ifll'� k'1:1F i.it+r;°. ...t 31 fJ 't`ffi:LJ1.i:'t, � .dri t5i'f.+2 !� t._
it r-._ 'i, oln1 ot)_`,'it a!'.•J �t•r.:)!./' .
.�;t.l Ini)1t lilt-,l + 1.�
Vi! .j L.:'S (!�lr i r,.--, 1 f�; f9i +. l't..y F1•. At, *`J
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•. ,� • '.-t • .- x + Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18-
Commonwealth of Massachusetts
,'. Title C� icial _ Ifispectio ForMr =l
dal Subsurface Sewage Disposal System Form =Not for Voluntary Assessments
38 Rosewood Ln �' }
Property Address
Linda Peterson r• " • '
Owner Owner's Name
Information is required for every Cotuit MA 02648 4-2-21
_
page. City/Town 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�(ifpresent must jbe op�ened)(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.):
Good condition with water at working level and no sign of back-up from pit.
t5insp.doc•rev.7/2 612 01 8• r Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18
f -
�•. ,� Commonwealth of Massachusetts t��t��,3� .-�r :, r ':;fr. -,.+.►fi,.7
p Title 5 OfficiaL lnspecti®n-F&M"
M Subsurface Sewage Disposal System-Form.-YNot for Voluntary Assessments.,,�tw2d!j8
V5.. ,
r Kl
._�, ,>' 38 Rosewood Ln r,-' LL T.r:j%,n
Property Address .a „ 1,
Linda Peterson rt.r �r;;7q T,bf' _1
Owner Owner's Name h,;" 4" t'
information is Cotuit 3_=,;, +; MA 02648 4-2-21
required for every _ -
page. City/Town - State Zip Code Date of Inspection
D. System Information (cont.) +-io! 5r,I—c. p T,
10. Pump Chamber(locate on site plan):
Pumps'in Working order:'�ftt+' af1,. ,r a: si.t=' .Q rinis7+!tf� �a,f:Yes'' ❑ No*
-Aiarms in working order' :a r•+'ir"`'ff figs +t +►111 +`� :' iafl�^ rii►i r'��if In-'Yesr ❑ 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.,.,trscl 4,
11. Soil Absorption System (SAS) (locate on site plan ii excavation,not required):,�,r1
If SAS not located, explain why: T::, .• � 1W to 111,419i;
Type:
o1iu+.tl1.�, �.a c*tFr�;+ oaf Fi `3'1'f1 1000 gal
®' leaching pits num� ber: of
❑ leaching chambers - j number:
❑ 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 r44.±a} ; , Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 18-
Commonwealth of Massachusettsr a
Title 5 Official l n pecti6n .Fo'r_m` •
s r i Subsurface Sewage Disposal:System,Form -Not-for Voluntary.-Assessments
38 Rosewood Ln
Property Address
Linda Peterson
Owner Owner's Name
information is Cotuit a` _. *u MA 02648 4-2-21
y
required for ever .
page. City/Town i":'� r State Zip Code Date of inspection
D. System Information (cont.) •-'' }�', -`.� +M._. t
t
11. Soil Absorption System (SAS) (cont.) f ,-•
1 Comments (note condition of soil, signs of hydraulic failure,,level of ponding,,damp soil, condition of
vegetation, etc.):
yl Octagonal leach pit in good condition and holding 24" of water with no other visible stain lines.
12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number-and configuration 21, ,GIs.,. f-, ;,;,
Depth—top of liquid to inlet invert I ',
Depth of solids layer a ;
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.): 1
t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18
Commonwealth of Massachusetts 4o`.1
Title 5 Official- I nspec$idn' Fore
hI Subsurface Sewage Disposal System Form.-Not for,Voluntary Assessments 71-,
38 Rosewood Ln I , ,Yc -440A&E
Property Address
Linda Peterson ,.r :,,g
Owner Owner's Name
information is required for every Cotuit MA 02648 4-2-21
page. City/Town ,. State Zip Code Date of Inspection
D. System Information (cont.) ; f a J, ;-a' . :,R. .'41,
13. Privy (locate on site plan):
?r '-,Cti„ ai�?- r'_ . V jivi ;3njt+,)10.
!• (`(. ti_.�1• {! ` L;i. ! ?)h tr, "ar1 :ne:,1.t _fta
Materials of construction: t✓�, n ,f. rr t y, ,�i,�••.t~ . r,f
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
f
t
v
r I
.L,�... _ ..._—_ - .�.....•.,,r .�R.err.- +., �.. _r*,-.►_�. ^
,
t5insp.doc•rev.712 612 01 8• ? _ - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18
Commonwealth of Massachusetts ?* _ ••
Title 5 Official, inspection Form. t
Yal Subsurface Sewage Disposal System Form -Not foryoluntary.Assessments
r
38 Rosewood Ln f
Property Address 1 r
Linda Peterson
Owner Owner's Name
information is COtult
required for every MA 02648 4-2-21
page. City/Town 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
ir
ILI,III
'etie
N_
r
4
t5insp.doc•rev.7/26/2018 TItIe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18
Commonwealth of Massachusetts 4-` �:, ; , .��a �" ► >"i ;�.;°����;�,.?-.7 .,�
4 Title 5 OfficiaL, Inspection- Fdt
} :m Subsurface Sewage Disposal System Form--Not for Voluntary-Assessments
38 Rosewood Ln
Property Address
Linda Peterson n,;,-rr 1, t,Fr i1 1
Owner Owner's Name t•;' +,n.e— ,
information is
required for every Cotuit MA 02648 4-2-21
page. City/Town _ +_ State Zip Code Date of Inspection
D. System Information (cont.,) r Z r w 1� -1 ;>io '5 .
15. Site Exam: �Lr..'1J+�," r_, ':l •c]rf� 'J +.� ;?3i.t!. i'il !' 11!i , :' r:t 7
❑ Check Slope •>�;. r; r. ,, ,�,.c;+ ;� :.rlf rft .r�< t3«r,r �'r 4 c;..; ..,, _4;
❑ Surface water v; . � � :c. ." i F c hs 1.;''1 " V4 . fl„ z-•-x. �:
❑ Check cellar :
❑ Shallow wells > 1. .1 r.,
Estimated depth to high groundwater; 1�';r; r :,' t't,, 4J 20'., .
feet*
Please indicate all methods used to determine the high ground water,elevation:t s
❑ Obtained from:system design-plans on record ioJ)Cof qi' ' ;`j io-
+If,checked;date of design plan reviewed: a-w, .-
-
® L, Observed.site (abutting property/observation hole within_150,feet.of SAS)
® Checked with local Board of Health-explain:
® Checked with local excavators, installers- (attach documentation)
® Accessed USGS database - explain:
You must describe how you established the high ground water elevation:
USGS and town maps show groundwater at greater than 20'.
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5insp.doc-rev.'7l28r2018• i ,. "ei e y r. - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18
Commonwealth of Massachusetts . �R _► k.- t�
;.,. Title 5 o 'iciai: Dfispection Form
r�l Subsurface Sewage Disposal System Form:-'Not forlVoluntary Assessments r ..
38 Rosewood Ln r
'L7r'T.iy
Property Address '
Linda Peterson
Owner Owner's Name
information is required for every Cotuit ! MA 02648 4-2-21 i- f
page. City/Town State Zip Code Date of Inspection t
E. Report Completeness Checklist.- .I
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 checked - =
® C. Inspection Summary: :1
1, 2, 3, or 5 completed as appropriate
r
4 (Failure Criteria) and 6 (Checklist) completed
® <D.•System Information:•t,,t' ,,, <r � •a
For 8: Tight/Holding Tank—Pumping,.contract attached
For 14: Sketch of Sewage Disposa[System drawn on pg. 16for attached
For 15: Explanation of estimated,depth to high groundwater included
eta ,r
fi r , r 1•li. r 'N`le
^}: .`if '«,' i ` l• .At � f e J{' .. of . ;.,, .l •. . ';.r j., -
t5insp.doc•rev.7/26/2018 _ Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18
I
FORM30 CDW HOBBSB WARREN TM THE COMMONWEALTH OF MASSACHUSETTS
BOARD F HE A TH
CITY/TOWN
39�W
A ARTMENT � r
eG� _ yt
ADDRESS
/l TELEPHONE
Address _ _ -- Occupant-
Floor Apartment No.of Occupants__
No. of Habitable Rooms Apartment-
No.Sleeping Rooms
No. dwelling or rooming units__ N Ston s-
S
Name and address of owner---,,
Remarks Reg. Vio.
YARD Out Bld s.:.-Fences:
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,. Stairs, Porches:
Dual Egress: and Obst'n.:
❑ B ❑ F ❑ M Doors,Windows:
Roof
Gutters, Drains:
Walls:
Foundation:
Chimney:
n
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Lighting:
STRUCTURE INT. Hall,Stairway:
Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central ❑ Y ❑ N Equip. Repair
TYPE: Stacks, Flues,Vents:
PLUMBING: Supply Line:
❑ MS ❑ ST ❑ P Waste Line:
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
❑ 110 ❑ 220 —Fusing,Grnd.:
AMP: Gen.Cond. Distrib: Box:
Gen. Basement Wiring:
DWELLING UNIT
Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks
Kitchen
Bathroom
Pantry
Den
Living Room
Bedroom 1 (�
Bedroom 2auzit
Bedroom 3 (7U
Bedroom 4 5
Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.:
5tgpks. Flues,Vqtit feties:
Kitchen Facilities iCY
've
Bathing,Toilet Facil. Vent., P'lumb.,Sanit'n.:
Wash Basin,Shower or Tub:
Infestation Rats, Mice, Roaches or Other:
Egress Dual and Obst'n:
General Building Posted
Locks on Doors:
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR.(See Over)
"THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIES OF P
INSPECTOR TITLE
R: A.M.
DATE i TIME P.M.
A.M. .
THE NEXT SCHEDULED REINSPECTION P.M.
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 5 Parcel
Permit#
Health Division
Date Issued
Conservation Division Application Fe
Tax Collector D
Permit Fee 2
Treasurer_.
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address <9 cSS` W�
Village
Owner l_ c ��� -� �j� ,Address 36 Q-'Oslz�<5�
Telephone `7 r7 5 Co 2<_
Permit Request
(lrz w la' X moo' V��c c- V3:�� ��� C
Square feet: 1st floor:existing proposed a5b 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation*!, Construction Type 5
Lot Size , 1 �� 5 = Grandfathered: ❑Yes ❑ No If yes, attach supp g ortin documentation.
