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HomeMy WebLinkAbout0059 CARRIAGE LANE - Health 59 Carriage Lane Barnstable A = 298 '054 1 No. 4210 1/3 BLU Hdmil Dame o � 1 � 10% ® ® 0 d o l 40 { CI Ion 9 oe�2P Arr Q ati kle X " yY P S U I tl { Al I p CA J '� oe s E f }(t f t 1 p _ 1 r { i i i { 3 i a l No. 2 L uZ Fee 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppfifation for P posal 6pstrm Construction crmit� Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.S� C141Ye mq/5— L/Ve1:5 Owner's Name,Address,and Tel.No. rp�hrr��/�� Assessor's Map/Parcel �{ Installer's Name Ad ess,and Tel.No.,f�08—-'J2 0-177 f$ Designer's Name,Address,and Tel.No. ���H a S 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(min.required) gpd Design flow provided gpd 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) mod/4 r*& fiilr /of la'�/ -�—r'G 121� 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 Certificate of Compliance has been issued by this Board of Health. SigneA Date Application Approved by Date ` Application Disapproved by Date for the following reasons Permit No. ► Q 2 9 Date Issued 9, _z - ------------------------------------------------------------- ---------�_--_—_— ----- No. � d /� � n � � Fee / 0 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes —� PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Applitation for loisposal 6pstem,ConBtrUttlon-Vermit /rj rXIst��yr.r�;dt,� r zwk- Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.s-17 y� L 14N/�, Owner's Name,Address,and Tel.No. i Assessor'sMap/Parcel _ Installer's Name,Address,and Tel.No.s"2�2-6/e 1773 8' Designer's Name,Address,and Tel.No. t Type of Building: - Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder 0. ) . Other Type of Building No.of Persons Showers( ) Cafeteria,(,- Other Fixtures r` Design Flow(min.required) ­gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title t { Size of Septic Tank t Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer/when applicable) ",/ 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 Certificate of Compliance has been issued by this Board of Health. Signed y s Date Application Approved by ; ;a Date Application Disapproved by Date for the following reasons Permit No.7 pQ 7 Date Issued ,,.. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Urtifitate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned(..)by Srta T=/% �` ��145 F/-�= /A/ k= /_r,Gi�L at �"� G4i/�!^/ � 3l� /���z�J has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 201.) _p,z Cdated / Installer ✓p4 ()� /�,�vl�(� y. Designer #bedrooms Approved design flow gpd The issuance of this permit shall pot b construed as a guarantee that the system wi•1 function de rgned. Date C9 A/�Z -- Inspector � No. 1 ^d 9 ' Fee w THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pstem ConBt rtion Vermit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at �-q ( � eZogai - %��hSff��2�i t 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:Con tru tion must be completed within three years of the date of this permit. r Date 2 U Approved by V,, fef 4 1M L S ��yYC7J bn Wol /y1c{. S�iz. Ct7i� S, �P, Fa ou �n � G�vzerrce THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) IMF DATA U� 05-18-2012 & 08 2 03u BARNSTABLA Town of Barnstable 12 g:'R 13 r„ _1 Zoning Board of Appeals Decision and Notice Special Permit No. 2012-021 - Leger Section 240747.1(A)(1) - Family Apartments To re-establish a 1,125 square'foot family apartment Summary: Granted with Conditions Petitioner: Linda M. Leger Property Address: 59 Carriage Lane, Barnstable Assessor's Map/Parcel: `298/054 - Zoning: Residence F-2 District Hearing Date: March 28, 2012 Recording Information: Deed: Book 261.08.Page 308 Plan: Book 260 Page 42 (Lot 42) Background In appeal 2012-021, Linda M. Leger sought to re-establish a 1,125 square foot family apartment in. her Barnstable home. The subject property is located at 59 Carriage Lane, located south of Route 6A off of Braggs Lane. The parcel is a half-acre corner lot. The principal dwelling was constructed in 198.1; the family apartment was constructed in 2004. The dwelling has a total gross floor area of 6,098 square feet and four bedrooms, including the family apartment. i A previous property owner obtained a Special Permit for a family apartment in 2002 (Permit No. 2002-072). The permit was issued under a prior ordinance that required special permits for all, family apartments, regardless of size. After receiving the permit, the prior owner converted an existing garage and constructed an addition to create the apartment unit. The apartment measures approximately 30'x 50' and has 1,125 square feet. The unit consists of one bedroom, 1.5 bathrooms, den, kitchen/dining area and living area. A small exterior porch is also included within the footprint. No exterior changes to the dwelling were proposed with this appeal. Procedural & Hearing Summary Special Permit No. 2012-021 for a family apartment greater than 800 square feet was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on March 1, 2012. A public hearing before the Zoning Board of Appeals was.duly advertised and notice sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened March 28, 2012 at which time the Board found to grant the Special Permit subject to conditions. Board Members deciding this appeal were Board Chair Laura F. Shufelt,'William H. Newton, Craig G. Larson, Brian Florence, and George T. Zevitas. The Applicant represented herself before the Board. Ms. Leger provided an overview of the special permit request, stating that she would like to reestablish the family_apartment in her home. She clarified the unit existed when she purchased the property. Ms. Leger explained that the family apartment would be for her parents. Public comment was requested and no one spoke in favor or in opposition to the request. Town of Barnstable Zoning Board of Appeals—Decision and Notice -Leger—Special Permit No.2012-021 Findings of Fact At the hearing of March 28, 2012, the Board unanimously made the following findings of fact for Appeal 2012-021, a request for a special permit filed by Linda Leger for a 1,125 square foot family apartment at 59 Carriage Lane, Barnstable: 1. The Applicant, Linda Leger, seeks to reestablish a one-bedroom, 1,125 sq.ft family apartment in her Barnstable home. 2. The subject property is located at 59 Carriage Lane, Barnstable as shown on Assessor's Map 298 as parcel'054. It is in a Residence F-2 Zoning District. 3. Section 240-47.1(A)(1) of the Barnstable Zoning Ordinance allows for a.family apartment greater than 800 square feet, not to exceed 1,200 square feet, with a Special Permit from the Zoning Board of Appeals. 4. After an evaluation of all the evidence presented, the proposal fulfills the spirit and intent of the. Zoning Ordinance and will not represent a substantial detriment to the public good or the neighborhood affected. The family apartment is located within the existing dwelling. No changes to the exterior of the dwelling are proposed. .5. Site Plan Review is not required for alteration or expansion of a single-family residential structure or for family apartments. The vote to accept the finding was: AYE: Board Chair Laura F. Shufelt, William H. Newton, Craig G. Larson, Brian Florence, and George T. Zevitas NAY: None Decision i Based on the findings of fact, a motion was duly made and seconded to grant Special Permit No. 2012-021 subject to the following conditions: 1. Special Permit 2012-021 is granted to Linda Leger to establish a family apartment within her house at 59 Carriage Lane, Barnstable. The family apartment shall.be limited to a one- bedroom unit not to exceed 1,125 square feet. .2. The family apartment shall be maintained in compliance with the requirements of Section 240-47.1. 3. The on-site septic system shall comply with the Town of Barnstable Board of Health ' regulations and Title V without variances from the Board of Health. 4. The decision shall be recorded at the Barnstable County Registry of Deeds and copies of the recorded decision shall be submitted to the Zoning Board of Appeals Office and the Building Division prior to issuance of a Certificate of Occupancy for the family apartment. The rights authorized by this special permit must be exercised within two years, unless extended. The vote was: AYE: Board Chair Laura F. Shufelt, William H. Newton, Craig G. Larson, Brian Florence, and George T. Zevitas NAY: None Ordered Special Permit No. 2012-021 for a 1,125 square foot family apartment has been granted subject to conditions. This decision must be recorded at the Barnstable Registry of Deeds for it to be in effect and notice of that recording submitted to the Zoning Board of Appeals Office. The relief 2 Town of Barnstable Zoning.Board of Appeals—Decision and Notice Leger—Special Permit No.2012-021 authorized by this decision must be exercised within two years unless extended. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within.twenty (20) days after the date of the filing of this decision, a copy of which must be filed in the office of the Barnstable Town Clerk. Laura F. Shufelt, Ch it Date Signed I, Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elap ince the Zoning Board of Appeals fled this decision and that no appeal of the decision s bee file i the office of the Town Clerk. /19 Signed"and sealed this 0 under the pains and penalties of perjury. Linda Hutchenrider, Town Clerk 3 L ' own of Barnstable Assessing Division .