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Home My WebLink About0007 MORGAN WAY - Health 7 Morgan. Way West Barnstable A= 174-001 - 061 i i .j TOWN OF BARNSTABLE .LOCATION `? � �t2.E� GtJ i SEWAGE# , 6 VILLAGE 0.=;�;b=n(,.1-r&-3L.0 ASSESSOR'S MAP&��PA""RCEL -t ? ` i INSTALLER'S NAME&PHONE NO. 6 e� (_mot - 456 T. 7?1 SEPTIC TANK CAPACITY LEACHING FACILITY:(type)--7-elt-FfC-4$- (size) 3n e NO.OF BEDROOMS _3 -Ica •4c 3s ,�d2a OWNER PERMIT DATE: 1?-/Lf- COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility °'r".`jam Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) r%E— Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 14 6: Feet FURNISHED BY 'et ��.yrsavh S ,I ��6 �� r ►° .� w �� , s � � ,se 0 .z No. [7 '/ C_1 ..—® 41 Fee , oe I / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISIDIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS fiprication for Misposal *pstem Construction i9ermit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No.`? M®( n � 1 i/� Owner's N e,Address,and Tel.No. 7�J, a✓'j 30g7 Assessor's Map/Parcel 17 A _ a to l29 IVo2 Oz Installer's Name,Address,and Tel.No. Desi er's�Name, ddress,and Tel. o. Q�� , P+o10444�°.av�6N' t c91�. , pC� c 70 n �P e , 1 i Zq i &�-'7'71 •9a0 `l bu,�1 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder )Jv(B Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3_�36 gpd Plan Date Q4, Q014 Number of sheets Revision Date A/ A Title I• ►-EC. n 'Elf Size of Septic Tank 110 Type of S.A.S. 5W �'4 (� bf r Description of Soil G Natur of Repairs or Alterations(Answer when applicable) -Q0f' �i -.ad) Chao Con c Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmenta a and t to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt gned Date r�3 Application Approved by Date �J Application Disapproved by Date for the following reasons Permit No. Date Issued y , oy 1) _0 `7I p0 No. Fee • '—'" ' THE COMMONWEALTH OAF MASSACHUSETTS Entered in computer: Yes v PUBLIC HEALTH DIVISION=-fdWN OF`BARNSTABLE; MASSACHUSETTS Z(Pplica.tion for Misposar Isteni (Construction 3permit Application for a Permit to Construct( ) Repair(001upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No._7 H01 i1 VJ Ct W� Owner's Name,Address,and Tel.No. 7� - a 3 " 30g7 Assessor's Map/Parcel 1 r/ A(�(c i _ Q5Q 0(p i G Rd ) Pk UZ Installer's Name Address and Tel.No. Des"iiner's Name' ddress,and Tel. o. , Cc ✓Irv'c icon.IY , PO.&s 70q, IXU)IN Cc�P�plo n i = C,` .11 r M ►s� N i ll 06 61 r �jk•77/ •9,30 6-n vu�h rf (o ?Cn�. Type of Building: Dwelling No.of Bedrooms % Lot Size sq.ft. Garbage Grinder ) 4 *s Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures i Design Flow(min.required) 3?�o gpd Design flow provided �j gpd Plan Date�C)b(U c:;:)q. o V Number of sheets Revision Date AZA TitleTiPe Pbl) 0� 7 064- 3 �. 4si- r�nsr pole Size of-Septic Tank 1 CW Cr_, I�)C) Type of S.A.S. Q 5W GO 14 -,_k C (-.a fs Description of Soil Q Natur of Repairs or Alterations(Answer when applicable) Gtu -CCU .�� ~ vDate last inspected: Agreement: f., The undersigned agrees to ensure the construction and maintenance of the afo e described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmenta 06, e and of to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt gned Date .3 //�/I Application Approved by Date Application Disapproved by Date for the following reasons Permit No. �o t Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(� Upgraded( ) Abandoned( )by BO 10 W GDO 4- AJC,�;W, t�A_oc at /�((y(` ��1A VIA- �C►7 (tyfi� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No ' 1 G� 1 dated Installers �(� � j �f � �. Designer #bedrooms Approved de 'gn ow gpd /The issuance of this p tt sha be onstrued as a guarantee that the system it/fit t• as d, ig d. Date Inspector ,-/ ------------------------------------------------------------------------------------------------- -------------------------` No. V 7 ^ O 7 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS bisposai 6pstem Construction permit Permission is hereby granted to Construct( ) Repair( L,4,1" Upgrade( ) Abandon( ) System located at-7 Mar6ep e'1 nA j P5;(,.. -�-q r- o 4: • =e3 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction mus be-coo7mple ed within three years of the date oft is permit Date `j � , �� Appro d by MAY-02-2014 23:46 From: To:15087906304 Paee:1/1 FROM :down cape engineering inc FAX NO. :15083629880 May. 02 2014 11'35AM P1 J - 01.E I Own Of B '�bomae F, (weilet�,Oil e,c90)' 3 Public Remith Divisiotn o � 'Illouau,xxte B,Director U�ice: 509462,454n Fax: 50 R•.79 0•63 a4 Cmsa :nlAi:>r A,Dni tilt altaon F a.a7 0 r b A4, Ad � • o. p lay -- all� A40 eA- tm It �,lpu, s i-%=d,a l exuo-ft to instal a ddt lnvf� (.l�L9t�Iler) R t1C glf;IIl�t r L w based on 3 i�Evi�7.i]zSlvD.by " �1J Q Y�'(•�' � r' �1.,I��,f,� f�FlteCj.-.. _. � .. .—� (dig ) _ 'f lnextify Alit le suptia vgtmn rcfnxnced ihQ-vc"W-119 ing%-1,ecl �stQn:I�ally ocac�rtli [u iry iwdlltie I:Oi:ridr 1pploverl Gbatt�eq srucll f>� lafr+1a3.i elor..atioo.of the IF desiP,which m di:,�i.•buti.ou box sadlox 9P-Pdr.tituk- T oertify that tbc: sephe. yystPm.retzr�:au.eri �ihcivr, ; $ insl�.i�.et3 wTlh Ltaejor t;tlall es eatGa t31fln I,0° laiEra],iGlac>�k%d:t cif iT>% SA oz iauy ver .c: 1,r�kj()ca iuu any ca'm.�x7ztt'.itt , LUC�1�E� �A117S_ Plan xgvi�iQD IC Of the BP wPaC h R G�•'tifted�••�inilt b ciPsi�l'i�to folinwr. • ��'� f1MMILL,�. G�� 1 Oli••A i p„Y, nun) . F777}es;gx,.sr's�farilA�.T�re) {D�,si�rrces'a�i xr • i.��'� iT, l]Vif,T., � �.1i47 ElNd;�l,►tf.DT.Ff.T�d::{Y_:{Y� ��TD�71� �N1't �st.�}S[I�;�rT C:�9.F��? �, RTTIC SPREE BRTHROOM 42 BRTHROOM tt3 ODOR BEDROOM tt3 DOOR HRLLWRY DOOR CLOTHES CLOSET RTTIC SPREE DOOR ODOR ODOR BEDROOM u3 CHIMNEY STRIRS 2N FLR , BEDROOM u2 RTTIC SPREE 7 MORGRN WRY, 2NO FLOOR ( FRONT ) NOTE: DRRWING NOT TO SCRLE DRRWING PROVIDED TO BORTOLOTTI CONSTRUCTION, SEPTIC FIELD INSTRLLRTION = TOHN MRCCINI, WENDY KEEMRN 9/ 101201Li DOOR SON ROOM DOOR t DOOR DOOR ` BRTHROOM R1 Uj I DINNING ROOM KITCHEN DOOR HRLLWRY HRLLWRY f DOOR 2 CRR GRRRGE DOOR T❑ BRSEMENT CHIMNEY - UNFINISHED I LIVING ROOM FRMILY ROOM n STRIRS 2NO FLR DOOR DOOR DOOR ENTRRNCE r DOOR 7 MORGRN WRY, WEST BRRNSTRBLE : IST FLOOR ( FRONT ) John Maccini 5 Highland Rd i Wellesley,MA 02482 } I down cape engineering, inc. SIEVE SOILS ANALYSIS 7 MORGAN WAY W. BARNSTABLE, MA DATE OF REPORT: 2/27/14 JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 7 MORGAN WAY WEST BARNSTABLE, MA LOCATION: DCE TEST HOLE SIEVE ANALYSIS Weight g t Sample(Grams): 154.8 SIZE :WEIGHT RETAINED € % RETAINED % PASSED (sum € -------------- ........................ ..........................---------------------:..................................... 1" 0.0€ 0.0%€ 100.0% 3/4" ..............................................�:0.€-------------- - 0---w---------100_0% 1/2" 0.0€ 0.0%€ 100.0% --------------......................................................>---------------------„------------------ 3/8" ..............................