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0032 REID LANE - Health
�_32 Reid Lane, Marstons Mills A= 125 - 060 i .t TOWN OF BARNSTABLE LOCATION 30� �,e`„ �,,��,�. SEWAGE# VILLAGEM o,.s ,^� ;\`�y_ASSESSOR'S MAP&PARCEL \Q5 �Cc'7 I>�S NAME&PHONE NO rc=d✓ off SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) ;�o x 9_5f x Q '� NO.OF BEDROOMS OWNER V',,y_, PERMIT DATE: COMPLIANCE DATE: C.I/ /O� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility S Feet Private Water Supply Well and Leaching Facility Of any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 4 a c.� P ® cr GcaaTe�1J `•OI as= 36 V3 , o a Commonwealth of Massachusetts _ Title 5 Official Inspection Form ' -- Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Reid Lane _ Property Address Rick An elo Owner Owner's Name information is required for every Marstons_Mills _ MA 02648 March 9, 2016 page. City/Town State Zip Code Date of Inspection >'. : N .Ca Inspection results must be submitted on this form. Inspection forms may not be altered'. nrany way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms S/� l� i139 on the computer, 7" jJ use only the tab 1. Inspector: key to move your cursor-do not Patrick T. Sullivan use the return Name of Inspector ; key. Ready Rooter Excavating r� Company Name P.O. Box 89 . Company Address * Forestdale _ MA 02644 Cltyrrown State Zip Code 508-888_-6055 _ S112843 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority March 9, 2016 Irispector'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 is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****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. l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 0 VS c Commonwealth of Massachusetts I Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 32 Reid Lane Property Address Rick An eg to _ Owner Owner's Name information is required for every Marstons Mills MA 02648 March 9, 2016 - - page. City/Town _ State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments.- Recommend septic pumeinkever -yeear unless garbage disposal is removed. B) 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. ' /j 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/h 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): i" f t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form W i l Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Reid Lane Property Address Rick Angelo Owner Owner's Name information is Marstons Mills MA 02648 March 9, 2016 required for every -- __--- -_--- - - --- page. CityrFown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken,,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or,replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ,❑ Y ❑ N ❑ ND (Explain below): r I C) Further Evaluation is Required;:by the Board of Health: ❑ Conditions exist which require,-further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR s manner which will protect public health, safety and the environment: ❑ 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form W ' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 6 32 Reid Lane Property Address Rick Angelo Owner Owner's Name information is required for every Marstons Mills _ MA 02648 _ March 9, 2016 — page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. 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 systern has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". ' Method used to determine distance: ** This system passes if the well water analysis,performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other/failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: ------------ D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts -_ Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Reid Lane Property Address Rick An elelo _— Owner Owner's Name information is required for every Marstons Mills MA 02648 March 9, 2016 - ------ ------------------------- ----- ----------------- --- page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is 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 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. �' i Yes No El the system is within 400 feet gfr a surface drinking water supply i ❑ ❑ 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 El ❑ Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accorcance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 IL — _ Commonwealth of Massachusetts �F= Title 5 Official Inspection Form — -- =1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments � _32 Reid Lane Property Address Rick Angelo ------- — - ------ ---- --- Owner Owner's Name information is required for every Marstons Mills _ MA _ 02648 _ March 9, 2016 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Was the facility owner(and occupants if different from owner) provided with ® ❑ information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3- -- Number of bedrooms (actual): 3 ---- DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 333 GPD t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts _ — Title 5 Official Inspection Form h; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Reid Lane Property