HomeMy WebLinkAbout0076 NELSON LANE - Health 76 Nelson Lane
,, f. Marstons Mills " P
/ \ 125 072
I
TOWN OF ARNSTABLE
LOCA U N 74 / ..*'� Ch2 SEWAGE#
`! VILLAGE ,44"Go ASSESSOR'S MAP&PARCEL
INSTALLERS NAME&PLTn'�v^."2 Q IkeIL--l'.
SEPTIC TANK CAPACITY /ODD r-a�/ �T
LEACHING FACILITY: (type) (size)
NO.OF BEDR OMS 3
OWNER
PERMIT DA E: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
}
FURNISHED BY
low UOC U �.
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EXCERPT FROM BOARD OF HEALTH MEETING MINUTES ON 11/10/09:
I. Septic Variance:
Adam Hostetter representing John and Shama Fulham, owners — 76 Nelson
Lane, Hyannis, Map/Parcel 125-072, existing 1,000 gallon tank (undersized per
Title V), proposal to add additional bathroom with sewer injector pump.
No one was present. Mr. McKean had asked Mr. Hostetter to speak to the DEP prior
to meeting to clarify new/old construction limitation.
Upon a motion duly made by Ms. Rask, seconded by Mr. Sawayanagi, the Board
voted to approve the system. DENIED — Unanimously. (person may resubmit in the
future.)
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�ppTHE Tp� DATE': doZ7.O
* FEE:
* BARNSTABLE,
:5 MASS.
Town of Barnstable �
i6ti39• ♦0 REC. BY
ATFD MA1 A
Board of Health SCxED. DATE:�OV/0
200 Main Street, Hyannis MA 02601
Office: 508-862-4644 Wayne A.Miller,M.D.
FAX: 508-790-6304 Junichi Sawayanagi
Paul J.Canniff,D.M.D.
VARIANCE REQUEST FORM
LOCATION Property Address:
Assessor's Map and Parcel Numbe S z f Lot S S off Ca
Wetlands Within 300 Ft. Yes Busi me:
No_� f Subdivision Name:
APPLICANT'S NAME: 5�&hjt t'+�� AA^ Phone -5761' 7 71 5�11
Did the owner of the property authorize you to represent him or her? Yes . X No
PROPERTY OWNER'S NAME CONTACT PERSON
Name: J06.1 �SAr Itigvv�
Name: /qVgm 1�5
Address: 74 NG1fyM LV M..Vs{vw At;I(S Address: ?D rl &14iN ST ' (/� vllle
Phone: 0 0-7-7 143 11 Phone: ! 7 q+ Z1 3 6 -3 o f U
VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE((May attach if more space needed)
4 / tt
i g Jaq Fy"trjA 1 QA,1, T�k S- Need & �d ) e>cfiee s& •f-v
se "L e•C vw {V CC,✓t• O t// T
— 1�c bGs��JL
7,.,
NATURE OF WORK: House Addition X❑❑❑❑❑ House Renovation 11 Repair of Failed Septic System 0
Checklist (to be completed by office staff-person receiving variance request application)
Please submit copies in 4 separate completed sets.
_ Four(4)copies of the completed variance request form
Four(4)copies of engineered plan submitted(e.g.septic system plans) r
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 dat-d at applicant'R- pensez�46r
Title V and/or local sewage regulation variances only) , ""I C l
Full menu submitted(for grease trap variance requests only) P ) 'T1
Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance rene vals[same owwi er/le s�;ee only],
outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal sytems[only o expansion to the
building proposed]) Cn
Variance request submitted at least 15 days prior to meeting date '
C]O
VARIANCE APPROVED Wayne Miller,Jhairman rn
NOT APPROVED Junichi Sawayanagi
REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D.
Q:\Application Forms\VARIREQ.DOC
, 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION
LL'
*.' 15.228: continued
EWl}T
(4) Septic tanks shall be inspected and main_tainzd in accordance with 310 CMR 15.300 and
applicable local requirements' -
3. t 5 229: Pumping to Septic Tanks
(1) System designs specifying pumping of sewage to aseptic tank may be approved by the local
Approving Authority for a single family dwelling provided that the volume of sewage pumped
is less than 25%of the design flow of the system,the pump discharge pipe is connected to the
building sewer and:
' (a) where a sewage ejector pump(non-grinder pump)is used,the discharge flow rate shall
x ,
x be fewer than 60 gallons per minute at the design total dynamic head(TDA)and capable of passing atwo-inch diameter solid, and the septic tank shall have a minimum effective
volume of 1,500 gallons;or
(b) where a grinder pump is used,the discharge flow rate shall comply with the discharge
capacity specified in the State Plumbing Code for sump and ejector pumps in sanitary
drainage systems,and the septic tank shall either be a multi-compartment tank or two tanks
in series.
(2) It is not recommended to pump greater than 25%of the design flow of the system to a septic
f d is tank;however,when necessary system designs specifying pumping of sewage to a septic tank
may be approved by the local Approving Authority for a single family dwelling discharging a
volume of sewage greater than 25% of the design flow of the system, provided the pump
discharge pipe is connected to the building sewer and:
a4kd (a) the requirements of 310 CMR 15.229(1)(a)or 15.229(1)(b)are met;
°' r... (b) the building sewer discharges to a multi-compartment septic tank or two tanks in series
w designed in accordance with 310 CMR 15.223 and 15.224;and
(c) standby power,a hookup for standby power or storage capacity in the pump chamber
equal to at least the volume of the design flow for one day is provided.
Non-grinder pumps are the preferred alternative.
(3) All other uses of sewage pumps prior to the septic tank without the prior written approva
of the Department are prohibited.
x,. 15.230: Pretreatme
(1) Grease traps shall be provided for kitchen flows at restaurants,nursing homes, schools,
h hospitals and other facilities from which grease can be expected to be discharged.
a
(2) Grease traps shall be installed on a separate building sewer serving kitchen flows into which
the grease will be discharged. The discharge from.the grease trap must flow to a properly
designed septic tank or to a building sewer prior to the septic g p p ' tank.
(3) Grease traps shall have a minimum depth of four feet and a minimum capacity of 1,000
gallons,and shall have sufficient capacity to provide at least a 24-hour detention period for the
................................ kitchen flow. Kitchen flow shall be calculated in accordance with 310 CMR 15.203.