Is QX% C�
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes RNo On Old King's Highway: ❑Yes 6No
Basement Type: - ❑ Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft:). Basement Unfinished Area(sq.ft)
Number of Baths:O/kFull: existingnew
Half: existing new
Number of Bedrooms ) existing new
Total Room Count not,including baths): existing
N
( g ) 9 new First Floor Room'Count
Heat Type'and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New ' Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:El existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal.# Recorded❑
Commercial ❑Yes 8 No If yes, site plan review#
Current Use Proposed Use 3
BUILDER INFORMATION -
Name.1w,-ss_7�� ;`� ,a (
ss Telephone Number
Address S S License#
-- Home Improvement Contractor# 5 l
d
Worker's Compensation#3 S Gx, - zr-3135
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO . S S m
SIGNATURE r. ---� DATE / D
r
I C �
-17}
Assessor's map and lot, number ' v
Sewage; Permit number Ct.r.... ........ _
..... ......... .
yoFT�ETo�� TOWN OF .BAR�STABL -..
ZA-
AHB3T
b 9:,em� a .BIJI DING INSPECTOR.. . .
'E0 YPY d'
APPLICATION FOR PERMIT-.,;TO c'............................. ......... ......... ...........................
TYPE OF CONSTRUCTION ..f 72.:9:.......
............................. 9.
TO THE INSPECTOR OF BUILDINGS: 1 A
The undersigned hereby applies for a permit according to the following information: S� 04 1 ',
Location CLI7.........>�.... -�..... 4'l/... ..... ..d��.//.rS? .r-......... .. . `
Proposed Usew.s'1 ./.fY ..;..... .....................
Zoning District e ...................................................
................................:.Fire District .. ....
Name of Owner f� � sr 4:.........�
Name of Builder ...... �� .........................Address ............ ........................................
��/
Name of Architect .....� rl.�P `'-J ...............:....Address ......
.............. .................. ..............................
Number of Rooms ...............Co..............................................Foundation . .......... a ..................................
Exterior �.. .. ..... G..... .......
�....1���......Roofing ,....����.�.... ��..
Floors ... ...../.......... ..... / ....Interior .. .......C. Y a.. l. a�.: � .......
��. �� Plumbing �4 c�
Heating �f� ........ ..... 0................................ T
Fireplace .. z��........ . ..�� C�! �� ...........:.......:......Approximate Cost ....��..C��d�...... ..... .......
✓%
Definitive Plan Approved by Planning Board __________---—_ ___________19 Area ....../........� ....��.............
Diagram of Lot and Building with Dimensions Fee `�
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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AFFIDAVIT OF LINDA GENE PETERSON
1) My name is Linda Gene Peterson.,I reside at 28622 San Lucas Lane,#201, Bonita
Springs, Fl 34135. 1 am the owner of 38 Rosewood Lane, Cotuit, MA 02635.
2) My Father and I bought this newly built house in 1977 as Joint Tenants. The home was
built by Tellegen and Ferrone, as a four bedroom, two baths, "Nantucket Colonial". On May3,
1977, George Low and Co.submitted a Certified Plot Plan, which included a schematic of the
septic tank and leaching pit for approval from the Town.
3) In 19 81, my parents moved 38 Rosewood, their permanent retirement home:
4) In 1984, a two-story addition was permitted and built including:
A. First floor enlarged kitchen with an attached mud-room;
B. Second floor, a large work room with a deeply recessed bookcase. The purpose of this
room was to provide space and light for my Mother's arts and crafts hobby. The entire outside
wall is composed of many, many, windows, for good lighting. This room was never intended to
be a bedroom, nor was it ever used as one.
.On the Application for.a Building Permit, the Building.Inspector indicated aside the
space for a sewage permit number, "No Sewage Needed" 7/17/84.
5) In 1989, my Father deeded his portion of the house to me, as my parents could no longer
afford to share in the mortgage payments.
6) In the year 2003 Better Living Sunrooms, obtained a building Permit, to enclose a
sunroom and add a sun deck.
7) My Mother died in 2004. I under took major repairs to the house. At all times this was.a
four bedroom house and changes aside it has never been used as anything else but a four
bedroom home.
8) In 2004, 1 moved my Father to live with me in Florida. I have always been his soul care
giver. I felt he needed the warmth of winter and as I was now living there, he needed to be with
me. We summered at 38 Rosewood in the years, 2005,2006 and 2007.
9) My Fathers increasing frailty has made it impossible for me to continue summering in
Cotuit. As he approaches his ninetieth birthday it is safe to say he will not be returning to this
home.
}
10) The only time the house has been.rented was for a four month period from October 2008,
to January 2009 and this to an old friend. I have rented weekends this summer to an acquaintance
of another friend. That arrangement will conclude in mid-September.
I swear these facts are true as represented, to the best of my knowledge, knowing the
pains and penalties of perjury. -
August 25, 2009 `~
inda Gen Pete on
State of Florida Notary /f
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J.E.LANDERS-CAULEY,P.E.
civil-environmental engineering
P.O.Box 364
West Falmouth,MA 02574
(508)-540-7733; 540-3022
508-540-3344 (fax)
Barnstable Board of Health August 25,2009
Mr.Thomas McKeon
Barnstable Town Hall
Barnstable,MA 02601
508-862-4644; 508-790-6304 fax
Re: 38 Rosewood Lane
(lot 26)Cotuit
Barnstable,MA
Mr.McKeon,
Please be advised that my office has been retained to review the design calculations for the above
referenced site. The purpose of our review is to determine if the original design,as noted on a plan titled: Test
Hole Results and dated: 04-05-1977 were capable of supporting the design flow for a four bedroom dwelling as it
pertains to the then design standards in 1977.
We have reviewed the plans based upon the 1978 on site state sanitary code known as Title V(code). The
code in 1978 allowed leaching pits and the use of 1000 gallon septic tanks. I have reviewed the percolation data
and profile data provided. According to this information the geology is a coarse sand. The notes in the profile
drawing indicate the leaching pit was placed entirely within the coarse sand. The code design standards for a SAS
permitted sidewall flow rates of 2.5gal-day/sf,bottom area flow rates of I.Ogal-day/s and the utilization of more
than 2.0' effective sidewall height.
Based upon the information provided I have determined the present system was designed for a daily
capacity of 549 gpd. It is therefore my opinion the system, if the system was properly maintained, is capable of
supporting a four bedroom house.
If you have any questions please notify my office.
Sincerely,
Cc: Mr. Jack Kowalski
OFF
JOHN
CLARK, BALBONI & GILDEA, LI,P
OFFICE OF ROBERT G. CLARY JR.
33 GREAT NECK ROAD SOUTH,P.O.BOX 1769,MASHPEE,MA 02649
TEL. (508)477-5567
FAX(508)477-5866
ROBERT G.CLARK,III** RHODE ISLAND OFFICE BRIDGEWATER.MA OFFICE: ROBERT G.CLARK,JR.(1923-1976).
MARK C.GILDEA** 72 SOUTH MAIN STREET 72 MAIN STREET PREDERtcx H.BaLsoxi(1939-1996)
JOHN L.KOWALSKI- PROVIDENCE,RI 02903. BRIDGEWATER;MA 02324 of Counsel
Member M..s h mtw B. TEL. (401)751-1111 TEL.(508)697-6211 RICHARD M.CLARK --
W`m` `"''s"`hw`"'Rc1t°°d`r'-'B— FAX(401)751-1554 FAX(508)697-8511
August 25, 2009
Wayne Miller,MD, Chairman
Town of Barnstable Board of Health
200 Main Street
Hyannis, MA 02601
Hand Delivered, Sharon Crocker
Re: Violations related to 38 Rosewood Lane,Cotuit.
Request to be heard on septic violation at the Boards September 8,2009 Hearing.
Dear Sir:
Referencing your Board's letter to me, as Attorney for.Linda Gene Peterson of Bonita Springs,
Florida, I am happy to report that violations concerning, 105 CMR 410.500 Owner's
Responsibility to Maintain Structural Elements,two counts,have been corrected. 105 C 105
CMR 410.300 and 310 CMR 15.00 has not been corrected. We have attempted to correct;
however,plans submitted for a five bedroom septic system was not accepted.
We, respectfully, would like to be heard on an alternative solution,which requires a hearing
before your Board.We have devised a way to create a five foot opening on a second floor den
area, so as to eliminate one bedroom.
We would ask to be.heard on the fourth bedroom. I am attaching to this letter;
C=
0-4
1)Affidavit of Linda Peterson; support documents;
c3v
2)Foot print of the home at.38 Rosewood, Cotuit;two floors;
c»
--a
3)proposed five bedroom septic plans; c
o M
4)Present working septic system flow numbers, engineer approved
We appreciate the Board's courtesy in allowing an extension to correct these violations. We,have
made every effort to comply, but now ask that a further courtesy be granted for an opportunity to
be heard on the fourth bedroom.
Thank you.
John L. Kowalski,Attorney for
Linda Gene Peterson
L ~
C41 ,Balboni&Gildea, LLP
33 Great Neck Road South
PO BOX 1769
Mashpee, MA 02649
Telephone Number 508-477-5567
e
EXCERPT FROM THE BOH MEETING MINUTES 2/10/2009:
B. John L. Kowalski, representing Linda Peterson, owner of 3.8Rosewo odj
Lane,Cotuit;Map/Parcel 025-048 requesting extension of time to
'6Iimina�ttwo (2) bedrooms, septic system designed for three (3) bedroom,
not five (5).
No one was present for the hearing. A letter from Mr. Kowalski stated his
client, Ms. Peterson, is in Florida and the letter addressed whether the deadline
to resolve the issue is correctly stated at 1/9/09 as they received the notice late.
Mr. McKean explained the issue is that all items in the Public Health Division's
file show the septic system is designed for three bedrooms. At the time of
inspection, five bedrooms were observed (one of the five was an office which
qualified for a bedroom). There is no apparent failure of the septic system at
this time.
Upon a motion duly made be Dr. Canniff, seconded by Mr. Sawayanagi, the
Board voted to request two bedrooms be.removed within six months and if the
owner wants to appeal the Board's decision, she must notify the Board of her
request within 30 Days. As no letter was submitted asking for a continuance,
the meeting continued as scheduled (the Board would like this mentioned in
their letter). (Unanimously, voted in favor.)
EXCERPT FROM THE BOH MEETING MINUTES 9/08/2009:
D. John Kowalkski, Attorney, representing Linda Peterson, owner iC38=--
t=�R_osewood-Lane-,-Cotuit.=violations and extension.