�:�.--------------0 0%=---------100_0% #4 € 0.0� 0.0% ..................100.0% --------------......................................................>--------------------4. #10 `......................................................-------------10 5%!......................89:5% #20 i..........................................50.... ----------32 4%�.....................67:6%.. #40 96.1 ___-------__62_1% 37.9% ......... -------------:....................................................._ #50 i.......................................ww. .4..... ------------74_1% ......................25:9% #80--------' ............................................... . -------------89---- %w....................10:1% #100 1....................................... .44..... -----------93.5%----------- 6=5% #200 151:1 _ 97.6% ----------- 2=4% PAN: ------------------153_1+----------- 100.0% ----------- 0=0% SAMPLE: € 154.8 NOTE:TEST ON PASSING #4 ONLY, 12.9% RETAINED ON#4 <45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-1-b (GRAVEL&SAND) (UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK #100 0%-20% OK #200 0%-5% OK SAMPLE MEETS TITLE 5 FILL SPECIFICATION >97%SAND RESULTS: PERMEABLE MATERIAL-CLASS 1 <2 MINJIN. MATERIAL �W OFbq s y NONCOMPACTED �� DANIELA. �N SOIL DESCRIPTION: MEDIUM SAND 0 OJA� CIVIL Cn No.�4-502 � 0 A�`,G TOWN OF B",NSTA.EL.E LOCATION ' vr W Ct SEWAGE VILLAGE (�", r-I A S AL /e �.. ASSESSOR'S FLAP&LOT INSTALPR'S NAME&PRONE NO. SEP11C TANK CAPACITY AiZ LFA.CI.iING T'ACILI'I'Y: (4p) � _ . _.....�. . (size) /0 Z' NO.OF'BEDROOMS.,....,.3 BUILDER OR OWNER. PiERMITDATE:_,_, . COMT DANCE DAZE: Separation Distance Between the: Maximum Adjusted,Groundwater Table to the Bottom of Leaching Facility Eee Private Water Supply Well and Leaching Facility (f any wells exist on,She or within 200 feet of leaching faccitity) _ Feei Edge of Wedand and Leaching Facility(if any.weil ds exist within 300 feet o Icasl►ing,facility) �CeI FuWshed by ci w� /(,�� 6",; - Q�� . , �� ._. ��-� k �- ; . ;.. a ;� �� !� � o D �� O C � ., C's .�� _, ,� —E —ay- ` . �� as ,� �► .a, . _ _ ... _. 13 'own of Barnstable PO Department of Regulatory.Services Public Health Division Date d 200 Main Street,Hyannis MA 02601 Date Scheduled !! r, � o - Time Fee Pd, V Soil Suitability .Assessment for ,fie � el Performed-By:�a h V 0 1,cGL ue Witnessed By: 19 / - l LOCATION& GENERAL INFORMATION Location Addregs 7 'Owners Name a--CGI nv • vV /��'r��/� Address ''` Assessor's Map/Parcel: /,/,1��) !o Engineer's Name CW 0 tnlw NEW CONSTRUCTION J REPAIR Telephone# 0 6 C S- Land Use: L ✓ Slopes P ( ) Surface Stoues / �h Distances from: Open Water Body R possible Wet Area >� $ Drinking Water Well W��ft Drainage Way �O ft Property P ttY Une 0 ft Other Ft SMCTCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands•In proximity to holes) 70,3 Un s Z `"e`.' /30. Parent material(geologic) " `GC,a I +i Depth to Bedmclt / Depth to Groundwater. Standing Water in Hole: Weeping fl"om Pit Ppee 'N1A y Estimated Seasonal High Groundwater /'/A DE'I'ERMWATION FOR SEASONAL,LUGH WATER TABLE Method Used: NG kA/ E_ Depth Observed standing in obs.hole: In, Depth to sell mottles: ht, Depth to weeping from side of obs,hole: In, Groundwater Adjustment fI. Index Well# Reading Date: Index Well loyal Adj.Actor..,.,._.r.r. Adj,CIrowidwaterLeval, , PERCOLATION TEST Baia ZL?I_ Time/0!0(/ Observation r Hole# t Tinto at 9" Depth of Perc t PV Time at 6" Start Pre-soak Time @ — --_ — Tima(9"-G") End Prc-soak Rate Min./lach l Site Suitability Assessment: Sitc Passed V Sitp Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back--------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable ConseVvation Division at least one(1)week prior to beginuiug, Q:\SEPTIC\PERCFORM.DOC "A— DEEP-OBSERVATION HOLE,LOG Hole# Depth from Soil Horizon Soil Texture .Sdil Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, o i ten w.%'Gravel) - � � • •L S I l Gyp�/�- • - to L S ' !C yR 74; D + ,P OBSERVATION HOLE LOG Hole# Depth from 5oi1 Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. - a sis en %Grave 10, (0 -3-�f c l L 5' y R 4/ t_a�Aar-f-- �y- rye c2 tirS ' fOYR �/� l ]DEEP OBSERVATION HOLE LOG hole#. _ Depth from Soil Horizon Sall Texture Soil Color Soil Other' Surface(in.) (USDA) (Munsell) Mottling (Structure,Stories,Boulders. ' Co i tc c G c ]DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders, Co si tan ' I Flood Insurance Rate Map: I Above 500 year flood boundary No� Yes Within 500ycarboundary No U%, Yes Within 100 year flood boundary No. '. Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occui-ring pervious material exist in all areas obstrved throughout the area proposed for the soil absorption system? �/2 If not,what is the depth of naturally occurring pervious matorial7 Certification //L I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with. . the required training,expertise and experience described in�10 CUR 15.017. Signature s ,/1 Date �-�Z IN Q:1S.BPT1aPE1ZCP0RM.'D0C D' r,t : .: m nj a OFFICIAL ,w; ., CO Postage $ r1J a o Certified Fee �� (� mark Retum Receipt Fee �P O H(En ere dorsement Required) 7 r3 p Restricted Delivery Fee . O (Endorsement Required) �� r-1 C3 Total Postage&Fees fL _ o John A & Wendy J Keeman\ 5 Highland Road Wellesley, MA 02482 Certified Mail Provides: e A mailing receipt n A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: a Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to prdvidevgroof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiec0-Retum Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail r?ceipt is required. 4.,' a For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". j o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 o Complete items 1,2,and 3.Also complete n t s:.s ❑Agent item 4 if Restricted Delivery is desired. g 17 Print your name and address on the reverse ❑Addressee so that we can return the card to you. by(Printe Da of Delivery o Attach this card to the back of the mailpiece, ,L or on the front if space permits. D. If very a s �e 1? V les 1. Article Addressed to: c If en t r31 e' dres flow: al o) � y FJOn..A &'Wendy J Keemanl 15 Highland Road 3. Service Type Wellesley,>:MA 02482 ❑Certified Mail ❑`Cxpress Mail ❑Registered ❑Return Receipt for Merchandise ❑.Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Feel ❑Yes 2. Article Number J 7012~1010 0000 2851 2033(Transfer from service label) 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS I Permit No.G-10 Sender:'Please print your name, address, and ZIP+4 in this box • Town of Barnstable Public HealthPvision 200 Main Street Hyannis, MA 02601 Intl� liti,,,�J►„ji►11,��t�;,,tllii � l,i�t1 „�tipji,�.