Lx5a_
(4) Grease traps shall be watertight and-constructed of the materials specified in
310 CMR 15.221 and 15.226(1)and(2).
(5) The inlet tee shall extend to the mid depth of the tank. The outlet tee shall extend to within
12 inches of the bottom of the tank. Tees shall be Schedule 40 PVC and properly supported by
r a hanger,strap or other device.
(6) Grease traps shall be installed on a level stable base that has been mechanically compacted
and onto which six inches of crushed stone has been placed to minimize uneven settling.
(7) Grease traps shall be provided with a minimum 20-inch diameter manhole frame and cover
to grade over the inlet and outlet tees.
spa`
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4/21/06 310 CMR-523
i�l/�1r�Ot�
t
October 27, 2009
Shama Fulham
76 Nelson Lane
Marstons Mills,MA 02648
Zoning Board of Appeals
Town of Barnstable
200 Main Street
Hyannis, MA 02601
Re: Variance request
Dear Zoning Board Members:
As owner of the property located at 76 Nelson Lane, Marstons Mills,MA(Map 125,
Parcel 072), I authorize Adam J. Hostetter of Hostetter Homes to represent me in my
variance appeal.
Thank you for your cooperation.
Sincerely,
Shama Ful
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LOT 22 �.o'
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Got. #76
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30 ANT .Ymw sQ 6 � 1)0
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Note: Tonh loco ted in "ield. a
Other septic components �>'J �•)�'
rrom os--built plop supplied
by ins toiler.
TOWN CIF BARNSTABL-E ZONING �57",BEET ADDRESS: i;7; NFLSON L,=!NE, MARS-ENY 1'ILL S
BY-LAIV DATED MARCH 14, 1997 Ag ASSESSORS' NAP 125 PARCEL :'S
S OWNER: PAUL PI TA
i
ZONE , RF- DEED REF.: CTF..t872450
I PLAN RE-F. L.C.C. 12034D L[IT 22
I / 1 CERTIFY THAT TO THE BEST OF i•1Y PROFESSIONAL
KNOWLEDGE, INFORMATION .AND BELIEF THE DWEL L IN'G
PROPERTY LINES SHOWN NEREOId SHOW/V HEREON CONFORMS TO THE HORIZONTAL SETBACKS i
WERE COMPILED FROM AVAILABLE OF THE Z13NIIVG BY-LAW FGR THE TOWN OF BARNSTABLF. I
PLANS OF RECORD AIVD DO NOT
REPRESENT AN ACTUAL SURVEY .=! '"'°
ON THE GROUND. PLOT PLAN
P9/.24/2009 07:21 508-428-1974 HOSTETTER REALTY PAGE 01
bA OY
HOSTS
TTER REALTY
770A Main Street
l
Ostervine, MA 02656
Phone: (508)428-2828
Fax: (508) 428-1974 . -41
Vv
tl
To. Sharon @ Barnstable Health Dept p20d
($Fax: 790-6304
From: Adam Hostetter
Date: 1019109
Pages: 1, including this page
RE: 76 Nelson M
BjftvvW9-, MA
We are reviewing our plans on this project Please
remove me from the Tuesday, Oct 13,
2009 meeting agenda.
Thank you.
oq
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LOT 22
43,945± S *�
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.,76
76.5'
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49
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ry '
z=
3,0 �T :Ym� o Sef 6 0
Note: Took loco tec•I in Field.
d' 1
Ether- septic cvmponen is
Fror+ os -buii t plon supplied /
by'instol(er.
E TOl✓N OF. BARNSTABL.E ZONING.
f 2 S TRCL T ADDRESS: i; 6 Nf_L SON '1li+E, i/1S;Uh,U 1421 L S
.. BY-Lr14✓ rf?TED.I1ARCN 14,--1997 ,��� ASSESSORS' M,4P 1c'5 PAiRCtI ,'S
S O6/ldER: PAUL PI TA
ZONE RF-
��/, L'EED REF.: CTF..t872450 �
PLAN REF.: L.C.C. 120.34D LOT -'2
1 CERTIFY THAT TO THE BEST OF 1•1Y PROFESSIONAL
KNO LIL EDGE, INFORMA T ION AND BELIEF THE DWE!_L INC,
PROPERTY ' INES S14GIVN HEREON SHD4IN HEREON CONFORMS TO THE ,YORIZGNTAI_ SETBACKS j
j t✓ERE- COMPILED FROM AVAILABLE OF THE ZONING BY—LAW FOR THE TigWN 5F BARMSTAiiLE. j
PLANS OF RECORD AND D0nh10T
REPRESENT AN ACTUAL SURVEY
ON THE GROUND. PLOT PLAN
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way.
Important: A. General Information
When filling out
forms on the
computer,use 1. Inspector:
only the tab key
to move your Robert Paolini
cursor-do not Name of Inspector
use the return
key. Capewide Enterprises,LLC
Company Name
raa P.O.Box 763
Company Address
Centerville Ma 02632
return City/Town State Zip Code
(508)428-4028
Telephone Number License Number
ifi 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
rQ ;,
Insp ctor's Signatur 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 shared system.or
has a design flow of 10,000 gpd or greater, the inspector and the system owne shall stllamit the
report to the appropriate regional office of the DEP. The original should be sentlo 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.
76 nelson lane-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 2
,a
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M
76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every 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:
® 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:
The septic system is in proper working order at the present time.
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.
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 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.
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
76 nelson lane•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 2
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
76 Nelson Lane
Property Address
John Zappala
Owner, Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ 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:
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
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.
76 nelson lane•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 3
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
C) Further Evaluation is Required by the Board of Health (cont.):
❑ 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:
1
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
❑ ® 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.
76 nelson lane•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 4
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
D) System Failure Criteria Applicable to All Systems (cont.):
Yes No
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
0 ® 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-
1 0,000g pd.
El ® 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.
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.
76 nelson lane'-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 5
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every 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?
® 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 (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
76 nelson lane•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 6
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
,M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date oflnspection
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): 330
Number of current residents: 0
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
2005:176,000
Water meter readings, if available (last 2 years usage (gpd)): 2006:110,000
Sump pump? ❑ Yes ® No
Last date of occupancy: unknown
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:
Last date of occupancy/use: Date
Other(describe):
76 nelson lane-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 7
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
^M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
General Information
Pumping Records:
Source of information:
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)
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed (if known)and source of information:
Were sewage odors detected when arriving at the site? ❑ Yes ® No
76 nelson lane-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 8
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Building Sewer(locate on site plan):
Depth below grade: 16"feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
Joints appear tight.No evidence of Ieakage.System vented through the house vents.