`� 367 Main Street,Hyannis MA 02601 v wwwAmm.barnstable.ma.us Office: 508-8624021 Jeffery A.Rudziak,MAA FAX: 508-86,24722 Director of Assessing ABUTTERS LIST CERTIFICATION P , March 08, 2012 RE: Adjacent Abutters List For Parcel : 298-054 59 Carriage Lane Barnstable, MA 02630 Leger- Sullivan As requested, I hereby certify the names and addresses as submitted on the attached sheet(s) as required under Chapter 40A, Section 11 of the Massachusetts General Laws for the above referenced parcels as they appear on the most recent tax list with mailing addresses supplied. Board of Assessors Town.of Barnstable Attachment Zoning Board of Appeals (ZBA) Abutter List for Map & -'Parcel(s : '298054` Parties of interest are those directly opposite subject lot on any public or private street or way and abutters to abutters.Notification of all properties within 300 feet ring of the subject lot. Total Count: 22I Close Map&Parcel Ownerl Owner2 Addressi Address 2 Mailing Country Deed CityStateZip 298031 BARNSTABLE, HYANNIS MA TOWN OF(LB) 367 MAIN ST 02601 15488/290 28 CARRIAGE LANE BARNSTABLE 22923/135 298040 LEVINE,LYNN A , MA 02630 HINCKLEY 298041 KATHLEEN I PO BOX 795 BARNSTABLE,MA 02630 21118/342 298042 DUANE, NEIL F& 17 WALNUT CT ROCKLAND MA PATRICIA B 02370 17243/207 298043 HICKEY,NANCY 72 CARRIAGE LN BARNSTABLE, 5686/336 MA 02630 298044 THAYER,MARY LOU 94'CARRIAGE LANE BARNSTABLE, 24183/302 MA 02630 298048 BAKER,LOUISE MAE 19 CARRIAGE LANE BARNSTABLE, #07C0013CA1 MA 02630 298049 CERUTTI,MIRIAM J 21 SURREY LANE BARNSTABLE, 23929/182 MA 02630 298050 GLARNER,JANET TR JAN.ET GLARNER 123 SOUTH GORE ST LOUIS,MO 21526/124 TRUST AGREEMENT AVE 63119 298051 DOHERTY,JOHN G SURREY LANE JR TR FIDUCIARY TRU p 0 BOX 566 HYANNIS, MA ST 02601 15483/280 298052 KENDALL,DORIS, KENDALL FAMILY 43 CARRIAGE LN BARNSTABLE, 1Z847/328 TR TRUST MA 02630 HUSKA,JEFFREY D LN 298053 &JULIE L BARNSTABLE, 55 SURREY 8656/086 MA 02630 SULLIVAN,CHELLMITCHELL M BERNADETTE E& 59 CARRIAGE BARNSTABLE, 298054 LEGER,LL M& LEGER,LL M& LINDA M LANE MA 02630 25468/211 LEGER,BERTHOL& LEGER,BERTHOL& . 298057 ALBERT,DONNA D 24 SURREY LANE BARNSTABLE, 8252/61 MA 02630 298059 BRIDGES,ROBERT 38 SURREY LANE BARNSTABLE W&JEANNE MA 02630 10274/45 298061 RHILINGER,SUSAN 2559 PLAZA DEL TORRANCE,CA 23947/59 MARIE AMO,#306 90503 291BO62 BLAKELEY,30SHUA 199 BRAGG'S LN BARNSTABLE, &FAUZ M MA 02630 20350/230 298063 SMITH,STANLEY W 64 SURREY LN BARNSTABLE 12411/305 298064 RAYMOND,LISA M 219 BRAGG'S LANE BARNSTABLE, 24986/305 MA 02630 298065 CRISBOIS,GIRARD 76 SURREY LN BARNSTABLE,MA 02630 13098/028 298066 RICCIO,ORLANDO J P 0 BOX 1132 BARNSTABLE &JENNIE MA 02630 7129/220 298067 KEOGH,DESMOND J 109 CARRIAGE BARNSTABLE, 20436/140 &BOLT,THERESA LANE MA 02630 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this fist is. from.the Town of Barnstable Assessor's database as of 3/6/2012. i http://66.203.95.236/arcims/appgeoapp/AbutterReport.aspx?type=ZBA Lj 3/6/2012 i FOYIIH;08{1RNSTABLE" TM a r ZONING BOARD& PFALS s NOTICE:OFPUBLIC,HEARING$ _ _;'' UNDER THE'ZO9ING-0RDINANCE •_..-.:. `; .MARCH 28 2012'�.�-.,,n..� y ' aO'persons interested:m 6c'affected;by_tlie.acfiorulof_the,` Zoning 3oa.,.O;Appeals;you aie'heietiX noti(led=_pursuant to Sechon �1 of;Chapter40A.of tfie;General Lsws of the Commonwealth of Massachusetts,and.all arrendmeiris thereto;; that:a'pdblic:hearing'on fhe following``aPpeals.will:tie'?,fieid_`.on`. Wednesday,March 28,2012,dtthe:timeindixted; 7:OO,PM Appeal Nb:1010-010Joyce Lapdscaping;lnc::'-:; - Joyce Landscaping.Inc:has applied for.a'modifirationr.bf.:Use: -Variance:Nb:.199816,._as modfied.;py.'.AppealNat20Q9.036.. P.ursirantto.ihe requiremerds:gf conditions No 2Ta_id 28�nAppeal i No.2009436,the AppGcantie66'::6modify fhe conditiaps:of tlie._ variance to allow mnshvcliori-of an app ppmatelly 9;5X.square foot warehoiise and office b@ld'ing The liutldrng will replace two` office trailers:and':elevemstarage boxes and iwo greenhouses WI be relocated:Further,the Applicant is:seelang:to,iiIIbWa.;second`.;. business-sign_tn.be loiatetl-pq;the'proposed,hirfidfng';_Jor aaotal of.50:gquare feet'of signagepn the property This requestwould, - mod6..-Condftion N6."8.of the.e-Asting.use irariarice:_Thesubjed` :-.-. �_.__._......:-- _... properties are located at 50 and 68 FTurt;Street;Marstons:Mifis,.: .. ' -`_`.:`.°':� .:--.. =s:..-..:.,.,,.<::.,:"....., . ....- MA as shown:an Assessor's,Map-123"as.pare4s':0041006;and. m 004/007:They are]: ihe.Residen6 F Zoning DlslncL- 7:05 PM'Appeal No.2012421 Leger TOWN OF BARNSTABLE a Linda.M,rLeger._hai.petitioned fora Bpeaa Permd pursuant ; - ZONING BOARD OFAPPEALS to Secton.:24047.1A(1)r Fanuly Apartinentg Lr re establish an: <J NOTICE OFPl1BLIC HEARINGS attached family oparbnent in.axi"9f-.800 s Wiej.foet TW-; s c J UNDERTHEZONING ORDINANCE a t Propel is addressed 59 C rria aLane Bmstabl e A n Trs �y a o reed Cn Ho 2r 8a�2eon;Assesso s Map 298aparel 054 It is m aResidence f 2 0c1te2d b J _ Zonmg;Board of A eats, Y the actions of the Zonin Dislnct..' cu - v; PP yoo are hereby nofiffe ursuant These public:heann s wriF:_be held of the Bamstable Towne' Secfioni1 pf Chapter 40A of the General Laws of the Hall;367 Main Sheet,H_y_annis,-MA;Hearing Room,2nd Floor Commonwealth of"Massachusetts,.and all amendments thereto •. that a pabGc,hearing on the.;following.appeals,.will be:field—on.- Wednesday March 28, 2012 Plans?and applications may Wedriesda March 28a 20 t7at;tf)e We and ted be.reviewed-at the Zonin Board of peals'Office Growth:- Y c g 9 AP I 7 OOM Appeal,No 2010-01.0 Jo ce Landsra in ;Ine Management;Department Town Offices;�200%Morn Street: Joycelandscapmg Inc has applied fora modficaghon of Use Hyannis,MA' ?_.,_r =_ Variance No 199816,as_ �'mLauraF Shufeti Chair>5 ne;-0t too3 t6h et rheeq Auiprepmhceanrittss moefo cdloifi etdod APP eal Nd lb:200936 B Purst o itionsNc27 admng 28 inAel The Barnsable Patriot ons o-the_allow construction of:an a March 9 and March 16,2012 foot warehouse and_office bwiding The buildmg will pep ace lwo office tailers.and eleven storage`boxes and.two greenhouses will be relopted Further„the•Appllcantis seekjng to allow a second..'busmess-sign to be°located on the proposed. a total iif_SDsqua buiidmg,,for re.feet;ofsignage.alpthe..property This requestivould:;-;noddy Condition No,8 of tfie existing use variance The subleer Properties ere�ocatedat 50 andr68 Fl..t Sheet Marstoris MiOs MA as shown on Assessors Map f23 as parcels 004/006 and 004/007[hey�areigie2esidence�ZomngpisM r 7 05 PM`Appeal Nod 012-027legei � s c Lmda M, e4eger aned bas:pehbtiora4SpeGalperrr pursuant.;. to Section 240 47y q�1� mBy ApartrnenIs 10 re estapirsh an.'. atlached fame aparheent in excess of 800 square feet property is addressed 59 Carnage Lane Bamstable MA as shown':on Assessors Map 298 as parcel p54 It is m a Residence F2'...Zomhg District "These publicearin's g vnll beF held at the Barnstable:Town ,i Half 36T Main�Street'FTyannis,MA Ifeanng Room 2nd�Floor Wednesday Marsh 2B�2012 plans.;and_applirx6onsrmay fie reviewed at the Zoning Board.of Appeals Office,Gibwtfi:, Management Departmerrt Town annrs MA' 2D0:Mani Sheet K rr '-Cry 1;l-y, '�• •-$ -'- - .s +ram - - '_ "Laura F 5hufelt Chai C Zonfng'6oardofAppeais The Barnstable Patriot and Tuts _. ' Maori""9. ��.1fi'•2012:"�',r::� P9!= _ f C� Z �- 71 I, T.W.sr k I ���+ 1 I.i. I �_ TMn"%TM I k I Noy '-iti-' I j I t �!m;Im-- i F 1 I _ — =-- Slow 0 Lry" I � t �� ��� '� 'OR,rirR I•I ' O.r.1.441.t4uil I : k I str R.r tvs �e .r I I ( I _- _ I OnTu16!'AR-46 1 __ c---- onvalrow — Rrr TW6 I , . - .. rwie mra.ea.mow wl.�l..r. V toposf:D POVNDATION PLAN . - PROFMCE R44. WAPARTMEN 11258,p- iwnlm dar�wrrrem '.NOf ?he purcha�araU�we ybe,OUrarpwletbb(or cant/ +Ka uA�l a95YA12 And LGGN.9Nl tOQee eld erdlneeicee.NpgAek; w wAr l�"eo.wanuW eaosA PLANS . _ _ <ALF.EN!1:Ob600D er wHlmottno Dmtalmei emu be naW raeolUfble lornFe pee a ule+s - •-„ _ - t ComrMnwreaith of Massachusetts pop T itte S -M n-s- Subsurface Sewage Disposal Sygtrrin Form'=Not:for Voluntary Assessirients" 59.Carriage.Lane _ P�aperty-Address MwKienzle:Farri0'Trust Owner: Ownta's:Name requir efo is Barnstatble MA a263t1. June 8,2t)>1:1. required.-for. ®very Page. Clty/•rown State:: Zip Code Qate of lnapedion.. Inspection results.mutt be submitted on this gnrrn inspection faints."may nofi;6e attered.in:any ,Kay, Please see completeness cfiecMt at"fhe end of thQ iorrm- Import nt. A Gen rai:I.nFormafion. hewfli ing.'ou{ form§.,onrttie: computer rise 1., Inspector; only It►t3 tab key' to move your` PatrickM..t3'Connell;.: cursor-domo# Name of<Inapecto ° use tfie_retum;, key_- Septiclnspectlon Services Ca: __ _. _ _ _ _. Company Name m. .1,,89'Carnmett Road Company Addresa - Marstont;Mi11s MA: 02648 ramie `CttylTourn state_.--- ZIp:Gode _ . ,08428-1779: _ Si 12055 Telephone Numl e[ L"h$e.Number• B.;.Certification- tct itify thai Ghave personally Inspectetl the sewage disposal:\system:°at:this address\aiZd f€of the: infanriatiin reported below is true,at:cirate and complete as of the.tfine of'the Ir>spection,Ttiewinspectian` was_perfnrrned based on;my firaintng and experience ii the proper tuncfton:and maintenance of on site. 'sewage disposal,systerrts;! Mil a"DER Appr6ued ysfem i`nspector'piarsuant to Secfiori 15, of` Tte1e 5�310;CAR"'F6.000� The.system� \ ❑ PassesIM. Contftttonalfy Plisses Fails 0 Needs Furthef Evaluattdn 4y`the Locst i4ppro ling Authority June 6,201`1 Jot�f 11-93_ 1 cto�'s•SlgnaWr ._. ,, ._ .. ,_. .:-- Da#e. ....- -.. _.... The system trtspector""shall'eubrnit a,copy of this inspecfion report to the Approving Authonty Board of Health or"DEP),within 3a days of complet,ng thrsf inspection if the system ls-a shared system of :has"a design flaw of 1t),0Q0'gpd or greaterthe inspector and the system owner5hali,subrnlf;ihe report to the appropriate regional'office of the DEP', The:original'thtaiitd'be Beni to the:systetri diwvne aiid..coptes sent,toile boyar rf applicab{e,;and the appriavi ng;authority:; ""'This report.onfy descrtties;Condlttcns attt7e time of.;`Inspection and'under the conditions of tUsa at tirne This inspection daes`-not address haw ttte system wilt'peift>crn rn the firtute under A he same or different-condi ons�4 use.,. t5ats•7:1r10 Tdta 5'Offic nrtns}?ei lion Foma;',:SlibswfabaSewege 0iePM b'ys m''P"S Colt inonweAlth of Ma"achuse Title, - Offf I n pection- FbMil 11 Subsurface Sewage Disposal System F4rrn-Not:for Voluntary Assessrntrtfs- 59 Carriage Lane .. FiopertyAddress . . _... MacXsnziwFamily Trust` _ -- Owner• - Owner's-Name information is Barnstable NiA; _ O'263 requited for 0 June 6,2011 ever y Rays CilykfoLvn „_ Slate; Zip Code- Date bf Inspection Certification (cont) Inspection 5urnrnary Check A,b, -6 or,.EJ always camptetealtaE Section t3 AT, bystem Passesc ❑ i have. pt;founo any In lion which indicates that:any bRhe failure criteria described In:310`CMR 15 303:or in 310 CMR_15 3Q4 exist Ali}r=failure criteria, 0(rd afuated are indicated below:•, ,Comments By system ConditionaflyF Passes . ® Q► e or more system components"'as described in the-"Conditional Pass'section need to.be replaced or tap a►red The system, upon completion of the replacement or repair;`as approuetl by' the:Board of Health, wilt pass. Check:the bolt:fnr yes", no or°not determined"(Y, N, ND)forthe following statemonts If"zat deterrninedf"please exOwn,. =ty, c tank is metal and;.ovor 2.0 years:old°o jhe septic tank .Mfethermetal or not) is unsound,:exhibits substantial infiltration or exfrltration or tank Failurs is imminent:System- will_pass inspection If.'the ex sang lank is,replaced with.a;.complyr rig,se...... ank:as approyea by the: Board o1 Health-.:. A metal septic tank will pass mspecti4r►if it is structurally sound, not I _and if a Ceriificate:of Compl`rance"'ridicating that ilia tank is less-than'20 years;old is'avarlab,Ce; ❑ Y [( N ❑ ND jExplain.below)= Outlet baffle in,septic tank is;::not in';place,,:need tp replace;with a PVC,tee ,Must;be'permitted and: completed by a town approved sysme - installer:. . . 