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0052 BAIRD WAY - Health
52 Baird Way Centerville A= 171 —244 1 (� I P No. 4210 1/3 ®RR M Wnd2gDeK ESSELTE 10%U& O O O O t u� M .-.. TOWN OF BARNSTABLE -LOCATION !T), SEWAGE# CS d �, c VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) L( L c [® a p (size) l/ X � ®2``O NO. OF BEDROOMS 3. C,\" OWNER v \�\�►L ?� + PERMIT DATEI 113 j `( COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on siie 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 �p ��� /A 3 s 3) �. ®e`er ` If � �`pA No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _V PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes j ZippliLation for Misposal Opstem Construction 3pPrmit Application for a Permit to Construct( ) Repair/ Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot NoSD. (3 ems.f WCAn C\Alk Owner's Name,Address,and Tel.No. Assessor's Map/Parcel V-7 s y Installer's Name,Address,and Tel.No. , a�y d o(_,I Designer's Name,Address,and Tel.No. 5 C_©Y\�_� `,-- 4s � �'t�S I Type of Building: q1 Dwelling No.of Bedrooms Lot Size j h �j_(, sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) .23 D gpd Design flow provided _732 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. LA L C. L aC (`.1nG/old 2I S Description of Soil �-��p 5 cgrld ;t C11f_—JtL u,,� I s.5u%^_e snot) .J C-1A P Nature of Repairs or Alterations(Answer when applicable) 1, C Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued b this Board of Health. e I iL i e Date Application Approved by Date Application Disapproved y Z Date for the following reasons Permit No. tV Date Issued No.' Fee THE COMMONWEALTH OF.MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 1 2pplicatlon for Bisposal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) El Complete System ❑Individual Components Location Address or Lot No5a, �3 e,%f-V WA'� Cv%\ -Owner's Name,Address,and Tel.No. Assessor's Map/Parcel \_7` — t InInstaller's Name,Address,and Tel.No. S O1 a�►\{ 0 069 Designer's Name,Address,and Tel.No. � \�� � "�� t r\.-S f 32 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) III Other Fixtures Design Flow(min.required). 33 gpd Design flow provided 333 gpd Plan Date 1 al.( 1 ,y Number of sheets Revision Date ` Title r Size of Septic Tank �X k `d 0 0 Type of S.A.S. Y L C L. 1-�a0 Description of Soil S qn d :1 &"t\_ l--,) 6h-rC50—J tNAe�1 S CnJ Nature of Repairs or Alterations(Answer when applicable) \ D sC V,,Uk, 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 i Compliance has been issued by this Board of Health. e Date i e Kr Application Approved by Date Application Disapproved y V Date for the following reasons Permit No. `- Date Issued / ) --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS I; Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( � Upgraded( ) Abandoned( )by S C.4k, at k-5 GAL has been consttucted in accor , with the provisions of Title 5 and the for Disposal System Construction Permit No. Installer S C O�A Designer �1� �� r^C. S #bedrooms Approved design'flow /r� �,, gpd The issuance of this pe it jall )of b const: ed as a guarantee that the system will fi'inct'on 'de]signed. b Date /(�-�/ InsPector V ----------------------J -----s ------------------------------------------------------------------z---------------------/------- No. L� Fee / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal *pstem (Construction 3oermit Permission is hereby granted to Construct( ) Repau'r-l"), Upgrade( ) Abandon( ) System located at ( G� C�,��►��� 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:Cons 1 io test a completed within three years of the date of this permit. Ae Date / Approved b PP Y Town of lRarnstable •.°F > o Regulatory Services Richard V. Scali, Interim Director Public Health Division 1639. ON Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer& Designer Certification Foram Date: Sewage Permit# \ -H ssessor's Map\Farce q Designer: . 