Septic Tank (locate on site plan):
1,
Depth below grade: feet
Material of construction:-
® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain)
l
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
-------------------------------------------------------------------------------------------------------------------------
Dimensions: 8'6"X4'10"X5'8"
6"
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle
30"
Scum thickness 0
Distance from top of scum to top of outlet tee or baffle na
Distance from bottom of scum to bottom of outlet tee or baffle na
How were dimensions determined? measured
76 nelson lane-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 9
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
^M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
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.):
Pump tank every 2-3 years.lnlet and outlet tees are in place.No evidence of Ieakage.Tank is
structurally sound. -
Grease Trap (locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
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):
76 nelson lane•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 10
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
;M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Tight or Holding Tank (cont.)
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
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert no
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.):
Box is level and has one Iateral.No signs of soilds carryover.No evidence of leakage into or out of
box.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
76 nelson lane•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 11
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
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:
Type:
® leaching pits number: 1
❑ 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 was dry at time of inspection.No signs of hydraulic failure.Medium fine sand to Medium
sand.Vegetation appears normal.
76 nelson lane•06/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 12
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�M 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
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.):
76 nelson lane•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 13
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
w 76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a sketch 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.
r
t
b
76 nelson lane•08/06 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 14
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
�M
76 Nelson Lane
Property Address
John Zappala
Owner Owner's Name
information is required for Marstons Mills Ma 02648 1/26/07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
r
® Check cellar
❑ Shallow wells
Estimated depth to ground water: 65'
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:
as-built card
❑ Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Used:gaherty& Miller Model 12/16/94 ground water elevations.Used:USGS Observation well data
June 1992.Used:Technical Bulletin 92-000-01 Plate#2 annual renges of ground water elevations.
. l
76 nelson lane-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15
eusto
OViXVIAY
90 0.0
s± S,F
AC.
�-`SNIA
Gar. #76/\
i
Tank
' 2
20.E
C SQ,'C-Y '
Pit
Cl/JIWF
a'
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. AC
`+%p.
a. �o
76,5
I v�pcs►-� a.�a �
Tank
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Pit
s
r � N
A
of CB/DH/FND
0S 0 O
036-15 A T
L OT 22 90.0' q
43 945+ S,F,
o
1,01+ AC,
U
30.5' �, J
- N
✓ W
N �
� Q
Gar. #76
76.5'
Tank
D-B x ,
z
20,D
Pit
cs '�
N �
Y 0
�g vo
Note: Tank located in field.
Other septic components
From as-built plan supplied
by installer.
TOWN OF BARNSTABLE ZONING 15 2� STREET ADDRESS: #76 NELSON LANE, MARSTONS MILLS
BY-LAW DATED MARCH 14, 1997 ASSESSORS' MAP 125 PARCEL 76
/ S OWNER: PAUL PI TA
ZONE ` RF f DEED REF.: CTF,#872460.
PLAN REF.: L.C,C, 12034D LOT 22
I CERTIFY THAT TO THE BEST OF MY PROFESSIONAL
KNOWLEDGE, INFORMATION AND BELIEF THE DWELLING
PROPERTY LINES SHOWN HEREON SHOWN HEREON CONFORMS TO THE HORIZONTAL SETBACKS
WERE COMPILED FROM AVAILABLE OF THE ZONING BY-LAW FOR THE TOWN OF BARNSTABLE.
PLANS OF RECORD AND DO NOT
REPRESENT AN ACTUAL SURVEY V0F
ON THE GROUND,
'MRRY PLOT PLAN
�.
THE DWELLING DEPICTED ON THIS WARNER SHOWING PROPOSED POOL
PLAN WAS LOCATED ON THE GROUND No.38721 $ IN
BY SURVEY ON MARCH 25, 2005 AND BARNSTABLE, MASS,
EXISTS AS SHOWN AS OF THE DATE
OF LOCATION. I +' r SCALE: 1'=40' MARCH 29, 2005
THIS PLAN IS FOR PLOT PLAN �O5t 05
TERRY. A. WARNER, P,L,S,
PURPOSES ONL Y. 22 LONG ROAD
HARWICH, MA. 02645 f
(508) 432-8309
THIS PLAN IS VOID IF NOT
STAMPED AND SIGNED IN RED, 0 20 40 80
PROJECT NO. 05-137PP
i
No. O Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Jzl_�
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zlppricatton for 30igool 6petem Construction Perm'
Application for a Permit to Construct( , )Repair'( Upgrade(. )Abandon( ) ❑Complete System �0Individual.Components
Location Address or Lot No. IWA 2 s 7 d Owner's Nppne,Address d Tel.No.
7's ICl� S O.✓ sF.✓ �" %[l We
Assessor's Map/ParcelAll cel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
/�i2cN Gv.✓3 �v
362
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Re e 1/"19� � ��p� 19
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been is Bo •d-ofVealth.
Signe Date
Application Approve Date
Application Disapproved for the following reaso s
Permit No. go Date Issued 7
n,.-F'*i.+yP,WS,.Y'Yt�M-Tr:0. ,N^,,'3~'mr,�..•'VY' .J �`..t",Mn '+efd^'h
x_
No. Fee `
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓�
Yes
PUBLIC HEALTH DIVISION -TOWWOF BARNSTABLES MASSACHUSETTS
01pplication for Migool bpotem Con.5truction ermit
:= Application for a Permit to Construct )Repair( Upgrade( ')Abandon( ) El Complete System .O Individual Components
Location Address or L �.N �` Owner's: acne,Address d Tel.No.
Assessor's Map/Parcel / � ...-- /') / /f U/i
Installer's Name,Address,and Tel.No. [/ Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot'Size sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow i gallons.
Plan Date i Number of sheets Revision Date
Title +t 1
Size of Septic Tank 4 Type of S.A.S.