John Kowalkski (not speaking as an attorney) but as a friend for the owner who
is out of state spoke on the matter.
They bought the house in 1987. They took out all the permits properly and the
septic was designed as a four bedroom. It was purchased brand new and was
always intending to be a four bedroom and there was an error on the initial permit
stating three bedroom. Mr. Kowalkski is willing to increase the door opening in
the room above the kitchen to five feet.
Upon a motion duly made by Ms. Rask, seconded by Mr. Sawayanagi, the Board
determined the house was originally built as a four bedroom, the owner will
increase the door opening in the room above the kitchen to five feet, and will
record a four-bedroom deed restriction at the Barnstable County Registry of
Deeds and supply the proper copy to the Public Health Division. (Unanimously,
voted in favor.)
I
+ ail
CLARK, BALBONI & GILDEA, LLP
OFFICE OF ROBERT G. CLARK, JIL Rb
33 GREAT NECK ROAD SOUTH,P.O.BOX 1769,MASHPEE,MA 02649
TEL. (508)477-5567
FAX(508)477-5866
ROBERT G. CLARK,III** RHODE ISLAND OFFICE BRIDGEWATER.MA OFFICE ROBERT G.CLARK,JR.(1923-1976)
MARK C.GILDEA** 72 SOUTH MAIN STREET 72 MAIN STREET rREDERicxx.BnLBoxi(1939-1996)
JOHN L.KOWALSKI* PROVIDENCE,RI 02903 BRIDGEWATER,MA 02324 O'Cou
*Mcmbu M---h— sBar TEL.(401)751-1111 TEL. (508)697-6211 RICHARD M.CLARK
•*Mmbc`M'u'h"m&Rw°'`�''°dBm FAX(401)751-1554 FAX(508)697-8511
December,26, 2008
Thomas A. McKean, R.S.,CHO
Director of Public Health
Town of Barnstable
200 Main Street,
Hyannis, MA 02601
Certified Mail, return receipt requested, regular.mail, postage prepaid. "
Re: 38 Rosewood Lane,Cotuit,MA
Dear Director McKean,
The writer represents, Linda Peterson, owner of the above captioned property. I am by this letter-
requesting a hearing on the matter of State Sanitary Violation Code, 105 C 105 CMR 410.300
and 310.CMR 15.00( septic issue), on behalf of my client..We have been noticed of other
violations which will be corrected within thirty days or less.
As to the timeliness of this request for a hearing,please note the Notice.bears the date of
December 9, 2008. I filed a written request for a copy of this Notice with Timothy O'Connell,
Health Inspector for the Town of Barnstable, indicating my representation of Linda Peterson. He
obliged and his enclosed Fax coversheet indicates his transmission having been sent on
December 22, 2008. My client received notice from,your offices on or about the same day at her
home in Florida. I believe the time of the dated Notice and the delayed reception of same,was
due to an after discovered violation from the time Mr. O'Connell first inspected the property on
December 5, 2008.
Ms Peterson, resides in Florida and is the sole.care provider for her very elderly.Father. She has
requested I represent her interests at her anticipated Hearing. I thank you in advance for your
anticipated cooperation.
Cordially,
J hn f,)owalski
Certified Mail#•7006 2150 C002 1041 3375
Town of Barnstable
Regulatory Services
n+ � Thomas K Geiler, Director
Puhhc Health Division
Thomas McKean,Director
200 Main Street, Hyam-4s,MA 02601
December a 2008
Office: 508-862-4644 Fay.: 508-190-6304
Linda Peterson
28622 San Luoas Lane,#201
Bonita Springs,FL 34135. . k .
NOTICE.T0 ,ABATE VTC}L.A TIONS.OF 105 CMR 410.0000'STATE'SANITARY
CODE IT - IV INIATUM STANDAR.S OF FITNESS FOR HUMAN H"TTATION
AND TITLE V.
The property owned by you located at 38:Rosewood Lane Cotuit, was inspected
on December 5, 2008 by Timothy O'Connell, Health Inspector for the Town of
Barnstable. This inspection was conducted on,the basis of the.rental registration in
accordance with Chapter 170 of the Town of Barnstable Code.
The following violations of the State Sanitary Code were observed:
lQ5tIOS C 411i.300 end ;i10 CME .15.00E n.ere were a total of five (5) bedrooms
observed in this dwelling. However, the existing Be tic systam engineered plan was not
designed for five(5)Bedrooms. It was designed for tlirae(3) II3daoezns.
105_C NIR 410,500--Owner's Responsibility to Maintain Structural Elements.
The bathroom on the second floor was observed to have walls in need of repair. it was
also observed that the front step is missing.
105 CMR 410.500—®vvnler's Rlesposibility to Maintain Structural Elements.
Water was observed to be leaking into basement through area around water line and
through crack in foundation.
,You°are ordered to correct the violations listed above within thirty(30) days
,of your receipt of this notice by-pulling,any required building permits (if
applicable);' You are ordered to remove two of the bedrooms from this home by
removing entrance doors'and by opening door-way entrances td'rooms to a
rninimuzn of five feet pride openings. This will bring the total bedrooms count down
Q0,0rder le-teTs%Hon igg v"olat(onsMan?al Ordirsnee0£rosewood.Ootuit
I
i
� i£rucr►(a) five to the aWoPriate( ,3 tbrec�as designated by your septic MOO et'rE4
plan; by repsirtag batbroon]walls on second floor aaud installing step at fyrant
e-atrance9 by repairing leeks wi.tJaio.basement.
you may request a hearing before the board of Health if written 1 thion requesting s&me
is received°n,iftin ten(10)days after the date ft Order i3 served.
Ncan-c Mpliance wi'l result in a, fine of $100.00 per Violatiol-I., Each uay's failure :o
i
comply with&-I order shall constitute a sepaate violation,
�%tions fags-riling above.violatio.zs, please. cortact Zile 1 CLVIl
Should you have any q'
flaalth Division aticl ask to speak with b�spector wlio performed t11�Jl"15�:�Ct10%1,
PER,O".Eli.OF'T 'B0A ;tD OF ktE41CLTH
omas A, McKcaai,R.S., C"1
Director of Public Health
Town of Barnstable
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Regulatory Services
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Public Health Div'
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Thoiaas McXtOn,Director
200 Mafia Street� F3yamnis,MA 02601
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Thomas A. McKean, R.S.,CHO
Director of Public Health
k Town of Barnstable
200 Main Street,
Hyannis, MA 02601
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EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES 9/08/09:
D. John Kowalkski, Attorney, representing Linda Peterson, owner— 38
Rosewood Lane, Cotuit,. violations and extension.
John Kowalkski (not speaking as an attorney) but as a friend for the owner, who is
out of state, spoke on the matter.
They bought the house in 1987. They took all the permits properly and the septic
was designed as a four bedroom. It was purchased brand new and was always
intending to be a four bedroom and there was an error on the initial permit stating
three bedrooms. Mr. Kowalski is willing to increase the door opening in the room
above the kitchen to five feet. j
Upon a motion duly made by Ms. Rask, seconded by Mr. Sawayanagi, the Board
determined the house was originally built as a four bedroom, the owner will increase
the door opening in the room above the kitchen to five feet, and will record a four-
bedroom deed restriction at the Barnstable County Registry of Deeds and supply the
proper copy to the Public Health Division. (Unanimously, voted in favor.)
Certified Mail#7006 2150 0002 1041 8375
��j rati Town of Barnstable
. Regulatory Services
• BARN SCABLE,
MA Thomas F. Geiler,Director
Public Health Division
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
December 9, 2008
Office: 508-862-4644 Fax: 508-790-6304
Linda Peterson
28622 San Lucas Lane, #201 -
Bonita Springs, FL 34135
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY
CODE II — MINIMUM STANDARS OF FITNESS FOR HUMAN HABITATION
AND TITLE V.
The property owned by you located-at 38 Rosewood Lane Cotuit, was inspected
on December 5, 2008 by Timothy O'Connell, Health Inspector for the Town of
Barnstable. This inspection was conducted on the basis of the rental registration in
accordance with Chapter 170 of the Town of Barnstable Code.
The following violations of the State Sanitary Code were observed:
105 C105 CMR 410.300 and 310 CMR 15.00: There were a total of five (5) bedrooms
observed in this dwelling. However, the existing septic system engineered plan was not
designed for five (5) bedrooms. It was designed for three (3)bedrooms.
105 CMR 410.500—Owner's Responsibility to Maintain Structural Elements.
The bathroom on the second floor was observed to have walls in need of repair. It was
also observed that the front step is missing.
105 CMR 410.500—Owner's Responsibility to Maintain Structural Elements.
Water was observed to be leaking into basement through area around water line and
through crack in foundation.
You are ordered to correct the violations listed above within thirty (30) days
of your receipt of this notice by pulling any required building permits (if
applicable); You are ordered to remove two of the bedrooms from this home by
removing entrance doors and by opening door-way entrances to rooms to a
minimum of five feet wide openings. This will bring the total bedroom count down
QAOrder letters\Housing violations\Rental ordinance\38 rosewood.cotuit
from (5) five to the appropriate (3) three as designated by your septic engineered
plan; by repairing bathroom walls on second floor and installing step at front
entrance; by repairing leaks within basement.
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.
Non-compliance will result in a fine of $100.00 per violation. Each day's failure to
comply with an order shall constitute a separate violation.
Should you have any questions regarding above violations, please contact the Town
Health Division and ask to speak with inspector who performed the inspection.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean, R.S., CHO
Director of Public Health
Town of Barnstable
Q:\Order letters\Housing violations\Rental ordinance\38 rosewood.cotuit
CLARK, BALBONI & CILDEA, LLP
OFFICE OF ROBERT G. CLARK, JR.
33 GREAT NECK ROAD SOUTH,P.O.BOX 1769,MASHPEE,MA 02649
TEL. (508)477-5567
FAX(508)477-5866 �.
ROBERT G.CLARK,III** RHODE ISLAND OFFICE BRIDGEWATER,MA OFFICE iOBEBT G.CLARY,JR.(1923-1976)
MARK C.GILDEA** 72 SOUTH MAIN STREET 72 MAIN STREET FREDERICK H.BALBorn(1939-1996)
JOHN L.KOWALSKI* PROVIDENCE,RI 02903 ,1BRIDGEWATER,MA 02324 OfCoumel
•M—b*M—h—msu TEL. (401)751-1111 TEL. (508)697-6211 RICHARD M.CLARK
••M—n� cn�e &Rhode w�aa FAX(401)751-1554 FAX(508)697-8511
December 18, 2008
Timothy B. O'Connell
Health Inspector
Public health Division
200 Main Street
Hyannis, MA 02601
Re: 38 Rosewood Lane, Cotuit,MA
Dear Mr. O'Connell,
This will confirm,per our telephone conversation,that I represent Linda Peterson, owner of the
above captioned address, but presently residing in Florida. Thank you for calling my office.
