Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0205 CEDAR STREET - Health
205 Cedar street West Barnstable A = 131-059 ,. 0 5 I aeC/IVII/A.Pws-417 /. (ooz��rt (� 7 ins(3� 2ti, ('t�Dr� D U f1 ri l &d rnm f H�f p,4 JV2, a 0 9 d 0 i e OK i;' x' a n4ca 0.2 r 1 p P� a� r1 f W A,d A'i lb�'S��� b Uz V j,i IT IAJ ti 6 •'`�` sF•{-ts �i - m�. �` � cam.� ,' e ,P 5 i Y� mild;' .Y fy Ig, p 's F Y -� 'h-1 � � •u _ ty. 1X s-y p •t � � pp CIJ tcn 71- 4 ssachusetts Commonwealth of Ma Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H &CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 9 2012 every page. Cityffown 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: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your KEVIN P MURPHY cursor-do not Name of Inspector use the return key. WEST SIDE SEPTIC o t� Company Name 4 ABBEY LANE Company Address MIDDLEBORO MA 02346 Cityrrown State Zip Code 508-947-8200 S1569 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 Pelow 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: 0 Passes ❑ Conditionally Passes Q Fails ❑ Needs Further Evaluation by the Local Approving.Authority APRIL 12,2012 Inspector'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. t5ins 09M8 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information for required W BARNSTABLE MA 02668 APRIL 9,2012 every page. City/Town State Zip Code Date of Inspection B. Certification (coat.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) 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: ALL REQUIRED COMPONENTS HAVE BEEN INSPECTED AND ARE FUNCTIONING TO THE REQUIRED REGULATIONS•AT THE TIME OF THIS INSPECTION B) System Conditionally Passes: Q 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 wilt 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): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Se"e Disposal System-Page 2 of 17 i f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H&CAROL,J BREWER Owner Owner's Name information is W BARNSTABLE MA 02668 APRIL 9, 2012 required for eve page. Cityffovm State Zip Code. Date of Inspection every p 9 i B. Certification (cont.) 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): El 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): 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 15.303(1)(b)that the system is not functioning in a 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.09M8. Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page a of 17 r n 7 , Commonwealth of Massachusetts Tine 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 0266:8 APRIL 9,2012 every page. City/Town state Zip Code°. Date of Inspection B. Gertification (coot.) 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 system hasxa 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 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:. t Applicable t Dj System Failure Criteria App r b{ a 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 99 P 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 Y day flow t5ins-09= Title 5 Official Inspection Form:Subwftce Sewage Disposat System-Page 4 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �. 205 CEDAR STREET Property Address JOHN H&CAROL d BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 9 2012 every page. City/Town State. Zip Gode Date of Inspedion 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: ❑ M Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ 0 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. El 0 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`fifes" or"no"to each of the following, in addition to the questions in Section D. 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 If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should.contact the appropriate regional office of the Department_ t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments W 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 9, 2012 every page. CitylTown 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? N ❑ 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? ® El information 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. ® El' Determined in the field (f any of the failure criteda related to Part C is at issue approximation of distance is unacceptable)[310 GMR 15.302(5)1 r D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example:110 gpd x#of bedrooms): 440 GPD t5ins•09/08 Title 5 Official Inspection Form:Subsurface Serfage Disposal System•Page 6 of 17 I Commonwealth of Massachusetts Title 5-Official Inspection. Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H&CAROL,J BREWER Owner Owner's Name required information orte W BARNSTABLE MA 02668 APRIL 9,2012 every page. City(rown State Zip Code. Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes M No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No WELL WATER Water meter readings, if available(last 2,years usage(gpd)): Detail: Sump pump? ❑ Yes No . Last date of occupancy: OCCUPIEDDate Commercial/Industrial Flow Conditions: Type of Establishment: t Design flow(based on 310 CMR 15.203): Gallons per y(9Pd) Basis of design flow(seats/persons/sq.ft., etc.): 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL.9, 2Q12 every page. Citylrown State: Zip Code. Date of Inspection D. System Information (cone) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: SYSTEM PUMPED EVERY YEAR/ HOMEOWNER Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® .. Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ 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): t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments .205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 9,2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components,date installed (f known) and source of information: INSTALLED 1976 PER BOH RECORDS Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 12"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): t Distance from private water supply well or suction Line. feet, Comments (on condition of joints,venting, evidence of leakage, etc.): NO SIGN OF LEAKAGE Septic Tank(locate on site plan): Depth below grade: TANK 6" DEEP feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate:of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5X4.5'X4' DEEP, 1000 GAL. 3 Sludge depth: t5ins•09/08 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 w 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owners Name information is.required for W BARNSTABLE MA 02668 APRIL 9 2012 every page. Cityfrown State Zip Code Date of Inspection Q. System Information (cont.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle 31 Scum thickness 1-2" Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 12" i How were dimensions determined? MEASURED IN FIELD Comments(on pumping recommendations, inlet and outlet tee or baffle condition;structural integrity, liquid levels as related to outlet invert;evidence of leakage, etc.): TANK LOOKS TO BE IN GOOD CONDITION, SCH 40 INLET TEE IN PLACE, PRE-CAST OUTLET TEE SHOWS A LITTLE SIGN OF DETERIORATION BUT STILL IN WORKING ORDER, LIQUID LEVEL IN TANK AT PROPER LEVEL, NO SIGN OF LEAKAGE. RECOMMEND PUMPING TANK EVERY TWO YEARS TO PROLONG THE LIFE OF THE SYSTEM. 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 t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 10 of 17 -- I I Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,. 205 CEDAR STREET Property Address JOHN H &CAROL J BREWER Owner Owner's Name information for required W BARNSTABLE MA 02668 APRIL 9,2012 every page. Cityfrown State Zip Code. Date of Inspection Q. 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: Material of construction: ❑ concrete El metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: = ❑ Yes ❑ No Alarm level: . Alarm in working order. ❑ Yes ❑ No, Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins•09108 Tittle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is W BARNSTABLE required for MA 02668. APRIL 9,2012 every page. City/Town State Zip Code. Date of Inspection D. System Information (cone.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert NO D-BOX FOUND 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.): 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-09108 Title 5 Official Inspection Forth: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 , 205 CEDAR STREET Property Address JOHN.H&CAROL J BREWER Owner Owner's Name information is W required for BARNSTABLE MA 02668 APRIL 9,2012 every page. City/Town State Zip Code: Date of Inspection D. System Information (cont.) Type: leaching pits. number 1' -6'X6' PIT ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ 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.): PIT IS 6" BELOW GRADE,WATER LEVEL IN PIT IS 20 in.(354 gals) BELOW INLET PIPE, VEGETATION NORMAL, NO SIGN OF PONDING OR DAMP SOIL 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-09108 Trtle 5 Official Inspection Form:Subsurface Sewage Disposal System•Rage 13 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 205 CEDAR STREET Property.Address JOHN H& CAROL J BREWER Owner Owner's Name information required for W BARN.STABLE MA 02668 APRIL 9,2012 every page. Cityl-rown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): bins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 14 of 17 setts Commonwealth of Massachu Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 1 2010 - every page. City/Town State Zip Code Date'of Inspection D. System Information (cunt.) 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 A r - Z05� C S1 a! Z - Z3' A �, kLb�-CAL 4 C�i t5ins-09M Title 5 Official Inspection Forth:Subsudace Sewage Disposal System•Page 15 of 17 ef-I\ Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 205 CEDAR STREET - Property Address JOHN H&CAROL J BREWER Owner owner's Name information is required for W BARNSTABLE MA 02668 APRIL 9, 2012 every page. City/Town State Zip Code Date of Inspection D. System information (cont.) Site Exam: ❑ Check Slope ❑ Surface water [, Check cellar Shallow wells , Estimated depth to high ground water: 12+ FEET feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked,date of design plan reviewed: rate Observed site(abutting property/observation hole within 150 feet of SAS) I� Checked with local Board of Health-explain: NEXT DOOR NEIGHBOR @ 431 WILLM!ST, PERC TEST 10!10106, DATE OF PLAN 04L95!07 NO WATER nu 12 FT. ❑ Checked with local excavators, installers- (attach documentation) . ❑ accessed USGS database-explain: You must describe how you established the high ground water elevation: PERC TEST RESULTS ON FILE @ BOH, ALSO, NO WATER IN CATCH BASIN IN LAWN AREA. BELOW SAS, 8 FT BELOW BOTTOM OF PIT h Before filing this Inspection Report, please see Report Completeness Checklist on next page. .15ins•C21O6 