Description of Soil
t
Nature of Repairs or Alterations Answer when applicable) E��'� �X Jq.=all
Date last inspected:
Agreement: j
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 is e byftl- Bard of H alth. =� '`-"`
' v
Signed ^ �, r� a !'� Date
Application Approv Jf�'`.��.• d/ � Date �/ f
Application Disapproved for the following reaso s
Permit.No. CA) `1LfDate Issued
r. THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of (Compliance
THIS IS TO CERTIFY,that�the On-site Sewage Disposal System Constructed( )Repaired (y) Upgraded( )
Abandoned( )by
.e A/l& s l ac�
at - has ct een const d i ordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 7 0)L" y dated
��? ��
_ Installer Designer
The issuance offthi perm s 11 not be construed as a guarantee that the system I function a designed
Date j U 01 Inspector E7,411 ~. I
No. ` --"' LT/�— ------ — — — --�--=•--=Fee �V
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Migozal *p.5tem ousstruction permit
Permission is hereby granted to Cons ruct� )Repair( Upgrade Abandon( )
System located at 7>'� ` s° "�'
6ZF i �
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:Constructie stbe bmp dited within three years of the date of thi perm t.
Date: �V Approved byir% U
J
1 C
• IP
5T 24 S
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
W
�oW PARCEL, L'T 13
5�. LOT � 0 2004
TOWN U- rS,gr STABLE
TITLE 5 HEALTH DEPT.
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 76 NELSON LANE MARSTONS MILLS 02648 0
Owner's Name: NICOLL-C/O EXCLUSIVE REAL ESTATE
Owner's Address: 119 RT. 149 MARSTONS MILLS MA.02648 ATT.JIM
Date of Inspection: 9/14/04
Name of Inspector: (please print) JOHN GRACI,INC.
Company Name: SEPTIC INSPECTIONS
Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 r..
Telephone Number: 508-564-6813 FAX 508-564-7270
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: ,
_ Passes s) 4 '�
X Conditionally,Pass -
_ Needs Further Eva ,tion by the Local Approving Authority :.u.
_ Fails a c�
Inspector's Signature: `< Date: 9/14/04 -77
_f
The system inspector shall submit a copy o 1this inspection report to the Approving Authority(Board of Fealth or DEP)within
30 days of completing this inspection. If th system is a shared system or has a design flow of 10,000 gp or greater,the r
inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The originalshould—ge
sent to the system owner and copies sent to the buyer,if applicable,and the approving authority.
Notes and Comments
THE SYSTEM CONDITIONALLY PASSES TITLE V INSPECTION.THE DISTRIBUTION BOX HAS ROOT DAMAGE
AND IS STRUCTURALLY UNSOUND.THE SEPTIC TANK NEEDS AND OUTLET TEE INSTALLED. ,
****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 1nCnPrtinn Fnrm 6/1 VIM) 1
Page 2 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of Inspection: 9/14/04
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:
THE SYSTEM CONDITIONALLY PASSES TITLE V INSPECTION.THE DISTRIBUTION BOX HAS ROOT
DAMAGE AND IS STRUCTURALLY UNSOUND.THE SEPTIC TANK NEEDS AND OUTLET TEE INSTALLED.
B. System Conditionally Passes:
X 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.
I
Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain.
n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits
substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced
with a complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating
that the tank is less than 20 years old is available.
ND explain: n/a
n/a 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: n/a
n/a 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: n/a
I
Page 3 of 11
OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of Inspection: 9/14/04
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
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 n/a
"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:
n/a
r
Page 4 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of Inspection: 9/14/04
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all-inspections:
Yes No
r system component due to overloaded or clogged SAS or cesspool
_ X Backup of sewage into facility o sy t p gg p
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged
SAS or cesspool
X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool
X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/z day flow
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times
pumped UNKNOWN.
X Any portion of the SAS,cesspool or privy is below high ground water elevation.
X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
X Any portion of a cesspool or privy is within a Zone 1 of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well.
X 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 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.]
NO (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in
3'10 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 now 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
X the system is within 400 feet of a surface drinking water supply
- X the system is within 200 feet of a tributary to a surface drinking water supply
X 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.
d
Page 5 of 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of Inspection: 9/14/04
Check if the following have been done.You must indicate "yes" or"no" as to each of the following:
Yes No
X _ Pumping information was provided by the owner,occupant,or Board of Health
X Were any of the system components pumped out in the previous two weeks ?
X Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X _ Was the facility or dwelling inspected for signs of sewage back up?
X _ Was the site inspected for signs of break out
X _ Were all system components,excluding the SAS, located on site'?
X _ 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?
X _ 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:
Yes no
X _ Existing information.For example,a plan at the Board of Health.
X _ 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(3)(b)]
5
Page 6 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of Inspection: 9/14/04
FLOW CONDITIONS
RESIDENTIAL
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): 330
Number of current residents: 0
Does residence have a garbage grinder(yes or no): NO
Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required]
Laundry system inspected(yes or no): NO
Seasonal use: (yes or no): YES
Water meter readings, if available(last 2 years usage(gpd)):rea
Sump pump(yes or no): NO
Last date of occupancy: n/a
COMMERCIAL/INDUSTRIAL
Type of establishment: n/a
Design flow(based on 310 CMR 15.203): n/agpd
Basis of design flow(seats/persons/sgft,etc.): n/a
Grease trap present(yes or no): NO
Industrial waste holding tank present(yes or no): NO
Non-sanitary waste discharged to the Title 5 system(yes or no): NO
Water meter readings, if available: n/a
Last date of occupancy/use: n/a
OTHER(describe): n/a
GENERAL INFORMATION
Pumping Records
Source of information: UNKNOWN
Was system pumped as part of the inspection(yes or no): NO
If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a
Reason for pumping: n/a
TYPE OF SYSTEM
X 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)
_Tight tank Attach a copy of the DEP approval
Other(describe): n/a
Approximate age of all components,date installed(if known)and source of information:
APPROXIMATE AGE 25 YEARS
y"' Were sewage odors detected when arriving at the site(yes or no): NO
Page 7 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of Inspection: 9/14/04
BUILDING SEWER(locate on site plan)
Depth below grade: 18"
Materials of construction:_cast iron _40 PVC Xother(explain):20 PVC
Distance from private water supply well or suction line: n/a
Comments(on condition of joints,venting,evidence of leakage,etc.):
TOWN WATER
SEPTIC TANK: X(locate on site plan)
Depth below grade: 12"
Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a
If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate)
Dimensions: L 8' 6" H 5' 7" W 4' 10`1
Sludge depth: 1"
Distance from top of sludge to bottom of outlet tee or baffle:33"
Scum thickness:0"
Distance from top of scum to top of outlet tee or baffle: 6"
Distance from bottom of scum to bottom of outlet tee or baffle: n/a
How were dimensions determined: MEASURED
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related
to outlet invert,evidence of leakage,etc.):
SEPTIC HAS NO OUTLET TEE-TANK IS OTHERWISE STRUCTURALLY SOUND. RECOMMEND PUMPING
EVERY TWO YEARS FOR MAINTENANCE.