You have done an inspection of her property. I respectfully ask that you send me a copy of your
findings in addition.to your notice to Ms Peterson. I will cooperate with your office in every way
possible. r
Again;thank you for the courtesy you have shown me.
LKK es egards and joys oft Season; 2-
JoZI
hn owalski r
Cc: Linda Peterson
WA&L W
Certified Mail#7006 2150 0002 1041 8375
J
jiirti Town of Barnstable
Regulatory Services
Y Y
MASS, Thomas F. Geiler, Director
xb q.
Ar°Ma' Public Health Division
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
December 9, 2008
Office: 508-862-4644 Fax: 508-790-6304
Linda Peterson
28622 San Lucas Lane, #201
Bonita Springs, FL 34135
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY
CODE II — MINIMUM STANDARS OF FITNESS FOR HUMAN HABITATION
AND TITLE V.
The property owned by you located at 38 Rosewood Lane Cotuit, was inspected
on December 5, 2008 by Timothy O'Connell, Health Inspector for the Town of
Barnstable. This inspection was conducted on the basis of the rental registration in
accordance with Chapter 170 of the Town of Barnstable Code.
The following violations of the State Sanitary Code were observed:
105 C105 CMR 410.300 and 310 CMR 15.00: There were a total of five (5) bedrooms
observed in this dwelling. However, the existing septic system engineered plan was not
designed for five (5)bedrooms. It was designed for three (3)bedrooms.
105 CMR 410.500—Owner's Responsibility to Maintain Structural Elements
The bathroom on the second floor was observed to have walls in need of repair. It was
also observed that the front step is missing.
105 CMR 410.500— Owner's Responsibility to Maintain Structural Elements.
Water was observed to be leaking into basement through area around water, line and
through crack in foundation.
You are ordered to correct the violations listed above within thirty (30) days
of your receipt of this notice by pulling any required_ building permits (if
applicable); You are ordered to remove two of the bedrooms from this home by
removing entrance doors and by opening door-way entrances to rooms to a
minimum of five feet wide openings. This will bring the total bedroom countdown
Q:\Order letters\Housing violations\Rental ordinance\38 rosewood.cotuit
r
from(5) five to the appropriate (3) three as designated by your septic engineered
plan; by repairing bathroom walls on second floor and installing step at front
entrance; by repairing leaks within basement.
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.
Non-compliance will result in a fine of $100.00 per violation. Each day's failure to
comply with an order shall constitute a separate violation. -
Should you have any questions regarding above. violations, please contact the Town
Health Division and ask to speak with inspector who performed the inspection.
PER ORDER OF TH BOARD OF HEALTH
omas A. McKean, R.S., CHO
Director of Public Health
Town of Barnstable
Q:\Order letters\Housing violations\Rental ordinance\38 rosewood.cotuit
S
LAW OFFICES OF °
CLARK, BALBONI & GILDEA, LLE
JOHN L.KOWALSKI
ATTORNEY AT LAW
i
126 Belmont Street 33 Great Neck Road South
j Brockton,MA 02301 Mashpee,MA 02649
Tel.508-586-1411 Tel.508-477-5567
Fax 508-559-5066 Fax 508-477-5866
johnkowalski@cbglawfirm.com
� � Le
_
FORM30 &w HOBBSRWARRENTM THE COMMONWEALTH OF MASSACHUSETTS
BOARD �HEA
CITY/TOWN
W
"- - ARTMENT � f
G,,M SVey`0w
ADDRESS
�f ell, TELEPHONE
Address O _ Occupant
Floor Apartment No.of Occupants—
No.of Habitable Rooms No.Sleeping Rooms
No.dwelling or rooming units N
/� Stori s
Name and address ofrowner
(Q iL� Remarks Reg. Vio.
YARD Out Bld s.: Fences:
Garbage and Rubbish
Containers:
Drainage
Infestation Rats or other:
STRUCTURE EXT. Steps,Stairs, Porches:
Dual Egress: and Obst'n.:
❑ B ❑ F ❑ M Doors,Windows:
Roof
Gutters, Drains:
Walls:
Foundation:
Chimney:
BASEMENT Gen.Sanitation:
Dampness:
Stairs:
Lighting:
STRUCTURE INT. Hall,Stairway: — cTv
Obst'n.:
Hall, Floor,Wall,Ceiling:
Hall Lighting:
Hall Windows:
HEATING Chimneys:
Central ❑ Y ❑ N Equip. Repair
TYPE: Stacks, Flues,Vents:
PLUMBING: Supply Line:
❑ MS ❑ ST ❑ P Waste Line:
H.W.Tanks Safety and Vent(s)
ELECTRICAL Panels, Meters,Cir.:
❑ 110 ❑ 220 Fusing,Grnd.:
AMP: Gen.Cond. Distrib. Box:
Gen. Basement Wiring:
DWELLING UNIT
Ventil. L to Outlets Walls Ceils. Wind. Doors Floors Locks
Kitchen
Bathroom
Pantry
Den
Living Room
Bedroom (1), 00'r �..
Bedroom 2 JLu-
Bedroom 3 1 uu
Bedroom 4 5
Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.:
k cks Flues,Vgj feties:
Kitchen Facilities Si
_ 've
Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: _
Wash Basin,Shower or Tub:
Infestation Rats, Mice, Roaches or Other:
Egress Dual and Obst'n:
General . Building Posted
Locks on Doors:
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH
MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE
OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE
AUTHORIZED INSPECTOR.(See Over)
"THIS INSPECTION REPO IS SIGNED AND CERTIFIED UNDER THE PAINS AND
PENALTIES OF P
INSPECTOR TITLE
A.M.
DATE 'X TIME . P.M.
A.M. .
THE NEXT SCHEDULED REINSPECTION P.M.
410.750: Conditions Deemed to Endanger or Impair Health or Safety
The following conditions,when found to exist in residential premises, shall be deemed conditions which may endanger or
impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those
items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the
occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for
human habitation,any other violation has the potential to fall within this category in any given specific situation but may not do so
in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that
other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local
health official to order repair or correction of such violation(s)pursuant to 105 CMR 410.830 through 410.833 nor shall failure to
include affect the legal obligation of the person to whom the order is issued to comply with such order.
(A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary
needs of the occupant in accordance with 105 CMR 410.180 and 410.190 fora period of 24 hours or longer.
(B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as
prohibited by 105 CMR 410.200(B) and 410.202.
(C) Shutoff and/or failure to restore electricity or gas.
(D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com-
mon area required by 105 CMR 410.254.
(E) Failure to provide a safe supply of water.
(F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR
410.150(A)(1)and 410.300.
(G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object,
including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452.
(H) Failure to comply with the security requirements of 105 CMR 410.480(D).
(1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar-
bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests
or otherwise contribute to accidents or to the creation or spread of disease.
(J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public
Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.)
(K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or
other dangers or impairment to health or safety.
(L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating,
gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352,
so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety.
(M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release
of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105
CMR 410.353.
(N) Failure to provide a smoke detector required by 105 CMR 410.482.
(0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or
knowledge of the owner of said condition or conditions:
(1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven
or any defect that renders either inoperable.
(2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any
defect which renders them inoperable.
(3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of
generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard.
(4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as
required by 105 CMR 410.503(A)and 410.503(B).
(5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550.
(P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con-
dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner
to remedy said condition within the time so ordered by the Board of Health.
AsBuilt Page 1 of 1
TOWN OF BARNSTABLE
LOCATION SEWAG;
VILLAGE � -ASSESSOR'S MAP
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)_
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility
Private Water Supply Well and Leaching Facility (If--any wells exist
on site or within 200 feet of leaching facility)
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility)
Furnished by
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, ~ Town of Barnstable
8 Board of Health
M . $
''rxvr, A 200 Main Street, Hyannis MA 02601
1 _ -
Office: 508-8624644 Wayne Miller,M.D.
FAX 508-790-6304 Paul Canniff,D.M.D.
Junichi Sawayanagi
March 9, 2009
John L. Kowalski
Clark, Bakboni, and Gildea, LLP
33 Great Neck RoadSuth
P.O. Box 1769
Mashpee, MA 02649
Dear Mr. Kowalski,
Durirfg the public meeting of the Board of Health held on February 10, 2009, the Board
vote to uphold the order from the Health Division to your client, Linda Peterson of Bonita
Springs Florida. The Board also voted to extend the deadline to correct the violations;
requiring all of the-violatuoins to be corrected within six months.
You indicated in your letter that the delayed reception was due to an after-discovered
vioation from the time Mr. O'Connell first inspected the property on December 5,`2008.
Therefore, the Board voted to grant an extension.
The following violations of the State Sanitary Code were observed by Health Inspector
Timothy O'Connell on December 5, 2008:
105 C105 CMR 410.300 and 310 CMR 15.00: There were atotal of five (5) bedrooms
observed in this dwelling. However, the existing septic system engineered plan was not
designed for five (5) bedrooms. It was designed for three (3) bedrooms.
105`-CMR 410.500—Owner's Responsibility,to Maintain Structural Elements-.
The bathroom on the second floor was observed to have walls in need of repair. It was
Also observed that the front step is missing.
105 CMR 410.500_.Owner's Responsibility to Maintain Structural Elements.
QAOrder letters\Housing Violations\KowalskiPeterson38RosewoodLane2009.doe
L 1
s-
Water was observed to be leaking into basement through area around water line and
through crack in foundation.
Ms. Peterson was originally ordered to correct the violations listed above within thirty
(30) days of her receipt of the original notice dated.December 9, 2008 by pulling any
required building permits (if applicable). She wds ordered to remove two of the
bedrooms from this home by removing entrance doors and by opening door-way .
entrances to rooms to a minimum of five feet wide openings. This will bring the total
bedroom count down from (5) five to the appropriate (3) three as designated by your
septic engineered plan.; by repairing bathroom walls on second floor and installing step at
front entrance; by repairing leaks within basement.
On February 10, 2009, the Board voted.unanimously in favor of granting your client
additional'time, six months, to comply with this order. The violations shall be
corrected on or before August 10, 2009.
Sincer ,
Wayne,_: ller, M.D.