15Ute'+.111:1D Trtta Fa b=0t,W ln�eclon mm Subs�Reaa-&swage Qlppo�al b'ysQim; ga:2:or 17 Commonwealth, of Massachusetts Title Offi ial In section i=orrn s bsurfaca Sewage Dspasai:System Form Not for VoluittaryAssessrnenfs 59 barfiage Lane._Property Address MacKenzie Family TruS# ,Owner, lOwnafs Name informai[on.is uired for Barnstatife<.. MA 02630` June'G. 2011 . . req every sags:, city/Town state 31p Code Date,otihspectioa B. C�rfsfict�on B} System=;GonditianalfyPasses(canC:) 0 Observation of sewage backup or break out ar high static.water ledel En the distribution box due to.-broken or obstructed'pipe(s)or due:to a broke settled or.uneven distribution t ox Sysf�m;sivill pass ins-pectran if(with;approv al of.Board-.of Health)` _0' broken`pipe(s)are replaced ETY 0 ;N 0 ND':(Expiain beioyu)_ 0: obsfrucOon is rentoued 0; Y [] N [] ND'(Expla n below):: 0 distribution boitas leveled or'replaced Y ❑ 7V, 0 ND'{Explain`betow) ❑ Ttie system required pumping more#loan 4 times a year duo:to'broken,arobstructed pipes) The; ystem will pas's nspechan if,(v►'ifh approval 01 the Board of Health).: 0 brgken pipe(s):are replaced. Y 0 N ❑ Nt]y(Explan below): 0 obstruction,is remove` Y [] N [] ND_{l=xplan below}; C) FuctherE�raluaton is Required byrEhe Board of Healthi C`onditiofis exist=which require further evalgat on by"the Board of,Healih ln=order., defermine if tho,system,i8 foiling.to protect;MOO'heaith/ safety or the.envimnment. f`. Systa'n wlll pass unless;Board ref HQalth determines in accordance whit 3f 0 CMR f'b.303(f)(b)fhet the system is not funetlaning in:a manner whi;eh Will,protect public-tiaalth,, safety and the'environment:, 0; Ce;;spogl ar--_privy ts=K�ifhin 50 feet of o surface water` 0 Cesspool or,priuy 1-1within 50 feet,of a bordering vegetated,wetlantl Or;salt marsh; tsims mspectioe Fam:;s swrace:sew a`otsPosai 9ysierim paga3 a iT tom Monwealth of ssa Machusetts 1'iti }ffici � In isOct Faun. 5"ub4urface Sewage disposal';Systent Form:' Not`-inrllotwntary:Assessrnerlts %Carddge Lane 77 'Propedy,Address. MacKenzie Family:Trust Owne Owners Name; Informaliotr is fired roe Bamstabie MA, . 42630. June 6, 2011 C' ff"n State Zip Code= Date oianspect in .everyp�e:. -. B.;CelftlfiGaV` 0 (660t) Z. System wili4ail unless the Board ot'Health(and Pulalic StVa#eR Supplier,if any} determines that`the system l'e functianing iri,,a rti anner-.that protects-the public.heatth, safety°arid ertvrarrrnent:: The system has a septic tank and soil.absorodbh system-(SAS)And the-S_' ]s:vrithin 10o feet.df a surface duster"supply or,tributary to a surface y►+atevzupply. [] The system has.a septic tank end:SAS andahe SAS is wdi in a Zone 1 of a public wafef' s:upaly. Thesysteni has a septic tank and SAS and the SAS is within 50 feat of.a prtrrate water supply,:well., 0 The system.hes a septic tank;and SAS and^the SAS is less_ than 100 feet l?ut'54 f e-- more frorr a private water suppiy weft". Me#lo used,to determine distance:: . Fhis system passes if the^well water analysis, performed at i t?EP certified lst-ora.-y- for fecal colifofm bacteria Indicates absent and'the;;presence f,aM, pnta nitrogen and nitrate nitrogen is equal to or.less"than 5 ppm;.prr vi ed'that no other failure c4t,00a are triggered.A cagy of:tiae•atral sl must be attached: 4 this:form. I .Other D), S�rstern Failure Criteria Applicable to All Sysietrrs:; You;:must"i'rtdicafe"Yes"-ae"No"to eaoh of tie following fir all nspactZotte .Yes: Nd Backup of seWage into faculty or system;companent tlue to oyeiioaded;.ar clogged SAS:or^ce spool. Drsct arge orponding of effluent to.the surface of the,g►ound or`surface waters due to an overloaded or.clogged SAS Or ees§066; Static;liquici:.level in the distr►butivn box sb6ve au_det invert du`e to an averio ed' or clogged SAS or cesspooI Liquitl depth in cesspoolis less than 6"belovri Invert or available volume is Less Moh,_day flow t6aia iy1/10: THk5.dffici®I Wped4n Form Sutsufaaa Sa�r&90 .sP���l 4'of f7 Commariwea[th of MAr;sachusetts' { Tilde: 5 ffi toI r � cti � Fora SutisuifaCe Sewage Disposal System Form;:-NptIor Voluntary, Assessirienfs: 59'0arriage Lane Pmperty:AddreM: MacKenzie Farttify`Trust Owner Owners Name information r8. 112630 _Ju'ne4 2011 Barnstable - - r+equ'Qed tor. _ . every p',ge: CdyJTown State' dip Coder bate of,Inspedion a B. Certiffcat►an (`cunt; Yes. No Required pumping more than 4 times In the tast,year NOT due to clogged or obstnYcted pipes) Number of times pumped, Any portion af'the SAS cesspool ar privy:is beiovr high^ground`water elevation: Any portion of cesspgot orprnry is within 1'00 feet,af,a<,surface water:supply-or tributary to a surface water supply; [] :. Any portion of a.cesspool or°pnvy is,vithin a Zone 1.of a;.pubH well: Any portion of a cesspool or`pnvy?is witht 50 feet of a pri-vats}water supply 0 well. 0:. Any Portion.of a ces5poot orprnry is-less 10C!test but greater than 50'.feet from a,private;water;supply well with no acceptable water quality analysis. [Chia; system passes rFth welt°.water=;k,Iys I s, perfiormed-ata:DEP certified laboratory,,;for€ecaiscoiiform bacteria Ir dleatas absent and'h- presence of ammonia n(trogett and riltrata nttrag'an.le equal to yr,less than 4ppm provided Aria#.no other#ai.lure criteria„ar®trigg_ered A copy:of the:;anatysis' arid cfaln of_custody must pe attached_to this form:] =The system is a.cesspool serving a facility 1 0- design flow 6f;2004gpd- 101000gpd. The system farts I have determined that one or rrtore`of the above failure criferia exist;as:described 31 Or. CNIR 15.303, iherefar�a°the system farlsF The ystern;oxrner-shoufdcontact the..:.Bpard;of'Heslth to deterrnrnerhat wil be necessary,fa:correct:the failure, E): Large System's Ta be considersed 4.aege system the system rnust`serve--'a facility watt a �feslgnfiotiy�o 10,,QQ.Q 9pd fo15,400 gpct - -71 Forla.rge systems, you must ind[cate etthe%"yes"'or"no"'to each.'of the;foltowng in addition fa the questions iri Section Q . `Yes N'o [� the"system i Hhh,.,06 feet,ot a surfaced' kng water�sWpply [ the.system is.:wf rt 200 feet of a.tributary to a surfacedrinklrig water.supply 6-6.system is.located',in a nitrogen senstuve area;gnterltP Wellhead Proteclioh Area=IWPA.:or.a ma ed Zone ll'ofa- ublI6_'"ter:su well; } _. PF P_ ppty: 1f youiave answered"yes`to any gaesfian-in`Section the system rs;considered a sgnlcarti4 threat;; ;or answered"yes°.irrSectton D above the.farge system tics filled The Own er;or operator of;anylarge system considered a.stgnrficant threat undersea on E orfai►ed under Sectbn,D shall';upgrade-tf e. system irraccordance with 310 EMfi 15 3t34 The:system;ownevshoud:contact the approp.rfate .iegiora!-afficeof,the Department; t5his ttt4 'True s Olfciat&soacton Foriix Siinswteca Sr�ape Disgmer System:•Pa�:6 6f17' C' meson traalthi of Massachuse9tss T T' ttefB ial. Bpro s car Subsurface=Sewage Disposal_Systtern':Form. ;;Not for Voluntary Assessments 59 Carriage-Lane _ Propatty Atldress Ma6Ke-hA6-FarWIV,Trust' Owner O*me�'s Name W0m'afiW{S t3amstable MA:- 02630 June.6. 2011 _ jequlredh every page. Gtyfiown State Zip Code Date of.lnspection C. (iha-01Ist Check;{lithe fallowing have been done.You:musE`indicate"yes or"no,"as to each of the foliowmg;. Yes No Furnping information eras pfovided-by the owner,occupant; or Board of Health: ;Mere any of the.system�amponents pum _in ped out . he previous two:weeks?. =[�. Has:thesystern`recoived norniai flotti:5 m the previous two,weeky�eriod7 Have large volumes of waterI_peen introduced to th°e system recenti}-or""as part of; ®' =this_I'n.§ectton? IJVere d wresoe sysemed and examine p notasbultpant . eaalabl notg.as NIA)', •Was the>factlity:;or 6Wiefiing Inspected for signs of sewage;back up? [} 1Nas the:site inspected for signs of�bresk`ou#1 S E' Were ati system components,excluding;the SAS, located on:site'?` Lj Were fhe septic tank manholes uncovered; openeef and tFie Interior of the tank. inspected for the condition of the,lief 169 or-lees, rnatefial Qf const<yquon d'imensions,�dep#h of`Iiguid,depth of sludge and depth of seurrl?: Was the facility'awner(and occupants If different'tVm owner)pr......t wtth information on the proper maintenance of subsurface sewage disposat.systems?' The size and locattan of the 5oi1 Absorption Sy_stetn (SAS}'on the site has 'been de#effnined based or �; Q _Existing;information.For example a;plan at _o Bnard of Health; i]etermined in the field'"(Ifany ofthe;fallure enteria retated`to Part G is at;ssue> ®' E' approximatlon:;of di"stance Is.unacceptable} [31 a-CMR 15e302i5), SyStOM infoll"irna�>fon k M6nttaff-iR wr"C0_Itlorts: bedr ms 4i idumber.of'bed roo (design): Number of aorns",(:actual),. =DESIGN flaw-based.an 3i"0`CMR_1`5.2t73"{for example "110 gpd x#of bedrooms):: 440 ISru•-11Mp_- Td 9 6 off at in? Cn lam:$ubsudxe:Savage Diapo_r Syaterti Psga;fi t('t7: ;.J'U:f'1. :LU L V'1 is :.V:. fir.�;y. r_r • �._ ..