GREASE TRAP:_(locate on site plan)
Depth below grade: n/a
Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a
Dimensions: n/a
Scum thickness: n/a
Distance from top of scum to top of outlet tee or baffle: n/a
Distance from bottom of scum to bottom of outlet tee or baffle: n/a
Date of last pumping: n/a
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related
to outlet invert,evidence of leakage,etc.):
n/a
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: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of Inspection: 9/14/04
TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan)
Depth below grade: n/a
Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a
Dimensions: n/a
Capacity: n/a gallons
Design Flow: n/a gallons/day
Alarm present(yes or no): N/A
Alarm level: N/A Alarm in working order(yes or no): NO
Date of last pumping: n/a
Comments(condition of alarm and float switches,etc.):
n/a
DISTRIBUTION BOX: X(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: n/a
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.):
THE DISTRIBUTION BOX HAS ROOT DAMAGE AND NEEDS TO BE REPLACED
PUMP CHAMBER:_(locate on site plan)
Pumps in working order(yes or no): NO
Alarms in working order(yes or no):NO
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
n/a
I R
1
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of Inspection: 9/14/04
SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required)
If SAS not located explain why:
n/a
Type
1000 GAL 6'X6' leaching pits, number: 1
n/a leaching chambers, number: n/a
n/a leaching galleries, number: n/a
n/a leaching trenches, number, length: n/a
n/a leaching fields, number: n/a
n/a overflow cesspool, number: n/a
n/a innovative/alternative system
Type/name of technology: n/a
Comments(note condition of soil signs of hydraulic failure, le
vel of ponding,damp soil,condition of vegetation,etc.):
THE LEACH PIT IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.THE PIT HAD 1' IN IT AT
THE TIME OF THE INSPECTION-THE PIT HAD STAIN LINES WITHIN P OF THE PIPE. BOTTOM IS AT 8'
6" SYSTEM HAS ONLY BEEN USED SEASONALLY FOR THE THAT YEAR.
CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration: n/a
Depth—top of liquid to inlet invert: n/a
Depth of solids layer: n/a
Depth of scum layer: n/a
Dimensions of cesspool: n/a
Materials of construction: n/a
Indication of groundwater inflow(yes or no): NO
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
n/a
PRIVY: (locate on site plan)
Materials of construction: n/a 1
Dimensions: n/a
Depth of solids: n/a
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.):
n/a
4
Page 10 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of Inspection: 9/14/04
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch 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.
I
`— L—l '
in
Page 1 l of 11 .
wr
a
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 76 NELSON LANE MARSTONS MILLS 02648
Owner: NICOLL-C/O EXCLUSIVE REAL ESTATE
Date of inspection: 9/14/04
t
SITE EXAM
_Slope
_Surface water
_Check cellar
Shallow wells
Estimated depth to ground water 12+feet
Please indicate(check)all methods used to determine the high ground water elevation:
NO Obtained from system design plans on record-If checked, date of design plan reviewed: n/a
YES Observed site(abutting property/observation hole within 150 feet of SAS)
NO Checked with local Board of Health-explain: n/a
NO Checked with local excavators, installers-(attach documentation)
NO Accessed USGS database-explain: n/a
You must describe how you established the high ground water elevation:
GROUNDWATER WAS DETERMINED ON SITE- 12+FEET
11
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0
TOWN OF BARNSTABLE ZONING STREET ADDRESS #76 NELSON LANE, MARSTONS MILLS
BY-Lr1 W DATED MARCH 14, 1997 0.g ASSESSORS' MAP 125 PARCEL 76
S OWNER: PAUL PI TA
ZONE RF �/ DEED REF.: CTF.#872460.
PLAN REF.: L.C.C. 12034D LOT 22
I CERTIFY THAT TO THE BEST OF MY PROFESSIONAL
KNOWLEDGE, INFORMATION AND BELIEF THE DWELLING
PROPERTY LINES SHOWN HEREON SHOWN HEREON CONFORMS TO THE HORIZONTAL SETBACKS
WERE COMPILED FROM AVAILABLE OF THE ZONING BY-LAW FOR THE TOWN OF BARNSTABLE,
C PLANS OF RECORD AND DO NOT
REPRESENT AN ACTUAL SURVEY y VOF
ON THE GROUND. q ' PLOT PLAN
o 7ERRY .
Tor nurt I Wr, nrPTrTrn nN TNTC MfA�1�l _ W SHOWING PROPOSED POOL
v� CATION
�o2 /1/e/sO•r/ �-� S E !4 G E �� R�p� NO.
VILLAGE
II' IN ST A LLER'3 NA E i ADDRESS
e
3 ged
d U I L D E R OR OWNER
DA T E P ERMIT I S S U E D s
DAT E COMPLIANCE ISSUED
` ��I �s' - ... �
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��
N(di.................. FEE..............................
THE COMMONWEALTH.OF MASSACHUSETTS
BOAR® XF HEALTH
............... .....OF......... .........................................
Appliration for Disposal Works Tomitrudion thrutit
Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal
Syst al:I
.......... ............ .......... .... ......7......................................................................
Loca on-Address, r
t No.
01�m
........ ............
...... ....
n�er -----------------------------------------
.0...... ... . ....... ..... ------- .............................
Tnstaller Address v).:3
Size Lot.-
Type of Building -..Sq. feet
Dwelling—No. of Bedrooms ............. ...............Expansion Attic Garbage Grinder
Other—Type of Building ---------No.- .....of persons............................ Showers Cafeteria
Other fixttir.@s...... .. ..................................
Design Flow....... gallons per person per day. Total daily flow__._. ....................gallons.
Septic Tank/-, Liquid capacity./ allons Length................ Width..............._ Diameter---------------- Depth................
Disposal Trench—No. .................... Width............._..._.. Total Length.....................Total leaching area....................sq. ft.