Chairmin
BOARD OF HEALTH
TOWN OF BARNSTABLE
Q:\Order letters\Housing Violations\KowalskiPeterson38RosewoodLane2009.doc'
r CLARK, BALBONI & GILDEA, LLP
OFFICE OF ROBERT G. CLARK, JR
33 GREAT NECK ROAD SOUTH,P.O.BOX 1769,MASHPEE,MA 02649
TEL. (508)477-5567
FAX(508)477-5866
ROBERT G. CLARK,III** RHODE ISLAND OFFICE BRIDGEWATER,MA OFFICE ROBERT G.CLARK,JR.(1923-1976)
MARK C. GILDEA** 72 SOUTH MAIN STREET 72 MAIN STREET FREDERICK H.BALBONI(1939-1996)
JOHN L.KOWALSKI* PROVIDENCE,RI 02903 BRIDGEWATER,MA 02324 OfC0=Sd
°Mcmbu M—h—Bu TEL. (401)751-1111 TEL. (508)697-6211 RICHARD M.CLARK
••Mcmbcr Massshmctts&Mode'''"'aBm FAX(401)751-1554 FAX(508)697-8511
December 26, 2008
Thomas A. McKean, R.S.,CHO
Director of Public Health
Town of Barnstable
.200 Main Street,
Hyannis, MA 02601
Certified Mail, return receipt requested, regular mail, postage prepaid.
Re: 38 Rosewood Lane, Cotuit,MA
Dear Director McKean,
The writer represents, Linda Peterson, owner of the above captioned property. I am by this letter
requesting a hearing on the matter,of State Sanitary Violation Code, 105 C 105 CMR 410.300
and 310 CMR 15.00( septic issue), on behalf of my client. We have been noticed of other
violations which will be corrected within thirty days or less.
As to the timeliness of this request for a hearing, please note the Notice bears the date of
December 9, 2008. I filed a written request for a copy of this Notice with Timothy O'Connell,
Health Inspector for the Town of Barnstable, indicating my representation of Linda Peterson. He
obliged and his enclosed Fax coversheet indicates his transmission having been sent on
December 22, 2008. My client received notice from your offices on or about the same day at her
home in Florida. I believe the time of the dated Notice and the delayed reception of same, was
due to an after discovered violation from the time Mr. O'Connell first inspected the property on
December 5, 2008.
Ms Peterson,resides in Florida and is the sole care provider for her very elderly Father. She has
requested I represent her interests at her anticipated Hearing. I thank you in advance for your
anticipated cooperation.
Cordially,
J hn L Kowalski
1
1 .
Certified 9i1 "7006 2150 C002 1041 M5
Town of Barnstable
Regulatory Services
> / Thomaa F. Gefter, Director.
to�p
M , Pub& Health Division
Thomas McKean,Director
200 Main Street, Hy=i.s,MA 02601
December 9, 2008
Office: 508-862-4644 Fax: 508-190-6304
Linda Peterson
28622 San Lucas Lane,#201 ,
Bonita Springs,FL 34135
?NOTICE TO ABATE VIOLATIONS OF 105 CMR'410 au0jT,,kT +' SANITARY
CODE 11 -- MINI1«M STAMoARS OF FITNESS FOR HUMAN H.-G TATI+ON
AND'TITLE V.
The property owned by you located at 38 Rosewood Lane Cotuit, was inspected
on December 5, 2008 by Timothy O'Connell,Health Inspector for the Town of
Barnstable. This inspection was conducted on,the basis of the rental registration in
accordance with Chapter. 170 of the Town of Barnstable Code.
The following violations of the State Sanitary Code were observed:
105 C105 CMR 410.300 an�7d 310 CMS 15M.L There were a total of five (5) bedrooms
observed in this d-vve?ling. However, *.e ex-i'sting Se uL systaSii angiileeraLd plan was not
designed for five(5)bedrooms. It was designed for three(3) bedrooms.
105.CMR 410,500--Owner's Responsibility to Maintain Structural Elements.
The bathroom on the second floor was observed to have walls in need of repair. it was
also obsarved,that the front step is missing.
105 CMR 410.500—Ovmer's Resposibility to Maintain Structural Elements,
Water was observed to be lacking into basement through area around water line and
tbxough crack in foundation.
You are ordered to correct the violations listed above within thirty(30) days
of your receipt of this notice by pulling any required building permits (if
applicable);` You are ordered to remove two of the bedrooms from this home by
removin®entrance doors and by opening door-way entrances to rooms to a
minimum of five feet wide openings. This will bring the total bedroom count down
Q.,®rderlc rxrslHousing v;olatlon0untal ordir nCOS rosewood.ootuit " ..'a
� Irite 3 t.l�roe asegig�n�>ted by your septic engi►�eerel
frog,(5) five to the approp (�)
plan; by repairing bathroom-walls on secoud floor aorl instalbug step at ftraut .
aks within,l�ascm�enf.•
entrance; by repairing le
you may request a rearing be#ore the Floa7'cl of Health if written.l�etition reque tin sane
days after the datel.a t order is served.
iS received r itum ten(lU) y
i
t�Tan-corzaPliance wi'.l resul . fine df. $1 Q4.Q0 Yer violation, 1✓aclx ci�`1'S failure to
t ir a i
cottzply �iitll a "' rde;'shall (,On ituto a separate via ation•
A above violatio;zs, please contact kne Tc �n
Should you have any q;lfstions tagard ng
Tlsalth.Division alid ask to spe'A' with Laspecter who perform�d tll�1�15 aC l0n.
pT,i�JR,ORDER OFT . '-J30ARD 07 HEALTH i
omas A. M'KeaT),R.5.,C'lx{�
Director of Public.Health
'Town of Barnstabe �
i
i
RF,:!�fF�.tjpl:31T.rclatianslFan;8:41'i;,C1P."2�,i6:G8e�Y0pd,G01�Ii'. ..
1
1
opZNE ,
Town of Barnstable,
I LJE. Regulatory S p
Ivi .Fs
, b41K'i.
�o nice 16 Thomas P. Geiler,Director
Public Health Division.
Thomas Mcke-am,Director
200 Mainz Street, Hyamju,s,)y� 02601
a 1
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rrUNMER ear PAGES TO FOLLOW,.
I PROXr. (708)862-S6dy '
PAX PRONE. (SOS)790-6304 �
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
o.w.n..... ............ ...���c . . .b.--fE .........................................
firatiun vrr u gvoiial Works Towitrnrtinn Vaniit
3 Application is hereby'made for a Permit to Construct (r or Repair ( ) an Individual Sewage Disposal
System at: i /
�b'� .0/w..�r~?X z�.:. _..._!�1_f/���' N t'!.f'L11 �d. -•----------------------•--.--.--------
.... ---- -•-- .------
ocation•Address --.••--------------------------•-------.-•or Lot No.
-----------------------------------
W � f �� r Address
nstalle, Address
Type of ding Size Lot_.__ `�_1_.ff_��__m......Sq. feet
wellin —No. of Bedrooms..._._,3_................................Expansion Attic (gyp) Garbage Grinder (rjo)
aler—Type of Building ----____________________--- No. of persons..___7a................... Showers ( ) — Cafeteria ( )
Q1 Other fixtures _________________________________
W Design Flow-----------5.70------------------------gallons per person per day. Total daily flow..........3®0......................gallons.
WSeptic Tc.nk—Liquid capacity/f 0__gailons Length____-____-__-- Width................ Diameter---------------- Depth....______._.--.
x Disposal Trench—No- ____________________ Width-------------------- Total Length.................... Total leaching area--------------------sq. ft.
Seepage Pit No----------,-------- Diameter.._k�----- Depth below inlet_: ..__ __ Total leaching area.___-.--_______sq. ft.
z Other Distribution box ( A Dosing tank ( ) v,0 6 ®"
..,.�j..._
� Al—--'7 7
Percolation Test Results Performed by------------------------------------------------------------------------- Date-.----------------------------e-------
Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water...1`l.._.-_------
Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__-_.._____--.____--.__.
a' -------------------- ---------------- ---------------•-••-••••--•----•-- -•--•-••-
O Description �=
x ..
U ..... Gu t l '�
----------------------- ----------------•-------------------- ------------------------------------ -. ------
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 Article NI 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.
Ligne.d ..-- ./. - -/---- .. .._ '�--- -- ��------Application Approved By----'... ---- •---- .--- �--- '..7-7------------
Date
Application Disapproved for the following reasons-------------------------------------------------------------------------------------------- -------------------
-------------•-------•-----------------------------------------------------------._._...-•--•-------•---•..---------------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued......7 /-`-zl--------------•-----------
Date
No. ....................
>k
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.._......OF...P +<;!s 1'� .............
Apph ration -fir J: i�i vlial Works C owitrurtinn Vanift
Application is hereby`made for a Permit to Construct O or Repair ( ) an Individual Sewage Disposal
System at i s
------_---_-----------..............
Location_Address or Lot No.
q- �' 4 7— 9`a_�"/ lye --•-•-------------•------
W der Address
nstaller Address
Q Type of 'lding Size Lot....®Z___"�1__. _�__Sq. feet
wellin —No. of Bedrooms--__ _______.___-__-Expansion Attic (40) Garbage Grinder (7a)
aer—Type of Building .............................. No. of persons.-•. --.'..•--...__..__. Showers ( ) Cafeteria ( )
Q' Other fixtures ___.___:_____
W Desi n Flow_________ 0........................ Mons er erson er da Total dail flow..__._ �� allons.
g �-- �� P P P Y. y .... ..-- - -g�
9 Septic Tc,nk—Liquid capacity 0__gailons Length............... Width........ ._.. Diameter---------- ----- Depth.---------------
Disposal Trench—No__________________ ___ Width-------------------- Total g ._ _
leaching area-------------------- ft.
Seepage Pit No-____-.__-_-___-__ Diameter....�! _:_._. Dept belown let Total leaching area------------------sq. tt.
Z Other Distribution box ( •} Dosing tank
aPercolation Test Results Performed`by __ .-. _______________________________________________________ Date-----------------------•a --
a Test Pit No. 1................minutes per inch 'Depth of Test Pit____________________ Depth to ground water ._.'*-'---_----. --
rXq 'Test Pit No. 2_____ minutes per inch Depth of rest Pit _ Depth to ground water �.-'-_:-.
p
® Description of oil -"""" '" = '" "� ... a"" _-
� -
w
W
UNature of Repairs or Alterations—Answer when applicable-----:_____. ._._
'Agreement
The_undersigned agrees to, install' the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the StateSanitary Code—The undersigned further agrees tnot to place the system in
operation until a Certificate of°Compliance has been issued by the board of health.