57 z:P•6 w A. f'<E_ Installer: <S C.<�'�\ �s�,,n�C• 11 Address: 523 /2c7v-77= 6,4 Address: J'\\'- �v c. ran:t 5 can c. U� 6 0 On '\( 2 \ -\�:A Lo r e was issued a permit to install a (date) (installer) septic system at GvN\�,k_ based on a design drawn by (address) dated \c:) (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. 5 . I certify that the system referenced above was constructed in compliance with the terms of the IAA approval letters (if applicable) or a � � (Ins 's Signature r No.3.501 r: (Designer's Sigma e) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic\Designer Certification Form Rev 8-14-13.doc Town of Ba rnstable Pit Department of Regulatory Services tAMUMM : Public ]Health Division Date 200 Main Street,Hyannis MA 02601 xt F � Mph j( Date Scheduled- _ _ �tfr` Time Fee Pd. Soil.Suitability Assessment for Sew is osa Performed Hy: Witnessed Gy. r i� JET LOCA ION& GENERAL INFORMATION Location Address , Owner's Name Address Assessor's Map/Parcel: ' I 1 —I `� Engineer's Name Z) e, NEW CONSTRUCTION REPAIR Telephone# V pl Land Use. /-C3.., bc"uTA—L Slopes(%) �Z; Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other _ ft SKETCH,:(Street name,dimensions of lot,exact locations of test holes&.perc tests,locate wetlands in proximity to holes) r aaF Parent material(geologic)w�� � Depth to Bedrock, Depth to Groundwater. Standing Water in Hole: Ala 6_1� Weeping from Pit Fnce Estimated Seasonal High Groundwater DETE MINATION FOR SEASONAL HIGH WATER TABLE Method Used: . Depth Observed standing in obs.hole: _ —in, Depth to soil mottles: In. Depth to weeping from side of obs.hole: In, . Groundwater Adjustment ft. Index Well# Reading Date: Index Well level „ AdI.factor AtII.0 roundwnter.Level PERCOLATION TESL' bate �r `AYma.��+ Observation / Hole# 1 Time at h q Depth of Pere _ o Time at 6". S v Start Pre-soak Time @ O,, . Time(9"-6") Z� End Pre-soak �✓`�' � �Y Rate Miu./luch Z Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1) week prior to beginning. QAS EPTICIPERCFORM.DOC D]EEP.OPSERVATION HOLE LOG Hole#�— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. onsistency %'Gravel) DEEP OBSERVATION HOLE LOG Hole# Z- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. // onsisten %Gravel) it A t-S (U VZ—3<3 ZP rr LS v Y�z se 7°v�` �`r F- joYA- !/ S QL �Z Nl >o'el i/ DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%o VEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. o s' t Flood Insurance Rate Man: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No-)( Yes Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on j/ (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,exp 'se and experience described in 310 CMR 15.017. Signature Date �lmf5/ Q:1$BPTIC�PERCFORM.DOC O..r.} tirh Town of Barnstable Barnstable Regulatory Services Department j ST"U I � Public Health Division m 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0000 2851 4129 July 16, 2014 Gerard Dedenis Estate %Attorney Thomas Paquin PO Box 1145 Barnstable, MA 02630 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 52 Baird Way, Centerville, MA was last inspected on 6/3/2014, by Troy Williams, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • 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. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH o as McKean, R.S., CHO Agent of the Board of Health Documentl Parcel Detail http://issg12/intranet/propdata/ParcelDetail.aspx?ID=11698 rl 41 Logged In As: Parcel Detail Monday, July 14 2014 Parcel Lookup Parcel Info Parcel _—� Developer — ID r171-244 ) Lot:-LOT 3 Pri Location 52 BAIRD WAY Frontage 195 Sec�-�---_._'- _�.,� - -____ _� Sec Road Frontage' Village ICENTERVILLE ire District Town sewer er exists at this Road 1=65�� � address'No Index Asbuilt Septic Scan: � 77 P �. 