�l�,.,�r- , I L Barnstable Town of Barnstable Regulatory Services DepartmentHARNSTABM Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 1890 January 27, 2014 John A& Wendy J Keeman 5 Highland Road Wellesley, MA 02482 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Morgan Way, West Barnstable MA was last inspected on April 5, 2010, by Shawn McElroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF E B ARD OF HEALTH T o s ean, S. CHO • Agent of the Board of Health - __ _ i j . � �� v Town of Barnstable Barnstable 0 , Regulatory Services Department P sn�xsrnst�, Public D sb3�. ., Pu b c Health Division . Dp 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7012 1010 0000 2851 1890 January 23, 2014 John A& Wendy J Keeman 5 Highland Road Wellesley, MA 02482 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Morgan Way, West Barnstable MA was last inspected on April 5, 2010, by Shawn McElroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH • Thomas McKean, R.S., CHO Agent of the Board of Health Parcel Detail http://issgl2/intranet/propdata/ParceiDetail.aspx?ID=12152 � .a. Logged In As: Parcel Detail Tuesday, January 21 2014 Parcel Lookup Parcel Info Parcel F174-001-061 _____ — -- __ -- Developer LOT 153 IDI Location L7 MORGAN WAY ( Pri Frontage Sect__ Sec --- __—_.. ._.. Road Frontage �.—__..—.____..�.,.____� ire Village;WEST BARNSTABLE �W TABLE District -- Town sewer exists at this Road address{No Index2051 � Asbuilt Septic Scan: w Interactive 174001061_1 Map �.� i . 174001061_2 ' k, o Owner Info Owner!MACCINI, JOHN A&KEEMAN,WENDY J �� Co- Owner 1 i Streetl`5 HIGHLAND ROAD 1 Street2 City WELLESLEY — —) State IMA Zip 102482 Country Land Info Acres i0.41 Use!Single Fam MDL-01 Zoning�RF Nghbd j0106 Topography jAbove Street I Road Paved Utilities li eptic,Gas,Public Water Location�� I Construction Info Building 1 of 1 Year, 993- I Roof IGable/Hip Ext I d Shingle i Built` Struct Wall Living r1942 — �) Roof pAsph/F GIs/Cmp AC(None ''^` pp Area�_ CoInt TB yy ed r__._..____. �Y __ _. _ Style(Cape Cod Drywall J3 Bedrooms 1 to Wall Rooms _ w _ �. b • Int _.__,._._ ,__,._.___,.. Bath I -- Model Residential Carpet 13 Full s rps , 7 up'r Floor Rooms` " cis Grade jAverage ) Heat��Hot Water Total 8� — � w t Type Rooms' _ ___._ Heat, _. Found- Stories 11 3/4 Stories Fuel lGas �___ _ ation Poured Conc. Gross http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=12152 1/21/2014 i 'TKETown ®f Barnstable Barnstable ti _ ° Regulatory Services Department U-M m;caC y +' BARNSCABLE, cb69. Public Health Division' Ar fd��k�, _ 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO 1/6/2014 John A. Maccini and Wendy J. Keeman 5 Highland Rd.. Wellesley, MA 02482 FINAL ORDER ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Morgan Way, West Barnstable, MA was last inspected on April 5, 2010, by Shawn McElroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: o Backup of sewage into facility or system component due to an overload or clogged SAS • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. The deadline for repair has passed. We, The Public Health Division Health, have not been informed that you have taken any steps to bring your failed system into compliance. Therefore, you are ordered to repair or replace the septic system within 60 days from the date you receive this notification. - You may request a hearing before the Board of Health, a written petition requesting a I hearing on the matter, within seven (7) days after the day this order was received. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH _ - 1 s McKean, R.S., CHO Agent of the Board of Health i co a CD a co Postage $ 1 ru f Certified Fee c- C3 T. Un 0 Retum Receipt Fee ce k O (Endorsement Required) re Restricted Delivery Fee !!!� �CVVA (Endorsement Required) O Total Postage&Fees a ru Sent To a �vhn m4l,CCi ----------------- --------------------------------------,-�------�( ----- NStreet Apt.No,* 1� or PO Box No. City State.ZIP+4 e- ( e rM f- 0 Z,4< Certified Mail Provides: w .. e A mailing receipt o A unique identifier for your mailpiece n A record of delivery kept by the Postal Service for two years Important Reminders. r e Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail.. For valuables,please consider Insured or Registered Mail. e For an additional,fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. e For an additional fee, delivery may be restricted to the addressee or j addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". e If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT. Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 • • • • • Complete items 1,2,and 3.Also complete A. tur item 4 if Restricted Delivery is desired. X ❑Agent o Print your name and address on the reverse ❑Addressee so that we can return the card to you.y B. >��(�y,(Printed Name) C. Date of Delivery o Attach.this card to the back of the mailpiece, or on the front if space permits. Dht'(delivery address dl Brent from item 1� ❑Yes 1 Article Addressed to: �{Y�Nnte e e a dress below- ❑No f -- �evl4 n; ,)ohr% MC-CC,r�, and 3h(Q ea . USPS 3. Service Type *Certified Mail ❑Express Mail ❑ Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number',i t t( ��i�t 1 t i .70 a* 12 1 11 t'"..}� �0 +j } �, ,; 183,8� l ICPn (Transfer from service fabeQ 0`� '� 2 8 51 ` LS Form 3811.February 2004, Domestic Return.Receipt 102595-02-M-154o; UNITED START r OST.SERVICE First-Class Mail Postage&:Fees Paid €ry USPS Permit No,&10 • Sqpder: [ease print/your name, address, and ZIP+4 in this box' C4 of Barnstable l pQ"'HND� �HealfhDivision : 200 Maim Sheet Hyannis; MA 02601 I - t�r Town of Barnstable Barnstable Regulatory Services Department A°'e`caC 1 BARN8TABC - " . ,m� Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO 12/30/13 John A. Maccini and Wendy J. Keeman 5 Highland Rd. Wellesley, MA 02482 FINAL ORDER ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Morgan Way, West Barnstable,MA was last inspected on April 5, 2010,by Shawn McElroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overload or clogged SAS • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. The deadline for repair has passed. We, The Department of the Board of Health, have not been informed that you have taken any steps to bring your failed system into compliance. Therefore, you are ordered to repair or replace the septic system within 60 days from the date you receive this notification. You may request a hearing before the Board of Health, a written petition requesting a hearing on the matter, within seven (7) days after the day this order was received. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health f I I 1 11 Barnstable oFWE Town of Barnstable All4ka° Regulatory Services Department , ca Ny OA RNwAsm 9� "i439' �' Public Health Division s A I 200 Main Street, Hyannis MA 02601 2007 s Office: 508-862-4644 Thomas F.Geyer,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 70081830000205009403 4/15/2010 Today Real Estate c/o David Holt 1533 Falmouth Road Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 7 Morgan Way, West Barnstable MA was last inspected on April 5, 2010, by Shawn McElroy, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component due to an overloaded or clogged SAS. • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within Sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Th mas McKean, R.S., CHO Agent of the Board of Health Official Website of The Town of Barnstable - Property Lookup Page 1 of 3 Assessing Division Property Lookup Results - 2013 367 Main Street,Hyannis,MA.02601 <<BACK TO SEARCH<< ry E �Print Friendly Owner Information-Map/Block/Lot: 174 1 001/061 -Use Code:1010 ........ ...... ............ Owner Owner Name as of 1/1/12 MACCINI,JOHN A&KEEMAN,WENDY J Map/Block/Lot GIS MAPS 5 HIGHLAND ROAD 174/001/061 WELLESLEY,MA.02482 property Address Co-Owner Name 7 MORGAN WAY Village:West Barnstable Town Sewer At Address:No GIs Zoning Value:RF ....---. - .......__ ......... .._...._ ....... .......... Assessed Values 2013-Map/Block/Lot:174/0011 061 -Use Code:1010 .... — - ----- 2013 Appraised Value 2013 Assessed Value Past Comparisons Building Value: $161,100 $161.100 Year Total Assessed Value Extra Features: $38,000 $38.000 2012-$379,200 Outbuildings: $3,500 $3,500 2011-$379,900 Land Value: $139.600 $139,600 2010-$374,100 2009-$388.900 2008-$419,600 2013 Totals $342,200 $342,200 2007-$485,900 ...... Tax Information 2013-Map/Block/Lot:174/0011 061 -Use Code:1010 Taxes W.Barnstable FD Tax(Residential)$975.27 Community Preservation Act Tax $89.93 Fiscal Year 2013 TAX RATES HERE Town Tax(Residential) $2,997.67 $4,062.87 Sales History-Map/Block/Lot:174/001/061 -Use Code:1010 History: Owner: Sale Date Book/Page: Sale Price: MACCINI,JOHN A&KEEMAN,WENDY J7/28/2010 24712/98 $315000 US BANK NA TRS 6/4/2010 24596/322 $380000 FLAHERTY,THOMAS R SR&DONNA M 9/15/2005 20263/024 $495000 HAXTON,ROBERT D 8/15/2005 20154/176 $0 HAXTON,ROBERT D&JANET 10/15/1994 9412/039 $100 HAXTON,ROBERT D&JANET TR 4/15/1994 9163/026 $100 HAXTON,ROBERT D&JANET M 7/15/1993 8679/309 $179500 DACEY,BRIAN T TR 11/15/1992 8315/152 $929575 NWE,INC 11/15/1990 7344/183 $1100000 SOLLOWS,JEFFREY A TRS 1/15/1989 6612/324 $1 . ......... ... -_..._ _. _._..-...__.. ......_ Photos 174/001/061 -Use Code:1010 t' Sketches-Map/Block/Lot: 174/001/061 -Use Code:1010 ......_.. ........ ..I........ .........................................._........... ...................... Constructions Details Map/Block/Lot: 174/0011 061 Use Code: 1010 Building Details Land Building value $161,100 Bedrooms 3 Bedrooms USE CODE 1010 Replacement Cost $177,041 Bathrooms 3 Full Lot Size(Acres) 0.41 Model Residential Total Rooms 8 Appraised Value $139,600 Style Cape Cod Heat Fuel Gas Assessed Value $139,600 Grade Average Heat Type Hot Water Year Built 1993 AC Type None Effective depreciation 9 Interior Floors CarpetHardwood Stories Interior Walls Drywall http://www.town.bamstable.ma.us/Assessing/propertydisplayscreen 13.asp?ap=0&searchp... 12/3 0/2013 Official Website of The Town of Barnstable - Property Lookup Page 2 of 3 S Aa8 Ti �f`a f�� Z i, AS Built Cards:Click card#to view:Card#1 1 Card#21 Living Area sq/ft 1,942 Exterior Walls TWood Shingle Gross Area sq/ft 4,284 Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp -- ._ ..... .......... Outbuildings&Extra Features-Map/Block/Lot:174/001/061 -Use Code:1010 ....... _._- _....._._. .......... ......... ......_... Code Description Units/SQ ft Appraised Value Assessed Value GAR Attached Garage 528 $13,100 $13,100 BMT Basement-Unfinished 954 $20,700 $20,700 WDCK: Wood Decking 170 $3,500 $3.500 w/railings FPL2 Fireplace 1.5 stories 1 $4,200 $4,200 ......... Sketch Legend Property Sketch Legend 82N Bam-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished)FUS Second Story Living Area SPE Pool Enclosure (Finished) BRN Bam GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) _ FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Q Print Friendly Contact Director of Assessing Jeffrey Rudziak P 508-862-4022 iF 508-862-4722 8:30a.m.to 4:30p.m. Helpful Links to Downloads Abatements FY 2013 SALES LISTINGS Barnstable FD Residential C.O.M.M FD Residential http://www.town.bamstable.ma.us/Assessing/propertydisplayscreen 13.asp?ap=0&searchp... 12/30/2013 d COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A , CERTIFICATION Property Address: 7 Morgan Way W. Barnstable Owner's Name: Robert Haxton u> rQ Owner's Address: Date of Inspection: y Name of inspector:(please print) Wi 1 1 i am E_ .Rob nson Sr. --» M Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1089 Centerville, MA Telephone Number: t5081 775-8776 2 _ Q CERTIFICATION STATEMENT �O U 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 15340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails J Inspector's Signature: � Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Healthvr DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of I0;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. 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 S Inspection Form 6/15/2000 page 1 l C Page 2 of I 1 " OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:_ 7 Morgan Way W. Barnstable Owner. Robert Haxton Date of Inspections Inspection S mmary: Check A,B,C,D or E/ALWAYS complete all of Section D A. Syst 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: B. System Conditi ally Passes: One or more sy tern components as described in the"Conditional Pass"section need to be replaced or repaired.The system,u on completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not de ermined(Y,N,ND)in the for the following statements.if"not determined"please explain. The septic tank is etal and over 20 years old"or the septic tank(whether metal or not)is structurally unsound,exhibits subs tial 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 wi 1 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: Observatio of sewage backup or break out or high static water level in the distribution box due to-broken or _ obstructed pipes -due to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Bo 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 obstn-Kted pipe(s).The system will pass inspection if ith approval of the Board of Health): broken pipe(s)are replaced obstruction is n=vcd ND explain: J Page 3 of I 1 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:__ 7 Morgan Way W. Barnstable Owner: Haxton_ Date of Inspection: . .--/il C Furthe Evaluation is Required by the Board of Health: Condi 'ons exist which require further evaluation by the Board of Health in order to determine if the system is failing to pr tect public health,safety or the environment. I. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system s not functioning in a manner which will protect public health,safety and the environment: — Ces pool or privy is within 50 feet of a surface water _ Ces pool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System ill fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is fu ctioning in a manner that protects the public health,safety and environment: _ Th system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface . ater supply or tributary to a surface water supply. e system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. he 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 front a pr vate water supply well'• Method used to determine distance 'This system passes if the well water analysis,performed at a DEP certified laboratory,for c.oliform acteria and volatile organic compounds indicates that the well is free from pollution from that facility and - e presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other f ilure criteria are triggered.A copy of the analysis must be attached to this form. 3. O her: 3 Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 7 Morgan Way W. Barnstable Owner: Robert Paxton Date of Inspection: t D. System F 'lure Criteria applicable to all systems: You must indic te'yes"_or"no"to each of the following for all inspections: Yes No Bac p of sewage into facility or system component due to overloaded or clogged SAS or cesspool Disc h ge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogg d'SAS or cesspool _ Static liquid level in the distribution box above.outlet invert due to an overloaded or clogged SAS or cessp of Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow Requir d pumping more than 4 times in the last year NOT due to clogged or obswcted.pipe(s).Number Ztin s pumped y p rtion of the SAS,cesspool or privy is below high ground water elevation. Any p rtion of cesspool or privy is within 100.feet of a surface water supply or tributary to a surface Ovate supply. Any onion of.a cesspool or privy is within a Zone I of a public well. — Any ortion of a cesspool or privy is within 50 feet of a private water supply well. Any onion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private Kaser su ly well with no acceptable water quality analysis.IThis system passes if the well water analysis, P g. P e formed at a DEP certified laborato ry.,for coliform bacteria and volatile organic compounds i icates that the well is free.from pollution from that facility and the presence of ammonia rtrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria re triggered.A copy of the analysis must be attached to this form.] . ( es/No)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: - T be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 gPd- ou must indicate either"yes"or"no"to each of the following: ( to following criteria apply to large systems in addition to the criteria above) y s 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 ou have answered"yes"to any question in Section E the system is considered a significant threat,or answered "} s"in Section D above the large system has fruled.The owner or operator of any large system considered a s' nificant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 5.304.The system owner should contact the appropriate regional office of the Department. 4 Page S of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 7 Morgan Way W. Barnstable Owner: Robert Haxton Date of Inspection: G 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? v Were all system components,excluding the SAS,located on site? v— Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baff les or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? `7/ 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 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(3)(b)j 5 Page 6 of 11 ~ OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 7 Morgan Way W. Barnstable Owner: Robert Haxton l ' Date of Inspection: '� G fGS ;FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):. 3 Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 1.10 gpd x#1 of bedrooms): 3 C G Number of current residents: Does residence have a garbage der(yes or no)j 6 Is laundry on a separate sewage system(yes or no):p [if yes separate inspection required] Laundry system inspected(yes or no): ' Seasonal use:(yes or no): iG 4 Water meter readings,if available(last 2 years usage(gpd)): 2004 — 50, 000 Sump pump(yes or no)- 2003. — =00 Last date of occupancy:27 COMMERC/ing DUST L Type of establ : Design flow( 31 CMIt 15.203): gpd Basis of desigs is/persons/sgft,etc.): Grease trap pr s or no):_ Industrial wasng tank present(yes or no):Non-sanitary scharged to the Title 5 system(yes or no): Water meter r ,if available: Last date of oy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped asp f the inspection(yes or no): !J If yes,volume pumped:_gallons—How was quantity pumped determined? Reason for pumping: _ TYP F 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 corlt�ngtlts�date installed(if known)vyd source of information: Were sewage odors detected when arriving at the site(yes or no): G 6 ]'age 7 of I I OFFICIAL INSPECTION FOI1M—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:_7 Morgan Way W. Barnstable Owner: Robert Haxton Date of Inspection: f BUILDING SEWER(Iota n site pl'.art) Depth below grade: � Materials of construct• n:_cast iron _40 PVC_other(explau,): Distance front priv a water supply well or suction lute: Comments(on c idition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: 1/(Iocatc on site plan) Depth below grade: A_ Material of construction:_concrete metal fiberglass polyethylene _odur(cxplain) — If rank is metal list age:_ Is certificate) v ► age confrttted•by a Certificate of Compliance(yes or no):—(attach a copy of ✓� Dimensions: L Sludge depth: Distance from top of sludge to bottom of outlet Ice or battle: _ Scunt thickness: 0_3 Distance front top of scum to top of outlet Ice or baffle: Distance from bottom of stun,to bottom of outlet tee or baffle--�C:�C flow were dimensions JctcnnincJ: e-�c� -r-6, 2 VL,3 Comments(on pumping recommendations, inlet and outlet ice or barite conditi(m,structwal integrity,liquid levels as related to outlet invert,evidence o f Ieaka e,ete.):, �w � GREASE TRAP:_(locate on site plan) — Depth below grade:_ Material of eonstructio ._concrete metal fiberglass_ltolyclhylcnc _other (explain): — _ Dimensions: Scum thickness: Distance front op of scum to 101)of outlet tee or baffle: Distance fr t bottom of scum to bouorat of outlet tee or battle: Date of I I pumping: Conlin nts(on pumping recommendations,inlet and outlet ice or battle cunditio:,,structural integrity, liquid levels as related to outlet invert,evidence of Icakage,etc): 7 v 'age g of 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOI01 PART C . SYSTEM INFORA'IATION(continued) Property Address: 7 Morgan Way W. arns a e Owner: Robert Haxton Dole or lospectloo: TICIIT or 110LULNG TAN- (lank must be plumped at time of ins pection)(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene other(explaur): Dimensions: Capacity: allons i Design Flororno): gallons/day Alann presAlarm leveorking order(yes or no): Date of lasCommentsd float switches,etc.): DISTRIBUTION