Seepage Pit No.-,../............. Diameter./&.......... Depth below inlet.__.....gx.!..... Total leaching area...a4 ' sq. ft.
Z Other Distribution box DosiA tan
Performed by .. . ..... Date....7n.7-Ad.........
Test Pit No. L.1...........minutes per inch Depth
Percolation Test Results ..
of Test Pit. ......I Depth to ground water________________________
Li, Test Pit No. 2................minutes per inch Depth of Test Pit..._................ Depth to ground water._..._..................
... ..... ------ vw&- .......................
_e.............W
.. ........
0 Description ofelf!... ------- _d --.W.
....... --- ------
W 41----------- ... .......................................................................................
U ---------
:4 ........... ..........................................................................---------------------------------------------...................................................................
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 TL I'I 1Z 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
�Slgned. ..........................................................Ig ............Dal................
. ......... . . ----------- .. .. ........
Application Approved By.._..... Date
Application Disapproved for the following reasons:...............................................................................................................
....................................................................................................................................................................................................
Date
........................
Permit No......................................................... Issued-__ . ....
Date
No:"":" --•- Fins..... ....................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
................ .. G?;. g....OF...-... `4...::r ,.. ......................................................
Fy'
Appliratinn for Uiipuia.1 Works Tonstrnrtiun Frrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System a .
i � F
Locat n Address
r � x
t-•o
.................
,.r; .,.2?�. rs�,M a: ,... �.�. �?-�' --'�--- -• f--� -�----- .,'�sy....-`- ..........................................
W ..................................q� P . . /nN dw °er g !.--
Installer Address
} .
Size Lot_ . feet SType'of Building q
U Dwelling—No. of Bedro U oms _Expansion Attic Garbage Grinder
( )
per, Other—Type of Building ' _._........_ No Q persons............................ Showers ( ) — Cafeteria ( )
a 1 Other t}kes �4
W Design Flow______ :_ _ .gallons per person per day" Total daily flow..... + ....................gallons.
WSeptic Tank-4 Liquid*•capacity 2gallons Length................ Width__ { Dlameter-___-__-------- Depth................
x Disposal Trench No .,....... Width _............... Total Length......... :_Total leaching area..._ .. ._:_sq. ft.
Seepage Pit No .Diameter .......... Depth below inlet ...�_ Total leaching%rea..-,:_Q sq. ft.
Z Other Distribution box_( Dosing tank,( o_ r
Percolation Test Results Performed'by_ a_ ._. � ""iY ............. Date.... •_ _._._.....
.• V
a Test Pit No, 1... ....._._.minutes per inch Depth of Test Pit..,�..... . Depth to ground water ......................
(i T4t Pit IVo 2 minutes per inch ? Depth of Test',
't Pit____________________ Depth to ground water----------..............
> s .
.. OUW Description of Soil J j �tra.:......._.
+S I. " . ......................
..t... ..�i....€ ............f +- --•-------------------•---•--------•----••----------------••------------ --•-'.... ------•--•---"-•---•-+a-•.9--•�---••-_.`._.Y.....✓._
....a.�..i._..._.........."e
UNature„of Repairs or Alterations—Answer when applicable.......................................___...._..__..._.._.___..___.............._..............
---=------------=--
-
Agreement
}
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance withy
the provisions of TITL 55 of the State Sanitary Code— The undersigned further agreesngt to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed -- ---------•-----------------• .
,,� Date
Application Approved B r _ d� _ = e.. PP Y�---- - _.
Application Disapproved for the following reasons:_...----•---------••---------------•----•-•-----....------•---...-•--•---------------•-•--•--•-••-••--•-•....._
....•-•---•-•----•------••-...-••-----•-=-......•-•....••-•................•-•--•---•-•---•-•---••••--•--......••---•-•-•--•-•--•------•---•---•--------------•--------•---------••••............••----
xar. Date
PermitNo.--------•-•-------•---------•--------------------------- Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
T rtifiratr of TnntpliFan ,v
T CART Individ SeGy�' al ern constructed (" �)or Repaired ( )
b _....�
.. ..
Y
y . 4 5 a+r° .r r� I t le. p _ kl g + .. 3 "a 100 ��v?�". d` f
at •---------.. • ••-•- -.. ---�-•�+--- -- -z ._. : ....� Ark
has,been installed in accordance with the provisions of T ?LE 1 of T�e State Sanitary Code as described,.in the
application for Disposal Works Construction Permit N&' �-__A 4-_�"-.........__• dated_. ...... ..........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WIL FUNCTION TI FACTORY
DATE' . . , . ' ..................... Inspector.�,. �' awrMw ............................. ......
� rv.f �
Wye._....__._...�� .:��.�ti»uv~.�.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF. HEALTH
.............. !.17........OF...............................................................,� ...............
No......_•-- ------• FEE.;,;
�.�- :...�..d.�am.._�.
.......
Permission.1 hereby granted----- .. ..........................
to Construct ( ) or Repair (y ¢) an Individual Sei#a a Disposal System11
at No._ ° t � .... � �� �� - �rt_.:�. _�.p.....01� �r3��'� .....................
Street er
as shown on the application for Disposal Works Construction Permit Nw.' .. Dated... �
..E ............................ .
Board of Health
DATE.......... ......--•.....................•--•-----------••-----------....... a�.
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
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EXTEND NDR TO CORN _ 2.6 VOL TOP PLATE - O
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PULL NGT.STUDS
JACK STUD
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TO BTM OF HDR _ APPLY SIMPSON MSTA18 CONNECTOR L�
W/7 ROKS OF I6d NAILS _ ON THE INSIDE FACE OF HEADER
O 9'O.C. TO EACN JACK STUD
STRUCTURAL PANEL HEADER
NAILED 6d COMMON INUOVS HEADER
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-
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DOOR TRIMMER STUDS c /�
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SCALE,N.T.S.