4 Interactive 171244_1 Map ' ' � s 171244_2 Owner Info Owner IDEDENIS, GERARD Owner I/oSULLIVAN,WILLIAM F III Streetl.5 B D WAY I Street2 E City(CENTERVILLE State�A Zip 02632 Country Land Info Acres 41 Use,Single Fam MDL-01 Zoning[RC �� Nghbd,0105 Topography'Level Road Paved Utilities 1 Septic,Gas,Public Water Location Construction Info Building 1 of 1 Year Built Ext 1992 !SRU°t,GGable/Hip Wall CWood Shingle Living I1663 Roof IAsph/F GIs/Cmp AC Area Cover Type Int,__ ____ _ Style[Cape Cod Wall!Drywall Rooms Bedrooms t — � Int _.___— Bath Residential Model HafdW00d2 Full �� Floor Rooms - Heat Grade Average Type[Hot Water Rooms — �— Heat��__ Found-r. Stories i1 1/2 Stories Gas !Poured Conc. Fuel - ation Gross { http://issg12/intranet/propdata/Parce]Detai1.aspx?ID=11698 7/14/2014 - � v� � , �/� �� Commonwealth of Massachusetts Title 5 Official Inspection Form s # kG7-2, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments C k, 5 4/QO y� 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name informationis required for every P.O. Box 1145 Ba rnstable MA 02630 June 3, 2014 page. Citylrown 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 forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Troy Williams use the return key. Name of Inspector Troy Williams Septic Inspections Q Company Name 19 Hummel Drive Company Address South Dennis MA 02660 Cityrrown State Zip Code (508) 385- 1300 S1682 Telephone Number License Number E2 C_7 B. Certification - rn! CD I certify that I have personally inspected the sewage disposal system at this address and thatthe 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`df on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15s340 of Title 5(310 CMR 15.000).The system: ? can ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority ��z. -�•�•- June 3, 2014 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 oS d 7jg.21�y Title S Official Inspection Form:Subsurface Disposal y r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .�° 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 page. CityfTown 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•3113} 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 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cunt.): ❑ 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): I C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments "t 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145 Barnstable MA 02630 June 3, 2014 page. Cityrrown 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. t5ins•3/13 Title 5 Official Ins pection 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 •'r 52 Baird Way, Centerville M- 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145 Barnstable MA 02630 June 3, 2014 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 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 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate Go Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3 2014 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 13=48,000 gals. g ( y g (gp ))' 12=42,000 gals. Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occupiedDate Commercial/industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): N/AGallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A 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: N/A t5ins-3/13 Title 5 Official Inspection Forth: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 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: N/A Date Other(describe below): NIA General Information Pumping Records: Source of information: No pumping info was available. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3113 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 °< 52 Baird Way, Centerville M- 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner owner's Name information is P.O. Box 1145, Barnstable MA 02630 June 3, 2014 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Tank, d-box and leaching were installed on 10/30/92 per compliance. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18'+ 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.): Lines were found clear at the time of inspection. Septic Tank(locate on site plan): Depth below grade: 1 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: 5'X9'X6' 1000 gallon Sludge depth: 4" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 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 2'81' Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? probe/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.): Pvc inlet and concrete outlet tees were found present and in working order. No evidence of leakage or damage was found. Grease Trap(locate on site plan): Depth below grade: N/A feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A Scum thickness N/A Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of last pumping: N/ADate t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form • Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 'f 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate Go Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 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, 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: N/A Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: N/A Capacity: N/A p ry' gallons Design Flow: N/A gallons per day Alarm present: ❑ Yes ❑ No Alarm level: N/A Alarm in working order: ❑ Yes ❑ No Date of last pumping: N/A Date Comments(condition of alarm and float switches, etc.): N/A Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3113 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 "t 52 Baird Way, Centerville M- 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 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 level Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box was found level and in working order. 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.): N/A *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 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 '( 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1,-6'X6' pit with 2 of stone ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit was found with water level 6" below invert on inspection with walls found stained above inlet line. Leaching does not have a minimum 1/2 day flow available at this time as required by BOH. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A Depth—top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 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 "< 52 Baird Way, Centerville M- 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 page. Citylrown 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.): N/A Privy(locate on site plan): Materials of construction: N/A Dimensions N/A Depth of solids N/A Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A t5ins•3/13 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 52 Baird Way, Centerville M - 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owners Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 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 10 , i I 0 �3I TV 2- 30 3 V �r� It t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 52 Baird Way, Centerville M- 171 P-244 V Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water El Check cellar ❑ Shallow wells Estimated depth to high ground water: 13.0'+ 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. 