Address Rick Angelo _ Owner Owner's Name information is Marstons Mills MA 02648 March 9, 2016 required for every _ _ — page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3--- ---- Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2014= 126 GPD g ( y g (gp )�' 2015= 170 GPD Detail: Sump pump? ® Yes ❑ No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: - - - - i" Design flow (based on 310 CMR 15.203): Gallons per day(9Pd) i Basis of design flow (seats/persons/sq.W,etc.): — i Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged/to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: - — t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 f Commonwealth of Massachusetts Title 5 official Inspection Form � P Subsurface Sewage Disposal System Form - Not for Voluntary Assessments e 32 Reid Lane _.--- —-------------- --- Property Address Rick--Angelo Owner -- -------------------- Owner's Name ------information i's is Marstons Mills MA-- 02648 March 9, 2016 required for every _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other (describe below): General Information Pumping Records: Source of information: Ready_Rooter record s:_Pumped 03/1 01 6/23 Was system pumped as part of the inspection? ® Yes ❑ No If yes,volume pumped: 1500 gallons How was quantity pumped determined? Site tube on truck Reason for pumping. Maintenance 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): Pump chamber 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts :1 Title 5 Official Inspection Form V Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Reid Lane Property Address _Rick Angelo _ Owner Owner's Name information is Marstons Mills MA 02648 March 9, 2016 required for every _—__ —____ _-_.-- — — — page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Septic tank installed 1986. Pump chamber and SAS installed 06/16/2006. Certificates of Compliance on file at Health Dew_ Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 32" Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other (explain): - Distance from private water supply well or suction line: n/a feet Comments (on condition of joints, venting, evidence of leakage, etc.): ----------- -_ ----- - ------- ---- -- ------ -------- - Septic Tank (locate on site plan): Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: ye_ years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 10'6" x-5.5' X 5' 1500 gallons 5" Sludge depth: --- -- t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Reid Lane Property Address Rick Angelo - -Owner Owner's Name information is Marstons Mills MA 02648 March 9, 2016 required for every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness 8" at inlet, 2" at outlet 6 Distance from top of scum to top of outlet tee or baffle -- — Distance from bottom of scum to bottom of outlet tee or baffle 13"_ _ _ ------ How were dimensions determined? Tape measure and dip tube. Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Inlet and outlet PVC tees in place. Liquid level at outlet invert. Risers bring covers within 6" of grade. Irrigation over inlet cover, cable line over outlet cover. Tank pumped and cleaned after inspection. Recommend removal of gwbaigedisposal._Tank should be pumped every year unless removed._____ Grease Trap (locate on site plan): Depth below grade: feet i Material of construction: other(explain): ❑ concrete ❑ metal ,�' El fiberglass ❑ polyethylene ❑ 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Jr, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 32 Reid Lane _ Property Address Rick Angelo---------- — ....------ - - -- Owner Owner's Name information is required for every Marstons Mills _ MA 0_264_8 March 9, 2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: -- - 7' Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: — — Capacity: gallons Design Flow: % gallons per day Alarm present: i ❑ Yes ❑ No Alarm level: -� - Alarm in working order: ❑ Yes ❑ No Date of last purr-ping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form I' 1.1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Reid Lane --- — -- -- ---------------- --- — Property Address Rick Angelo __ Owner Owner's Name information is required for every Marstons Mills MA 02648 March 9, 2016 _— page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 011 — --- -- - ----- 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.): One inlet, four outlets. Speed levelers in place keep 3 lines level. 4"' is 2" above liquid level. Not affecting system operation at time of inspection. D-box is 1" below grade. No sign of leakage or high water staining. 