__,_ Commonwealth of Massachusetts: `Title Off i 14 napecti n err sabs;6yfac®Sewage Disposal System Form-Notfor Voluntary,Assessments 59 Carnage Lang ProperttAddress M'aCKenzie Farnily'Trust" _ _ - "--- - _ owner. .. Owr►ers Name _ information is= regptredfor 8arnst6ble _ 0263't3 June:C,20t1 Cdy/Tvm o Stata Zip Cade Date of{nspsctiort every'page-: . D SYa.fem nformatEor pescripaom Number of curreni res-dents.. Unknown Does_�esidence;have a garbage gr►ndin?' O" Yes ® N: is iau_n_dry on'a separate sewage system :,[if yes:separate MWs!gbgr requuedj ©, Yes; ® No Laundry system rnsjected?` 0 Yes ❑; ',N"a Seasonal use.?' ❑ Yes ® 'No Wafer meter read+ngs,tf available(last 2 ye2es usage (gpd?}. De[a1 Sumppump? E, Yes ® fdo Lastdale of-oecupancyr: Currently Commercralflntli,sf�fa! Flow Conn#cans: Type:of EstattlishrneRt: Dasign:;tlow(based on 31 Q'CMR iS.203) Gaibns p-er day.t9Pdl Basis of design flovi>( 'p- p etc Grease tra present? Yes No; Industrial waste holding tankpregent? ❑ Yes El No. Nor=sanitary waste.'discha*d`to, he Title s system?` (� Yes 0 No Water;meter readtngs,.if available; t5na;:7;1t70.' Titls 5 OfCicFa lnspaelicn Fame Sub�a!&oA;S�ws96 i)ii-p"Syalem.�Rs961;pr t 7 Commonweaft. of Massachusetts Title 5 0 Metal Ins. ction, Fir Subsucface_Sarrag®b GpcsaI System Form: Not for Voluntary Assessments, 59 Carr lane Prnp"t ddrns MacKenzie Family Trust owner . Owner's Name require for is Bamstabl'e= - NIA 02630` June':6, 2011 required for= every=;pace:: Ciiy/Town: 51ate• Zip;Code Data;ofarispection D: System Inf6n"Atf0 (cool,.} Last;date of occupancy/use: Date Other;'(fiescribe M- U hknowr _ r.. Source of riiformation: Wassys,tM pumped`as par of--the inspection? Yes No. If yes;volume Now was quan ptautmped:; ed:dety d? _gallons;: _ .._ Reason forpumping - _.... Ty.pe-gf System: Septic tank;drstrlb:ution box, s011 absorption system Q Singe cesspool 0 O�rerflow cesspool 0_ Fivy 0' Shared system(yes or rio)(if.yes; attach:previous rnspec 16n.'record.t If any:)' Q Innovative/All:664 64echnolbgy':Attaeii a copy of ihe:current:aperation and maintenance'coF�tract(to>tie obtained from,system owner)and,,a copy of kdest' inspectron'of the UA-syste►-T y system;operator under contract; Tight tank,;Attacfi`a copy of fhe DEP atapro►ial dtfier(describe):; Olins -in4= Title 5 Otlklel O rpection Fam Cony onwea!th--OfmassacPiu'set#s T tip -5 Offici Ins ecti on form Subsurface.$ewage t)iSpoaa[Sysiem Farm-W*fbr Vaju y-Assessments:: 59,Carriade-Lane Pro Address f,�edY-'. MacKenzie Family Trust Owner Owner's:Name` inforEnatlon_ia required for Barnstable MA 02630 June t3.,20�_1 �y'P 9 flow" State. ZipCcde Dateof,IMpedc"nl . 1. . System` nfor,mation conf:} Approximate age of'ali componen#s,-date instalfed(If known}and source of rnfcirmabon:; Cornpiiance date.for-leaching systeM.- 7130102' Wem sewage odors-detected when;arrnrrng at-the-site? ❑ Yes 9.. No. Buiidng,Se.irer(locate'on site gepth below grade> feel: iVlaterial of.construction cast :lion ®40 PVC` ❑otherI xpia►n}.: - Distance front;prn atewater." upply-well Qrsuctio-tine - foler Comments ion cond t[on of ointsi ventingq;ewdence of I®akagey,,Wt ) Soptic Tank(Iocate on-situ-plan): t]ept. below•grade feet= _ ....... . Maferiat of constrtrctfon;` ® concrete ❑rrietal ❑7fterglass 0 pOjy.ethylene ❑other-(eicpla q) If tank is.rnetal, list;a years• Is Zoel.co fiaMdty a Cerfifioate='oF Compliance?(attacta copy;of cerifiicaie} [] Yes.;❑ IVo Dimensions:: Sludge depth:: 3.,.._. .. din t:i IV T+Ue50Nletal,I_ act Pepe9ar1T. :J U'1::1, LiJ L�:U..1;1 J,.•:{J:Gt .1.t. .a.I' .�i�.c�. • +, v _...:...�_....� _ -- — ' Cotntnanwrealth of N9assacfius�t#s° Title 5 .fifi gal` t pest o Farm: Subsurface..Sevlrage.D spOsal>Sys em-F.orM.: Not for:Voluntary Assesstner tS Property-Address MacKenzie-Farnil`.Trost Owner. Owner s iVame; rntormation Is. Barnsta6la, requf'red°tor MA_ 02630 June 6,.2011 StaCe r Code. Date of inspection every page: Ciiyfiowr P D. Systelrn• I`nformat bil (,cant Septic Tank(tq(" Distance fro m."top ofsl dlge to bottom of-outlettee.or baffle Trace Scum.#hickness, Distance top of'!kdern to top of outiet`Cee Orn or t affies Dl'starticerfram:bDttom of scum to tigttom of autleftee or baffle- - lVleasured Now,were drnenscons determined? - - i Comments'(on pumping recommendatlons; tnletand outlet tee`oc baffle�coridtionl structural►ntegnf y; liquid levels as related to outlet invert; evidence.ofIeakagei etc); Liquid level eras found a#outlet invert Outlet•baifle=is-missln - - -. Grease Trap (locate on site plan);: DeptYil3eloV1'grade:: . tee(: -- .. .: Malarial aF corlstrucion L. conl:rete: metal ❑fiberglass polyethylene other(explain}. . Dlmerislons; : _ _ Scam thickness D�starice.from top of: turn fo tap of outlet tee-or baffle: Distance irrim bottom aF scum to bottom:of outlet ieex or baffle �— .r astR Date;;af l ` urnpmgi Date l61(igt.•:11710; TNIa S;Dtlipal,Inepecrn Falls.3ubs'urreere:8ewame DlipOSd syol�m Peaa 10 c!,17 C'ommont iealA of hutetWv Title 5" Offi" Ir�����t��n F�r�rt 66surfacfif°Sewage DJsposal System Form Not'for-Voluntary Assessments 59 Carriage Larie PtoperlyAddrem MacKenzie t=arnily Tract. off= Owner's dame-_.. .....: Information is reyri ed for Barnstable:. June 6;20,11 every;page.; CNylTown - _.._.. Stare,. zip GO Q*e o(Anspecgatt; M System information.(,cont) Comments (on pumping recommendations;.lnlet and outlet tee or baffle concfit'ion,.structtical fnfegrlty', liquid levels. reiated:to ouilst invert,.evitl"eriee of leakage etc.): Tight=crH:olding-Tank (tank must be pumped at time of"inspection),(;locate.:on sate plan) Depth below.;grade - M_06t as of'cortstruct on ❑concrete; ❑ metal :.:Ell fiberglass:: ❑ 0. N M 061 ❑other in) imerisIOS. gallons. Design Flow: gallons per;day Alarm present: 0 Yes ❑ J.o Alarrri'leVel; Alarmn inruuor9 ldn order ❑ Y 0 "No Date;of last pumping:'; ..._.... t7ate Comrnents:(oQndition of'alalrn-and'float si itches,;etC.):4 Atfsch copy of cuiTent pumping contract(regtaied). Is copy attached2 ❑ Yes `❑ No 15ets.l=tllg Tale 5.Q(fcal MtpetfiDii Fwm:'S�iscura�:S�infge`�npnaet S)zterii.�:Psga 11 d7- :J UfI. :G"U CC IJ:a'1_ -J•.�`:CJ'L U. FI . . . .>.�.. _.. _. _..-. _. -..- -. .-. .... i Commonwealth of Mas-sachuseits �Sutssurface Sewage Disposat'Systent'Farr' Not_for V,0 ntary Assessmarit Propedy.Address: MacKenzie Famlly'Trutt.- owner Owners Name:. requiredrot. Barnstable: MA_.. 0263D .. JW 6., 2QtT. eve y,page; Citylr'own> 3tata Zip Cede.; Oate 046.6*tion D :system.wformation (cont.j DWtrltiutian Sox(rf regent must b:e opened)(locate on stte pianj Depth of liguld,ley aWve"outtet`inverf Comenis(note tf box Is level and°distrtbukiort to;outlets squat,any e�rdence of solitlscarryover, any evidence ofaeakage:into a�out of:6ox, etc;,}, Trace-af soli&c arrjrover, no-'high.,-stains: - Purrip Cha Ayer(locate on site:plan; Pumps.in Woking"order ❑ Yes ❑ No Alarms in W&k," order ❑ Yes ❑ No Corrrmerrts (note condition of pump champs.' condition of pumps anttappurtenances,=,etc.} -Sall Abeorptlon System {SAS):..(10cate an site plan;'excavation not-required): Uf S :not located,explain;mhy,: t5rs 1thg; Ta'e 60Hctal InsFa�on Forrtti Su�eu�fsc�Se+aageoisp�&�slein•Peaa l2d t7 Commortwealth Qf Massachusetts: 9 Tithe, 5 M.Ci -1 Inspecti n Forte Subsurface sodge Disposal Syafr'irt Form l;q,*forllolurtt3--nm essments` 59 carriage Lail e . Property Address , MacKenzie Family Trust OwnBrr, Ownees Name feg6jtedtorW H Bams.table M!' 02630' June':'.6, 20.1-1 requinze _ ____.- _... .. . ... every page: Gitji/Town State Zip Gade Dale of m4pect cn �. S.ystetm lnfOr r[at'an Copt.),- - - Type; leaching pif, number Three 500'gal teaoh-.ing"chambers number: drywe[Is - leaching galleries: number: l 0 Aeaching-trenches: number, 6hgth [j IEaching fields number, dirnensiors; =- El overflow cesspool nurnber_ [] Ihnovatrvelalt- tye system: Typ�fnameof techr=iology;, COMMONS(Able conddron Qf sfltl,signs of'hydraulio faiture�level of pondrng, d:amp soil,;condition of° vegetation; etc.),.. Leaching,chambers:were'fiound-empty attrrne ofi'rrspectionvirith._na>eydence af..satuiation:Leaching: system was:video inspected;due to tlepth of syo--..;Stone:on bottom of leaching chambers ui?as vi5ibfe with no slgnifcant solids carryover AI! piping was f-,un_clean with r o.sludge:deposits or. ., .evidence:of surcharge: -_...... Cesspao[s"(cesspool mu5t::be punsped as part.of"inspection)(IocaEe on slte plan):? Number and cantlgurat�on - Depth'�top of Irquld to rnletinyer Depth of safids fay.er -06 Ah_of scorn layer _ _ _ _t- Dimensions of,cesspodl _ Mater;lats of;;pnstructiot Indication of grounduraterin€low [] Yes No t5 ns':1:1L10 T�1e 5 0(fi sl hspeclion Fonic Stitiwfecs:3evragaDi POW p ft o'_Page 19"d''17 Jury fev. Cu=1.i; -J::uc.r i. Crl_I IC.1 l+{a ua.us-n.-L,c�- tbrnmanweatth of`Massachusetfs p Title 5 C�ff i=cia`Ir�� � ectior Subsurface Sewage,Disposal System Foram N.6f,:for-Voluniary.Assessmenls. S9 Carrla&bane -prope Address _..._ MacKenzie Family Trust _.. Owner:.. Owner's Marne _ Information:ie M re{ ked roc Barnstable: MA 420'.. JunGA— 2011 every page,. C-ity/fcrxn state -zip;;Cc de ❑ate of Inspection D. System.!`nt& msbian (cant Comrtients..(note bondition of soil,;signs of hydraulic failure, level of ponding,.contlition d#vegeta#fort, etc:j: privy (locate on site-PIMA.. Materials of_constrttctlon _ Dimensions. _ : _ , Depth asolitls: Cornrnents (note eondihon;af sari;signs bffiydrauifC failure, level of ponding,condition.- vegetation;: etC - 15k�a ri;illo; -Tile,SOFfra9,'4mpsaim Form>pi4sLuece Sewage b4opoaaiSystan'Pags1'ko 17 Jum 20 20;11 ; i.00PM PFITRICK UCUNNEL'L burr CommatiwreaCth of, Massachusetts r-- i .5 Oft" nspec I t Farr Subsu�ase.:Sswaga Disposal'SysteRn Form Not,for,lioluntary Asset_eats P roperty Address MkKcnzie Family Trust` - &drnstable Owner own r" Name tmormedon;Is M%ti _ 0263Q June e,20.1'1 . req od far Stale" �i Code 'Date o1.lnspedton CRy/rowrf P 77 =D. System tat rn;tt dn- (cons)�. Sketch Of Sewage'Disposal System: Provide a_view of':the sewage disposal sysfem,artciung tree to at.least two pe`rrrianent r,,efe�ence fandrnarlcs or kenchrriarks.t.ocata all wells within tDQ Eft: Locate wher:+r`public wafer supply enters the building_Ch6 one of the boxes below: retch in the area b ,OW d'rawing-attaoFied separately; 24 3- Front bard. '30� _' 30. 