.
/ 7
..
ate
Application Approved BY-- '" h /`
Date
Application Disapproved for the f ollowZng reasons----------------------------- ---•-- -------- -------- -----------------------------------------------
--•-••-•-•---------•---••-----------------•-----------------•---•---•----------------------------------•--------------•--•-------•-------------------------------------------------------------------
Date
Permit No. ----•-. -------•-•-••---......_. Issued. ------------- ---••-- .-:__- -•----
Date
M THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH ,A,
g: . : OF..: .: . ✓�......... .�
�prtifir tr of"Tompliana
THIS I .TO ERT FY, That,,oe,Individual Sewage Disposal System constructed X) or Repaired ( )
by a'��'
* "
in rtiler
at ---_---------- ........ i - t 9�' - .. ----- -----' ---- �-.. --. -----•------------------
has been installed in accordance with the provisions of ArXI 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 A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY,, `
DATE l--T-- --�- Insmctor . ......
� L -----------•-•--------------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
;U47 ;
16�.?..... OF.:.lr s f'I ................................
i� ta>attl larks ( �ttr�trti> itrrmit
Permission is hereby granted----- ----- -- --- -----04-` _.-. . -------------------_.................................................
to Construct ( `) or R .pair ) an ndividual Se ge Disposal,, ys m
at No -••-••---••--- -----------.�.� ? !�?? '� P .......��'� i_�_ ----------------------- -------
Street.
as shown on the application for Disposal Works ConstructinPm•i N ted____ --••--..-
.... ......../ i4
Board of Health
DATE----------------------------------------------------- ------------------------• _
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS -
§k t Y.
1�� ---- --;-f.•= ,� Fug �+
No..- .0 .......
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Appliration tar Mapaagal Workii Towitrnrtinn Prrutit
Application is hereby`made for a Permit to Construct (, ) or Repair ( ) an Individual Sewage Disposal
System at: F
�pd L.l�' _._. % l�A.r_ _..__ '_,l._/��irl1.` ..---- !'.'Z'Y_ " '_li �G"..'.!CI•_..._.."-�7_.._ ..
Location-Address or Lot No.
.^r_Qa7e-----------------•-----------•---•----- --•---..._---------•------•-•--•--..__...._...--•---._.._.__.._..-•---•-----._..__._.......__._._.
-------------------------------------- ---•--•--------------------------•----._....nddres5••....------------------------------•-----.
Installer Address
Type of •Iding Size Lot....a.y__/`J?._,�._.Sq. feet
wellin —No. of Bedrooms......3.................................Expansion Attic (4o) Garbage Grinder (7ej)
Ier—Type of Building ................. No. of persons...._ Showers Cafeteria
p-I Other fixtures ..............•--"----..__....---"-•---._...._..----"-........................................................................................
P� Sept "I'auk—Liq�d0capacity��•'_C..gallootss PeL per-son
gth n per day.�Total daily flow
lliamete�0®---•---•-•••------��-�-gallons.
W Design Flow________..
r---------------- Depth-----._._.......
W Disposal Trench—No. .................... Width__.___.__:_._...._-- Total Length.................... Total leaching area....................sq. ft.
x
Seepage Pit No_________ __________ Diameter...k k....._ Depth below inlet..... Total leaching area..................sq. It.
Z Other Distribution box ( ,�i} Dosing tank
Percolation Test Results Performed:•by-------------------------------------------------------------------------- Date-------------------------- tom.
Test Pit No. I..._............minutes per inch Depth of Test Pit-------------------- Depth to ground water...*.__:__.--_------
44 Test Pit No. 2........._______minutes per inch Depth of Test Pit-------------------- Depth to ground water........................
--- ----- ._...-•_•_-- ------------
-
/--
0 Description of oil__ *''"' M " ! ! ""
W
UNature of Repairs or Alterations—Answer when applicable..___:`...................................;... __._____--__--._--__-.._-------_-.-_________--
Agreement:
.:
_The:._undersigned..agrees te- install=tl-ie`aforedescribed Individual Sewage Disposal.System in accordance with
the provisions of Article XI of the StateeSanitary 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.
igned 0: � �� ` ?7-
- Date
Application Approved By-----"' ___•- ." - ................ ---- •»- ------------•- ......--`�I-------a-•--�-� ----•-----
Date
Application Disapproved for the following reasons:------------------------------................................................................................
Date
Permit No.............................. : 'Issued----------------------------------- •••......__......--
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Tatifiratr of TaQmphaurr ,,
System constructed ( ) or Repaired ( )
----- ---
THIS I T/O" ERT.FY That•,,,Ilie„Individual Sewage Disposal
by_
/ - — - Inst(pller g�
at __________________Xlrkt_.__..__ __.....___4 t F .� � !___.___ _____._._...___._.._... l d ....................................y.c.______ __ ___________
has been installed in accordance with the provisions of Ar • XI of 1 The State Saflitary Code as described in the
application for Disposal Works Construction Permit No... ------- /_-----------_____ dated--...--. __._._...._.._
THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT RE CONSTRUED GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY,-
DATE -------- ------ :Inspector c/
�_ d
THE COMMONWEALTH OF MASSACHUSETTS
- BOARD OF HEALTH
7
...... ..........OF .. _1 �� �" :. -
- -------•.................
No.......... .---- _- FEE
�i��aa�tt1 nxk� C�a� �trnrtia�it �rrntit
Permission is hereby granted----- ----- ......... .. ... ...............•-----------------------
to .Construct (,) or R .pair ) an{ ndividual Sew ge Disposal ys em
atNo..................... .........
Street
as shown on the application for Disposal.Works Construction. :Permit- No_____ ____ ______ <ted______� �` �._."7 7_____.____
--"".----o tom-.
---------------------
DATE.......................................................................... - Board of Health
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
Assessor's map and lot riumb r ........
IVOFTHETO�
Sewage Permit number...
Z BAUSTABLE, i
House number ........ 9 rasa 0........ .... .......
00,0�i G3 q• \e�°�
TOWN OF ;BARNSTABLE
GUILDIG INSPECTOR
APPLICATION .FOR .PERMIT TO ,��A ... ...... .. .. ..................
TYPEOF CONSTRUCTION ............... .. .... .......................................................................................
..........�. .........19.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .......... .. ?.4 ....... r .& . ... . . .. .. ........... .......................
Proposed Use ........... ........r. . .............. ................ ..... .... ...........................
Zoning District ...... ...... ................................................Fire District .......... ... 5m....................................
Name of Owner ... 9 .e ... ..Address ..... ......� ..�. �.'... ....
Name of Builder .... ...... .Q.a Address ....... .. ........ .... � .�.
Nameof Architect ....................... ...............................Address .................:..................................................................
eu :�.�
Number of Rooms ...................... ........:..........:.......................Foundation k®...? .. .............. l ........._.....................
m ..........Roofing ........ .......
Floors ................. S;?O.0...................................................Interior .. ..................................
Heatin .._.7 .... ..Plumbing ............ .�� �... n: �... .
g ........ ::o.... r....
Fireplace � ........ Approximate Cost �..
p ..... ..... ..... ......... �. . ..........................
44
Definitive Plan Approved by Planning Board -----------------------_---------19________. Area ......�c°. �.......................
Diagram of Lot and Building with Dimensions // .
Fee .,.,1...�i..�.....................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .. . Am; p 9...�..........
Construction Supervisor's License ..ernz ..............
1
ra G953 u 348 59056
Russell W. Peterson and Linda-Gene Peterson father and daughter,
of 38 Rosewood Lane, Cotuit, Massachusetts 02635 and 15 Rosewood
Lane, Cotuit, Massachusetts 02635, respectively, as joint tenants
with the right of survivorship in consideration of Ten and 00/100
m(510.00) Dollars
*&It*ARW1 ieok*KkipAagnsdNkftwxhic
grant to Linda-Gene Peterson of 15 Rosewood Lane, Cotuit, Massachusetts
m
m
u
m
with gsiftl4m ramants
{ 3hecbuad inc
y.i
.A
D (Description and encumbrances,if any)
the land in together with any buildings thereon situated in the
Town and County of Barnstable. Massachusetts, described as
follows:
[ 4.
a NORTHEASTERLY by Lots 19 and 20 as shown on a plan
0 hereinafter mentioned, one hundred sixty-two
y and 00/100 (162.00) feet;
A NORTHEASTERLY by Lot 18. on said plan, seventy-eight and
ro 30/100 (78.30) feet: i
SOUTHEASTERLY by land now or formerly of June F. Lyons, one 7
hundred thirty-seven and 29/100 (137.29)
,� ro feet.
°q SOUTHWESTERLY by Rosewood Drive on a cul de sac, as shown on
said plan, having an arc length of one
r. hundred ninety three and 77/100 (193.77)
,a feet:
f; o NORTHWESTERLY by Lot 25. as shown on said plan, one hundred
seventy one and 52/100 (171.52) feet.
t 0
I m Containing 24,195 square feet, more or less and being shown as
o LOT NO. 26 on a plan entitled "Chalais" Subdivision Plan of
a Land in Barnstable, Mass., Scale 1 in. = 100 ft. November 16,
1973 for Cranberry Acres Realty Trust, 371 Main Street,
Yarmouth, Mass., by Ewald 6 Maschi, Inc. Engineer-Consultants, i
Route 6A, "Sea-Lake Building", Sandwich, 906 Concord Street,
y Framingham. Mass.," said plan being recorded in the Barnstable
County Registry of Deeds in Plan Book 284, Page 42.
This conveyance is made subject to the restrictions set forth
in a deed from David Geele and Louis A. Lapio, Trustee to
aJoseph J. Reardon recorded in the Barnstable Registry of Deeds.
w
in Book 2150. Page 56. `
Q'
a Included in this conveyance is `the fee in the roads as shown on
the aforementioned plan recorded in Plan Book 284. Page 42.
subject however to rights and privileges granted to Joseph J.
Reardon by deed referred to above.