BOX:Zorprescm must be opcncd)(locate on site plan) ) Depth of liquid level above outlet invert: . Conunerrts(note if box is level and distributio, to outlets equal,any evidence of solids cary'over,any evidence of - leakag into or out of box,etc.): PUMP CHAMBER: ocate on site plan) Pumps in work-ing or r(yes or no):Alums in work-in rdcr(ycs or no):— Conuncnts(no condition of pump chamber,cundition of pumps and appurtenances,etc.): 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: 7 Morgan Way W. Barnstable Owner: Robert Haxton Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): �V(locate on site plan,ezcavation*not required) If SAS not located explain why: T�pelea I Ching 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.): IV CESSPOO/,notecondition ( esspool must be pumped as part of inspection)(locate on site plan) Number an ation: _ Depth—top to inlet invert: Depth of sor. Depth of scr: Dimensionspool: Materials oction: Indication odwater inflow(yes or no): Commentsndition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (locate on ite plan) Materials of construc�on: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 7 Morgan Way W. arns a e Owner; Robert Haxton Date of Inspection: — . 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. V o 10 } Pave l l of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 7 Morgan Way W. Barnstable Owner: RobertHaxttoo_n i Date.of Inspection: 1•-/�—6 s SITE EXAM Slope Surface water Check cellar. Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting propertylobservation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how ou established the high round water elevation: 11 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 475-10 every page. CitylTown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Eval ation by the Local Approving Authority 4-6-10 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. 7 morgan barnstable•03/08 Title 5 Official Inspection Pone:Subsurface Sewage Disp at System•Page 1 of 15 � ' r n Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r �M 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 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: 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 7 morgan barnstable-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 ` 4 ; Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 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)(4)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 fleet 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. 7 morgan barnstable•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments ,M 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 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: k ° D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ID El clogged 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 ® El or liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than.6n below invert or available volume is less than '/ day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or 'obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. An portion of cesspool or privy is within 100 feet of a surface water supply or P P❑ ® YP Y PPY tributary to a surface water supply. 7 morgan barnstable•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 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. ❑ ® 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 CM 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. l 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. ` 7 morgan barnstable-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 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? Was the facility owner(and occupants if different from owner) provided with ® ` El 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 CM 15.302(5)] 7 morgan barnstable•03/08 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 every page. City/Town State Zip Code Date of Inspection 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 agarbage 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 (last 2 years usage (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: 2-10 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 hoidingtank 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): 7 morgan barnstable-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts ' W Title 5 Official Inspection.. Form Subsurface Sewage Disposal System Form -Not for Voluntary'Assessments 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real'Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: N/A 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): Approximate age of all components, date installed (if known) and source of information: 1991 Were sewage odors detected when arriving at the site? ❑ Yes ® No 7 morgan barnstable-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 20 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: p pp y feet Comments(on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank(locate on site plan): Depth below grade: 14"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 , --------------------------------------------------------------------------------------------------------------------------1000 gal Dimensions: Sludge depth: 12 Distance.from top of sludge to, bottom of outlet tee or baffle 20" Scum thickness 2" 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 14" How were dimensions determined? Tape 7 morgan barnstable-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts N r Title 5 Official Inspection, Form Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable - MA 02668 4-5-10 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.): Tank is in good condition with baffles installed. Grease Trap (locate on site plan): 3 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: D ate- Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): i 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): 9 7 morgan bunstable-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is W required for Barnstable MA 02668 4-5-10 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 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box in good condition with water at working level. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No I 7 morgan barnstable•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4�M 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 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.): of required): Soil Absorption System SAS locate on site Ian, excavation n P Y (SAS) P If SAS not located, explain why: Type: . ® leaching pits number: 1-1000 gal ❑ 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 pondin damp p soil, condition of vegetation, etc.): Leach pit has clear signs of hydrolic failure with stain line at inlet invert. 