41 01 45 �.Mlle. L.V. �:�:aka �s ��:a..•_•. • • ...:��.�: .� ._._���. cimm'onwiWth of Massachuss##s Title 5 OfflOw 1���Title ��ton Form ;Subsur.facwSs."g,e Disposal System Fo-rn NdVfgr Voluntary_Assessrr tints °59 Carriage Lane .. . Pro AV Addles MM Owner Owners:Narr� intormalim is required for Barnsfable: Mf? 02630. JdadS 20, 1 `Pa9e;. Mylrown: State. ZA-Code pate of lh .01c on D: System information, cow} .Site Ezarn: [9 Check 81'ope,: 0 surface water ® Check cellar =Shallow-wells: Estimated depth'to-nigh'ground wader._: Feet Plesse,'indicate all:methods-used-to defer lne•the'Woo,gr 0-nd waterrelevatlan Obtained tror_n system�desrg'nplarts:an record:- I:#;checked,date of design ptae reviewed&= pate - _ [] Observed srte:(abuttii g property/abservatian hole.w thln " fe 4f 5A5) ❑ Checkee!with focal Board of Health='explain:: [] Ehedked with local-.excavators,installers-(attach docurne'ntatton_), Accessed USES d'atabase-;explain: USGS topo map and town GIS _ __ You must describe how you established the high ground;water`;elevatiort Town.grountiv+rate corEtoti�crap,$h water at ei 20 and top property atel a0 , �eiot®fl[ing 4hts l sp$ction Report,please`see Report Compfstenew Ch IdIst on nex1.page. t6'a}s t.iHO, Tnb.6;ofieallnspecoonFarmSuD9wfeceSwreaeNs,^oestgysiam;�Pa�ais;a_yT pmmonwealth of IVlassadhus, US v; ie 5f al tns=pctiar:n �rri Subsuiface Sevuage Disposal Sys#em Form-,tVot for V.oluntary:Assessments 59 Carriage Lane -Prppert.y Address MacKenzie Family Trust,; owner° -owner's Name- .-- _ .._.. . . ini�mehon-fs required rar Barnstable. _ _ MA 02-- 0O _- June:$, 2-011 Om pie 6kyRown SCate :Zlp Code Date of:':Inspeolion E Report G'oirnpletent s Ch dklts. ® I:n -Sp ecf on Sur m2 r--y;A. B, G, D,or E;checked ® tnspectlon Summary D.(System Failure Criteria.Applicable-to Ali.Systems)_MT.,pldt6d ® System Infomration Estirnat`ed depot to high grour,d�veter O $ketch pf bewage'blsposa[:Systern either dra4vn ort;pag - 15 or attached In sepa ate fife rGrri r'1liQ TMe S Dflicial r�spedion FgSn SuN�eaa'Ssw Uigpoid SYalem.•'Pega 17G(t7 i BAXTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,P Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622 July 11, 2011 Mr. Thomas McKean Health Department, Town Offices 200 Main Street j Hyannis, MA 02601 Re: 59 Carriage Lane, Barnstable Dear Mr. McKean: On June 6th, I accompanied Patrick O'Connell of Septic Inspection Services Company, on an inspection of the septic system at 59 Carriage Lane. A remote camera was used to conduct the inspection of the septic tank, distribution box and leaching system. I have also reviewed the inspection report prepared by Mr. O'Connell (date June 6, 2011) and agreed with the "Conditionally Passes" evaluation of the septic system. If you have any further questions or comments, please do not hesitate to call me at 508-771-7502; ext. 13 or via e-mail at swilson@baxter-nye.com Very truly yours, Baxter Nye Engineering& Surveying ., S en A. Wilson, P. P . Q 3 9 �♦ ✓yam 1 �Uj cc: R. Spinney D.Creedon 0A2011\2011-029WDMIN\LETTERS\2011-029 Ll TM 59 Carriage Lane,Bamstable.doc Land Surveys • Site Design • Subdivisions • Septic Design • Wetland Filings • Planning rod, Town of Barnstable Barnstable of�� P� '""e`caN"Regulatory Services Department � a DP 9RA f %S. .M Public Health Division m Arlo MAC a, 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.GeilerLeach pit is only3f >undwagter,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7006 0810 0000 3525 5552 July 5, 2011 Mr. & Mrs. Mitchell Sullivan 59 Carriage Lane Barnstable, MA 02630 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 Y The septic system located at, 59 Carriage Lane, Barnstable,MA. was last inspected on 4/27/2011 by Robert Paolini certified septic inspector for the State of Massachusetts. According to the private septic system inspector, the system "Fails" due to the following: • System shows signs of hydraulic failure. Observed heavy staining and solids in ' leaching chambers. Emergency pump 11/4/2010. Pumped septic tank and backflow from leaching 1300ga1. • Evidence of solids carryover in distribution box: Evidence of water.level being over outlet invert. � a a • Outlet tee is missing in septic tank..- You are ordered to repair or replace the septic system within sixty(60) days Tom the date you receive this notification. Failure to repair/replace the septic system within the.deadline period may result in future enforcement action PER ORDER OF THE BOARD OF HEALTH ean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures\1-I SAMPLE 60 Day Deadline.doc A pp THE Tp� Town of Barnstable Barnstable ,Regulatory Services Department AMmalcaMy a o , ' BARNSTABLE, Ass. p Public Health Division i639, �Ab m Arf°MAC a 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.GeilerLeach it is onl 3f P Y )undwagter,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7006 0810 0000 3525 5262 May 31, 2011 Mr& Mrs Ronald Spinney 59 Carriage Lane Barnstable, MA 0263Q ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 c The septic system 59 Carriage Lane,Barnstable MA was last inspected on 4/27/2011 by Robert Paolini 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 (3.10 CMR 15.00) due to the following: • System shows signs of hydraulic failure. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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 i PER ORDER OF THE BOARD OF HEALTH Th mas McKean, R.S.,'CHO Agent of the Board of Health k , Q:\SEPTIC\Letters Septic Inspection Failures\1-1 SAMPLE 60 Day Deadline.doc 1,f• kP. Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments ,M 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 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. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the computer, use 1. Inspector: J only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC. Company Name P.O.Box 763 Company Address Centerville Ma. 02632 City/Town State Zip Code (508)477-8877 S14454 Telephone Number License Number B. Certification 1 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. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: r ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority { .e ,r 4/27/2011 Inspector's Sigh%tuK 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 systermor 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. 'y hx 1 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page t of 17 3" s r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the . Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11/10 Title 5 Official,,inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) f B) System Conditionally Passes (cont.): 4 ❑ Observation of sewage backup or break out or high static water level in the distribution box'.due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): r ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): 3 1 Y 4 f ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s) The system will pass inspection if (with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): , ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 'S a 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 CMR1 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: r r ❑ Cesspool or privy is within 50 feet of a surface water ; i ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh r 15ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 r- Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° ., 59 Carriage Lane Property Address Ronald &Jane Spinney t, Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 x every page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Yes No Required pumping more than 4 times in the last year NOT due to clogged Or ❑ ® obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. El ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. I ❑ ® 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.f[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. s: ® ❑ 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. i t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name information is Barnstable Ma. 02630 4/27/2011 required for 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 ® ❑ information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 r Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments ° 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name 4 information is required for Barnstable Ma. 02630 4/27/2011 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2009:180,000 g ( Y g (gp ))' 2010:292,000 Detail: t Sump pump? ❑ Yes ® No Last date of occupancy: NA Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts _ Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other (describe below): General Information Pumping Records: Source of information: 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 ,1 ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) f ❑ 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 �t ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): i t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 c s° y. a Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2002 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other (explain): Distance from private water supply well or suction line: 10'+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank (locate on site plan): Depth below grade: e6t Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain) If tank is metal, list age: . years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallon Sludge depth: 3" t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name information is Barnstable Ma. 02630 4/27/2011 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle No Tee 2° Scum thickness Distance from top of scum to top of outlet tee or baffle No TEE Distance from bottom of scum to bottom of outlet tee or baffle No Tee 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.): r, Pump tank every two tears.lnlet tee is in place.Clutlet tee is missing.No evidence of Ieakage.Tar k appears structurally sound. 