11/4/81 Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: SDW 253 Zone C 48.6' 3.7'adjustment You must describe how you established the high ground water elevation: Test hole recorded on plan showed no water found at 13.0'. Groundwater adjustment at the time of inspection was 37. Bottom of leaching at 9.0'was found not to be located in the high groundwater elevation at the time of inspection. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 52 Baird Way, Centerville M- 171 P-244 Property Address Gerard Dedenis Estate c/o Attorney Thomas Paquin Owner Owner's Name information is required for every P.O. Box 1145, Barnstable MA 02630 June 3, 2014 page. Cityfrown 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•3173 True 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 SZ 6UlrcP w�+ -2-a 0 ?"U - 7 9 ► A i 71 3 Oee�ivd�►3' v�c a q .See L ass t- b 3 a�",2 J, Afew-e-q �6 t't9 �►v1 26'-O" Y� / Y 6 �Q� fo -----, S �� c�✓t Cr-�e ��e�' er, J/l 5fi oU ot-- For Sv, 15A,rO 1 of%y Lera-VV it�`''• ��� � ,f�-� ---� • i 6t��`� 3 TOWN OF BARNSTABLE L-�- A, LOC kTION I,--- Zc LJ SEWAGE # %), . -q VILLAGE ,V� rZa/i�� ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. ( SEPTIC TANK CAPACITY �Q-t,,ro & LEACHING FACILITY:(type) p-,'f rt-- (size) �Jc I r NO. OF BEDROOMS PRIVATE WELL <P=UBLIC,;�TER BUILDER OR OWNER DATE PERMIT ISSUED: �'..�-��• DATE COMPLIANCE ISSUED: ® %2 VARIANCE GRANTED: Yes No I _ w � F ` 1 r� t7l - ILI L No.� -------�=-- Fps............................. THE COMMONWEALTH OF MASSACHUSETTS _ BOARD 0 '+� I,-IgEAILTH .... ..... . �.W..t.�....-----OF... ............................................. Appliratiou for Pisp.aiial lVerkv Tonstrn.rtinn ramit Application is hereby made for a Permit to Construct (Ll�or Repair ( ) an ividu y' a D'i;p sal System at: V ✓✓ ......_. ..�.'�..i —: c �.r�x�.. �~( � .... ----..fit....�-- -----.....Of...�.�.---p ..: __._p Location- Lot No. ress ................................ ......................_. --..- l�L�xa.�1 --..1Mf ... ...._._........_ tJ wn r _ � Address W Installer Address d Type of Building Size Lot........... L_5Q Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures ................................. W Design Flow.....................5!�_____II______....gallons per person per day. Total daily flow.___.__......_ -�-.0................gallons. WSeptic Tank—Liquid'capacity. gallons Length................ Width__......_._..... Diameter__-_-___-___-__- Depth................ x Disposal Trench—No. .............................. Width--_--------------- Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No.--_____--V--------- Diameter---------I_P----- Depth below inlet........ ......_ g 72&..sq. ft. _ Total leaching area..._ Z Other Distribution box ( V51" Dosing tank ) e' PP ff Percolation Test Results Performed by...............�XmC -. _ I(( ___4N e........ Date.........��.-.4.7BI......... ,aa Test Pit No. I...... _....minutes per inch Depth of Test Pit....... ...... Depth to ground water---------- _-___--_-- (i, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ----------------- .............-- 0 Description of Soil.......... .. d�-lrlt4.__.___ e3 ._.__ • -------------------•-----•--••--•••---•-••------•••--•-•------•-•-......•-•......--•• x ..... ' ------ ' . ....... .........-----------------------------•----------------------------•------------------------------- -------------------- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees to lace the system in operation until a Certificate of Complia e has be n issued y he bo d ea1tXS„ V/(l /' Signed ...: ... ....... : .............---------------------- Application A roved B r' ��1 '� '�` �r PP Y ---- --------- - -.... ... .... . ...................................... 0':.l Date Application Disapproved for the following reasons- ........--------------------------------------------......-------------------.-------....................................