Titie 5 C•Ycial inspection Foon:Su,sutace Sewage Disposal Syste:r•Page 16 cf 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form 11 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H &CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 9,2012 every page. CityTrown 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 t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 EWy:nn &Wynn, P.C. ' • ATTORNEYS • 300 Barnstable Road Hyannis,MA 02601 (508) 775-3665 Fax(508) 775-1244 1 (800)899-3003 http://www.wynnandwynn.com August 21, 2012 Dianna M.Gallagher Jeni A.Landers David W. Stanton, R.S. Jeffrey L.Madison Town of Barnstable James M.McCarty Kevin P McRoy** Public Health Division Robert F.Mills Charles D.Mulcahy 200 Main Street John J.O'Day,Jr. Hyannis MA 02601 Kevin J.O'Malley , Anthony T.Panebianco* Raymond C.Pelote* Thomas E.Pontes RE: 205 Cedar Street, W. Barnstable, MA Michael J.Princi Ryan E.Prophett Rebecca C.Richardson Dear Mr. Stanton: Janice E.Robbins William Rosa* Tharshini N.Sanon*** Dina M.Swanson I enclose herewith the layout of John and Carol Brewer's property at 205 Andrew A.Toldo Paul F.Wynn Cedar Street, West Barnstable, MA. I would appreciate your providing me with a Thomas J.Wynn convenient time for you to inspect the property. I will ensure that John is present to Of Counsel guide you through your inspection. You may contact my assistant, Aimee,to Hon.Robert L.Steadman(Ret.) schedule the inspection. Hon.James E McMillen,II(Ret.) Keough 6t Sweeney William E.O'Keefe Edward F.O'Brien,Jr. Thank you for your attention to this matter. Very truly yours, Admitted: *Massachusetts and Rhode Island **Massachusetts and New Hampshire ��T kr ***Connecticut , a,l, w C. ****Massachusetts and New York ich el Princi MJP:aIu Enclosure ,Kynn &Wynn, PC,. • ATTORNEYS • 300 Barnstable Road Hyannis,MA 02601 (508) 775-3665 Fax(508) 775-1244 1 (800)899-3003 August 2, 2012 http://www.wynnandwynn.com Dianna M.Gallagher David W. Stanton, R.J. Jeni A.Landers Town of Barnstable Jeffrey L.Madison James M.McCarthy Public Health Div lslOil Kevin P.McRoy** Seth D.Miller*** 200 Main Street Robert F.Mills Charles D.Mulcahy Hyannis, MA 02601 John J.O'Day,Jr. Kevin J.O'Malley Anthony T.Panebianco**** RE: 205 Cedar Street, W. Barnstable' MA Raymond C.Pelote* Thomas E.Pontes Michael J.Princi Ryan E.Prophett Dear Mr. Stanton.: Rebecca C.Richardson Janice E.Robbins William Rosa* I enclose herewith the most recent Title V Official Inspection Form dated Dina M.Swanson Andrew A.Toldo April 9, 2012 with regard to 205 Cedar Street(Property of John H. and Carol J. Paul F.Wynn Thomas J.Wynn Brewer). Of Counsel Thank you for your attention to this matter. Hon.Robert L.Steadman(Ret.) Hon.James F.McGillen,II(Ret.) Keough 6t Sweeney William E.O'Keefe Very truly yours, Edward F.O'Brien,Jr. WYNNLi Admitted:*Massachusetts and Rhode Island **Massachusettsand New Hampshire***Massachusetts and Connecticut****Massachusetts and New York Mica MJP:alu Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments yY 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is r W BARNSTABLE MA 02668 APRIL 1 2010 every a wired for e. City/Town State Zip Code Date of Inspection rY page. 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: A. General Information When filling out forms on the computer,use 1. Inspector: only the tab key to move your KEVIN P MURPHY cursor-do not Name of Inspector use the return key. WEST SIDE SEPTIC Company Name +� 4 ABBEY LANE Company Address MIDDLEBORO MA 02346 City/Town State Zip Code 508-947-8200 S1569 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 16.340 of Title 6(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails I-. ❑ Need urther Evaluation by the Local Approving Authority Uj --I � f. �co Ln 7= 01 0- C�N, APRIL 6,2010 In Inspector's Signature Date CD wV 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 rep6 t"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. I t5ins•09= Title 5 Official Inspection Form:Subsurface Sewage Dis I System•Page 1 of 17. s Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 1, 2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) 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: ALL REQUIRED COMPONENTS HAVE BEEN INSPECTED AND ARE FUNCTIONING TO THE REQUIRED REGULATIONS AT THE TIME OF THIS INSPECTION 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. 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 exfil ration 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): t5ins•09M Tdle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information required forts W BARNSTABLE MA 02668 APRIL 1,2010 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cunt.) 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): 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 15.303(1)(b)that the system is not functioning in a 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•09/08 Title 5 Official fnspecton Form:Subsurface Sewage Disposal system•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r� 205 CEDAR STREET b•y Property Address JOHN H&CAROL J BREWER Owner Owner's Name information required for r W BARNSTABLE MA 02668 APRIL 1,2010 evepage. Cityrrown State Zip Code Date of Inspection every P 9 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 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 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 Y2 day flow t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments "Y 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 1, 2010 every 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 16,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. 