9 2 b; 'x Grease Trap (locate on site plan): Depth below grade: feet Material of construction: } i ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): .f f Dimensions: Scum thickness ,j e Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 i I 1 ' Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °wM 59 Carriage Lane Property Address Ronald &Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): * Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form Not for Voluntary Assessments r 59 Carriage Lane A Property Address Ronald &Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) z { Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No ,r 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 Ievel.Box has one outlet lateral.Evidence of solids carryover.Evidence of water level being over outlet invert. t Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): 7 i Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 THE FOLLOWING- IS/ARE THE BEST IMAGES FROM POOR , , QUALITY ORIGINAL (s), IMF DATA i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address Ronald &Jane Spinney Owner's Name 'S Barnstable Ma. 02630 4/27/2011 Cityfrown State Zip Code Date of Inspection i D. System Information (cont.) - - j Type: i ❑ leaching pits number: 3 ® leaching chambers number: ❑ leaching galleries number: i ❑ leaching trenches number, length: j �I ❑ leaching fields number, dimensions: f ❑ 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.): System shows signs of hydraulic failure.Observed heavy staining and solids in leaching chambers.Emergency pump 11/4/2010 Pumped septic tank and backflow from leaching 1300gal. d ,r e g P 4. Cesspools(cesspool must be pumped as part of inspection) (locate on,, » � !Z Number and configuration Depth—top of liquid to inlet invert — � � Depth of solids layer Depth of scum layer a k Dimensions of cesspool � y Materials of construction � Indication of groundwater inflow ❑ Yes ❑ No Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 4 C� � ��!'�. Z E � _._. Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 59 Carriage Lane M Property Address Ronald&Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ 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.): Fc stem shows signs of hydraulic failure.Observed heavy staining and solids in leaching ambers.Emergency pump 11/4/2010 Pumped septic tank and backflow from leaching 1300gal. 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 15ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form �r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 59 Carriage Lane `$_ Property Address Ronald &Jane Spinney Owner Owner's Name ' information is Barnstable Ma. 02630 4/27/2011 required for �. every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): f 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.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments ^M 59 Carriage Lane n Property Address Ronald &Jane Spinney Owner Owner's Name information is required for Barnstable Ma. 02630 4/27/2011 every page. Cityf town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of LC 44' 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 ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate #2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 ` Commonwealth O Massachusetts . Title 5 Official Inspection Form { / Subsurface Sewage Disposal System Form . Not for Voluntary Assessments ` 59 Carriage Lane Property Address < Ronald &Jane Spinney Owner Owner's Name information� Barnstable Ma 02630 +2%m] required U mamma, City/Town State Zip Code Date @Inspection E. RepoC 0ompleteness Checklist ^ 0 InspcloSummary: ARC, DorEchecked . Inspection Summary D (System.Failure Criteria Applicable to All Systems) completed System Information— Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn onpage 15 or attached inseparate qe I � i �} � f � � { .} :A Jr. . . . \ƒ . � \ \ :q «� »� <� \ƒ . . . y < :s nm . Title,Official inspection Form:Subsurface Sewage Disposal SystemP/ia 9 � \ • • i • • • • • r �EWA lM ' t • i {. . Fi h sX. t g 1 �yy�}.l vN S �6.�� a,• �� k t, 0-1 -n)s i� FUY-u S f ✓ - t p ,:tart+4 Y�` '�j�,Tr� 14,u s y.:S r'rF";. lh. :. �` x -i✓„�„'"�, �.'�.t1 q'�n''t J a 4 ff ;-ar•'ta 4 - • • ;J>r{ r Town of Barnstable Barnstable YHE �Of T� . Regulatory Services Department 1 er,caC j • BARN STABLE, 9 MASS.039. $ Public Health Division m ATf°rKA�a, 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.GeilerLeach pit is only3f wndwagter,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7006 0810 0000 3525 5552 July 5, 2011 Mr. & Mrs. Mitchell Sullivan 59 Carriage Lane Barnstable, MA 02630 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at, 59 Carriage Lane,Barnstable,MA. was last inspected on 4/27/2011 by Robert Paolini certified septic inspector for the State of Massachusetts. According to the private septic system inspector, the system "Fails" due to the following: • System shows signs of hydraulic failure. Observed heavy staining and solids in leaching chambers. Emergency pump 11/4/2010. Pumped septic tank and backflow from leaching 1300gal. • Evidence of solids carryover in distribution box. Evidence of water level being over outlet invert. • Outlet tee is missing in septic tank.. 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 may result in future enforcement action CQRDER OF THE BO RD OF HEALTH Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures\1-I SAMPLE 60 Day Deadline.doc i r vc Commonwealth of Massachusetts - + Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owners Name information is required for Barnstable MA 02630 June 6, 2011 every page. Cityfrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information forms the �� I computer, r,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not use the return Name of Inspector key. Septic Inspection Services Co. Company Name r� 189 Cammett Road Company Address Marstons Mills MA 02648 Cityrrown State Zip Code 508-428-1779 S1 12855 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this addre s and that the- information reported below is true, accurate and complete as of the time of the inspection. The M#ect0 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 15.34d of , Title 5 (310 CMR 15.000). The system: Ln - ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority June 6, 2011 Job# 11-93 In ector'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. l_1G 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage i pose l Syste age 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. Cityrrown 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. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old"or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): Outlet baffle in septic tank is not in place, need to replace with a PVC tee. Must be permitted and completed by a town approved system installer. 15ins•11/10 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. CityRown State Zip Code Date of Inspection Be Certification (coot) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which.require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form f Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. Cityr town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems,you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. 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. 15ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 I Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. Cityffown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of.the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: - Unknown 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 Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: CurrentlyOccupied. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. City/town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: . Source of information: Unknown 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): 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. City/town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Compliance date for leaching system: 7/30/02 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3' 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.): Septic Tank(locate on site plan): 18" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5' long x 5.2'wide- 1000 gal. Sludge depth: 31- t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M .•'" 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Trace Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 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.): Liquid level was found at outlet invert. Outlet baffle is missing. 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 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 N Commonwealth of Massachusetts UTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition structural integrity, g y, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): `Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 15ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 011 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Trace of solids carryover, no high stains. Pump Chamber(locate on site plan): ` Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name i tiris Barnstable MA 02630 June 6 2011 en requireequire fo d for , every page. City/Town State Zip Code Date of Inspection D. System Information (coat.) Type: i. ❑ leaching pits number: ® leaching chambers number: Three 500 gal drywells. ❑ 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.): Leaching chambers were found empty at time of inspection with no evidence of saturation. Leaching system was video inspected due to depth of system. Stone on bottom of leaching chambers was visible with no significant solids carryover. All piping was found clean with no sludge deposits or evidence of surcharge. ` I 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 15ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 { Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): (Sins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 --- - every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: hand-sketch in the area below ❑ drawing attached separately \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ 3 21 ,a I, Front Yard 30 30 41 45 f- Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name information is required for Barnstable MA 02630 June 6, 2011 every page. City1rown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: ' 20+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from sy'stem.