There is granted herein an easement over the Ways as shown on a
Plan of Land entitled "Sandalwood at Santuit" Subdivision Plan
of Land in Santuit. Barnstable, Mass. for Everett B. and
i Bernice D. Jackson. 4E-eels 1 in. 100 ft., dated September
1955, by Scott Associates-Surveyors, South Dennis, Mass., Cape
I Cod" which said plan is duly filed with the Barnstable Registry
of Deeds in Plan Book 199, Page 81. for all purposes for which
ways are commonly used in the Town of Barnstable and more
particularly for securing means of access to the land conveyed
herein.
i{
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BOCK 6 9 J 3 PAGE 3 4 9
Included in this conveyance is the title to all roads as shown
in the plan recorded in the Barnstable County Registry of Deeds
In Book 199. Page 81, and subject to an easement for the
benefit of Lots 13. 32, 33 and 34 as shown on said plan to use
said roads and ways for all purposes for which ways are used in
the Town of Barnstable, including but not limited to, easements
for water, electricity and other easements over or beneath the
ways, and also subject to a grant of easement to Lots 31 and 33
as shown on a plan of land entitled "Chalais" duly recorded in
the Barnstable Registry of Deeds in Plan Book 284. Page 42;
however, reserving to and for the benefit of the Grantor, it
successors and assigns, and right to use the ways in common
with all others entitled thereto for all purposes for which
ways are used in the Town of Barnstable, including but not
limited to, easements for water, electricity and other
easements over or beneath the said ways. Said easement and
right to use the ways is for all of the ways as shown on plan
of land known as "Sandalwood at Santuit", said plan being
recorded at the Barnstable County Registry of Deeds in Plan
Book 199. Page 81.
For title, see Deed recorded July 11. 1977 from
Tellegen-Ferrone Associates, Inc. to Russell-W. Peterson and
' Linda-Gene Peterson, Book 2544. Page 015-017.
}
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... ,L'<c:�'%�.:.:.C��' lP•................ ...:;`:.......
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e
Tellegen-Ferrons Associates, Inc. y3� •. . �n
a corporation duly established under the laws of Massachusetts
and having Ito usual place of business at PO Box 373, Centerville
of Barnstable County, Massachusetts, in consideration of
Forty One thousand Nine Hundred ($41,900.00) Dollars
grants to Rus oil VW.=Petereon-and'Lin'de-Gene Peter_son7father and daughter, of
90 Packard Avenue, Springfibld and 175 Adam Street, Newton, respectively, as joint
ante with the right of survivior ship
with quitrlalm rourtwido
the land in together with any buildings thereon situated in theTown and County of
Barnstable, Massachusetts,,described as follows:
NORTHEASTERLY by Lots 19 and 20 as shown on a plan hereinafter mentioned, one .
hundred sixty-two and 00/100 (162.00) feet;
NORTHEASTERLY by Lot 18, on said plan, seventy-eight and 30/100 (70.30) feet;
SOUTHEASTERLY by land now or formerly of June F. Lyons, one hundred thirty-
seven and 29/100 (137.29) feet;
SOUTHWESTERLY by Rosewood Drive on a cul de sac, as shown on said plan, havi g
an arc length of one hundred ninety three and 07/100 (193.77) t;
NORTHWESTERLY by Lot 25, as shown on said plan, one hurl red seventy one and
52/100 (171,52) feet.
Containing 24,195 square feet,more or less and being shown as LOT NO 26 on a plan
entitled "Chalais" Subdivision Plan of Land in Barnstable, Mass., Scale 1 in-100 ft.
November 16, 1973 for Cranberry Acres Realty Trust, 371 Main Street, Yarmouth, Mass,,
by Ewald & Maschi, Inc. Engineer-Consultants, Route 6A, "Sea-Lake Building",
Sandwich, 908 Concord Street, Framingham, Mass.,11 said plan being recorded in the
Barnstable County Registry of Deeds in Plan Book 284 Page 42.
This conveyance is made subject to the restrictions set forth in a deed from David
Goals and Louie A. Lapio, Trustee to Joseph J. Reardon recorded in the Barnstable
Registry of Deeds in Book 2150 Page 56.
Included in this conveyance is the fee in the rce ds as showh on the aforementioned
plan recorded in Plan Book 284 Page 42, subject however to rights and privileges
granted to Joseph J. Reardon by deed referred to above.
There is granted herein an easement over the Ways as shown on a Planof land entitled
"Sandalwood at Santuit" Subdivision Plan of Land in Santuit, Barnstable, Mass. for
Everett B. and Bernice D. Jackson, Scale i in Q 100 ft., dated September 1955, by Scot
Aaeoclates-Surveyors, South Dennis, Mass., Cape Cod" which said plan is duly filed
with the Barnstable Registry of Deeds in Plan Book 199 Page 81, for all purposes for
which ways are commonly used in the Town of. Barnstable and mcre particularly for
securing means of access to the land conveyed herein.
Included in this conveyance is the title to all roads as shown in the plan recorded in
the Barnstable County Registry of Deeds in Book 199 Page 81, and subject to an easement
for the benefit of Lots 13,32,33 and 34 as shown on said plan to use said roads and ways
for all purposes for which ways are used in the Town of Barnstable, including but not
limited to, easements for water, electricity and other easements over or beneath the ways,
and also subject to a grant of easement to Lots 31 and 33 as shown on a plan of land
entitled "Chalais" duly recorded In the Barnstable Registry of Deeds In Plan Book 284
Page 42; however, reserving to and for the benefit of the Grantor, its successors and
eccx 2844 PAcF 016
assigns, and right to use the ways in common with all others entitled thereto for al
Purposes for which ways are used in the Town of Barnstable, including but not
limited to, easements for water, 'electricity and other easements over or beneath
the said ways. Said easement and right to use the ways is for all of the ways
as shown on plan of land known as "Sandalwood at Santuit", said plan being
recorded at the Barnstable County Registry of Deeds in Plan Book 199 Page 81.
For title see deed of Alden M. Zleman, Trustee for AMZ Cape Trust, dated
February 11 1977, recorded in Barnstable Registry of Deeds in Book 2467 Page 215.
For authority to convey, see Vote recorded in Book 2279 Page 192, Barnstable Riegisl ry
of Deeds.
�op r�vez! is hpieb�, ,Q '' p/�•v� a.+a goeU r rr s 4.Geo.c&41
1AWb=f1hNVd the said Teliegen-Ferrone Associates, Inc.
has caused its corporate seal to be hereto al6ued and these presents to be signed, acknowledged and
delivered in its uame and behalf by Michael Ferrone and David Tellegsn
its Pre s/Trea s, hereto duly authorised,this 1st
day of July in the year one thousand nine hundred and Seventy-seven.
Signed and sealed in presence of
i
by , ._. :.T._...
.m.
eoox2544 Pat (d7 .
�hcQwauatdtltot�tt�i
Barnstable July 1 19 77
Then personally appeared the above named Michael Ferrone and David Tellegen
and acknowledged.the foregoing instrument to be the free act and deed of the Tellegen—Ferrone
Associates, Inc.
before me
My commission expires Pj 19 ��7
COMMONWEALTH OF MASSACHl)SETTS
(TN11 POIAOWINO le NOT A PART OF Till)DEED,AND 19 NOT TO BE nECORDBD.)
GIIAPTDR 183, BEOTION 11, gBN141W. LAwe
A dodd in aubstanoc following the form entitled "Quitclaim Deed"shall when duly executed have the
force and oRootof a dood in foo simplo to the grantee,his heirs and assigns,to his and their own use,with oov-
enaats on the part of the grantor, for himself, late heirs,executors, administrators and successors, with the
grantee,his heirs,successors and assigns,that at the time of the delivery of such deed the promisee were free
from all encumbrances made by him,and that lie will,find his heirs,executors and administrators shall,warrant
and defend the same to the grantee and his heirs and assigns forever against the lawful claims and demsnde*of
all persons claiming by,through or under the grantor,but against none other.
RECORDED JUL 11 1977
ecc�2150 .056. 0277M
We, DAVIil GLELF and IAIIIS A. LAPiO, MUSTEK of CRASnEnRY
NCR ES REALTY TRUST under a written lleclarntiun of Trust dated Augus
1, 1972 and duly recorded in the Barnstable County aegistry of
ecds in Book 1703, Page 62, of 5£ ,lass liver Lane, South Dennis,
3arnstahle County, '•lassachusetts, for consideration of 8kno n .00
aid, grant to,sr rd 1. ".1:ARDG.`: cif 132 Pleasant lines Avenue,
.cnterville, Town and County of Barnstable, 'Iassachusetts. with, gUIT
.LAI'I CO\'LSANTS two certain parcels of lanil situbted in the Town
and County of Barnstable, lassacausctts more fully 'rounded and
described as LOTS 33 and 31 shown an a plan of land entitled,
"C1IALAIS", a Subdivision flan of Land in FarnstaLle, 'lass. Scale
100' , November 16, 1973 for Cranberry Acres Realty Trust, 371 . j
lain Street, Yarmouth, 'lass. by Ewald ; Maschi, Inc. , Engineer/
Q A Consultants, Route 6%, "Sea-Lake Building Sandwich, M Concord
Street, Framingham, "ass." said plan heinrrec:orded in the Barnsta-
le County Registry of 'feeds in Plan Rook 234, Palle 42.
Included in this conveyance is a right to use the roads and
ways as shown on the aforementioned plan for all purposes for which
roads and ways are commonly used in the.Town of Barnstable, includ-
ing but not limited to casements for water, eiectricity and other
casements over or beneath said ways. j-
I
This conveyance is made together with a right of way over the
ways as shown on the aforementioned plan. This conveyance is sub-
ject to the following restrictions:
1. No building shall he erected, maintained, remodeled or al-
tered until the plans showing exterior finishing, any rooting and
the proposed exterior colors have been approved .in writing by the
grantor, their successors or assigns or such other person as they
may from time to time appoint for that purpose.
2. All buildings placed, erected or ailowed to stand on said
lot shall be used for single family residence only] and shall con-
tain not less than 950 sgnare feet first floor area, excluding open
Jose m i.seesooM breezeways, porches, garages. (A garage, attached, not .exceeding
.Tram AT LAW two cars).
rss rsu MMa
"I ors
Mures.rasa
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e;:cr2150 057
3. :1nv exterior l;nmdry drying, facilities or trash or garbag
cans shall he enclosed within a screened service area.
4. No animals, or for:l , except common household pets shall b
kept on the granted premises, and outside shelter for the same
shall be screened from view.
5. o trade or husiness activity shall be carried on upon
said lot, except with the express consent of the grantors and no
signs except the usual owners signs on said lot, or one "For Sale"
or "Fur dent" !--irn, not exceeding the Sinn size as allowed under
the Town of liarrstable sign code shall he placed on .the granted
premises.
G. All commercial vehicles, trailers or boats shall he kept
in ., garage ur kept in a screened area where they may not he seen
from the street or ;nry adioinins lot.
' To raint;rirr the residential character of the area, the
granter ::hall ,.evil the preniscs clear of underbrus!1 nn,.. dnhris
prior to the erection of a huildinq thereon.
