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HomeMy WebLinkAbout0130 LONG POND ROAD - Health 130 LONG POND ROAD MARSTONS MILLS A= 029-001 -001 S M E A D No.2-153LY UPC 12934 smead.com • Made in USA J�qp,CYC�c CO� FORESTRYY INITIATIVE Certified Fiber Sourcing www.sfiprogram.org / _ __ _ .` �'"� Gv� 2�1�'��j .- TOWN OF BARNSTABLE LOCATION L. SEWAGE # VILLAGE yI/a 257 Co ",<5 �(�ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. rr'L-C-f� 7 7- SE P TIC TA NK CAPACITY LEACHING FACILITY:(type)���a� �I� \ / (size)��va� /�3 NO. OF BEDROOMS PRIVATE WELL WATER ) OR PUBLIC BUILDER OR OWNER /�)"7'140 t,4 DATE PERMIT ISSUED: / DATE COMPLIANCE ISSUED_ VARIANCE GRANTED: Yes No I q.� I C p I S � w \\ - 4 =--`► TOWN OF BARNSTABLE LOCATION 1-Na SEWAGE # VILLAGEt_NUr�,r<k,, M rIl G ASSESSOR'S MAP & LOT INSTALLER'S NAME Si PHONE NO. 2� 77�� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) /T PC Wr (size NO. OF BEDROOMS "( P PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes No I7 . 3 l' 31 r { Y TOWN OF BARNSTABLE LOCATION /3 O 6^t( t-0,0NI) SEWAGE # VILLAGE /Z�A�STBNS l�h�LL S ASSESSOR'S MAP LOT\\ INSTALLER'S NAME & PHONE NO. f�/�MI. Lor/;S% c'Lo` ✓ `.:°,��7 S - �c36Z SEPTIC TANK CAPACITY S-6 D LEACHING FACILITY:(type) (size) NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No _ � � _ � , S� � t � �-- � �. � � + � � � � � �_ I � '" (. ,� �5�,�,r ' � f � � ? -- ��. _E i I , : i r I r : , ( r I i •�''-r—mow J I i .... ._ .. .._..I .. ; , , GLI U , qJ", , • G�1 ' I ' i , : I ; : r ; r i � I r ; ; r • J�7t : I I i i i 1 : 1 l ' ' c.. t r t � � ' a.. i , t : t i : I , I f ; , I + t : I , I : ; c� , • i 1 1 , ( k + . y' ( r P 1 1 , , 1 1 rt I I , : : • � 1 , ��PoR , , k , V : 2 I • I �S 1 ' ( ( 1 ; 1 I e)p 1 1 - i , 1 • : , , , Pa.ae 1 NOVEMBER 10 . 1994 . TOWN OF BARNSTABLE BUILDING DEPARTMENT BARNSTABLE, MA FROM: DR. & MRS . PARTRIDGE 130 LONG POND MARSTONS MILLS . MA TO WHOM IT MAY CONCERN, THIS IS TO INFORM YOU THAT THE INTENDED USE FOR OUR GARAGE DORMER IS FOR USE AS MY STUDY AND STORAGE. IT IS NOT INTENDED FOR USE AS AN APARTMENT. SINCERELY , DR. & MRS . PARTRIDGE �"� Town of Barnstable " Inspectional Services Department BARNSTABM Public Health Division t619, `0� �Fc 39 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 8081 October 23, 2020 PARTRIDGE, RAYMOND & ALISON TRS PO BOX 886 MARSTONS MILLS, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 130 Long Pond Road, Marstons Mills, MA was inspected on 10/01/2020 by Chad Hathaway, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • The H-10 distribution box is in the drivewayand rotted. See policy attached. p Y • Need to re-plumb the garage apartment into the septic tank. You are ordered to repair or replace the septic system within two years (2) years from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PEP. ORDER OF HE BOARD OF HEALTH omas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report letters Mailing\Conditionally Passes Letters\130 Long Pond Road Marstons Mills.doc �* Town of Barnstable Barnstable BARNSTABLE e r 9�A MASS. �,�� Board of Health rEn►++u+ 11 200 Main Street,Hyannis MA 02601 I 2007 Office: 508-862-4644 FAX: 508-790-6304 October 9,2012 Revised November 20,2013 Public and Environmental Health Program Policies,Procedures,and Guidelines H-10 Components Discovered Beneath Parking Areas and Driveways During Septic.System Inspections Conducted Under 310 CMR 15.301,State Environmental Code,Title 5 No.2012-005 When a DEP certified inspector discovers an H-10 septic system component located beneath a parking area or driveway during a septic system inspection, conducted under 310 CMR 15.301 State Environmental Code Title 5,the system shall be deemed as a"conditional pass." The system owner will then be ordered,by the Board of Health,to correct this problem within two (2) years and will be provided several options to rectify the issue, including by: a.) replacing the septic system component with a new component relocated into another area of land which is not beneath any parking area or driveway, and properly abandoning the discovered H-10 component; or by b.) replacing the septic system component with an H-20 component beneath the parking area or driveway, and properly.abandoning the discovered H-10 component,(or in the case of leaching pit,replacing the top of the leaching pit with an H-20 slab top); or by c.) relocating the parking area or driveway in such a way that no vehicle will have access or the ability to drive over the existing H-10 septic system component. If it is unknown whether or not a particular,system component which is-located beneath a parking area or driveway, is H-10 or H-20 (for example: a leaching pit is located beneath a paved driveway without an accessible steel cover to grade and there are no records on file indicating whether the system