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 If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form 5 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H &CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 1, 2010 every page. Cityrrown 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): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 GPD t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H &CAROL J BREWER Owner Owner's Name information is W BARNSTABLE MA 02668 APRIL 1,2010 required for every page. City/Town state Zip Code Date of Inspection D. System Information Description: 2 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available past 2 years usage (gpd)): WELL WATER Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date 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 Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•MOB Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .'" 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 1,2010 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: SYSTEM PUMPED EVERY YEAR/ HOMEOWNER Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank,distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H &CAROL J BREWER Owner Owner's Name information is W BARNSTABLE MA 02668 APRIL 1, 2010 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (f known) and source of information: INSTALLED 1976 PER BOH RECORDS Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 12" Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from rivate water supply well or suction line: >50' P PP y feet Comments(on condition of joints,venting, evidence of leakage, etc.): NO SIGN OF LEAKAGE Septic Tank(locate on site plan): TANK 6" DEEP Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No 8.5'X4.5'X4' DEEP, 1000 GAL. Dimensions: 3" Sludge depth: t5ins•09/08 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 r 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 1, 2010 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) cunt.Tank Septic P (cont.) Distance from top of sludge to bottom of outlet tee or baffle 31" Scum thickness 1-2" Distance from top of scum to top of outlet tee or baffle 8'r Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? MEASURED IN FIELD Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): TANK LOOKS TO BE IN GOOD CONDITION, SCH 40 INLET TEE IN PLACE, PRE-CAST OUTLET TEE SHOWS A LITTLE SIGN OF DETERIORATION BUT STILL IN WORKING ORDER, LIQUID LEVEL IN TANK AT PROPER LEVEL, NO SIGN OF LEAKAGE. RECOMMEND PUMPING TANK EVERY TWO YEARS TO PROLONG THE LIFE OF THE SYSTEM. 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 t5ins•09108 Title 5 Official Inspection Form:subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form C Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Y 205 CEDAR STREET Property Address JOHN H &CAROL J BREWER Owner Owner's Name information is W BARNSTABLE MA 02668 APRIL 1,2010 required for every 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: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes' ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): •Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09M Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 it t . Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 1,2010 every page. City(rown 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 NO D-BOX FOUND 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.): 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Forth: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 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is W BARNSTABLE MA 02668 APRIL 1,2010 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 -6'X6' PIT ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ 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.): PIT IS 6" BELOW GRADE,WATER LEVEL IN PIT IS 2 FT.(423 gals) BELOW INLET PIPE, VEGETATION NORMAL, NO SIGN OF PONDING OR DAMP SOIL 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-09108 Title 5 Official inspection Form:Subsurface Sewage D'sposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �~ 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is W BARNSTABLE MA 02668 APRIL 1, 2010 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solid's Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): LtSin. 09/08 Tide 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 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name Information is W BARNSTABLE MA 02668 APRIL 1,2010 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) 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 A _ 2b S C cQcoy- S1 13 - Z Z3 iA C3 (3 - 3 - 35 ' bLcl 'X i o � Glwaq e- NJ t5ins•09= Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments "e 205 CEDAR STREET Property Address JOHN H&CAROL J BREWER Owner Owner's Name information is W BARNSTABLE MA 02668 APRIL 1,2010 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ® Check cellar ® Shallow wells Estimated depth g g th to high round water: feeetet FEET Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked,date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: NEXT DOOR NEIGHBOR @ 431 WILLOW ST, PERC TEST 10/10/06, DATE OF PLAN 04/25/07 NO WATER 12 FT. ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: PERC TEST RESULTS ON FILE @ BOH, ALSO,ONLY 3"WATER IN CATCH BASIN IN LAWN AREA BELOW SAS, 8 FT BELOW BOTTOM OF PIT Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5irts•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments y 205 CEDAR STREET Property Address JOHN H &CAROL J BREWER Owner Owner's Name information is required for W BARNSTABLE MA 02668 APRIL 1, 2010 every page. City1rown 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 t5ins,09108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 350 MAIN STREET WEST YARMOUTH,MA �O 508-775-2800 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP ! 3 j PARCEL O g? Property Address: O. O,� �' C 2) 4 Ap 15 7- 66 Owner's Name: �o //(s Z3 ,@ £(4 e Owner's Address: ,� O �` �' E Z ,Of S'T GW- /SI/P A- Date of Inspection 7 —® 3 Name of Inspector:(please print) �1 C �� ���&S6 v\ Company Name: A& B Canco Mailing Address: 350 Main Street West Yarmouth,MA 02673 Telephone Number: 508-775-2800 CERTIFICATION STATEMENT 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: Y Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: �,u 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 tot he buyer,if applicable,and the approving authority. Notes and Comments ****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. Title 5 Inspection Form 6/15/2000 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: Owner: Date of Inspection: Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: V _ 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: B. System Conditionally Passes: N A 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. Answer yes,no or not determined(Y,N,ND)in the 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 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. ND explain: 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 obstruction is removed distribution box is leveled or replaced ND explain: 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 obstruction is removed ND explain: Title 5 Inspection Form 6/15/2000 2 Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: Owner: Date of Inspection: C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to detennine 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 15.303(1)(b)that the system is not functioning in a 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 salt marsh 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 I of 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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: Title 5 Inspection Form 6/15/2000 3 Page 4 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: Owner: Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No �ackup 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 j/A Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or i/ cesspool P/7-- ' Liquid depth in o@4@pevl is less than 6"below invert or available volume is less than /z 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 well AMAny 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) 0 (Yes/No)The system fails. I have detenroined that one or more of the above failure criteria exist as described in 310 CM 15.303,therefore the system fails. The system owner should contact the Board of Health to detennine what will be necessary to correct the failure. E. Large Systems: /V A To be considered a large system the system must service a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well. 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 is failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. Page 5 of I I Title 5 Inspection Form 6/15/2000 4 i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: Date of Inspection: Check if the following have been done. You must indicate"yes"or"no"as to each of the following Yes No V 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 nonmal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? 1/ Were as built plans of the system obtained and examined?(if they were not available note as N/A) t/ Was the facility or dwelling inspected for signs of sewage back up? t/ Was the site inspected for signs of break out? Were all system components,including 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)has been determined based on: Yes No !/ Existing information. For example,a plan at the Board of Health. Detemmined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CM 15.302(3)(b)] Title 5 Inspection Form 6/15/2000 5 I Page 6 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Inspection: RESIDENTIAL FLOW CONDITIONS � - Number of Bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms:& Number of current residents: Lf Does residence have a garbage grinder(yes or no): R 6 Is laundry on a separate sewage system(yes or no): i4 u _ [if yes separate inspection required] Laundry system inspected(yes or no): y p S Seasonal use(yes or no): too �� p - Water meter readings,if available(last 2 years usage(gpd)): w L Sump pump(yes or no) Last date of occupancy: ,$ COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of infon-nation: D O Was system pumped as part of the inspection(yes or no): If yes,volume pumped: gallons—How was quantity pumped detennined? Reason for pumping: TYPEQF SYSTEM 1-1"Septic tank,9HIM0111M. 