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.): Pump chamber is 1000 gallon H-20 with 24" metal ring and cover 1" below grade. Electrical connections outside chamber. * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments e-fir 32 Reid Lane Property Address Rick An eg to - -------- -- Owner Owner's Name information is required for ever)' Marstons Mills MA 02648 March 9, 2016 -------------------------- ---- ----- -- page. Cltyrrown State Zip Code Date of Inspection D. System Information (cons.) Type: ❑ leaching pits number: ❑ leaching chambers number: — - ❑ leaching galleries number: - ❑ leaching trenches number, length: - ® leaching fields number, dimensions: 1-20' x 55' x .5" ❑ overflow cesspool number: - --- ❑ innovative/alternative system Type/name of technology: ------- ---- ---- Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.;: Hand probing over SAS found clean dry soil with stone. No sign of ponding or past hydraulic failure. No breakout around retainink wall of system_ Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration - - -- Depth -top of liquid to inlet invert Depth of solids layer - - Depth of scum layer Dimensions of cesspool --- -- Materials of construction - - ---- Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 F Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts - _ Title 5 Official Inspection Form 1 I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 32 Reid Lane Property Address Rick Angelo_ _ Owner Owner's Name information is Marstons Mills _ MA 02648 March 9, 2016 _required for every _ _ _ page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): i Privy (locate on site plan): Materials of construction: -- i r Dimensions ;` --- -- - --- Depth of solids ---- — —-—— - - i Comments (note condition of soil signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Reid Lane Property Address Rick Angelo _ Owner Owners Name information is required for every Marstons Mills MA 02648 March 9, 2016 -- -- page. Citylfown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public waver supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately IA < {er 0 4 i . `� t Q J 0 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts -_ Title 5 Official Inspection Form i 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Reid Lane Property Address Rick An elo _ Owner Owner's Name information is Marstons Mills MA 02648 _March 9, 2016 required for every —_—_—.—__ —_ _ _ _ page. Citylfown State Zip Code Date of Inspection D. System Information (cant.) Site Exam: ® Check Slope ® Surface water ❑ Check cella- ❑ Shallow wells Estimated depth to high ground water: 5-- — -- 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: 03/23/2006 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers - (attach documentation) ® Accessed USGS database -explain: -map s_massgis.state.ma.usbliv�r-Php You must describe how you established the high ground water elevation: Test hole on 2006 found high water line at 60" below grade (elv= 92.22). Raised system puts base of SAS at elv= 97.22 per engineered plans. Accessed local 9 round water contours and topo mapping_ Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 I� I r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 32 Reid Lane Property Address _Rick Angelo _ Owner Owner's Name information is required for every Marstons Mills MA 02648 March 9, 2016 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 ' TOWN OF BARNSTABLE, LOCATION 3Q, R't;� \sue. SEWAGE# VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. C2(e SEPTIC TANK CAPACITY /gj6 LEACHING FACILITY: (type) (size) NO.OF BEDROOMS OWNER PERMIT DATE: COMPLIANCE DATE: a Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY � 1 1 � r � 3a C , - 6 �CZ_ �� yy 4 3� L0 �C A 10M. S I-W A G E PE RMIT KO. ate , ) INSTALLER'S N & ME ADDRESS Pti V k� y I'" x 9 No. �INtO - i 1 j. Fee THE COMMONWEALTH OF MASSACHU$ETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Z[pprication for ;Diopooar Opgtem Cone;truction Permit Application for a Permit to Construct( . )Repair(•/upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 3-4, ([.44 L_L,/ j s X1 Owner's Name,Address and Tel.No. Assessor's Map/Parcel j Z-- 06 V �`i'f w,;t4 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. rn�e,S�su rh 4ts �. v2 Type of Building: Dwelling No.of Bedrooms —3 Lot Size 4;,s�o sq.ft. Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design.Flow 3 3 0 gallons per day. Calculated daily flow 3 r ..gallons. Plan Date Z' Ti0 ( Number of sheets L- Revision Date Title Size of Septic Tank /-rb -f s/ Type of S.A.S. / Description of Soil: IP/I Z G Nature of Repairs or Alterations(Answer when applicable) r A ff. G R XW ` 4000 1411 GAGW v��✓ D(l'J' Of �+ a Z Z ZZ' 0.r C Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the vironmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu y t 's Bo of Health. Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. c�= Date Issued d No. -2 W b Fee (>l} l Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION -TOWN OF`'BARNSTABLE, MASSACHUSETTS . t 2pplication for 0igpogal *pgtem Cott.5truction Permit Application for a Permit to.Construct( , )Repair(✓Upgrade( )'Abandon( ) El Complete System El Individual Components Location Address or Lot No. 3 7 L V Owner's Name,Address and Tel.No. Assessor's Map/Parcel ) Z 1 _ 196 V / �5 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Ef t(_ � N 5 �o19�7 7(.-90 y �. aox �I U£ C G �(c� � � , rnAf T6N m o!t!