-------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------- re Permit No. � --------------------- Issued ........ ........ Date No f J...�. ....�j% Fss............................._ THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH .................. .........OF... r'..1S�11! 1.�----------------------------------------------_ ` ppliration for Disposal Works Tonstrnr#iun Prrutit Application is hereby made for a Permit to Construct ( V�or Repair ( ) an Individual Sewage Disposal System at: 1-11 kk ................__......_. ..�.............................••-•-- ------. --------------- `� Location-Address or Lot No. ------------------------------- ...........!::....._4...t..... ..........-•...................................................................................... t Owner Address W Installer Address Type of Building Size Lot_._._______ �Qk�Sq. feet Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) p14 Other—Type T e of Building i yp g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Pa Other fixtures ................................. . W Design Flow..................... !�...............gallons per person per day. Total daily flow.__..._..._.._-5 30_.____......_...gallons. WSeptic Tank—Liquid*capacity-�M.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._......_..k---------- Diameter----_----1U..... Depth below inlet____.___C_........ Total leaching area..... e�.sq. ft. Z Other Distribution box ( !I-f Dosing tank ( ) '-' Percolation Test Results Performed b j, v T��t,P.�'..�� �___1!4C........ Date...... a Y i ,-a Test Pit No. 1..... -_•_minutes per inch Depth of Test Pit.......!_ ...... Depth to ground water...........«,.--.,,�.:............ G%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ................... ............. .•.--- .......--•-•... ,...•-•--••----------•--...------------------------•••-------•-••---•-••........--••--......-- O Description of Soil........._n._- ___�-v =V* !J_"5 �, �^' U ....................•---......_......_..._........'.___?....•_..........J:............'.......................................................•..---.._......._..•.................................. �4 ..... ..-A ..-----------------------------------------------------------------------------•---------....----------- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees nod to lace the system in operation until a Certificate of Compliance has been issued by the board ofthe`alth `Irt � -�` Signed ... ---------------------- Application Approved BY _.'- �---(�-~�r'�k�.. � `..� ............ � ' �.' _/.- . :- . -------------- �! ate Application Disapproved for the following reasons- ---------- ---------- ------------------~-..----------......--- .-- . ...--------...--- ......... . . ........ ... . . .... .... ............................................... . .............................................................. .................................... ........................................ Permit No. f .................. ° -------------------- Issued �.. �� t i ----------- - ---- Dm THE COMMONWEALTH OF MASSACHUSETTS --'— '"' BOAR - OF HEALTH ------ -------------------------------•-------- C6.ertifirate of C'Iamplianve THIS IS TO�CERTIF , he Individual Sewage Disposal System constructed ( � ) or Repaired ( ) by ............................. ...............................--. -- .........:..............---- . .------------------------------- -- ---.-- ----. ------ .......... l I / � , Installer, at ---` !f ? , ', " --... `` .t I ---f /P _7f..-----.. f �l �1..•` , ----------------_--- ---- has been installed in accordance with the provisions of TITLE 5 Q f The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..... . ' �...-��'.�j'., dated ...../" './_...''...... . THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACC�TORY. DATE-------------------------------/0..:.....E�...... 