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) Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: V NKA-,® fir/ Were sewage odors detected when arriving at the site(yes or no): Al Q Title 5 Inspection Form 6/15/2000 6 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: BUILDING SEWER(locate on site plan): Depth below grade: Materials of construction: Cast iron _ 40 PVC _ other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK(locate onsite plan): Depth below grade: Material of construction: E/concrete metal fiberglass polyethylene _ other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) �� �!J £ S7— Dimensions: �o0 0 ��� �/� Sludge depth: i Distance from top of sludge to the bottom of outlet tee or baffle: Scum thickness: 0 Distance from top of scum to top of outlet tee or baffle: / Distance from bottom of scum bottom of botto of outlet tee or baffle: How were dimensions detennined: '7/¢.4£ 1� " o 6 Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): ,q p� IV/�/� S � � e —��ti� A7^ LFUEL4 'IWAlh- 7-,'7 C'o y£,e S `� ,� £•Caw /i'�4.� £ /A., £ 7- /1/,,4 S 40�e T £r //�S — =L £ 3112- E7 £-*7 /-t 62 A.- GREASE TRAP(located on site plan) Depth below grade: 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: TIGHT or HOLDING TANK: IV� (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/day Alann present(yes or no) Alann level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: Al 14 (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 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.,): PUMP CHAMBER: //14 (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Title 5 Inspection Form 6/15/2000 8 Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): L,"O' (locate on site plan,excavation not required) If SAS not located explain why: Type Vleaching pits,number: leaching chambers,number: leaching galleries,number leaching trenches,number,length leaching fields,number,dimensions: 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.) 7�P o is d 1 T i S A 4, s3 �F4 o w �/'i /�a £ E.c. C o U £2 7- S/ y o r j 14 T f.f i A- 0 r, 5'T,q I�iT' S�ylows iLa sr�.� o�-' ou£.c .�vAai�L CESSPOOLS: A/ (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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation etc.): PRIVY: .4111� (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.) Title 5 Inspection Form 6/15/2000 9 Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two pennanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. a Ll pV jc K e R Z A I 1 Title 5 Inspection Form 6/15/2000 10 Page 1 1 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: J Owner: Date of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to roundwater 1 feet Please indicate(check)all methods used to detennine the high ground water elevation: Obtained from system desi n lans on record-If checked,date of design plan reviewed: Observation site(abutting prope observation hole within 150 feet of SAS) Checked with local Board o ealth-explain: Checked with local excavators,installers-(attach documentation Accessed USGS database-explain: You must describe how you established the high ground water elevation: r �r 6,,177m �- y Title 5 Inspection Form 6/15/2000 11 1 Septic Service Mechanical Services Pumping & Heating&Plumbing Installation cNarico Fire S rinklers Since 1930 NAME �a�i�' �l1'fw£� MAP DATE STREET 6�©S f t--b,p1f Sr- PARCEL PERMIT, TOWN (ti -6111? v LOT PHONE, GRADE TANK TEST HOLE b COVERS TOP INLET TANK � OUTLET n 1 GRADE D-BOX TOP D-BOX 1N OUT PIT 1 PI7 / o GRADE �v TOP PIT � b a w r • N i V lf+I �'� +A V _ y_� �� ,, .� �� �� � , SEPTIC INSPECTION CHECKLIST NAME A OFF CAPE ADDRESS CAPE ADDRESS PHONE NO. PHONE NO. DEPOSIT RECV'D AMOUNT CREDIT CARD # AMOUNT CUSTOMER NO. DIG SAFE NO. 1.CL DATE 8. GARBAGE DISPOSAL .2 CKET N0. 9. DISHWASHER Yes . YEAR HOUSE ILT �Z 10. NO. BATHROOMS � . NO. BEDROOM 11. SUMP PUMP 5. WELL ON PROP RTY 12. NUMBER OCCUPANTS 6. IRRIGATION �/O 13. SEASONAL 7. WASHIN ACHINE / WATER USAGE: WHERE SEPTIC LOCATED: NOTES: DIG SAFE # 1-888-344-7233 CONTRACTOR # 11122 **IF EMERGENCY DIG SAFE NOTIFY ERNIE-RICK-DOUG-JEFF ffFF 11 FM-ii I HU AC GRADE �� John and Carol Brewer REAR VIEW 205 Cedar st West Barnstable, Ma AC b. NOTE+ WOOD FRAME CONSTRUCTION AZACK DECK GRAY John and Carol Brewer RIGHT SIDE VIEW 205 Cedar st West Barnstable, Ma sst b N F. . Z1 a - 3 . qp n Y/. 28. o ` � - u zif� ' a• - F 60.. _. - - . . �:'E�T/FiC TJ �Lo T PLC✓ `�� " . �•q� .4cs+r/o.,� �q74 SA6 w.v. N ' - .. ? �I��rN AEI`.- ~•YS - � _ .. ... .• - - S - To -7?1E ZoAei�vG LAWS' oiC T W Al off' 13. ;WV5Z4 ScE" x>, 4 /976 .�IwATP/i}w. .C/i�PLSo.u,.r/�E�'T/T/vNC',�'•. : - .c-cG. �D �.Q✓ G��. Map Page 1 of 1 Town of Barnstable Geographic Information System New Search Home I Help Parcel Viewer Custom Map 1[77;b-utters Map Size ■ Zoom Out In }4 y Q ,,...f1( ® 49 6-]PG Map: 131 Parcel: 059 lroperty 1' Location: 205 CEDAR STREET Info 131016 131018 . #305 Owner: BREWER,JOHN H&CAROL 7 1#313 26 \2226 131033 1i 365 �, Location Information 1 131060001 % o 131027001 Map&Parcel 131059 1 ,t5 ue 1 Obi 245 131017 Location 205 CEDAR STREET 1t 245 y f 8305 f Acreage 1.02 aces V 131027002 t1304 Current Owner 9 ® v r� Mailing Address BREWER,JOHN H&CAROL J 205 CEDAR STREET 131050 WEST BARNSTABLE,MA 02668 130M 1205 0400 pA praised Value(FY 2012) 131050 Extra Features $36,300 _- 031 Out Buildings $53,700 Lan® Buildings $1 , 00 Build� 130007 ings $14949,800 �05s Total Appraised $401,100 - 131001 /431 4� Assessed Value(FY 2012) 13W2t30005 Extra Features $36,300 0 s46 v 04984 4 Out Buildings $53,70046 13l1033 153 Land $161,300 r�o` ar4es Buildings $149,800 Total Assessed $401,100 Set Scale 1"= 153 I Aerial Photos - ' MAP DISCLAIMER Copyright 2005-2010 Town of Barnstable.MA A0 rights reserved.fiend questions or comments to GIS BarnstabieMA v1.2.4672[Production) i http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=131059&m... 10/23/2012 r� TO/�t UP � ��l'LUMf yv«:H Vw�jQ f �C,��vM QV`Pl�jpf6vyP, BED RM 1 LIVING RM II �r Al PlA of "r"m C 'A. 4 CLOSET p� FIREPLACE (1° ✓(�� fr v�,c i 'lpjIb" I inacf Pkve.