�, bzllyps To7- Z/ Z7- GZ Type of Building: Dwelling No.of Bedrooms Lot Size 9 S t'v sq.ft. Garbage Grinder(,e-o Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 770 gallons per day,,Calculated daily flow gallons. Plan Date t- t - Z Number of sheets .L Revision Date Title Size of Septic Tank F of /To U f C / Type of S.A.S. k X o/d Description of Soil y + Nature of Repairs or Alterations(Answer when applicable)_ r tt4lp fop �c , G� f�1 4-1 /OOU "a 11 w:�cL, rl��• VIU D(I-J- d-60)( -A—d Al z t ' x Z.? x O, r c/�esa /e kC4 Date last inspected: rt Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with.the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued-by thisB� oa�rS�o,of Health. ` Signed f'' Date /rill c!h Application Approved by .n t Date Application Disapproved for the following reasons Permit No. Or).- 29) Date Issued (A I lb ()67 THE COMMONWEALTH OF MASSACHUSETTS Z v BARNSTABLE, MASSACHUSETTS Certificate of Comoliauce THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( ) Repaired�k)Upgraded( ) Abandoned( )by F/'A T• p Vey I at 3Z 2P J _k o P'^. . lit has been constructed in accordance with the provisionsv�otiTitle 5 and the for Disposal System Construction Permit No M,,h-� dated /! a Installer 51t LA� S Designer The issuance of this permit sh 11 not be construed as a guarantee that thj system wi I fun ti, as esigned.,....._.... Date Inspect,r 4--------------------------------------- No. 'N no 6— � Fee A) V THE COMMONWEALTH OF MASSACHUSETTS ( 7 a- 06 0 PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ais�po!gaf *p5tem CowAruction Permit Permission is hereby granted to Construct( )Repair( X Upgrade( )Abandon( ) System located at A r e,,, /V1. ✓4 / and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of thins perm Date:_ ( I fn/0 Approved by �v fv v•' w` r Town of Barnstable Regulatory Services o� Thomas F.Geiler,Director • BARNSrnste. MASS. 1�g Public Health Division 'biro ram+° Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Sewage Permit# Assessor's Map\Parcel / 0 Designer: Installer: erz i c- S,rf r eN S Address: Address: Po, 6ek '1 i yr tM«c.-% On was issued a permit to install a (date) (installer) septic system at 1 z C/ Lo , 44 4-,7 based on a design drawn by (address) 15- . i2��i 6W J. dated WA. / (design t�/ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by.designer to follow. H oF�,yss�� �c GLEN 1 l ERIC c, HARRINGTON (Insta r s Signature) No. 1070 co /TAR\�, "_ 407. (Desig is nature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc r Town of Barnstable P# �/ c o�TMF ' Department of Regulatory Services r LE Public Health Division Date >105 0 200,Main Street,Hyannis MA 92601 gl R �{ Ail ' . 31 Date°Scheduled ' •' 'Q' Time Fee Pd. 'Soil'Suitabilli Assessment or Sewage Dis�,gsaltJ' .f g /J/��L� nA.✓/c N P IG..l. �D ►S Performed By: l�T �• � r� h� Witnessed By: � ,s , LOCATION& GENERAL INFORMATION Locadon Address 3 Z 122 i d h �(/f pt i /!/t•dI Owner's Name .4 Address fA_wl r Assessor's Map/Parcel: Engineer's Name &(ck, F, NEW CONSTRUCTION REPAIR Telephone# �'�i z 3�6 Z Land Use 1 Slopes(%) — Surface Stones w Distances from: Open Water Body b�/Z� ft Possible Wet Area ft Drinking Water Well —,—/A _R Drainage Way S ft Property Line ?r ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) #1Z lb 7 N• il'l Parent material(geologic) OW&,&4 1_ Depth to Bedrock 7 Z D Depth to Groundwater. Standing Water in Hole: 77 weeping fromPit Face— Estimated Seasonal High Groundwater 60, Art)k'z')f 0%f A4"( U4040 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottl6s: I Depth to weeping from side of obs.hole: in, Groundwater Adjustment fr. Index Well# Reading Date: Index Well level a Adj.fhctor AdJ,Groundwater level PERCOLATION TEST Day Thne Observation Ttme at 9" - — Hole# Depth of Perc 7 Time at 6" Start Pre-soak Time @ V: 6 r. 71me(9"-6") -- End Pre-soak V Rate MinJlnch LZ �• Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y& Observation Hole Data T6 Be-Completed on Back----------- Original: Public Health Division ***If percolation test is to be conducted within 100'of wetland,you must first-notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:SEPPICIPERCFORM.DOC r DEEROBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv. ray 0 - � � Q `7'3Z ITw . .L S d l'a r �'� . C 1 M—G S Z.S. 6 ycJ r�r:c''bo�o ao(� vG;/ DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consi ten DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Tenure"• -""Soil Color Soil Other r Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Con t "*G el J� t Y •.f DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) ... (USDA) (Munsell) Mottling (Structure,Stones;Boulders, Consistency, r; _ Flood Insurance Rate Maw; Above 500 year flood boundary No— Yes Within 500 year boundary No= Yes Within 100 year flood boundary No— Yes Depth of Naturally Occurring Pervious Material t'r Does at least four feet of naturally occurring pervious material exist in ali'areas observed throughout the area proposed for the soil absorption system? V4e4 -- ;,:� If not,what is the depth of naturally occurring pervious material? ...�. Certification ,0 I certify that on _1___I d f (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysi$was performed by me consistent with . the required training,expertise and xperience described in 3 10 CMR 15.017. Signature Date Q:\SpVnCUPERCFORM.DOC No.