S. Upon co:-yletion of any structure built upon said premi-
tics, all lot owners shall seed or pine needle all disturbed areas
and shall sur:ace all driveways with hot top, sea shells, crushed
stone, or other suitable surfacing, materials.
!l. The grantors reserve the right to modify or anend these '
restrictions in any way they nav deterriine shall he of benefit to
the lot oi:nc s in the development.
For onr title, refer^nce m'Iv l-c had to a dead to Cranherry
Acres Realty Trust from David Uccle and a deed from I:rinice A.
dodges 1.0 1a.i,l Cede dated and duly recorded
�n the Itnrastably Coilnty Registry of Deeds in Pool. 1707, Pagc 211.
WITNV.";', our hands anti seals this 67'%— day of F117UORy
1n7,C.
CRANIA RRY ACRES REALTY TRUST
BY:
Iv i d Gee I c, 1 r Stcc
O S A.. La 1)1 C."ZI 0^tee
JOSVN J.RLAROON -
MORMIT AT LAW
m MAIN EMIT
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VENT PIPE r•Least 24 lichee
--10' min. from 'NOTE All PIPES ARE TO BE 4" SCFIEDUI.E 40 P.V.C. Schedule 4d PVC w/01orcoal Odor Fllter SECTION A A
EXISTING Foundation [house to septic tank be PROPHZ VIEW OF 7.8ACBING SYSTEM
Septic lank ODYefe 11NAt be ---
w of GRADE SAS sailer lrewt be
ift s it a flnWW graft .
Rude am septic Tank-99.00 Dade ow D-eee-99A0 ed"Iil e•d GRADE or SAE-99,00
b I r/e"9Y1W 0 I Men ff#A1`-//R•Ob1Ad P embne
• 1111e it
S.0.02 9RSPECI1011 seller Inlet M
3(H L OISf.BOX lop OF SAS am aRNn a tit d bridled grade �
Tta m is NEW 1.500 G �. ot!r bat '-
rim 01 SEPTIC TANK IrI+.� o i � '�fr �► �
H-10 n is' o c o c c tz •'�' •
0 0 �
C011CRIM nRl o " of a�j 4 !kits I GUY = 34'
SYSTEM PROFILE o " r ,w,/, '
Not to Sooty i • EI Nldeh "al40 40
t Ef Lanoth
. C ( 5' STRIPOUT ALL I s SOIL ABSORPTIDN SYST" (SAS) GENERAL NOTES
NOTE ENTS: ALL COMPON MUST HAVE RISERS TO V117M 6" BELOW GRADE a to of 3/4-1 1/4• AROUND
oalgeeted Stolle L,_TO C-2 LAYER 500 - C H-20 LEACHING UNITS / WMMS PRECAST 1. Contractor is responsible for Digede notification, Verification of Utilities
and protection of all underground utilities and pipes.
m Botto of Test Hale t Box- MOD Not to Scale 2. The septic tonic ar1j distr udion box shall be set
NOTE: ALL OOMPONENTS MUST HAVE RISERS 70 WITHIN r BELOW GRADE level on 6" of 3/4 -1 1 2 stone.
3. Backfill should be clean sand or gravel with no
stones over 3" in size.
ALL CUR"�v3"10M TIE 4. This system is subject to inspection during installation
P E R C 0 LATI 0 N TEST 9ls,le9lnloN BOX E11AtL K ,�. ase Tt axle by Carmen E. Shay - Environmental Services, Inc.
5 FOOT STRIPO AROUND SAS TO C-2 LAYER �*' ATT 2 Fr 5. The contractor shall install this system in accordance
Date of Percolation Test: JUNE 1. 2009 Note: Remove soil down to el. 93.00 (Estimated) & ''' 3-r OURV with Title V of the Massachusetts state code. the approved plan
Test Performed By. CARMEN E. SHAY, R.S.. C.S.E. replace with clean coarse sand w/perc. rote less than or 101OCKMIE and Local Regulations.
Results Witnessed By. DAVID STANTON. BARNSTABLE BOH or equal to 2 min. in. before & after placement - OUR" 1r OR" S. if, during installation the contractor encounters any
EXCAVATOR: SHAY ENVIRONMENTAL SERVICES, INC. e- soil conditions or site conditions that are different
Percolation Rate: Less Than 2 MPI A 72" r9� :� �~ from�� installationse shown on the must R & mil log or in our
notification be design
4 - SCH. 40 T
Test Hole Test Hole
No. 1 No. 2 PLAN SECTION CROSS-SECTION made to Carmen E. Shay - Environmental Services, Inc.
7. No vehicle or heavy machinery shall drive over the
DEPTH SOILS ELEV. DEPTH SOILS ELEV. septic system unless noted as H-20 septic components.
0 99.00 0 99.00 3-HOLE H-10 DISTRIBUTION BOX 8. Install Tuf-rite gas baffles or equals on all outlet tee ends.
=Y sLla=,* MOTTO SCALE 9. All Distribution Lines shall be 4' diameter Schedule 40 NSF PVC pipes.
10 YR 3/2 10'0 3/2 10. All solid piping. tees & fittings shall be 4" diameter
0"-6' As 9&501 0"-12" An 9&00 PS? s Schedule 40 NSF PVC pipes with water tight joints.
Loam Loamy 00, S`�d 11. Municipal Water is AVAILABLE to ALL OF The Residence and Abutting
sandy sand TEST HOLE #1 Properties.
10 rR s/b /o tiR s/e ELEV 99.00 • ?� �0,
;` ,� •,
6"-36• Be .00 12"-3r B' .00 �:- • ` 1A �, THE PROPERTY LINES ARE APPROXIMATE AND
/ COMPILED FROM THE PLAN BY GEORGE LOW, RLS ENTITLED
SILT LOAM SILT LOAM /' '
zs Y 7/9 Ls Y 7/is • :;�� CERTIDIED PLOT PLAN OF LOT26 ROSEWOOD DRIVE, COTUIT, MA-
C, - C, 3.00 / E ,, / DATED MAY 2. 1977. AND PLAN BOOK 284 PAGE 42
•' AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN
_ a
Sand
M Sand / c�"` • :"ti
IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
�1j 25 Y 7/4 2.5 Y 7/4 b �s g. /b � y�� THE SEPTIC SYSTEM INSTALLATION.
1t•-132' SILOO 72'-132" C6 88.00 : • •'jj/ sy 99 EXISTING LEACH PIT TO BE PUMPED OUT AND REMOVED
`� O �`} %•fs Failed TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION
s' TEST HOLE #2 LEACH PIT NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE` � �s >
ELEV = 99.00 (AP'Rft) FROM THE EXISTING LEACH PIT TO BE DISPOSED
DECK OF AS PER BOARD OF HEALTH SPECIFICATIONS.
Depth#1 Pere: 72" to 90" y' O THERE ARE NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY
Perc Rate- <2 MPI ® 72" or 6' below grade SCREEN PO 0
Groundwater Not Observed 155000 gal. -1 ASSESSORS MAP 25 LOT 48
No Observed ESHWT Septic Tank x O*
ADJUSTED H2O Elev. - None C4 LEGEND
.Wh,
� L7
��- ExISTI�YG NOIE: ElQS7NG SMIC TANK TO BE REMOVED AND MUM cri DENOTES PROPOSED
Design Calculations 4 BBDR00M 104X1 SPOT GRADE
Number of Bedrooms: 5 Equivalent to 550 Gal./Day (550 Gal./bay REQUIRED) 801792 DENOTES EXISTING
Garbage Grinder. No i X 104.46 SPOT GRADE
Leaching Capacity Proposed: 550 Gal./Day �38
Septic Tank : - 2 x 550 Gal./Day - 1100 USE MIN. of NEW 1,500 GAL Septic Tank. / L = 193.77'
SOIL ABSORPTION AREA: Using percolation rote of <2 min./inch LOT ,26 'e PL PROPERTY LINE
Bottom Area: 0.74 got/sq. ft. x 546 sq. ft. = 404.04 gallons R = 55.00 24,195 Square Peet +/-
Sidewall Area: 0.74 gal./sq. ft x 220 sq. ft = 162.80 gallons 96 PROPOSED CONTOUR
Providing: = 566.84 gallons
r, ec ------97 EXISTING CONTOUR
AFF
Use: (4) 500 GAL CONCRETE CHAMBERS H-10 . HAVING A 2' EFFECTIVE DEPTH, DEEP TEST HOLE &
TO BE USED WITH 4. OF WASHED STONE ON THE SIDES AND •� PROJECT BENCH MARK
TOP OF FOUNDATION
4' OF WASHED STONE ON THE ENDS. �g -..-- -__ PERCOLATION TEST LOCATION
�` 6 FOOT STOCKADE FENCE
ELEV. = 100.00 (Assumed)
s-z�iwu1.AOCE'34 uANttotls ; `.
H P LOT PLAN
eItET 11 11 t 6 S
TH�EA� CaomH-IX7WSWMTANK •dos, � QSg OF PROPOSED SEPTIC SYSTEM UPGRADE
DIS7M)TION eox AND LEACIIM T i 59 PREPARED FOR
;yy la FINISHED GRADE.
,n W17lIN 6• aF �� FOpT o p� ' °� LI N DA PETERS 0 N
STEEL REINFoRCEn PRECJISr CONCRETE INSTALL TUF-71E GAS IMMES OR mums OF W*) i
PLAN VIEW ALL aU7LET TEE END. A�J� AT
�3-24- 00VM, 38 ROSEWOOD LANE
COTU IT, MA
edn aleaaloe _--__�
MET laic 2•er►wilt ell adYt p IT eicr _______- --��
+� Uio ,< a ---- � F s PREPARED BY:
s-r �s s-r � �•
>;s an .' �dp� Kitchen A 'CARMEN E. S HA Y
Living Room N NVIRONMBNTAL SBRYICES, INC.
yam• �''',•4 :fI H LIVI Bedroom m 1
tr-r Din' t °' N �0 185 ASHUMET ROAD
•' `�GIsTER MASHPEE, MA 02649
CROSS SECTION END-SECTION m tiN1TAR�P�
TEL/FAX 508-539-7966
TYPICAL (H-10 LOADINGS 1500 GALLON SEPTIC TANKfO°m m 1ST FLOOR Bedroom sari 2nd Floor NOTE: FLOOR SCHEMATIC PROVIDED BY OWNER SCALE: 1"=20' DRAWN BY: CES DATE: JULY 7, 2009
NOT TO SCALE PROJECT#SD1147 FILENAME: SD1147PP.DWG SHEET 1 OF 1
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