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 ofHealth -explain: ❑ Checked with local excavators, installers- (attach documentation) ® Accessed USGS database-explain: USGS topo map and town GIS. You must describe how you established the high ground water elevation: Town groundwater contour map shows water at el. 20 and topo map shows property at el 50 Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 f - Commonwealth of Massachusetts • Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 59 Carriage Lane Property Address MacKenzie Family Trust Owner Owner's Name`. information is required for Barnstable - MA 02630 June 6, 2011 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 r TOWN OF BARNSTABLE LOCATION J.r �¢rr%Ag a SEWAGE # VILLAGE RA C-4 4?2�a/� ASSESSOR'S MAP & LOT' INSTALLER'S NAME& PHONE NO. MCP 1� SEPTIC TANK CAPACITY j00� LEACHING FACILITY: (type) 3 ' SD® I>/'V.GlP � (size) AQ X X, NO. OF BEDROOMS BUILDER OR OWNER lIr/91G'S PERMIT DATE: / COMPLIANCE DATE: d 2 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 l t 3 � f TOWN OF BARNSTABLE UK'ATION �7 C �rr�`��1 L h SEWAGE # 49AO' oL6 VILLAGE LLrl 47 9� & ASSESSOR'S MAP & LOT �l P 05 7 INSTALLER'S NAME& PHONE NO. All el ee l0,90 SEPTIC TANK CAPACITY ' LEACHING FACILITY: (type) 3 _ ® Drjlk4h (size) ?3 % I NO: OF BEDROOMS_ BUILDER OR OWNER_� ✓�/��'s �,� PERMIT DATE: Sze®2 COMPLIANCE DATE: U 2 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 '. Fro 07+ a J 0 1 1 it V No. �;b l�^ � w Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0(pprication for Zigpooal 6pgtem (Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.` C,C�rv-r a i e-- Owner's N ddress and Tel.No. 3 r►'l S 1k�, c�v-�a P-V_@..[4-e�Z Assessor's Map/Parcel `� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size &'ZI S`W'— sq.ft. Garbage Grinder(M Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow `t�� gallons per day. Calculated daily flow *4Z_ 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) Y 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 issu this Board of Health. Signed Date —7 2- "L Application Approved by Date Application Disapproved for the following reasons Permit No. �17b c� ' 3a� Date Issued 4. Nb U C r � Fee I l THE COMMONWEALTH'&MASSACHUSETTS Entered in computer. { � °PUBLIC HEALTH,DIVISION`z TOWN OF BARNSTABLES MASSACHUSETTS es a - Zippricatio" n,for Mi5pool *pztem Congtruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Nam,.Address and Tel.No. J Assessor's Map/Parcel �V,Q-.- ;07 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Y C. Type of Building: 14 Dwelling No.of Bedrooms `4 Lot Size 22,5'11 S'_ sq.ft. Garbage Grinder(W Other Type of Building No.of Persons Showers( ) Cafeteria( )_ Other Fixtures /n� 1 Design Flow y�d gallons per day. Calculated daily flow Y�0�- .. °gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank s eX,ST i,_ -___Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) c r\ Y WC_ r e�c�....4 rt"r e--4n(_ 12 X s Z i L°Yt S 1_7�/ TG �► 1. i 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 issu this Board o Health.� Signed .k Date Application Approved by >, `_ 1 Date _.> > Application Disapproved for the following reasons Permit No. Date Issued 2 S hy? 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 e�C4v d1Z 11, 1;1�- CA e► L_a at " l..c. has been4constructeq in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 U2-'2.3dated `25 6 Installer Designer .50LO\c..-...+ The issuance of this p }t shall not be construed as a guarantee that the system ill ul c 'o,�}as d`�es'-ned. Date o t Inspector r ( J i' No. d�'�, Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Mi.5pogar bpgtem ngtruction Permit Permission is hereby granted to Construct( )Repair( h pgrade( )Abandon( ) System located at 512I t --�-�t-- and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction ust be completed within three years of the date of Iffis permit. Date: � 2 Jf 1? Approved by �N j07 .49, 1`18� -G� LOCATION SEY�OIf.ACE PERMIT NO. VILLAGE N S T A L L E R'S NAME ' & A,D-D R E S 5 ASSESSORS MAP NO:-228" �{ = y PARCF� Nam_ BUILDER OR OWNER DA T E PERMIT ISSUED OAT COMPLIANCE ISSUED y // 3.� 96 6 `,Z a 9s)6�� No........ FEs......41........./. THE COMMONWEALTH OF�MASSACHUSETTS BOAR® OF HEALTH 77QW..�...._.....OF......ln�10t'1 /5,>_tJ&C— ............. . ................................... Appliration for Uhipoti al Workii Tnntrurtion 1hormit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at =........_. .....'!::. 9.......------------------- Location-Address or Lot No. ----------------------...........------.................... W ��,�_R n ner ---•--•--•-----------•--•-•---•---•---------Address ---- � ............. Installer Address Type of Building Size Lot..Z 7~ ��...Sq. feet Dwelling—No. of Bedrooms.._...................................Expansion Attic ( ) Garbage Grinder (AO) Other—T e of Building .... No. of persons............................ Showers — Cafeteria a' Other fixtures ---------------------------- W Design Flow.............Sr7.......................gallons per person �r day. Total dal} flow..__.._.._330.................._ � 95 lons. WSeptic Tank—Liquid capacity/WQ.gallons Length__ ?��_._ Width.41% Diameter._ _.6.__- Depth. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No________ ___________ Diameter______-.......... Depth below inlet..4:.,%........ Total leaching area__�...sq. ft. Z Other Distribution box (J) Dosing tank ( ) Percolation Test Results Performed by..... ..03. _.G.:._ ----- ?......._...... Date................. p-_-_-__-. `4 �'-z___minutes per inch Depth of Test Pit.._. �....... Depth to ground water_._� AJ...... Test Pit No.� p p p Test Pit No. Z L Z minutes per inch Depth of Test Pit... Depth to ground water, NSF Eb P4 Descriptionof Soil------•-------------- - -----------------------------------------------------------------..._....._...._.. G'...............................s o.c6. ----------------o. . •-• ---------------------------...-------------------------•-------------------------------•--... W --------------------------------------------- 60 �� 6_._...... .5 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 A-7 p LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued by the board of health. Signed.-2- (�... = •••-- -•--•..................•-------- Date Application Approved By--••. ................................ a" = ............. Date Application Disapproved for the following reasons:-------•-------------------------------------------------------------------------------------------------------- ------------------------- -------------------•---------------------------------------------------------------------------•------------------------------------------------------------------------------- Date PermitNo......................................................... Issued....................................................... Date No...... t>� t..6 •� Fics.....�3.................. THE COMMONWEALTH OF MASSACHUSETTS � BOARD OF HEALTH ...................................... Appliration for Bhipoii al Works Tomitratrtinn ' omit. Application is hereby made for a Permit to Construct (%,/) or Repair ( ) an Individual Sewage Disposal System at: ...... GAddress--------- ----------------•- _-- Location or Lot No I . ..... GG.. � ....�� -/1 �.�----- 12� D ?RG .�7���..-' ..d''r: �/y,�3�.✓�� ner / Address Installer Address y Type of Building Size Lot-----...&__'..................Sq. feet Dwelling—No. of Bedrooms....................................Expansion Attic ( ) Garbage Grinder ('NO) aOther—Type of Building ............................ No. of persons............_............... Showers ( ) — Cafeteria ( ) Q' Other fixtures .................................. W Design Flow..............•�F_%....._...__.........__.gallons per person gr day. Total daily flow_.._.......- ' Q..............-..._.. lions. WSeptic Tank—Liquid capacity 'e _gallons Length_ ...___ Width..4.2_d_ . Diameter--4__4 Depth_ �__-. x Disposal Trench—No. .................... Width.................... Total Length...................... Total leaching area....................sq. ft. Seepage Pit No---------- Diameter......4;--------- Depth below inlet..4=y ........ Total leaching area..�� ��....sq. ft. Z Other Distribution box (V) Dosing tank ( ) ` '-' Percolation Test Results Per by ' .. .....a�........_.....�� :��,.............. Date....��l_` �� _..__.... aTest Pit No..5__ _ '___minutes per inch Depth of Test Pit-----1*......... Depth to ground water.... � P P �3` P ground (i, Test Pit �o. 2________________minutes per inch Depth of Test Pit..._...._ _.______. Depth to water........_.:___..._.._... D Desgiption of Soil....�.._____to-�� lrvoo�����. � � �� . .. ------ ... ----- ----------------------------- .................... ................................ U .... �trlS,,,- 0�4••..--•-•--------------•----•-----•-••----•-•---•-------•---•---•-------•-------....•-- 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'i`:...`" p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been •sued by the boo rd of health.f�,, � igned .. .......................... yy�� Date Application Approved By.........•..• -�.! I.e-' ,.✓� �; M -AV.........--- Date Application Disapproved for the following reasons----------------------------------•--•---------------------------•---------------•------........................ Date PermitNo._....................................................... Issued__....-............................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . .... ......................................... Trrfifiratr of Toutph anrr THIS IS TO CE �IFY, That the ividual Sewage Disposal System constructed ( ) or Repaired ( ) by..............