—Q- =� © 3 Fee— ---------------- BOARD OF HEALTH TOWN OF BARNSTABLE Zippticat ion,forVell Co0truct ion Permit Ap licatio s hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: Location Address Assessors Map and Parcel f A �� —Ow er— Address Installer — Driller Address -- Type of Building Dwelling — --— -- --- Other - Type of Building----___—__________ No. of Persons-------------------_________. Type of Well Capacity— - ----- Purpose of Well _--�— Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private ell otection Regulation — The undersigned further agrees not to place the well in operation un ' a ific liance has been issued by the Board of Health. / Sig _— ate / Application Approved By -- — —__—___—------__— date Application Disapproved for the following reasons: date Permit No. W o`ZO© �p — Issued --------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS � (;E77F�XT th -Individual Well Constructed (Z Altered ( ), or Repaired ( ) r Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. --------------_-___Dated--.------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE---- — —_ Inspector ---- No.— _ ____ �� 3 A Fee--- BOARD OF HEALTH TOWN OF BARNSTABLE ztppiication;�rVeil CongtructionPermit Applicatio is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: d G''� ---1'? ��Ls — -— - --- --- ---- --- ----- / Location — Address Assessors Map and Parcel // Owner Address ----------------- -- - - - -_-- - - Installer — Driller Address _ Type of Building Dwelling- ------------------------ - Other - Type of Building--------_—______________ No. of Persons---------------------------------------- Type of Well Capacity Purpose of Well-- - Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well P otection Regulation - The undersigned further agrees not to place the well in operation unti a C ifica pliance has been issued by the Board of Health. / Signed ate Application Approved B — _ 1�_/ _ ------------------- ---------- date Application Disapproved for the following reasons: ----_-------------________________________—__—_____________ date Permit No. \a©d �_— � 3 � -------- Issued------------------` -------�----------------------- date ,_______________________ _---__________.._— BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate Of (Compliance THIS IS E Thal-the,Individual Well Constructed (Zr--Altered { ), or Repaired ( ) by� � G` ��'`�- -------- --- - --- - -- - --—- -- ----- -—-- w / Installer ---------------——-------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ----------------------Dated-------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------- - —-- Inspector------------------ -------------- ------------------- 5 -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Vell Con5truct ion Permit No. -0 3 b Fee- -S--- Permission is hereby granted ----- -— -------- -- --to Construct (Alter or Repair ( ) an Individual Well at: N o. - -- ------------------------------- street as shown on the application for a Well Construction Permit No.-- -------------------------------------- I '1 DATE Board of Health � --- --- ------ A, e �F THE Tp� DATE: r FEE: • BnxxsTnace, Mass. REC. BY 'Town of Barnstable SCHED. DATE: 0 0/ Board of Health 367 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION J/ Property Address: 3� !� LIN_ 11)&fsAmJ Assessor's Map and Parcel Numb J �E Lo/'3-> Size of Lot: f7 acre— Wetlands Within 300 Ft. Yes ✓ Business Name: No Subdivision Name: APPLICANT'S NAME: 0 mk Phone 5_0&— V2-8—S?S0 Did the owner of the property authorize you to re t esent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: OrGt/r_ Name: C` Address: Y(:;7— Awt &C Address: 0 za,, M Phone: Sy y Zb' S/p So Phone: 60 00' rf— 7 2 O "' Z/1 F VARIANCE FROM REGULATI N(List Reg.) REASON FOR VARIAN (May attach if more space needed) NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System ❑ Checklist(to be completed by once staff-person receiving variance request application) _ Four(4)copies.of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee only],outside dining-variance'renewals[same owner/leasee only],and variancesto repair failed sewage disposal systems [only-if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/VARIREQ i We recently purchased for a pasture Lot 35 (1.12 acre), adjacent to our home. I recently discovered that because the parcel is on a separate deed, I now need to apply to the Zoning Board of Appeal for a variance to construct a barn on the property. The earliest date for the hearing is currently September 20. As an alternative,I would like to house our two horses in the utility barn that exists on our property.The barn is 2 years old, 16'2"x 20'3"in size with a ventilated loft that would serve for hay storage. 