�{' Q�rl'�1'S< DOWN HALL KITCHEN/D1NET DINING RM BATH/LAUNDRY (( coO FIRST FLOOR PLAN John and Carol Brewer 205 Cedar st West Barnstable, Ma Y E CLOSET CLOSET BED ROOM 42 DOWN MASTER BED ROOM LINEN CLOSET BATH 2 SECOND FLOOR PLAN John and Carol Brewer 205 Cedar st West Barnstable, Ma c v CLOSET HALL a� frru hio�i + "-� aT CLOSET EXERCISE ROOM �`^eo�$Sj 5�1i` MEDIA ROOM o�t�; t 1 q V f+"A' CLOSET or r.�4, ,vI 1,)ti`� SHELF bavlt�y tilt- DOWN 7 6 STORAGE STORAGE \ , C Z 7 C BASEMEN T FLOOR PLAN John and Carol Brewer - 205 Cedar st West Barnstable, Ma u . CLOSET SITING AREA BED ROOM r~ LIVING RM BATH down STAIRWAY KITCHEN John and Carol Brewer GARAGE LOFT 205 Cedar st West Barnstable, Ma 9'-5' CLOSET SITING AREA BED R13DM 29[5' LIVINd RM - BATH ,a r" down :)a 4JrD STAIRWAY KITCHEN co LtqLi GARAGE APARTMENT 783 SO FT John and Carol Brewer 205 Cedar st -P- West Barnstable, Ma 5��5f a i J UP � BED RM I LIVING RM CLOSET FIREPLACE DOWN HALL KITCHEN/DINET DINING RM t BATH/LAUNDRY O O FIRST FLOOR PLAN John and Carol .Brewer 205 Cedar st West Barnstable, Ma CLOSET CLOSET a MASTER BED ROOM BED ROOM 02 DOWN LINEN O CLOSET BATH 2 John and Carol Brewer SECOND FLOOR PLAN 205 Cedar st West Barnstable, Ma. CLOSET MALL CLOSET EXERCISE ROOM MEDIA ROOM rF1 CLOSET SHELF STORAGE ST12RAGE BASEMENT FLOOR PLAN John and Carl Brewer 205 Cedar st West Barnstable, Ma LO CATION E �AGli PERMIT NO. VYI L AG E ��ee: �7f Cucrc !31— v 1NtST]A LLER'S NAME & ADDRESS B U I-L D E R OR OWNER -7/ D-A—T—f . PERMIT. tSSUED ��� �S, _ 'TG DATE COMPLIANCE ISSUED 7 a / 77 j �: ,' ) '� i}�` y.i ' ' `✓ �� �� ` - �� r L,LAA o............... 0 T., THE COMMONWEALTH OF MASSACHUSE S Coe*c/........ BOARD f HEA T C0(rt+'Ad)0fT I%, ....... .......... ..... ......................... ce dq r s . Appliration -for Miipviial Works Tatuitrurtion Vanift A-::. 131-059 Application is hereby*made for a Permit to Construct or Repair an Individual Sewage Disposal W- System at: 06..N N 11p. .............................�_L, A.......................................... .................................kof.•-,1:141----------------------------------------- Lo t Location dr.e 4.1 .23 No. ................................ ............ ._.T ..S. ................................................ O,Y.er Address _4,.......... .................... ................ . ...... ----------------------- .... .................... ___ _�ie_�ns'ja Address Type of Building, Size Lot....._'I ...Ll....Z...111�3.Sq. feet U 3 Dwelling ";;No. of Bedrooms............................................Expansion Attic Garbage Grinder ( Other—Type of Building ....076.�-_ No. of persons............................ Showers Cafeteria ( Otherfixtures .......... ----------------------------------------- -------- ------ ----------------------------------------------*------------------------------------ Design Flow...........' SO ---------------------------------gallons per person per day. Total daily flow.............3_Q0--------------------gallons. P4 Septic Tank I Liquid capacitvlgP�qgallons Length................ Width.._.........._.. Diameter-----_-------- Depth----------_--- Disposal Trench—No. ..................... Width-------_---------- Total Length_-__-__-_-__----___ Total leaching area....................sq. f t. Seepage Pit No.......1------------ Diameter_..J0_*_0__r)Depth below let Total leaching area..................sq. ft. Z Other Distribution box Dosing tank Percolation Test Results Performed by............................................................... ....... Date---------------------------------------- a Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.--------------------_- rX4 Test Pit No. 2----------------minutes per inch Depth of Test Pit.-__-_---._._______- Depth to ground water------------------------ 9 ------- _/ -- ---------------------------------------- -- ------P- -------------/---------- ........ ------ ............ W/ 0 --------- ------- Description of Soil J� -- ---- .... �J,. . ..... ....... ------- -------------- U ........................... ----------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------- ----------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee is W XA.__ bby the ,r of health. CIIJ/1\1Z.................................. ................................ ign d- T7... Date Application Approved By..... .. --- --- - --------------- Date Application Disapproved for the following reasons:................................................................................................................ ...........................................................................................................................................