component is H-10 or H-20),the system shall also be deemed as a "conditional pass". In this case,the seller must make the potential buyer(s)aware of the "conditional pass" status,the unknown construction of the septic system component(s), and it's safety concerns. Wayne Miller,M.D. Paul Canniff,D.M.D. Junichi Sawayanagi Q:\POLICIES\H I OComponentsBeneathDriveways&PaikingAreasRevised2013.doc I r Town of Barnstable WRNSfABM HASM 039. p Insectional Services Department ,0� t" r �prfD MP'�A Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An "x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ❑ Structurally unsound septic tank or SAS ONE (1) YEAR DEADLINE CRITERIA ❑ Static liquid level in the distribution box is above the outlet invert due to an overloaded or clogged SAS or cesspool ❑ A portion of the SAS, cesspool, or privy is below the high groundwater elevation ❑ A portion of the cesspool is located within a Zone I to a public well ❑ A portion of the cesspool is located within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA Single Cesspool C y "conditionally passed systems" (broken cover, relocation of a pipe, relocation a driveway due to H-10 components, etc) aching facility with standing liquid level at or above the invert pipe (per Town de §360-20 h) ER �� �-h�Y t n Gli'��ev�c•la �. P'U�".�p� 1����U (�I✓r+1�7 e,c,P�ti.P � Gr��n.eq� i Repair deadline: �etir Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc I Commonwealth of Massachusetts 0.29-0b 1.O0 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 130 Long Pond Rd Property Address c Partridge Owner Owner's Name / information is required for every Marstons Mills ✓ Ma 10/1/2020 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information Sl# Pq 90101- on the compute.-, use only the tab Chad Hathaway key to move your Name of Inspector cursor-do not Hathaway Septic Inspections use the return Company Name key. P.O.Box 151 Company Address Forestdale Ma 02644 Cityrrown State Zip Code 774 274 2581 12866 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); I have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ® Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 10/1/2020 spector's Si ure Date The system inspector sh submit copy of this inspection report to the Approving Authority (Board of Health or DEP)withi 30 days completing this inspection. If the system has a design flow of 10,000 gpd or greater, t ector 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.7/26/201Er Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 2) System Conditionally Passes: ® One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc-rev.7/26/201 E; Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts !� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ® distribution box is leveled or replaced ® Y ❑ N ❑ ND (Explain below): H10 Dbox located in driveway is crumbling and has rotted through. Studio apartment over garage septic pipe is directly piped to leach pit. flow tested with toilet paper went rom apartment directly to leach pit#2 ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2013 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS).and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool '{ Discharge or ponding of effluent to the surface of the ground or surface waters El ® 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.712 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page of 18 Commonwealth of Massachusetts r Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ° If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® El Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. CityrTown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): design n Number of bedrooms (actual): 6 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Description: leaching pits are 6'x6' precast with 2'stone around them. tank is 1500 gal. permit is for 5 bedrooms Number of current residents: 1 seasonal Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: seasonal Date t5insp.doc-rev.7/26/2C18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form lob Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding.tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: pumped during inspection Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500gallons How was quantity pumped determined? tank size Reason for pumping: thick solids t5insp.doc-rev.7/26/2C18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 2'feet Material of construction: ❑ cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line. 10, feet Comments(on condition of joints, venting, evidence of leakage, etc.): no signs of poor venting t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 1'6" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) H10 1500 gal If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'6"x5'6" Sludge depth: 14" Distance from top of sludge to bottom of outlet tee or baffle 16" Scum thickness 6" Distance from top of scum to top of outlet tee or baffle 2" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? tape and sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): tees in place no major decay. no visable cracks or leaks. tank was pumped during inspection t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 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(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Dbox is no good heavy decay t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts !� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 130 Long Pond Rd Property.Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): "If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 2 ❑ leaching chambers 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 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130'Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 2) 1000 gal H2O 6'X6' precast pits both pits are dry with no sidewall staining to indicate past failure. risers (1-120) in place with covers close to grade in stone driveway 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater. inflow ❑ Yes " ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2C=18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 c Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �n 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is Marstons Mills Ma 10/1/2020 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): Materials of construction. Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . � 130,Long Pond Rd Property Address Partridge Owner Owners Name information is Marstons Mills Ma 10/1/2020 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately I' 6 ► s Aa - a� �a A3 ' � ' 1 4 Ok W Q3- ab y 40 7 OJ2f' e t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form F Subsurface Sewage Disposal System Form -Not for Voluntary Assessments J� 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 48'feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date [+ Observed site (abutting property/observation hole within 150 feet of SAS) El 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: topo GIS mapping lot el. 98 in area of septic. low area (long pond el. 48) bottom of leach pits 11, be:ow grade. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/2 61201 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'au 130 Long Pond Rd Property Address Partridge Owner Owner's Name information is required for every Marstons Mills Ma 10/1/2020 page. Citylrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5,01'ficial Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map A Parcel Permit# :75 / E 5 Health Divisions ' l/� �.� Date Issued 'C CL 'O Conservation Division 31 Fee : ��1 �j Tax Coll Treasur Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address /30 0 tj C-or PVAJb Village 'aAf Yh I US Owner RhV- a i. 66, Address "n,-_ Telephone I Permit Request S 7Z P, o 0' A�r 0A1 Cd f.j�rls;oo a4 ain g el,� Bea�hon s Q.c mli5Rsi&i 7z) g G a 5e-r Square feet:1 st floor:existing proposed l 0 l 2nd floor:existing proposed Total new Estimated Project Cosm-,_QL —Zoning District Flood Plain Groundwater Overlay Construction Type fN a U d 69ft Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family 9K Two Family ❑ Multi-Family(#units) Age of Existing Structure L-ob` `10 �9$ Historic House: ❑ r to Yes L�lo On Old King's Highway: ❑Yes Basement Type: QAII brawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 3 `� X 3 G Number of Baths: Full:existing A—new Half:existing 1 new Number of Bedrooms: existing 5 new JW,,�,,, Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas 2 Oil ❑Electric ❑Other hnr4d I-tn-f UO +ry- Central Air: ❑Yes O'rNo Fireplaces:Existing _ 2. New Existing wood/coal stove: UY?es ❑No Detached garage: existing ❑new size Aiui Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes �No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name C AY1 Telephone Number 4vlg"C?51 Y N Address 16 yS Ale v.n w1 J roc L License# C S O 0 VA a d�35 Home Improvement Contractor# /DO TJ1d Worker's Compensation# 0X& gAz,?6 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO idol f,Q`CG_,J! SIGNATURE DATE I Assessor's office 1st Floor): d $ r ma and lot number � o Assessor's p � � o� �n� �' e Conservation(4th Floor): digE�j°,� � Board of Health 3rd floor ��i;'baaT^ • Sewage Permit number !��,� � oo 1639. Engineering Department(3rd floor: �* ®� �. �� r; '�to r• House number Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARN STA ,,Rb BUILDING INSPECTOR APPLICATION FOR PERMIT TO A-1)-D 19 S7-L) E.) i U ®`/ JZ A 4 Of � �q z f1 1't� TYPE OF CONSTRUCTION U 2 y» if i A b!