2 - 10' x 9' box stalls would be constructed within. The new lot will serve as the pasture/riding ring. All 1.12 acres minus the setbacks will be fenced with 5'No Climb Wire horse fence with a solid top board or vinyl fencing. The manure trailer will be stored on that lot. I am applying for this Variance Request because the barn is located on the other side of the driveway, 37' from the attached garage. The Board of Health Stable Regulation#8 states that, "No horse or pony shall be allowed to be pastured on any land unless said area is fifty(50) feet from a home or dwelling". If this arrangement proves to be convenient, the horses may stay in the utility barn indefinitely. However, I would ideally like to construct a barn on the pasture lot if the Zoning Board of Appeal grants me a variance. LOT 35 O9 w 1612 M REID 53-4 LANE N O o� LOT 34 �' o Q ---� Mound O v. LOT o� Plan is For FLOOD ZONE: T" FTE: E. "RF" This MORTGAGE INSPECTION Bank Use ORnt &�TQ� — — REGISTR R CHROB & BOARAH` 'F �T�— 94 — —BUYER' ;2034 4 SCALEFT. s 91PLAN REF: L 10ERTIFY TO ` YANKEE SURVEY Ea��_wHa7,g_q g4gACHus xsTHAT THE BUILDING z�' PAUL ° CONSULTANTS THIS PLAN IS LOCATED ON THE -ROU CONFORMND S MENITHEW SHOWN AND THAT ITS POSITION DOES OF THE ,� No. 32096143 TO THE ZONING LAW SETBACK REQUIREMENTS AND THAT °°� Af�ISTE�``� �,� MARSTONSRMILLS MA.902648 TOWN OF B_�1S ------------- g Fs IT DOES_NOT — LIE WITHIN THE SPECIAL FLOQ1�19� �RD s�oaac LaN�� TEL 428-0055 AREA AS SHOWN ON THE 5 H.U.D. MAP 15 CTFD— o unit — a CIS PLA NOT MADE FROM AN INSTRUMENT 6612 F!WU 797.TI � PLS SURVEY NOT TO BE USED FOR FENCES ETC. 1 at I r TOWN OF BARNSTABLE �FTHETO OFFICE OF ro '^ i BAaasTABL BOARD OF HEALTH .y MAO& p . p 039• 367 MAIN STREET 0 MAY�\ HYANNIS, MASS.02601 July 12, 2001 Deborah Angelo 32 Reid Lane Marstons Mills,.MA 02648 Dear Mrs. Angelo: You are granted a variance from the Board of Health Stable Regulation, Part X IC Paragraph #6, to utilize the existing utility barn as a horse barn located 37 feet away from the onsite home with an attached garage. The variance is granted with the following conditions: (1) No more than two (2) horses are authorized at this barn. (2) All the other provisions.of the Board of Health Stable Regulation, Part X shall be strictly adhered to. (3) Horse manure shall not be allowed to accumulate on the property and shall be removed from the site on a regular basis. This variance is granted because the proposed horse barn is actually located more than fifty (50) feet away from the living areas of the home. The attached two-car garage is approximately twenty (20) feet wide and is located between the home the utility barn. Sincerely yours, Susan G. Rask, R-.-S. Chairman Board of Health Town of Barnstable SGR/bcs angelo New Page 1 Page 1 of 1 LOCATION SEWAGE PERMIT 140. INSTA LLER'S NAME & ADDRESS Rv ,BUILDER OR OWNER N -S r 21:vL N, ZZ a t �b 4, aATf PIS 114IT ISSUED QAT E CQWI' LIAAtCE tSSUI; II� • i J�. 1 � http://www,town.bamstable.ma.us/assessing/2010/HMdisplay.asp?mappar125060&seq=1 8/24/2010 Nc...... . ........... Fizz............................. THE COMMONWEALTH OF MASSACHUSETTS + q r4 BOARD OF HEALTH i'�l� �a5�660 r ..........................................OF. a ��-,� ltrtttt�aYt for Uhipaual Workii Tomitrurttnn famit Application is hereby made for a Permit to Construct (x) or Repair ( ) an Individual Sewage Disposal System at: ......... tQ...._ A---------------••--------------........----------•-••---- Location-Address or Lot No. KF-Str'eAL, •MJ42srosi.sp.........k1t_c. _5.......................... Owner O� S Address ............... .R*11 ..i .......44111 5........................... �!/ t2 �a staller �/ Address Q Type of uildin �`" v _ Size Lot............................Sq. feet U Dwelling No. of Bedrooms...._.....�............................Ex Expansion Attic`-^K Garbage Grinder a g P (..,) g, ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ),— Cafeteria ( ) Q, Other fixtures ------------------------------------- Q ------------•--------------------•---••---------•-------..........._•-••••••••....... WDesign Flow............................................gallons per per 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........................................ Test Pit No. 1................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........................ P4 •-•-•--------------•-•--•............................--•---•----............._............_•-----••-----•-••--•--........_......_..........---•••••.......................................................... 0 Description of Soil........................................................................................................................................................................ x V ---.._...-•----•---••••----••-•-----•--.....---•---•--•---------------------•---...------•-•-•------.......------------••--•-•--•--••---••---••-•-----•••-••••-------....•--•---•--••.....----••-----•-• ------------ -------------------------------------------- ------••--• ------------.......------•----•-------------------------------------------•••--••-•---•••-••-•-•---- --- ................. U Nature of Reairs or terations—;As er when applicable_.__. ........ �.��.. z� Agreement: vL � ��e� The undersigned agrees to install the aforedescribed Individual SeAv -* sposal System in rdance with the provisions of TITIL 5 of the State Sanitary o e—The undersigned further &rnot to place s in operation until ertificate of Compliance has a issue by the of healt +' igne .. ......... ...... .... Date Tp -, 1 Ap cation proved BY .......................................................... '. Date Application Disapproved for the following reasons:---••..................................