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-STAGGER NAILIN
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VERTICAL _
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JOINT AESCRIPTION NMER OF - NUMBER OP NAIL SPACING VERTICAL
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STAGGER NAILI BREAK ON SECOND FLOOR
ROOF FRAMING INTO BOTH PLATES RIM JOIST
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/IE'ADER TO NEADM(PACK!WILED) 16d Ifd 74'O.C.ALONG EDGES, -; RIM JOIST
FLOOR FRAMING VERTICAL VERTICAL
STRUCTURAL P AN EL STRUCTURAL PANEL N
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COMMON NAILED 9d COMMON O LIA
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SLOCKIN4 TO SILL.OR TOP PutE(Tlx RAILED) E-I6d 4-16d EAGN BLOCK ` I t W
LEOQR STRIP TO B OR OIRDER(}ACL NAILED) 5-I6d 4-I6d EAa JOIST
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BAND JOIST TO JOIST(END NAILED) S-Ud 4-Md PER.DEIST
SAND JOIST TO SILL OR TOP PLATE(TOE NAILED) 2-LLD 0-Ifd PER FOOT �l
ROOF SHEATHING STRUCTURAL _
k700D UCTURAL PANGS DOUBLLER NAILINNA !•:_: DOUBLE ROW'r"; `+ BTAGG_S R NAIL
IN
INTO BOX AND SILL 'C <ts INTO BOX AND BILL iJ
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RAFTERS OR TRUSIM SPAQW OVER 16'O.G. Sd 10d 4'EDG"'F1CLD n;;l
ti. \SABLE ElOO,LAl.l.RAKE OR RAKE TRiJ88 uVe GABLE OVR6AlYs Bd IOd 6'm6E/6'FIELD I
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NOOD STRUCTURAL PANG"
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JOB: 0902
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DATE: 4/23/10
• •—� -
�. P.O. Box 224, Cotuit, MA 02635 or by' 50CIety, H5nu1nG� a��u Take the H annlS-JPK. you!
t. museum calling 508-771-2585.All proceeds Long Pasture Wildlife y
The.Cape'Cod Children s Mu- benefit the cause. family compound Walk The Coast Guard Heritage Museum
seum, 577 Great Neck Road.South in Sanctuary
Mashpee, is holding several classes. . Cape Cod Canal Visitor (508-362-1426, call for detailed . Walk Hyannis and enjoy.ocean views. in Barnstable Village nes.Training
to-
Among the offerings is Toddler Time, information) on a 1 OK jaunt beginning at the Heri- . be volunteer interpreters.Training.is
Center tage House Hotel, 259:Main Street in _ provided. Call All at 508-420 981.0 to
Pre-K Prep, Infant Time,-Down on the. side of. the Canal, Ed Moffit M1SS1ChUSettS Audubon
Farm, American.Red Cross.Babysit- (Cape. Hyannis. Walk sponsored.by the Walk _ sign..on.
ting, Story and Craft Hour, a cooking Drive; across from the Sandwich Society, Wellfleet Bay 'n Mass Volkssport Ch)b. Start times jVISPCA needs help
class and more. Me and My Dad event. Coast Guard Station. Information, ye are daily sunrise to sunset. Informa- The MSPCA is.looking:,for volun-
is held Sept. 29 from.6 to 8 p.m. when 508-..833-9678.) Attractions include V1ljldllfe Sanctuary tion. 5N-.775-7000.
(508-349-2615, Route 6 in.Wellfleet, teers to clean, do laundry;transport.
there will be an obstacle course, ka- a retired 41-foot U.S. Army Corps ) VOLUNTEERS animals, help with special events,
rate demos, crafts;pizza, sundaes and of Engineers' patrol boat,.real time call for a complete schedule of events foster care.for cats and kittens and
more activities. Tickets are $1.5 to $30. radar and camera images of the more. Volunteer orientation is held
For details, call 508-539-8788. Canal, a theater showing continuous- M1SS1CI1U8ettS Audubon Drivers Wanted for
presentations on the Canal history, Society, Long Pasture the first Thursday of the month at
There's a fall fair in the air bookstore, rangers presenting ongo- deliveries the shelter, 1577.Falmouth Road in
The 16th Annual Harvest Festival is ing free programs and more. Open,
Wildiife.Sanctuar. Yarmouth Meals on Wheels Centerville.
held Sept. 30 from 10 a.m. to 4.p.m. Wednesday through Sunday.through, (Cummaguid;508-362-1426). is in serious need of drivers to
ble Count Fairgrounds, Oct. 15.:Ranger- GAL NOTICES
LE
led walks-and%bike
rns LEGAL NOTICES
LEG
to 9
t the Ba
rnstable Y
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- "° COMMONWEALTH OF
�NTY Tq 9
'I P GO V F $ � i COMMONWEALTH OF NOTICE OF.MORTGAGEE'S•SALE OF REAL ESTATE MpgSACHUSETTS
,,. <t t > re v MASSACHUSETTS THE TRIAL COURT
{� xµa LAND COURT By yirtue.and in execution of the Power of Sale contained in a certain mort- PROBATE AND FAMILY COURT
CLAY I l DEPARTMENT OF THE TRIAL gage given by Denise F.Pita and Paul F.Pita to Option One Mortgage'Corporation; DEPARTMENT
COURT dated October 17,2005 and registered with the Barnstable County Registry District of BARNSTABLE DIVISION
the Land Court as Document No.1016603 as noted on,Certificate of Title l r,for
breach
; DOCKET NO.06PI299EPI
H LADIES 6 G� yr; Case No.328478 of which mortgage Option One Mortgage Corporation is the.present holder,for breach
I F r To Marcelo Goniaga and.to all persons of the conditions of said mortgage and for the purpose of foreclosing,the same will be Estate of HANORAH G.DESHON
s WA HANORAH DESHON
E Q Qaaa ,L entitled to,the benefit of the Service- sold at Public Auction aC 12:00 p.m.on.October.24,2006,on the mortgaged premises
�+ ° j members Civil Relief Act:Homecomings located at 76 Nelson Lane,Marstons Mills,Barnstable County,Massachusetts,all and Late of BARNSTABLE(HYANNIS)
rlas �t e' Financial Network,Inc.claiming to be the singular tare premises described in said mortgage, In'the County of BARNSTABLE
*° holder of mortgagecovering'realproperty ' TO.UVL�T: : Date of Death June21,2006
E • _ in.H annis; MA numbered as 43 Sunny The land:together with the buildings thereon shown as LOT:22 on Plan No.12034-D
' r. y NOTICE OF PETITION FOR .
i , µ :.� Knoll Drive given by Marcelo Gongaza to (Sheet 6).