� C—t9r 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accor&ng to the following information: Location 3 0 4-0 N4 ( p D+mot'0 ) r" !9 9 S 770 5 rn 1 L E S Proposed Use T-u D 1 0 A-6 0 v A-L cc l3 A T-i-f Zd o nt I q /VJ,l crt fz 5C) tom Zoning District Fire District Name of Owner�(Z 4 N\V-S �G f�16 ER-FTM ddress 1&) k00 At L1 , AA11 T 0AJS Name of Builder s t C-10 N1 l iM f, Address 16"1'5- NE FO J,,J ED, (�q DO 1 (— Name of Architect Address Number of Rooms Foundations I S T f I!Q Exterior �) 14 l 7-6- X 214 l KD.LUSRoofing Floors Interior Heating t L Plumbing �UfZ- !�Z '- H S -814 Fireplace Approximate Cost O 0 0' Area Diagram of Lot and Building with Dimensions Fee :' m . °� p � o3 III �ArN � - A c o y Zl h <NTJI °•'1 r` 2 w y m2� 32 � p � rn Nw 'A3 rr L , b3 rh v ' '77— ..p OA/ f,R�Y,gTE G�� n � t� . . � 6 n . i. v o � n It r Pv� 6 Y e iL M1 V •' I •} � NOW 0 lot i r J3 Nf} � o � N 1' •LiVt. low T + f7 .j i { +'O y VZ * r i� ^� N fu ;, - � 3at•, T, s i :i4' r'''stxxc.i t .J 'was Y .'L •s Tom-. �_`r^'e-i — ) .i>`�t7�x►.}!7 V?,,1'O� t - _ ;�I�7No_•''_�7 Y7'.Lb6� r. � �, _ i .� < ¢,F� ��• :.iOZ ,v _ , v i Barnstable Office: 508-862- 4 FAX: 508-790-6306304 Town of Barnstable Board of Health 11111.1 200 Main Street, Hyannis MA 02601 2007 August 10,2010 Revised March 9,2016 Public and Environmental Health Program Policies, Procedures, and Guidelines Enforcement of 310 CMR 15.223, Septic Tanks/ Properly Sized Septic Tank and Two Compartment Tank Enforcement No. 2010-007 Septic Tank Size When/if an applicant requests a local or State Code variance involving a setback distance to wetlands, high groundwater, or any other environmental type of variance to the Board of Health to be reviewed at a public meeting of the Board (not a variance request involving a setback distance to a foundation or property line), the Board of Health will require full compliance with Section 310 CMR 15.223 of the State Environmental Code, Title V. Specifically, when an environmental variance of any type is requested, a properly sized septic tank will be required by the Board. Two Compartment Tank or Two Tanks in Series When a design involves facilities other than a single family dwelling unit or whenever the calculated design flow is 1,000 gallons per day or greater, a two compartment septic tank or two tanks in series will be required. This requirement shall be enforced during the construction, repair and/or upgrade of a septic system, regardless of whether the repair or upgrade is proposed for the leaching facility only. (See back of page for clarification and examples regarding the requirement for two compartment tanks at dwelling units.) However,this policy does not apply to minor component repairs such as replacement of a distribution box, tee, piping, or component lid. Wayne Miller, M.D. Paul Canniff, DMD Junichi Sawayanagi Q:\POLICIES\Dual Compartment Tank Enforcement.doc Two Compartment Tank or Two Tanks in Series at Dwelling Units Two Tests (1)"Self Sufficiency"AND(2)If Work is Needed or Proposed To Be Done To the Septic System Double-compartment tank installation or installation of two tanks in series are only required when there is a need or proposal to construct,upgrade,or repair the septic system or the soil absorption system(for additional bedrooms above the existing septic capacity for example)AND where there is self-sufficiency is each of the two living units(e.g. in-law apartment). The addition of a second kitchen,by itself,does not trigger an upgrade. However, if an additional kitchen is proposed along with additional bedrooms above the existing septic system capacity,then a double compartment tank shall be introduced(see example list below). Here are some examples for Test#1 only (remember there are two tests involved here) 1) Separate Pool House-NO(double compartment tank is not required) 2) Separate Pool House with private room(s)that may be considered as possible"bedroom(s)" -NO 3)Separate Pool House with private room,bathroom and kitchen-YES(double compartment tank is required) 4)Bedroom over a Garage-NO 5)Bedroom over a garage with a bathroom-NO 6 Bedroom over detached with bathroom and kitchen-YES garage 7) Bedroom over attached garage with bathroom and kitchen-YES 8)Addition for an apartment with a bathroom,kitchen and its own bedroom,regardless of whether there is an increase in flow ov.-rall or not(i.e bedroom relocation)-YES A double compartment tank is required for the proposed construction of an in-law apartment which may be attached or detached from the main house and for other similar separate structures. If there is self- sufficiency,then a double compartment tank would be required. If the structure is a detached bedroom with self-contained living quarters,the applicant will be required to install a double compartment tank. However, if there is a connection in the house to the new living area,this would not necessarily be considered as a separate dwelling. If what is proposed requires someone to travel to the main house for amenities(such as traveling to the main kitchen in the house), it would not require a double compartment tank. Double-compartment tank installation is only required when there is"self-sufficiency" in each of the two dwelling units AND if there is a wish or need to construct,upgrade,and/or repair the septic system and/or the SAS itself. Q:\POLICIES\L>ual Compartment Tank Enforeement.doc No.... Fx$......��. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. O F............................. ......................................................... , pphratiou for Dispaii ai Work i Tvaastrurtion 'Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( -an Individual Sewage Disposal System at: i�� J� ........... ._......... ...... ....................••........... -•--•-•------•-----••----••-•--------�.-------------•--•--•-------------.----------------------- ion / esl ,lL oc 7--Address �� � or Lot No. Owner Address Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building -_-__-•-___---- No..of persons............................ Showers p., yp g ------------- p ( ) — Cafeteria ( ) P4Other fixtures ..................................................................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No...................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1.................minutes per inch Depth of Test Pit.................... Depth to ground water•._-_-.______-_____-___. GT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.......--__--___--_____- 9 -------•--••-----------------•-•••••••••-••--••--••-••••....-•------•-•----...........------•--•----......................................................... 0 Description of Soil........................................................................................................................................................................ x U •-•••--•-•-•-•••-•••-----••••••-••••-•--....----•----•-----••••----------------------------•-•---••-••-------••••......-•-•-•-•--•--••------•-••-••---••••-----•-••------------•----•-•••--•-----•--••- W U Nature of Re airs or Alterations—Answer when applicable�.T_ll__ ---------__I S-__ v 5'�_ '� (� �-�.- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'T T LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss ed by the board of ealt ASigned_ P"e—:v:....................... •--------------••-- -•- - -.----------- Application Approved B Date Date Application Disapproved for the following reasons_____________________________________________________________••--_-_-__-_---------..___..-__........-_........._ .......................................................................................................................................................................................................... Date PermitNo.------.... ...4-0.11...................... Issued....................................................... Dste .x. do .,: No.... ...f21/...... Fps.....A-0........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH -....... ApplirFation for Dispos al Works Toaastrurtioat Funfit Application. is hereby made for a Permit to Construct ( ) or Repair ('_` an Individual Sewage Disposal System at: � r ..... - _ ................................................. ✓""; Location Address _, or Lot No. 1 a •--•--------•-•-••---------•---••-•--- ..................................•rn............................................................ W '4n Owner Address iG G /-/ -------------- ........ a Installer Address Type of Building Size Lot............................Sq. feet r-, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) ,-I -' p-, Other—T_✓pe of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures .........................................-•-•-----..... W Design Flow............................................gallons per person per day. Total daily flow..........._................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-, Percolation Test Results Performed by.......................................................................... Date........................................ W Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (Z4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P+ -•-----•-••-----------------••--••----••••-••------•--•••••-•-------••...-•----••--•---•-•-•--••-•••......................................................... 0 Description of Soil......................... x U •---••-•-•---------•-•----------•-----••-•••-------------------------•---•---------......._......_.......---••••-------------•----•-••--•------------•-••••-••••-••••---•------••-•--••......--•--•----- W VNature of Repairs or Alterations—Answer when applicable.7t_-Z./�"'__�__._.._._..'.. _ _ _....'r...