1....:�.----------.......--- Inspector ------............---.... ...-----------...-................ THE COMMONWEALTH OF MASSACHUSETTS BOARD �,OF HEALTH FEES ................... Disposal Works Tannsfrudion rruti# Permission is hereby granted.............................................................................................................................................. to Constru t (-L--)' or,eRepair Ate) an Individual. Sewage Disposah System; //. at No..-• - �s-`� �'' f=----..•........ ,��.�.'.?:_,'. ._...- -•P�•�"�- 4.�"✓yJ ' `` `' �' ='--••--. Street i •- - as shown on the application for Disposal Works Construction r t No ' ;_.. ^-_._'_'`Dated-----t_.......!.......e... ....... ......... ................l il�- Board of Health DATE...... ....--...................... / FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS `f 514i.'La FAMILY 3 BEVVEMMjr o .- IJo 6bI5AC-E 6fzItJ�EK � - ` .t> :i.'. .;SEPrIC rt'atJV. 33o x�So�o=495' GPI logo GAM_ i A, 'DlSPoSA PIT I-►ooa GAL. �21 51arJE `.`. SIDEW4LL AREA I SP, SF mom Sr 1'IT JJ,3 r TOrAL VAIN- MOW = 33o. P0D ;,'ok F PETER , . �� I _ S1,1LIL�11IVA ��t� ,q •. N No. 29733 Fr, DZAIN It o 13 O o o - �wCo, i � -DA WF IF P � �¢ T-V5T �61ga ��D �A/A\7 �t..t- II'4-$I 1-t II-r�c={DD TF= Iol f FF6-Itlo ,. ---• ----�,• fJT� '7TT�TJ�4�7 ' Lb 4w + — � tuv MT, {N� Iiv loco* 91d. ! iJ {qv 9l2 $b➢C 9lKb Ne 6AL- 97 { WI F,4 I sTo9E t Ct- 2-44 E Saute to i..: ILs— �.OG.ATIDh1 C.&QTE��.�/I JJ o scA.� : . ►3- Ire-a; 244 LE-, � '! 4c- 'PATE 4'L _N D.C�A'TL�ILs�o PLAN P-E -''RF�JCE 1 CFJZTIFY THAT Tt•{'E DW EU-1u� r 4owN WMwt4 CoM'PL wrrw -Mf- 51 U1JE Lor- 6-7 15 - �t�. ID; S L- `DWN of'Bt,�TnSLjt- 79K RAN IS NOT" ?4ED oN AN l�15'T>zvtitE+,YT' c I L E+JGi IJ!JE>zs 1 SuCta/E`f AtJv 1� oFF3e1"S 4400tZ) u T3E o 5TE2vILLB MA/?4 u5M ro E5TABU'5 APPLICANT, Town of Barnstable Geographic Information System August 8, 2006 171075 A �r?e 1.71040 , 171271 171238 171266 �' #�91 >r 1.71 s. # 195 # 188 :171251 171252 =4 # 2 171076 1710.1 �i1 1.7127) # 78 .•4 /� -fin # 103 # 88 #-15 .ti �, 171118 . c, 1.7126 5C 7107 P t /�. a <_li�+.'� .'204 1.71269 "~ �, f 31711-19 7 171042 "s.-'' + `A 4 �' ''-i�285 .�S 171249 �y 1.71120 171098 171268' r r # 295 # 75 v r F '► . # 1 �, 1.71248 31 1710 78 �` # 11817115 3 339 �� � 1 i 171121 ' '"• r # 305 17 44--,- It # 12 � 1.71160 1 ;y 7116-1 ^ 22 r `k �{ 242 1 f1079 ? � •• 155 .J�"+` - rrJ aV� � a 302 355 �r 171161 171087 .E �� 171245 0323 # 354 171 t ,% e� r # 148 � I #F 316 # 1 �• ;, N. r ,� _? ' '` ; z y wf/ _ 1.71-162 1.7 244 15� 171090 = �s� r ., P r e l ' `• �' 171-164 I • r # 33 �r I.A— x j 170243 ### 54 . 171173 # 348 # 386 q 1 171277001 - t 171165 # 56 / +F�i ••4yy4 J• 171219 y1. rr 170244003 #'42 •.` '� # 39 1.71 12i 1711.74 r P r?. : r= J # 363 # 358 - i' # 56 DISCLAIMERS This map is for planning purposes only It is not adequate for legal Map. 171 Parcel:244 boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel 1"=100'may not meet established map accuracy standards The parcel lines on this map Owner:DEDENIS,GERARD Total Assessed Value:$293600 are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner Acreage:2.41 acres Abutters w'`-+} boundaries and do not represent accurate ry �;ationship physical features on the map Location:52 BAIRD WAY such as building locations. Buffer ACCESS ,COVERS MUST_BE.WITHIN 9" MINIMUM.' INVERT ELEVATIONS : DESIGN CR l TER I A : GENERAL NOTES : 6" OF FINISH GRADE 3' MAXIMUM COVER FIRST 2' TO INVERT OUT SEPTIC TANK: 99•2 DESIGN FLOW: BE LEVEL MIN 2" OF PEASTONE INVERT IN DIST. BOX: 98.67 3 BEDROOMS AT //0 G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION OR F I L TER FABRIC INVERT OUT DIST. BOX: 98.5 BEDROOM EQUALS 330 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY. 3/4" a- D/AM PIPE - l 1/2- DIA. INVERT IN LEACH CHAMBER: 98.4 DOUBLE WASHED STONE BOTTOM OF LEACH CHAMBER: 97.4 NO GARBAGE GRINDER 2. VERTICAL DATUM 1S ASSUMED. FOR BENCH MARKS 98.5 I2" �� SET. SEE SITE PLAN. GA �/4 .99.2 98.67 0. � 98.4 97.4 ADJUSTED GROUND WATER: N/A BAFFLE SEPTIC TANK REQUIRED: 3 OUTLET 4 LC-6 LEACHING CHAMBERS OBSERVED GROUND WATER: N/A 330 G.P.D. X 20OX - 660 GAL, J. ALL CONSTRUCTION METHODS AND MATERIALS AND EXISTING D-BOX W/4' STONE SIDES. 