` , i I, "V � ,` WMC Mortgage Corp.by and through its For title reference,see Certificate of Title registered as Document No.984,465 with PROBATE OF WILL
"M Mortgage Certificate of Title No.174,888.
I� nominee Mort a eElectronic
` "'� a Systems,Inc. dated September 30,2005 For mortgagors'title see deed registered with Barnstable County Registry
PLATE1 r a to n� £
`R and recorded with the Barnstable Registry District of the Land Court as Document No.984465,as noted on Certificate of Title No• above captioned To alle tatena petition has been
6 of Deeds in Book 26313 Page 241,and 174888. .
uorting to be t
u.4
now held by Plaintiff.by assignment,has These premises will be sold and conveyed subject to andwith the benefit of presented praying that a document pur-
g filed with said court acomplaintforAuthority all rights,rights of way,restrictions,easem tssacevand all u'npaiden Is rtalxes textitlesaims in the tu re be proved andeallowed,and last will of rthat MARY'
-.v/ptirchase of any ' ,''7 to foreclose said mortgage in the manner of lions,improvements,public assessmen y
�Y-� following:by entry and possession and liens,water and sewer liens.and any other municipal assessments'or liens or existing DESHON of BOSTON in the County of
cValid Every DaY ,.F having priority PP
j n:a. s exercise of power of sale. encumbrances of record which are in force and are applicable,havin no over said SUFFOLK be a oinith executor,named
'r •,. mortgage,whether or not reference to such restrictions,easements, improvements, in the will to serve without surety.
3: s r. If you are entitled to:the benefits of the IF YOU DESIRE TO OBJECT
Pt ( H 7 y liens or encumbrances is made in the deed.
s xr, K <: Servicemembers Civil Relief Act and' ou THERETO,YOU OR YOUR ATTORNEY
' `' x y y TERMS OF SALE:'
vuvwui�rl� ak��ep � pit0� object to such.foreclosure ou or our at
r to eyshouldfileawrittenappearanceand 'A deposit of Ten.Thousand ($10,00000)Dollarsbycertfiedorbankcheck; MUST APPEARANCE
war will be required to be paid by the purchaser at the time and place of sale.,The balance IN SAID COURT AT BARNSTABLE ON.
a answer in said court at Boston on or before
THE
the 61°,day of November2006 oryoumay is to be paid by certified or.bank check at Harmon Law Offices,P.C., 150 California OR BEFORE TEN O'CLOCK.IN M
be forever barred from. that such Street,Newton,Massachusetts 02458,or bymaiL to.P.O.Box 610389,Newton High FORENOON(10:00 AM)ON OCTOBER
CASg.pAyMENT ONLY ;}. foreclosure is invaIWunder said act. lands,Massachusetts 02461 0389,within thirty(30)days from the date r sale. Deed 1T:2006:
CREDIT CARD&DINING CARDS �. r tf�fl, Witness, KARYN F. SCHEIER; Chief will be provided to purchaser for recording upon receipt in full of the.purchase price. Inaddition,youmuhe eawrit-
(ACCEPTED oNTHIS PROMOTION, � ... � Justice of`said Court..this 21st day'of. The'description of the premises contained in said mortgage shall control in the event ten affidavit of objections to the petition,
si as stating specific facts and grounds upon
September 2006. of an error in this publication. which the objection is,based,within thirty
Other terms;if any,to be announced at the sale. (30)daysaftertheretum day.
(orsuchother
# j Sf 1 Deborah J.Patterson
4 OPTION ONE MORTGAGE CORPORATION time as the court;on motion with notice to
r� r►+ r►►� ►� r+
Recorder
Present holder of said mortgage the petitioner,may allow)in accordance
By its Attorneys . with Probate Rule 16.
The Barnstable Patriot HARMON LAW OFFICES,P.C. ` WITNESS, HON. ROBERT
September 29,2006 Zarnzam Syed,Esquire E. TERRY, ESQUIRE, First Justice of
JApANESE.CUISINE. i ��
i 160
02458 September 19,2006. B this A LE s day,
isaki S
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USk 7,BAR (617)558 0500
r WINTER SG iEdUIE
The Bamstable Patriot. FREDERIC P.CLAUSSEN
Register of Probate
C�OSEd"MON�Ay '
5 � .A..� ��� � ��� �� � ,��,��� _� �' �������,�� � September 29,October 6 and O�ctober�l3,2006�
a � "ay . . `�a -
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4 AuThENTic a� ash e 7 ff w x eat: z ': ro September 29,2006
,j JAPANESE C�IEI � � pill d�R
!. 3�9 WEST MRIN ST H AN,NIS (ACROSS IROM C&NTRy GARdEN� l
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TOWN OF BARNSTABLE ZONING
BY-LAW DATED MARCH 14, 1997 Ac�'2 STREET ADDRESS, #76 NELSON LANE, MARSTONS MILLS
5 ASSESSORS' MAP 125 PARCEL 76
ZONE- RF � OWNER, PAUL .PITA
DEED REF.' CTF.#872460
PLAN REF., L.C.C. 12034B LOT 22
I CERTIFY THAT TO THE BEST OF MY PROFESSIONAL
KNOWLEDGE, INFORMATION AND BELIEF THE DWELLING
PROPERTY LINES SHOWN HEREON SHOWN HEREON CONFORMS. TO THE HORIZONTAL SETBACKS-
WERE COMPILED FROM AVAILABLE OF THE ZONING BY-LAW FOR THE TOWN OF BARNSTABLE.
PLANS OF RECORD AND DO NOT
REPRESENT AN ACTUAL SURVEY .
ON THE GROUND. y�tOFM4
' TERRY PLOT PLAN
THE DWELLING DEPICTED ON THIS ANN SHOWING PROPOSED POOL
PLAN WAS LOCATED ON THE GROUND WARNER
BY SURVEY ON MARCH 25, 2005 AND No 3$721 IN
EXISTS AS SHOWN AS OF THE DATE BARNSTABLE, MASS,
OF LOCATION SCALE, 1'=40' MARCH 29, 2005
THIS PLAN IS FOR PLOT PLAN / /(J C�A/ / TERRY A. WARNER, P.L.S PURPOSES ONL Y,
22 LONG ROAD
HARWICH, MA. 02645
(508) 432-8309
THIS PLAN IS VOID IF NOT
STAMPED AND SIGNED IN R£D, 0 20 40 80
PROJECT NO. 05-137PP
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