7 morgan barnstable•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 r Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 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.): 7 morgan barnstable•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forth -Not for Voluntary Assessments _ ,M 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate-1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 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. y a l: a F. as' 7 morgan barnstable-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 14 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 7 Morgan Way Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for W. Barnstable MA 02668 4-5-10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells i Estimated depth to high ground water: 20'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: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database - explain: You must describe how you established the high ground water elevation: USGS maps show groundwater at greater than 20'. 7 morgan bamstable•03/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 -� � TOWN OF BARNSTABLE } LOCATION L(q+ � 15,i5 vol SEWAGE # VILILAq' ,4E tVV4 611�05�01 ASSESSOR'S MAP & LOT f INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY 006) pq LEACHING FACILITY:(type) LC'�t(,� Q� (size) 1+0®y 141to1l NO. OF BEDROOMS 3 PRIVATE UBLIC iiWELL O P WATER BUILDER OR OWNER 5AJ5�� N fj%a ,g CO, �771 Ocb T— n DATE PERMIT ISSUED: 7 V l l'T f DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1 � 1 l` 1 I LA � 153 I ry bo C. o� N �No.. ._. . .. W /............�3�........ THE COMMONWEALTH OF MASSACHUSETTS 6 3 BOARD OF HEALTH ..............1.. ....:.....oF........ 3 �C Appliratiun for Utsp ial Works Ton.itrur#inn 11Pruti# Application is hereby made for a Permit to Construct ) 'or Repair ( ) an Individual Sewage Disposal System at: .............. -_..-__ Cf', 153 _ v hut.. . - .. ...... -..:................ .. Lo.atipi ..... ud� 4 ...... ..................-....... r Address, a .....--••---•---......--•-------- Installer Address Type of Building Size Lot....... .9.!�j.....Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder p4 Other—Type of Building ............................ No. of persons............................. Showers ( ) — Cafeteria ( ) QOther fixtures ....................................: W Design Flow.............I._l..0............ .. gallons per PI Fr �ay. Total dail flQw.........� ................... IIon�s� WSeptic Tank—Liquid capacity...gallons Length._�.b..... Width:... ..J.Q. Diameter................ Depth...Vf------� x Disposal Trench—No..................... Width.................... Total Length......•.....__..._. Total leaching area.__.......__... sq. ft. Seepage Pit No....... . Diameter .. Depth below inlet..S:-.Y...... Total leaching area. Z 3 P� �------------ •- - P g -• ��....sq. ft. Z Other Distribution box (�4) Dosing tank ( ) '~ Percolation Test Results Performed by...... rlZ:...`JiTL![!- ---- --------------------------- Date.....151.�1. .�_ ? .......... . Test Pit No. 1__._ _..minutes per inch Depth of Test Pit_.. .`{.. Depth to ground water...l..�./�. f=, Test Pit No. 2................minutes per inch Depth of Test Pit..... ._... Depth to ground water...)....(................... w P r_ . ... .. .._ 0 Description of Soil.....--- ...... .........................................•--...--•---•---...----•-------..................--•--•--..............----......... W UNature of Repairs or Alterations—Answer when applicable................................................................................................ Agreement: The undersigned agrees to install the aforedescribed ,Individual Sewage Disposal System in accordance with the provisions of LITL U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been iss d by the board of health. Signe .... • ..... ..... .. .. •..............-.............................. .................. e �y ApplicationApproved By-•-••-••--•............. •-• . ............ ......... '........ ...........---••_ 'l..�. Date Application Disapproved for the following reasons:......................................................... ................................................. ---•-•---•---•.......................•----....--••-•-•------•--------•--------..................•..........------•---•-------------•---•-------•-••----------•--.........----•---••--..................- 'Permit No....: _.1.. -._.. Issued.----...'.�......_ �'�.---•--- �� ... Date •+.++ram.-$ i ��.��'��'.j,Llp I � r� .. r THE COMMONWEALTH OF MASSACHUSETTS ? 3 BOARD OF HEALTH �� ,��r�lirtt#i�ait�fur �9i��rn�tt1 urk� C�tta��#rttr#watt �rrmi# } Application is hereby made for a Permit to Construct °(,p ) or Repair ( ) an Individual Sewage Disposal System at ...__. 1 3 ..Ind u... �.......... - ........................ Locationf-Addre r or Loth N W — •- -- /N«�!1.`....................................� rAddress....^ ......•................... =-�erI (. � 1(t 1114 t 4 Installer Address i ��^� Type of Building Size Lot...._...,....,..,,..._�.....Sq. feet .-� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building .............. No. of ersons......_.........._._.__.___. Showers a Other—Type g ---•--•------- P ( ) — Cafeteria ( ) dOther fixtures ....................................•y'��y- .1 .-.-.--•--.-•-•----•----------------------------••---•----..............----.............................. w Design Flow.............-. - ....................gallons per persol per day. Total daily flow........ �' - -..................gallons. WSeptic Tank—Liquid capacity- (.gallons - Length..�,.�!1..... Width_...4.11A Diameter................ Depth...4?_.4.' x Disposal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No_______ ____________ Diameter_.__..Le-4 ..... Depth below inlet..!:21........ Total leaching area..?`�1...sq. ft. Z Other Distribution box (�) Dosing tank ( ) Percolation Test Results Performed by.................... - I`. 4 Date.......... 1 . + ...... ._---.. Test Pit No. 1................minutes per inch Depth of Test it.. :.. Depth to ground water...Y..l.t�.k.� .. LL, Test Pit No. 2----' ....minutes per inch Depth of Test Pit.... ..... Depth to ground water... .w.'... ODescription of Soil......... �...fir......... ....---•---•---....-•-•-----•--.....---••---------------•-----------.....--•-•-........---...------..................---........ x w VNature 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 TAI T TIL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beenF issued by the bola of health. / Signed.. 7:� r 2 a� E'%r.!J .. ...................................... !Gf f.........._.... ' _ e ••-- Application Approved By..- ••-- ...... `�� at'`� Date Application Disapproved for the following reasons:............................................................................................................ --••---••..................•-•-••-------......--•---------......---------.............---......._........._.... . ..