2' ENDS. ll 'a x 33'1 x 12"d BOTTOM OF TEST HOLE *1: 91.3 SEPTIC TANK PROVIDED: 1000 GAL. EXISTING MAINTENANCE OF THE SEPTIC SYSTEM SHALL 1000 GAL y-20 CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL SEPTIC TANK 6" CRUSHED STONE OR COMPACTED BASE SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS. DES l GN PERC RATE l 5 M/N/l NCH PROF L E : NOT TO SCALE SOIL TEXTURAL CLASS - I 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER EFFLUENT LOADING RATE - 0.74 GPD/SF AREAS SUBJECT TO VEH l CULAR TRAFFIC OR GREATER N 330 GPD / 0.74 GPD/SF - 446 S.F. REQUIRED THAN 3' IN DEPTH SHALL BE CAPABLE OF WITH- STANDING H-20 WHEEL LOADS. PROVIDED: 4 LC-6 LEACHING CHAMBERS W/4' STONE SIDES. 2' ENDS, A-451 S.F. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR 451 S.F. x 0.74 - 333 G.P.D. APPROVED EQUAL. SOIL TEST P l T DA TA 9 6. SEPTIC TANK AND 0-BOX SHALL BE REINFORCED PRECAST CONCRETE OR APPROVED POLYETHYLENE. INDICATES INDICATES BOTH SHALL BE WATERTIGHT: D-BOX SHALL BE WATER PERCOLATION _ OBSERVED / TEST - GROUNDWATER TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE / TIP ♦1 P#14466 TP •2 OUTLET. 1 0" HORIZON TEXTURE COLOR l0/.3 0' HORIZON TEXTURE COLOR 101.3 A LOAMY IOYR A LOAMY /OYR 7. BEFORE CONSTRUCTION CALL "DIG-SAFE SAND 3/3 SAND 3i3 1-888-D 1 G-SAFE AND THE LOCAL WATER DEPT. 8" - - - - - - - - - - - 100.6 6" - - - - - - - - - - - - - - - 101.8 FOR LOCATION OF UNDERGROUND UTILITIES. LOAMY 10YR B LOAMY 10YR B SAND S/6 SAND 5/6 c8/DH END\\ N 87°06'00'E / 24" - - - - 99.3 28- - - - - - - - - - - - - - - - 99.0 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE \ 18 J.2S' / C/ FINE- - - - - - - - - -NE SAND IOYR C FINE SAND IOYR _` \ AND GRAVEL 6/4 AND GRAVEL 6/4 DESIGN ENG l NEER TWO DAYS PR l OR TO CONSTRUCTION - - - - - - - - - - - - 46' OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE / CONSTRUCTION INSPECTIONS. / N 78" - - - - - - - - - - - - - - - 94.8 78" - - - - - - - - - - - - - - - 94.8 / APPLE TREES -�,-10/-6 / C2 MEDII/M IOYR C2 MEDIUM IDYR 9. EXISTING LEACH PIT TO BE PUMPED DRY AND l 4 LC-6 CHAMBERS SAND 6/4 SAND 6/4 W/4- STO1VE SIDES.DES. 2- ENDS / BACKF I L LED. 101.9 i / 33' y - NO WATER 120' 91.3 /20" NO WATER 91.3 STONE DR 1 VEYVAY I :.':..........:..... - DATE: SEPTEMBER 4. 2014 1� O, D-BbX-••_•.•.•a•• / 5 TEST BY: STEPHEN HAAS --�- / (GP WITNESSED BY: DONNA MIORANDI /' io/-1 PERC RATE: C 2 MIN/INCH _.-------� DECK r- __ _--_ - ._ y�_�Y ,_-.,u,.�_�_�_._ ..--.. _ ---_- -�_ :-„ ,- .__-.,�".. ..,..-W:;,,: _,F, .._•. .,-_ . __ .,- / OHM' W ... W EXISTING ,� G UP 123/-4 V SEPTIC;TANK 16"BEECH TREE \\ EXISTING G� DWELLING <II LOT 3 N IQS, 120+ S.F. /'' EXISTING D / ' LEACH PIT 1 / / 8M. CORNER BH ( EL-l0/-96 ; TPA 150 + c e,4 ��-_ TPs2 w 222.93 ,L N 84-24'59"{y -� SEPT l C SYSTEM © l ES ON 52 BA / RL WAY . MAP l 7 / PARCEL 244 yc / BARNS TABL E ( CENTERV l LLE ) MA �o PREPARED FOR Q LEGEND W I L L AM S UL L VA N ■ CB CONCRETE BOUND -w WATER LINE SCAL E / 20 ' OCTOBER 24 . 2014 ti O HYDRANT OVER OCUS OHW- OVER HEAR HEAD WIRES RES STEPHEN A . HAAS L � -0 LIGHT POST ENGINEERING , INC --E- UNDERGROUND ELECTRIC LINE r ` R . O . B o x 1 6 -T- UNDERGROUND TELEPHONE L l NE South D e n n i s MA 02660 / rr� 1 I/1;I -CTV- UNDERGROUND CABLEVJSJON LINE ���� I � ` � SO8 362-8 1 32 +40.4 SPOT ELEVATION ..•--40------- EXISTING CONTOUR / / A,� L O CV S I Vl A P 0 l D 20 40 I40I PROPOSED CONTOUR .JOB NO: 14-062