---------------------------------------------------------- Date PermitNo......................................................... Issued...................... ................................. Date No.v`!91. Fiziic THE COMMONWEALTH OF MASSACHUSETTS BOARD HEA T *� -- --------OF......... ... .... .... .. ................... Appliration -for Uigpoiial Works Tonfitrurtion Prrmit Application is hereby made for a Permit to Construct or Repair ) an Individual Sewage Disposal Systemat: C � S� of:11-4................................................................................................. ..................................... ....... L.c. A dress or L t No................................ ............... ......................................... Owner Address V1 C? Q L, Lvq�J,-A j� C --------------------------- _V .............................................. .............�.. ............... Installer Address Type of Building— Size Lot....- feet L) 3Garbage Grinder ( V51JO P 4 Dwelling—No. of Bedrooms._............ .............................Expansion Attic ( ) �1 aq Other—Type of Building ---- No. of persons............................ Showers Cafeteria (--t-_t-------------------- Otherfixtures ----- ----------------------------------------------------------------------------------------------------------------------------------------------- Design Flow----------------_r.. 0 ...........................gallons per person per day. Total daily flow..............O Q---------------_---gallons. WSeptic Tank—1 Liquid capacity--0)0�?gallons Length................ Width..._............ Diameter_.........------ Depth.._............. Disposal Trench—No..................... Width.-.---------.--.---- Total Length.._._--.-.--.-..--_ Total leaching area--------------------sq. f t. Seepage Pit No....... ........... Diameter....Z0.0.0,4,"bepth below 1 let Total leaching area------- ----------sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I----------------nunutes per inch Depth of Test Pit...-..-.-.-__-_----- Depth to -round water......__............__.. �Z4 Test Pit No. 2----------------minutes per inch Depth of Test Pit...-.-.-----.-_---.- Depth to ground water.........---------_-.._. ............................ --- ------------ ----- - ---------------------------------------------- 0 --------- Description of Soil------- --------- ............ -- ---- --------------- ------------------------------------- 772 ....LZ........... U ---------------- .................I.,................................ ---------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable............................................................................:..................- -----------------------------------------------------------------------------------------------•----------------------_............................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee rissued by the b ar of health. ;igne ... d ..... ..................................... ..... _ Date Application Approved By------ / Date Application Disapproved for the following reasons:.......................... ..................................................................................... --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo......................................................... Issued---------------------- ----------------------------•-•-• Date THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH 06....................Z..................................... .......OF........ .. .... (9rdifiratr of Tompliaurr TH TO CE IF hat the Individual Sewage Disposal System constructed or Repaired by-----......................... . ... ....... ......... ............. ------/I•---------- Installer------- I------- ----------------------------------- 6 at..--.... --------------- ---- -- I J 641------- --- ------- . .......... 4�..... .................. has been installed in accordance with the provisions of ti XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.. ---------vil ---------- dated .. ............ THE ISSUANCE OF THIS CERTIRCATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--- ------ ------I... ..7----------- Inspector-- ............................ THE COMMONWEALTH OF MASSACHUSETTS Z BOARD W HEALTH 0� ... 04-/ ...... ..... ............ ............OF......0. ............................................... NO....... FEE.f/V............ %xivati orkii 010 trurtion famit o 11 1 Permission Z,i �reby granted--"---- I......... ----------- - -- -- -------------------- ---------7-------r----------------------------- to Construct '4/) Rep an, &id 7- ewiaDispos m. ... .....I ... ......... ...... .......... .... ......................................................... at No. ....................... S ree as shown on t e application for Disposal Works Construction Pe i o.... . ...................................... -------- ..................... ...... ...... .............. Board of ealth DATE.. ........ FORM 12 ........ /1 N-C----- )--Be I ARR PUBLISHERS 5 '0 - , " s, N y 3�t,o3 k� p �`ACN Pl2oPoSE7� 5C'n17C PIT 60 � zz3� C'C T/F/C b Rzo T PLAT/ ZoCATioi✓ W937- BA2a/STfJ$G MA55, SCOW E /��4� S/k w.v ow A"Va ELZL/ S, C,4RLsv.l , �Gb27?E7� IN RZA-iv 8At'- 306 - ` � ,ro,,I1D. V0" S/,bWN oN 77/1S AEG /S GoC►WEIV oN 77V-6:- G.L'ou.va AS S,66 wA/ 5f, To 7W Lc- Zo"/MG To W AI oG QA),eNSTA $L ter• ¢ 174 Jo•v�7N.9� �.�1,eLSo.cl — /�E^riTloNt� '`'cy• -va l( y bowE OPIA . N1 � - bv 3 Air (D book LAC efk 11 A y • -. Agog GA o PAS ILI r ti 4f n d if-e--A:- -� �L. egg,4-lcl- � . . ,