••---_-----------------...--•----•-------........._.........._....___.... ---------------------•-------•--..............__....----------...........--•-•---•-------......---•-•---•---.......--•-•••••--.....••.....-•--••-•-•--------••----....•----•-----------•-•-•--•-•--••-- p Permit No......j•�--/--�-� Date -----------------_ Issued----------------•----------•--•----•---•--- ------- Date .���. ._ ------------ —_-------- ------ ----------- N"...... FEjc.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................... _..................OF Appliratiou for Digpoiial lVarkii Tomitrurtion "nutit V Application is hereby made for a Permit to Construct O or Repair an Individual Sewage Disposal System at: ............ ................................................... Location-Address or Lot No. Owner Addres s er is M=....... ..... . ............... Add.......94 vv�v- j1p .41.LL_5........................... nstaller Address Type of IC l •Ing Size Lot............................Sq. feet U A4No. 0 Bedrooms.__..._...: Dwelling f Bedr ..........;41...........................Expansion Attic Garbage Grinder Other—Type of Building ............................ No. of persons_._..._......:.............. showers Cafeteria Otherfixtures ...................................................................................................................................................... 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. f t. Seepage Pit No--------------------- Diameter.................... Depth below inlet............._..._._ Total leachino,area..................sq. f t. Z Other Distribution box Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date................_ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.........__._........... GT, Test Pit No. 2................minutes per inch Depth of Test Pit.___......._........ Depth to ground water..__.................... 9 ------------------------------------ .........................*-------- ---------------------*....... --------------------- .............. 0 Description of Soil................................................................................. ................................................................................ �4 U ......................................................................................................................................................................................................... W ................................................................................................................................................................................... ................... Z 2�7 U Nature of Repairs or)Aterations—Answer when applicable------ I........ J Agreement: VL X-e-'," The undersigned agrees to install the aforedescribed. Individual��Disposal System in Wordance with the provisions of T IT LE 5 of the State Sanitary o e The undersigned further r e not to place the s in operation until a..Certificate of Compliance has e ssuej by the J of health I I _ . Signe —------- ......... ....... ....................... Date PP tion Approved By......... -------- 4V ............................................................................... ......................... .............. Date._....... ate App -tion isapproved for the following reasons:...................................................................... . ............ .................. ...•................................................................................................................................................................................... - //A'p tion pp . tjoll Date PermitNo....... ... ........ ............................. Issued....................................................... Date THE COMMONWEALTH OF.MASSACHUSETTS I BOARD OF HEALTH ....... ..........OF.�.................................................................................... (9rdifiratr of Toutpliatta THIS IS TO CERTIEY, That the Individual Sewage Disposal System constructed (11</0r Repaired by-------------------------------------- ........................................ ............................................................................................. Installer at................................ Z-AiVE ------------------ .............. ----- ......M!t�S........................... has been installed in accordance with the provisions of T I T r,"F, 5 of The State Sanitary Code as descri ed in the application for Disposal Works Construction Permit No.__.... ... ..... dated.............. Zz ��--------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL m1�-AlF UNCT O SATISFACTORY. DATE._.....:1 •- -I------ Inspector................4..4I. ....... .......................................... C-Ai\ Fi THE COMMONWEALTH OF MASSACHUSETTS--— \j3%VN* 'e'r : wv, I1e \ ('_e 4 -1 ,0 BOARD OF HEALTH K1 , .r l 7-1rowl-V.........................OF......7-&-Ifiw ............. ..... No. ..... Dispooat Workii Tonotrurtion rWt 14g. Permission is hjereby granted........... ....... ...a to Construct o Repaj� �an Individual Sewage Disposal System 17 at No. .... ... 