•---•---• -`° --------------•......--•--------....._..---•......._.__•----•-•--•..-------........----..........---••--------•--•••---- + Instal at '.- " ;.� ." ----------- -------------------------------------------------- has been installed in accordance with the provision TIT j o The State. Sanitary Code as described in the application for Disposal Works Construction Permit No.___ ...... f-_______________ dated-............................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................... ............................. Inspector....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................................................. .t .. NO... r ... .._ FEE...��4_.- Dispos al Work,5 Ti n4 udion Vamit Permission is `ereby grante:1 e�" ''u ' ,� to Construct ) or Repair ( ) an Individual Sewage Disp al ystem atNo.......... ........... V..... ++ ....St.: —....---/ .�::. Street as shown on the application for Disposal Works Construction Permit No-----_-------------- D5ped.......................................... �4_ alth Bear ��� j.____y......................................, DATE------------------------•-- ................................................ ipdf He FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - i %••tt• t3'-B'x4-4 —— ————— —,— DW a F4r.•e. LAUN W. r-T - •`r, T Ty. I I I I I § KITCHEN EATING Ctma 34" 14'-4•x 11-3• AREA I I I I 1 1 ,t'-W x 11'-5• II II I I I I § Y-11•x3.3"°' I I § m L-- --o J i !1 GARAGE —II------------- ----ttTtDN — t� - -- - -- — a.: 21'-7x21'-4• T --------------- I I ROOM tp•r uh5ET 13'-r x 21'-4' r-----) r-----I DEN Ir72' 3 I I I I I °I II 11•x„'' I I 1 1 II § u05�T I I I I I h z•r.Y I I k I I . P LIVING § II II II z CL I I ii I I d iI II rII §2T-r x 16'-1 t.er a ~ IIL®JI I —T-1H-1"AxL TL--9• --• —§ —-o tef—a__t—r o s—sf-rcOu�"--et-4'I _- - ---B15E'-D9i—s'R xtO v1 — IIiIIIIIIII IE IiI1II . . . -1 —IIIIIII p':.►• {III{ z I z EXISTING FIRST FLOOR PLAN UdZ"_ JN 1183ft 7 11' 0• X— — — �—�— 4*11 —ale BATH 8'-5'x T-® —— — — ——- -- -N— MASTER BDRM HALL— — tun OPEN B O� 5TORAGM 26x -v OOF EAS x 11'. y, 21'-rx4-1 - -- ---- - - - ------------- EXISTING SECOND FLOOR PLAN 1066 sq R I __ L ' $r� Il o t s scue Es116'Ell JIM AND EMILY It n t P.uGrcOhOaDse e..s. igne._ r; .anneihiP!nf I�0.CP'/tE 1h . . ��_ . M P ��is-is ioc lance with all STATE and and ordinancesr of these Plense 'or D HIt•BOS oatlno M_ RrtIA v'6� rh: f ` ma•ha-hold'.ro : 5Dd (t,OTe:NALP]xe PRAM AND .. . HALF CONL.FROST WALL TBD) � x gad t"1 VHA1-F -[-'—t MASTER GL I v e I+4 et I t4 r T-11•x Y-0• - I I e I anoq ,p•ac � I �. I � III a MASTER BDRM 2,'-0 x,3'-,D I 0 O 14 i b 4 TER BATH a T-t 1•xB'-s• I I NEW GAR+F-/ADDITION I-�w, _ I ¢ I 24'-1 I x 26'-9• 11 Cal= 9 ® ®. L_ S FORM 4 kmT WAW"(9. I 1tr In BELOW 6ARAGE DOORS- I I - _ FRAME LL 2x6 WALL t, I I 5TUDY I I HALLt �_ 4'*/-CONCRETE PLpOR 14'-b•x 17-4' 1-Tx17t I W/6"rb'stoge.Wri.F. 1�1 C1.05 • ,-----`4.000p MIN.NOTE SLOPE 3'-1 •xB'� h ,Y•1' =-tJ'' 4' <� I I bAR SLAB MIN. I I - b D - j 7p^- § TWD OND'S NLLS' '� T Kr R' ti' I I_. GROUT QPIN NEW g gggp ENT T.YUt? T e T tl T•,1•x111 O.c. 1 - 'LI •� `- I II S 4. I I RY J lAU N T as e I HALL ... I I NEW WRT AND FLOOR 1 I I I b T I SYSTEM Wl6 MIL POLY ' LNING b xlrs VAPOR OARWER-ADJUST a 7T-B•x 1 '-Y 1LTOSzr Y _ O n� I I TO ExST.PINISN FLR xiep u6a 3 p LEVEL . a Y 1i III S L VIA,STL/LONC.LALLT O� .§.• OUTLINE OP I .�.I COLUMNS®p'O.G. pO0 h I ''� 4-t l'x3'-3•� 3 PORCH AND .. . :r b'-11• 1T•T � - ��pp , T NeW I � �, STAIRS n EXISTING GARAGE I t _____- I I1 I I______Y m-r (5EE NEW FIRST t i I 4-0• I' I FLOOR PLAN) III DEN 3+ 4 � � 11•x11' I I j '� � al•a I I ¢ KIT H N/EATING 11 REM OVF EXST.6ARAGe DOORS '. AND FBl IN MUCH-PARGE exfeRlOR TO MATCH EKST. h FND. J 72d - - T"�'— PROPOSED FOUNDATION PLAN 4 , PROPOSED IN-LAW APARTMEN 1125 S.F. x 1125 S.F. o 5 . 0 1 5 ® SCALE SCAM E916NFJ) JIM AND EMILY NOTE:The purchaser of these laps is res onsible for com Ilance with all STATE and LOCAL Building codes and ordinances., Neither " 41r�rstt `y P P P p . ALLEN B.056000 or oartiaioatim Vesianers-Mau be held resonsible for the use of these' MAP NO. 'fit ��ar�:afi,uef'_•- II ' � � i,557- T / NOV V . moo, /980 4) /� /7p 73 t TO wAi /A/S pEcToA 60" WOO DLOA M� i; I sTLOTZZ, /2' 60'-h:N DEAJ.S&, /5 F/A Q IAIL� sj. 40 SstA iD, LA YEAS of A!O WA77-=,- EA/COUA.)7�:eE.7,-� 1 D .jawRY B °, 45 t , ZZ 5 5Z A .00 35 3 A � P,6 vr5; .s _Lj��jlnl 13'� O TA/GE7 5, i E d ✓ L4. 36,7 Nc� livA,-�-f� EA/C�u�v rE2�b SCALD / 40 vv �e0Ai 7- 3D ' s/z-�z� TOP OF FOU/v��1 T/ON MAA.1A40LE- COVF� TO ��CTF�/D TO F/N/S�/ GeAD� OI�F� /'v/ ELEV. SZ• Ts-1/N OA/E FOOT OF LEA M/N. 251. ^ > 2 'b/,4•CoV�.�S C ' >i D/57 r- / �;J Z"0F PEA STOA/E XDe /p / 4 �l aox ✓1 DUs COVE.2 To pi �H / / Ti6 TH r /n/i SN v ! sr /n/PiL >2 4 T/ArG STUa/� 4,.a�A. Z'LB✓� G.2ADE 4 C ST/.CON n, OP Sc,y.Qp p✓O ^ FG.O w� L i.vE �- �-- ,, ,a1iG �� •' i /o'%yiv. l4" %4%Fr. .z„ ,7 o eQV,0 M/A/. /0.00 �aD was�En: S•35 �jS. a p06 /A/V�T /A/VE.e r //N✓E BT _ J` e i%f� - STb vE� CG4PAc/Y 4'M/n/. �Aeouvr, 45•� S�GT/C TAn/,�. 4S.i ^6 � 3•S LE-�c/<1 cc,L /n/✓:f er (WA TE,�T/G f-/T) I /AIVE eT 44.7 /A/VE�T % 6C. t} NO GA e8,4GE G�/A/DE.� :o v� 24 / -3 3 SEP77/C S Y5 TEM CONS T-,2UC T/O,&j S<-/ALL CONF0,2/—I TO TyE M,4 SS• 4 IS E�vV1.20,A//v1EA/TAL CdDE. Ti7"LE V EMI EV. 36. �7 ZeEViSED 7-/- 77,4A/D 7A/E TO✓Vn/ BOA2D O� ,L/EAL7N 2EG /L A TONS NUMBE,E O/=- 0ED.e0ON/-s -� ,*S EPT/G TLI A/I-- D/ST,2/BUTT 0A-1 /30X A/v D L-`A CA-//A/G ,a/7- TO r3E O� CPAIG 330 �E/A/�CeG�O CO�/C��TE nq/Ai. SATE M/1\1.1//AV'C// COA/C/aETE 57,eEA.1GT1-j 3000 BSI amf ,eEi�'L7 L ACE-/ CAP. 30 G.4L./I�AY M/A/. STL 20000 f/-/O Z-0,4 z�/,(,JG 4 43 " 02/VEAVA y A./OT TO 8E LOCATED s + 3, 57r z 77-�'g 44-3 O✓F-P- SXSTEM UA/L.ESS //- 20 mow, i 1 DES/6,V LOAD/A1G /S USET� f AL L_ TO 13E VVA TEAET/G�-/T SITE PL A N ..r G0CA7/0A/ : 5A4',V57-A5L6 M.�1 7�Es CAST/,cony o� �e�C�sT -%k�°FAf L67- 42 AS S/-/oLUAv Iry o� c. � FRANK � o WHITING c� No. 29869 w Q Foy 14:::��EI\//VE 7" A VOL A ey �. BAYSIDL st-,evEY COZ)=) T-A 89 WILLOW ST. YAe/M0U7-,4-/p0,rP7 /`PASS. �FO,¢MERLY CaOtJELL f T�YL0,6 GORP02.ATiONJ ACCESS COVERS MUST BE WITH.N 9" MINIMUM. INVERT EL E VA T 10%'S : DES I Gh' CR i TE,R I A : Gr NERA L NOTE"" 6 ' OF FINISH GRADE 3 MAXIMUM COVER INVERT OUT SEPTIC TANK: 100. 6 FIRST 2 TO - — DES IGN FLOW: BE LEVEL IIA41N 2' OF PEAS TONE INVERT IN D/ST. BOX: 100 5 4 BEDROOMS A T 110 G. P.D. PER l THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION INVERT OUT DIST. BOX: lo0. 33 BEDROOM EQUALS 440 G. P D OF THE SEWAGE DISPOSAL SYSTEM ONLY. 4• DI AM PIPE INVERT IN LEACH CHAMBER: 99. 5 o� r � 100.6 100. 33 � 211F`1�_l 5t9 DOUBLE WASHED STONE E'OTTOM OF LEACH CHAMBER: 975 NO GARBAGE GRINDER 2. VERTICAL DATUM ISASSUMED. FOR BENCHMARKS SET. SEE SrTE PLAN. /00. 5 99. 5 7 5 <DJUSTED GROUND WA TER _ NIA SEPTIC TANK REQUIRED- 2-500 GAL LEACHING CHAMBERS OBSERVED GROUND WATER NiA / 3 OUTLET 440 G. P. D. X 200% - 880 GAL . J. ALL CONSTRUCTION METHODS AND MATERIALS AND I000 GAL D-BOX W/4 ' STONE AROUND. 2- 12. 8 'X /6. 5'X 2 ' LOTTOM OF TEST HOLE •l : 92. 3 SEPTIC TANK / SEPTIC TANK PROVIDED. 1000 GAL . EXISTING MAINTENANCE OF THE SEPTIC SYSTEM SHALL IEXISTIPJGI L 6' CRUSHED STONE OR CONFORM TO MASS. D.E. P. TITLE 5 AND LOCAL SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS. `OMPACTED BASF DESIGN PERC RATE l 5 MIN/INCH ILC— NC TO SCALE SOIL TEXTURAL CLASS - 1 4 ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER PROF ; . EFFLUENT LOADING RATE - 0. 74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER 440 GPD / 0. 74 GPD/SF - 595 S.F. REQUIRED THAN 3 ' IN DEPTH SHALL BE CAPABLE OF WITH- STANDING H-20 WHEEL LOADS. T PROVIDED: -a-500 GAL LEACHING CHAMBERS I W/4 ' STONE AROUND. A-406-S. j 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 OR 1 VV - 606--9rF. x 0. 74 ---44-8�� APPROVED EQUAL 59 Li-1 b (�,P1�, 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED SOIL TEST P / T DA TA °RECAST CONCRETE AND WATERTIGHT. O-BOX SHALL. I ND I CA TES i ND I CA TES BE WATER TESTED TO CHECK FOR LEVEL WHEN THERE BM CATCH BASIN PERCOLATION OBSERVED /S MORE THAN ONE OUTLET, R r u-95.4 I I TEST - GROUNDWA TER --� 7 BEFORE CONSTRUCTION CALL "DIG-SAFE•, S ep°35 33.E Pe/0149 1-888-OIG-SAFE AND THE LOCAL WATER DEPT /70 73 FOR LOCATION OF UNDERGROUND UTILITIES. \ PROPOSED DRI VEV'A \ N r`' 0. HORIZON TEXTURE COLOR 102 3 A LOAMY IOYR 8. EXISTING LEACH PIT TO BE PUMPED ,-,,R' REMOVED SHED SAND 3/3 5" 101 . 9 AND BACKF I L L ED W/ TH CLEAN SAND R LOAMY /OYR SAND 4/6 9 ALL UNSUITABLE MATERIAL I'A & B HORIZONS. Cl 20' /� SANDY /OYR 100. 6 LA YER) ENCOUNTERED BEL OW THE INVERT OF THE SAS TO BE REMOVED FOR A DISTANCE OF 5' 1 FOAM 6/4 AROUND AND REPLACED WITH SAND IN ACCORDANCE 1p 0iO \� �. �\ 48' 98. 3 WI TH TITLE 5 �osFp LAWN MED-COARSE /OYR ov �.\ C2 SAND 5/6 !O. NO DETERMINATION HAS BEEN MADE AS TO 60" COMPLIANCE WITH DEED RESTRICTIONS OR ZONING cr Qoe `•\ `; o REGULA T I ON$. IT SHALL REMAIN THE CLIENTS 1 % RESPONSIBILITY TO OBTAIN ALL PERMITS, SPECIAL 1 v /08" - y3. 3 PERMITS, VARIANCES ETC. FOR THIS PROJECT. C2 SAND 120- LOAM 92. 3 / l . IT SHALL REMAIN THE CLIENT'S RESPONSIBILITY o, tic oF�r A �� NO WATER TO HAVE THE PROPOSED BUILDING FOUNDATION 7 DESIGNED TO ACCOUNT FOR THE EXISTING GRADE 0G F rFr �� DATE: JANUARY /5. 2002 tip <<� -•- TEST BY: STEPHEN HAAS AND SOIL CONDITIONS AT THE LOCATION OF THE „1�� / �oC of , � JI WITNESSED BY: DAVID STANTON PROPOSED BUILDING. p�Eo °� ♦ �� c� 04� \ ,� // PERC RATE: ( 2 MIN/I NCh 5t,�004 �, L`0 T 42 x aE s° 22545 S.F. EXISTING /000 G SEPTIC TANK 1 � HYD IL REMOVALS 2-500 GAL 1 SEE NOTE 9 \ LEACHING CHAMBERS W14 STONE AROUND cEACHEYISTIPOr - 6° 30 00 W / S E C 5 J / / V/ D � 5 'A' �IZSL 00 j i / -5 CA RR / A (3E LAVE . MAP 298 PARCEL 54 SURREY ,�, S 6 A R /V S TA 6 L E . "A ` / M CA TCH BAS I N RIM-100.78 PREP.4 REO OR OCUSr- - -' .� A /VIES �� o c K E /�/z i SCAL E / 20 ' �EBRU,4R Y / / 2002 f � l EAGL E SLJRVE ' -r I NG I NC ! _ 923 Rou t e 6A _= Yarrr)outFhport , MA 02675 •,� ( 508 ) 362-8 1 32 ( 508 ) 432-5333 LOCUS MAP c IQ 20 40 i08 NO: v0- 119 FIELD CFW/EEK CAL C: SAH/CFW CHECK. CFW DRN: SAH