�.4.�.•�•� �r Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 1TT1 i of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health- .............................................. Signed: - - . ' Date Application Approved By-•--•••... a-' '*�"` .............. ........ =�D�e-• �� Application Disapproved for the following reasons----------------------------•------•---•-------------•---------•-------------•--•-----------------------•••--••-- ................................•••--••.....-•--•-•----•---•-......_....-•----------........-------•----.••---••-----•---------••----•-----•-•-••---•-•-•--•---••-•----•------•------••......---•---•--- Date PermitNo.--------•��•<••_.... .E!----------------------• Issued....................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Trrtifiratr of Tompliaatrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( � by ,'2 c.H...................•--------•--......--------- n ngtaller at. O [� ....... ; .................... ............. .......................................... has been installed in accordance with the provisions of TIT E 5 of The.State Sanitary Code as described in the application for Disposal Works Construction Permit No------- ........... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......................�.�!_. .. .Q -' ...................... Inspector........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH lG� 1 ....-..1 .. '.` .... ...OF...... ..... .6`" -.........................\....................... Disposal Works Coato#rioat rruti# �) 2. c. 1. Permissionis hereby granted .-•-- •----•-•--•---•----•••--.-------------------------------------------------------- ...................................... to Construct ( ) or Repair n Indi p dual ;Age Disposal/ .y�stem� . at No........... ......G d ,L.. o ,.......................-.....1� efl Street � �,f as shown on the application for Disposal Works Construction Permit No-_��_ Dated.......................................... ------.• Board of Health DATE.................. Q ---1.2.:.....�--------- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS TOWN OF BARNSTABLE LOCATION 0 ZI � � ®`'e`` SEWAGE VILLAC,EASSESSOR'S MAP G LOT_ INSTALLER'S NAME PHONE NO. .?.C-f/ 77�� SEPTIC TANK CAPACITY LEACHING FACILITY:(type)L,E1.,e. ) (size)/�c�c=G NO. OF BEDROOMS �I—PRIVATE WELL /Oft PUBLIC WATER /y 1122,ic i BUILDER OR OWNER DATE PERMIT ISSUED: /,0 DATE COMPLIANCE ISSUED: acI VARIANCE GRANTED: Yes � t k � 7 E March 30 , 1988 Board of Health Barnstable Townhall Hyannis, MA 02601 Dear Sirs, This is to inform you that I , Wayne Archambeault , of Arch Construction Co, did an on site inspection of the septic system at 130 Long Pond Road, that consists of two seperate systems. Owners name , 130 Realty Trust , John E. Murphy Jr . , Trustee . System #1 shows two (2) block pools, 6'by 8' Pit #1 full Pit #2 three (3) feet of water System #2 shows two (2) block pools, �'by 8' Pit #1 full Pit #2 four (4) inches of water . These systems appear to workippg an'd in use . Thank you �'` `µ• •"� °` ,4L . Wayne Archambeaulta Pres. Arch Const . , Co. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map U )-r Parcel Application "` D i,S o � � Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Q� Historic - OKH _ Preservation/ Hyannis Project Street Address �� L y v1 6 Village M kg S.,rvn1 HI 1 f 5 Owner R A . 0 D , A �i S 0 o �A TR) tie Address 'PC BOY, key 1�'14rd.T�n S J''tj7IS M�� t>a6 V Telephone L Permit Request zX�Sf�N � uvl 3Ar'[N 0 0 M C144AJi e. T a .eAii ;tv1 .. ' ,Je rlOdV A)-tLy l'► ,,Lru(it s Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District R r Flood Plain Groundwater Overlay Project Valuation i S"i VOL F y L) Construction Type W o c D ri?A me Lot Size A C.R,?, Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure I q 2-0 Historic House: ❑Yes ❑ No On Old Kings Highway;, ❑Yes 0 No _ Basement Type: Full ❑ Crawl ❑Walkout ❑Other .; © Basement Unfinished Area (sq.1t) Basement �°Wished Area(sq.ft.) -•- �-� ' er Number of Bafn 3 h- new Half: existing news: Full: existing '- Number of Bedrooms: existing new Total Room Count (not including baths): existing 10 new 0 First Floor Room Count Heat Type and Fuel: ❑ Gas 0/0iI ❑ Electric ❑Other Central Air: L]Yes W40 Fireplaces: Existing__.,__New Existing wood/coal stove: ❑Yes ❑ No Detached'garage: /existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes C/No If yes, site plan review # Current Use S W ht� FA m i L I Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Telephone Number �' �j Name��IMus Mc- Copthge� p �4obie- -XMfgiue-meK4- j��L CS d 761G / Address i 61 y License # Home Improvement Contractor# 1 00-7 lid C ��-���� r�A �21p3 �' p A� i. � .zwc��l7zon Email J'iI C��I Z2'��rie` ci�r Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO a4j or 11�APW 17ABie, 1AAArdl SIGNATURE d DATE