14 X ...... ..... ..................... .........................................................................................4........................ Street as shown on the application for Disposal Works Construction-P-Prmit No..................... Dated............___............_._............ ................................. ............................................................. Board of Health DATE--- ..................5. ....... ..... FORM 1255 A. m. suLKIN, INC., BOSTON rA R Board of Health Town Hall Hyannis, MA. 02601 Dear Board: I certify that the sanitary system shown on a plan on Lot 34 Reid Lane for Robert Kesten was installed as designed. Sincerely, 1 R , SiNu.� r,LY — 3 gets i Ste• �L� ��LI-�'L i ZOO `T'v7-,L 7-�).4/Ly IL'[ra"/ IUTARTIN �� � fcz MOR4ry N l`�CT,cI/L c� �fSJ�5�1L 3G-D $23k1I i v /A. / PIA-A,? °•;; b`� ?5 �Y3 /L /AX) S � 5z.d T4�/ 5/.o -' E«✓ S4�/� ,dr]Ju JE» x/v �cT 3 Sri 2 Ll CA LE EG N D RACW i B M . hs jo PPOPOSED '000 'w [o- H—'20 PUMP CHX�%-,-IER EX;:ST)Ns-3 1500 GA;. 11 Ira SEP-1C drive 4. DENOTES PROFOY-iv` X '0 SPOT GRADE DEN3TES EXISTING X IOC46 ', SP(Y:' GRADE 9 P 5 PROPCISED Ci NTO::,,� ..............95................ EXIS71NG C0NT0j'P,* DEEP TEST HOLE' POND APPROX, LOC.ATION .......... BARN: Ex 6TIN, WATER " TEXIS 11 G MARSON MI!..1...S I .......................................................................................................................................... PPROX. L AT ON ... 10 EMSTING WS L ................................................ V. 5CA[l: k� SHOWN LAWN GEM RAL NO I E5 . .... I ADDR;7SS. #32 REID LANE, MARS TONS `,x:LLS 2. ASSES 0-R S, NUMBER: 125 060 3. DE'"ELOPER'S T, G-� 34 -0 L 4, "OPOG-R -:C INFORMATION WAS COMP;: ED FRC M A.'IN DN HE GROUND :NSTRUM ENE Y SURVEY. " Y. SITE & SURROUNDINC, PROP;-RnES. T OF 6 J 5. T OWN WATER IS PRO"ADED ----22'L X 22'W X 0-5' D 6. REFERENCE PLAN; LAND COURT PLAN 120341), SH - 4 N 7. RESOURCE AREAS WERE 1-0C`Ay'E0 BY GLEN E. HAR.;,'ON GTON, R.S,, AS SHO-A, le,,xhino field Usi',C 4" dia, ` SCH 8. NO POTABLE WELLS ARE LOCATED WITH:1N,* 15,1) 17;7c,'T OF SAS, -9r[OrOtec, 111 40 PVC pipe P ent 9. UNDERGROUND UTIUTIES LOCATDID PER ','):GSAFE NOCTIFICA�--IQN 1'20o6120()74a "QN:�TRUQT10N NOTES --------------------------------- 1, Contractor is responsible for Digsn-fe r%,,%t:ficat!on 9SZ!• and protection of all underground and pipes, 2. The sept:'ctank & Pumpchomber be set level or. 6, of 31 4 1 /2" stone. 3, Backfill should be clears or -rov�: wi- no Zy ^ti stone-. over 3 in size, - -i k This ��ystem is. subject to inspeclka:on d n-f instaliolion by Glen E. Harrir?-ton, R,S, S. The contractor shj:; install th:s systen- %n accordon-ce with 7 U- V of the !VassechuseUs Envi,o.--irnenta: Code fir an t e Regulations of th'.. T-own of RA> cs 6. All existing inverts o nA site condltion.i qiEQll be verified by contractor. heQvy moci-inery ,�hail or.�, er - ie 7, No vehicle w e 0v zeptic sy's"em urk,.si; no4ed as H-20 t;r- corr-r-,-onts. if C)T 34 960S 8, insioli gos t)& !4c,, or equal on septic k outlet tee end. 98P 9, DESIGNER AND BOARD OF HEALTH ARE INSPEICT AND CERTIFY INSTALLA TION, -T S(1, T:R :OR E A J 3$ CONT AC X. 9?F) TO PROVIDE AT LEAST :-OURS NO'rIC;` TO 80T!-i PAR-DES. ARE U 10. Provi&.,. five foot removal and replocem-.,nt of soil interally around proon", d S,16 kind v�r'icolly to an opprox, depth of 32 INC-114ES to encounter medium to coarse sand i0ye'r 1,01` 1 Provide a two in&- ilia, SCP. 40 PVC 'E at 'nlet -*o D BOX or force moin. SAY- 96 12. Provide I Acme Precost H-10 D6-5 i":=:tribution box or ecual. Ex'st'ng 1,)AS to be purnoed and obanco.,:ed per 31() CMR 15.",54, ribfoot 14, Instoii a 45 mil rubber membrone ot p-rimeter of five ..:pout around AS. V :he t%,-)D elevation of the membrane sh,,-fli be at the top of peastone eievation. Z The botto-1 elevation of the� mernbrant-i shall be at elevation=94.00' ; P P-R K Tr-`---T 'S 0 11 . EVA[.. JATION .............................................................................................................................................................. DATE 0" PE.RC TEST & SOIL EVAL.: MARCH 23, TEST PPRFORMIED BY: GLEN E. HARRINGTON, R.S. �MTNEF-kr()i By: DONALD DESMARAIS, R,S. < EXCAVATED BY: AALTO LA-INOSCAPING Z PERK RArE: LESS THAN 2 MPI IN C1 j .................................................. Test Hole I PI 1246 L;j No. I rA Pr.ppi soll.s F.1XV, §i 20 FT, WIDE DRAiNAGE EAMMEN'T,' 32' 94':5115: 33* PROPOSED SEPTIC SSYSTEM UPGRADE m E"'RK"' S'I'EVENS -2�L V14V AT .......... # V.32 REID LANE sk I BARNSTABLE (MARSTONS MILLS,, MA y ............. ................................................................................................................................................................................... �P��HofM�s PREPARED BY: GLEN E. L-1ARRINGTON, R.S, N E 1 r 9 LEDA ROSE LANE H RR 0 70 N/11111ARSTONS M11 (....'S, MA 02648 TEL: 508-428-3862 'E") I E P1--AN /S'T SC FAX: 508-428-3862 A: E: 1 "=20' v/TAvk L (RENCI'i-( MARK oN cz- I FNI) ASSUMED MAY 22, 2006','ALE- I ....... DRAWN BY. 1 IDATUM: AS S E D r::LE: STEVENSREIDLN SHEET 1 OF 2 ------------------