---•---------•••-•---------•----•........ Permit No.--- /..... . / ..:�--��....--•----..... Issued-----•--�'.�- .. --._......��_.�u...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH < '?............OF.............,.... ..................... �............................ Trrtif irtt#le of T a utpliattrie t THIS IS TO CERTI Y�,�4.4 hat e Individual Sewage Disposal System constructed ( ) or Repairedby ( ) .T..._ ................... f>... .......,... ....... ...........•.................. at_.........04�.. \ ...��`.�...� ff....C!�.�l�,Instal lex...... ,✓....- ........................ ,� 7 ..... has been installed in accordance with Vie provisions of TITLE j of The State Sanitary Cod as described in the application for Disposal Works Construction Permit No...... dated_... !',----------- . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � DATE........... ............................ Inspector...............-•-- .t'' >•-•--..... ........... ...... •� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH NO.?-d .....L-.. FEE. OV.: 470 Disposal 16orks TAtts#rttr#ion Prrutt# Permissionis hereby granted.............................................................................................................................................. to Construct ( I or Repair )yyayn Individual Sewage Di posal Systa�' at No....--- .e,2�.�--sa... .C!.' . '�.��...�� ' .....................= • ...........•.-- 4./ 'Street e as shown on the application for Disposal Works Construction Permit Xo.?//"-ZZ,2" ated... ......................... " ? ----=---------------- DATE.. / r/( ! �/ •.....................•........... Board of health SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE — MARKED WITH MAGNETIC TAPE OR NOTES SCALE (NOT TO ) COMPARABLE MEANS FOR FUTURE LOCATION. PROVIDE MIN. 20" DIAM. WATERTIGHT h 1. DATUM IS ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE APPROX. NGVD e 2" PEASTONE OR GEOTEXTILE `t'Ih' \ TOP FOUND. EL. 133.9' FILTER FABRIC OVER STONE 2. MUNICIPAL WATER IS EXISTING MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE 'REQUIRED OVER SYSTEM 134'-135' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. PRECAST H-10 BLOCKS OR 4. DESIGN LOADING FOR ALL PROPOSED PRECAST RISERS (TYP.) MORTAR ALL PRECAST RISERS UNITS TO BE AASHO H-20 2'0 131 .4' 4"OSCH40 PVC COMPONENTS H-10 PIPES LEVEL 1ST 2 (TYP,) INV'S EL. 128 5' COW 5 PIPE JOINTS TO BE MADE WATERTIGHT \ 5 dler voe°ea o o°o 0 0 0 0 r .. . o° ooubau8• . o e . V� °d �LO S 10" EXISTING 14" ®�oDo�o p ��0 0000000000 0 �� O —l�000 °°°°°°0 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE TEE SEPTIC TANK** TEE 130.0' 0000®aa®aoa ogod0000tio 0��0�� 'o°o°o°o° WITH 310 CMR 15.000 (TITLE 5.) 0 0 0 0 o 0 6 MIN. SUMP 'o°o°o°°° o 0 0 0 0 0 0 0 0 0 0 °o°o°°°°°° o o 0 0 o o ;o° °°°° 00000000000o N >°000°°°o �a�Daaa�a�� 000°o°oo°° ��a�a��a� ° ° o o GAS BAFFLE.., 12" MIN. INT. DIM. ;°o°o°o°o DDO��OO®�0 0°0°0°00 ��0 0/000000 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND ;0000000g -000000p000 °o°a0000 1 26.5 NOT TO BE USED FOR LOT LINE STAKING OR ANY +: 4' LIQ. LEVEL (ACME OR EQUAL) 128.81 128.64 EL. XX.O OTHER PURPOSE. LH-20 500 GAL.. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. Stfe 3/4"-1-1/2" DOUBLE WASHED STONE (2) UNITS REQUIRED 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. \yob 0°k OVERALL DIMENSIONS TO OUTSIDE OF STONE: 30.0' X 9.83' 9. COMPONENTS NOT TO BE BACKFILLED OR Roce one 6" CRUSHED STONE OR MECHANICAL , zo CONCEALED WITHOUT INSPECTION BY BOARD OF COMPACTION. (15.221 [2]) Ui HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. /� (2•9 % SLOPE) ( 1 % SLOPE) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP LEACHING 121.0' BOTTOM TH-1 CALLING DIGSAFE (1-888-344-7233) AND FOUNDATION— EXIST SEPTIC TANK 41 ' D' BOX 1 6' FACILITY NO GROUNDWATER FOUND VERIFYING THE LOCATION OF ALL UNDERGROUND & NOT TO SCALE OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL WORK. ASSESSORS MAP 174 PARCEL 1-59 UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 11. ANY UNSUITABLE MATERIAL ENCOUNTERED PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT 1000 GALLONS AND ITS SUITABILITY FOR RE—USE. REPLACE 12. EXISTING LEACHING FACILITY SHALL BE PUMPED WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE AND REMOVED OR PUMPED AND FILLED WITH CLEAN CONDITIONS IF NOT SUITABLE SAND. 44 VARIANCES FOR SEPTIC SYSTEM REPAIRS WHICH MAY BE �P IMMEDIATELY GRANTED BY THE BOARD OF HEALTH AGENT OR BY HEALTH INSPECTOR SYSTEM DESIGN. PAPERWORK AND HEARING REDUCTION PROPOSALS APPROVED Q►� BY THE BOARD OF HEALTH REVISED DURING A PUBLIC �• GARBAGE D'IISPOSER IS NOT ALLOWED HEARING HELD ON AUG. 4, 2009 3) FAILED SYSTEMS ONLY : SOIL ABSORPTION SYSTEM O�► DESIGN FLOW: 3 BEDROOMS 110 GPD = 330 GPD INSTALLATIONS PROPOSED MORE THAN THREE FEET BELOW 4 p USE A 330 GPD DESIGN FLOW GRADE WITH PROPER VENTING (PIPED TO THE ATMOSPHERE) AND WITH H-20 LOADING, BUT IN NO CASE SHALL THE SAS BE LOCATED MORE THAN SIX FEET BELOW GRADE. SEPTIC TANK: 330 GPD (2) = 660 �^ **RE-USE EXISTING 1000 GAL. SEPTIC TANK LOT 153 \r TEST HOLE LOGS 17,959 Ft. \ , LEACHING: o SIDES: 2 (30 + 9.83) 2 (.74) = 118 GPD ENGINEER: DANIEL E. GONSALVES, SE #13587 \T °" BOTTOM 30 x 9.83 (.74) = 218 GPD WITNESS: DONNA MIORANDI, IRS TOTAL: 454 S.F. 336 GPD DATE: 2/21/14 BENCH MARK CORNER CONC. USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) — PERC. RATE _ < 2 MIN/INCH \ BULKHEAD. ELEVATION = 133.4 WITH 2.5' STONE AT SIDES, 4' AT ENDS AND 5' CLASS I SOILS p# 14292 BETWEEN UNITS PAVED DRIVE �f (APPROX. DUE SNOW) EXIST. DWELL. TOP FNDN. EL. 133.9' ELEV. ELEV. O„ 4 133.0' Ott 4 133.0' MA A A Q 10 GAR. SLAB ^� APPROVED DATE BOARD OF HEALTH ALS �LS �o 6,� 1OYR 4/2 UNSUIT. 6�� 10YR 4/2 UNSUIT. �6 �� o 0 �o/ TITLE 5 SITE PLAN / OF B B LS UNSUIT. 3 TH2 o �� 7 MORGAN WAY rz �LS UNSUIT. 10YR 5 6 10YR 5/6 �o. '�6 T 1 y� N�0 1� lost / 10 WEST BARNSTABLE OA� 1 PREPARED FOR /LS UNSUIT. /LS UNSUIT. /138 BORTOLOTTI CONSTRUCTION/ � 1 OYR 4/4 10YR/4/4 13g / oo° MACCINI 54" 128.5' 54" 128.5' PROP. VENT WITH CHARCOAL FILTER AND FEBRUARY 24, 2014 SIEVE C2 C2 BUGSCREEN FINAL PLACEMENT BY CONTRACTOR ( ��'q AS %��FF M cN of t �ASH OF�"�q off 508-362-4541 MS MS WITH HOMEOWNER CONSULTATION) �P s f<a Ass � ��_ yyFA ss � fax 508-362-9880 ° DANI�I AGa�v L A �. ° D. r•.� r�°� DANIFL "I� downca e.com �Y 1 OYR 6/6 1 OYR 6/6 MALL BLOCK WALL c of � � o�F � ' ' A.E ' � � D�°Nigl ��{ '� �' CIVIL CIVIL �,_I I OJALA down cape endineering, iim No.46502 °. a Pdo.4 1 No.40080 v 144" 121 .0' 144" 121.0 0 ° �� o �P civil engineers Fs ��s r�R G)I °�F\ si�¢i ��' �a FF �" �y Fss�°�o�/ land surveyors Scale: 1"= 20' s ,; o q o su �`' °suRv � y NO GROUNDWATER ENCOUNTERED - I � "� ti 4 � 939 Main Street ( Rte 6A) DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 A_O 1 3 0 10 20 30 40 50 FEET mot- , � I i� P _ > r. 1 a Y� , ♦. .. -e «.._,ems..' u NOW ..W... Y i" � (✓�'�,ct,. 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