Loading...
HomeMy WebLinkAbout0009 BIRCHILL ROAD - Health 9 Birchill Road Centerville 189-059 i IN UPC 12534 a No.2153LOR N* M"TINGS.UY Commonwealth of Massachusetts Ila : Title 5 Official Inspection Forma Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° 9 Birchill Road h-W Property Address Patrick Hill Owner Owner's Name information is Syr required for every Centerville Ma 02632 5/22/2018 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. i Important:When filling out forms A. General Information Sett /368Y� /�, on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. Title V Septic Inspection Company Na Company Name 74 Beldan Ln. --�v Centerville Ma 02632 Citylrown State Zip Code 774-248-4850 smjonestitle5@gmail.com S14522 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 5/22/2018 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 I/ y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 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: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The dwelling located at 9 Birchhill Rd Centerville is served by a Title V septic system consisting of a 1500 gallon septic tank, distribution box and 3 500 gallon leaching chambers. The system was found to be in proper working condition at the time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or 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-3/13 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 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. Cityrrown 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 (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): El 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 16.303(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 Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °y 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. Cityfrown 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 '/2 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 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 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 11 of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system 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 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 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 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 ❑ E 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? ❑ E Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 gpd t5ins-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 M ' 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. Cityrrown 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? (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 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current 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-3/13 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 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. Cityfrown 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 ❑ 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): (Sins•3/13 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 ,.° 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 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: system installed 1-10-2006 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No BuildingSewer locate on site plan): ( p ) Depth below grade: 2.5 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.): Joint were ok, no leaks, vented through the roof Septic Tank(locate on site plan): Depth below grade: 2 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: 1500 gallons Sludge depth: 6" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 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 3" Scum thickness 3" 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 10" How were dimensions determined? opened covers, took measurements Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank does not need to be cleaned now but should be done soon and again every 2 years for proper maintenance. water level was even with outlet, tank was not leaking and was structurally sound. Inlet cover is on a riser. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. Cityfrown 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 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box was in good condition, no rot, water level was even with outlet invert. 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.): *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: l5ins-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 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. City/Town 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.): s.a.s. consists of 3 precast leaching chambers. Leaching facility was found to have 6"of standing water with no stain lines higher. Cover is on a riser. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 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 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): I t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments yy< 9 Birchill Road Property Address Patrick Hill Owner Owner's Name information is required for every Centerville Ma 02632 5/22/2018 page. Cityrrown 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 (Z-r AD— Q 8 t � ❑3 � l 36 A Z 7_1 t3 2 3S''. �3 21 C Z6'e A-`f 31 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,.' 9 Birchill Road Property Address Patrick Hill Owner Owners Name information is required for every Centerville Ma 02632 5/22/2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12'+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts N W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 Birchill Road Property Address Patrick Hill Owner Owners Name information is required for every Centerville Ma 02632 5/22/2018 page. City/Town 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 f � t 22-141 50 SHEETS d--;� .gin I CVY) �'(eW G d !.,'io_ r..-1 <_ -100 SHEETS mil( In �p rs._ 'rt..,, ru,i: 22-144 200 SHFETs �j.,,��ir•V S€calo,J � � . se-l; I 0G) I 04 ,c E+ 1, / �l 4 " 'oJs b �� ;� b Zxlo psFtl�Rt (L o •� - % quo VJ / I � rn \ � I ( o� 16„p.e m I Z IL �5 Ib'o.C- _ II 6 flelGQT to MM04 /` I i /j A11 CONCRETE <-j� /1) I 12 oat i� LA , { � � \ ° � Q � . � ( k9 � p . m . f : $$$ � ! Ft.dd F i \// � } | . � - . � 2 � Q !I � J } � o : � � l ; ] � � \ \\2 ; §ge I ` } Amƒ � a ; I , . � | ! � -- — � - � i � \ % < w - j $ 4z : . � � > , ' + . ; ! : � � \ �}} � \\J� \k§ M m m � wee , 77 ) � 7 | : �OC , � � � � --------- ------- --z -- - -- � i i Q V • i o v I � G e I I ( wpo� rl �3a21r✓��l � \ J j w 01£y'tr'LL C°5119 v Ctl o1E�tM1 C'OS��'"17 I i i H9 '4. if 35 v E i i c n a0 cn cn c: S Eo i0 C; w , I I D 1381 Ml c'°Sa3C tl ' i i ' I i I i ; III a I I i � 1 I ;I I I 1• D a l ; 1 - � r is Zv rub iid ati f I I O M I N � 0 Z I � i Qo c o o c , L ; z r a , - i -• i i . I 1 i i i 0 � r ° Ica - p \y ( m j O— l Z , i I i P - = LEGEND rent --'—n I o��c�9 c Marsh Rd Benchmark Set 3e PROPOSED CONTOUR e r' 0i.{ x Right cor, bulkhead rJ`V o R UP/888/2 E1,=98,44 (Assumecl) 1J8 PROPOSED SPOT GRADE 1 96;12 h; a 0 m ,y PK/SE T I. —•-110--•.-- EXISTING CONTOUR na dr v a (o p 96 68 96.96 110 EXISTING SPOT GRADE 9 \740 ® TEST PIT 4 -`� \ —W-- EXISTING WATER,SERVICE �196 49 ?-55,91 yr�6 f/�6.10 �� \., Q� EXISTING WATER SERVICE n n �,.-•.`'- 0°'! ' h i / J�� 97.86 ` N Raoa Route 28 95,48 �d9 6 >G3,2 s� x tp Q A c Sylvia Ln 5.18�. o N 9 79'00 -�.� 2� ass / 98 05 LOCUS 97.57 - c' . 5" s- �� LOCUS MAP N.T.S. 7.65 x yes p� 2 x 9E,54 /` 97.56 <dG 97.7..r '� a• '� GENERAL NOTES: 13 97 / /' 5 '6 / r 2-8' /�/ B t �04 1, ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL lO� �"9 77 nn cy �i d,F BOARD OF HEALTH AND THE DESIGN ENGINEER. \�� \ n 2, ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS o \ 6 q 1-BEDROOM OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE ' FT- ' ? ADDIT D!V / LOCAL RULES AND REGULATIONS. (crawl pace t 97,86' 98'30 3. THE .SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 1 D ox Inv,-95,77 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE v "'\ / { �.\ ` DESIGN ENGINEER. i 4_ 'D•. �` - fEXIST7/VGj �t � ?�, , 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING _ 1, jerk �3• BEDROOM \, �� FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN � � ! �� oy' J� I HDUSt C#9) \ "c�_ , ENGINEER BEFORE CONSTRUCTION CONTINUES. x -6.9 i TDF=98.44 LOT 12 E o 15,124.± S.F , 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. (AssuMed) \ \y � � O O � 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF ��_ , 0,35t /10,. (n THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF J"� \ (full cellar) Q:% Map 189 �I Q 9s•36 HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 1 X 96 li oa N` �\ N \\ Septic Parcel 57p ' 7. WATER SUPPLY TO BE PROVIDED BY TOWN WATER. /, 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A.S. a, CD-I, b XA9 \ ' 9. SEPTIC SYSTEM COMPONENTS SHALL BE INSTALLED AS DESCRIBED TP-1 /i 98,J8 IN 310 CMR 15.000 SUBPART C. \ �\ E�•3Q \ i 10. ALL AREAS CLEARED FOR CONSTRUCTION ARE TO BE LOAMED AND FISTING CESSP�DL / SEEDED UPON COMPLETION OF CONSTRUCTION. v L9 TV BE REMOVE 11, IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY''97.56 (SEE NOTE 11A 9 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO STARTING CONSTRUCTION. rr , 12. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. x 96.11 9,;..-.- �i 96:51 x 9 6.11 AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). � OWNER OF RECORD ZONING CLASSIFICATION: ZONE RC - p8 - PATRICK HILL 09, e 41 EXISTING LEACH ,PIT ' p( Mq 9 BIRCHILL ROAD SETBACKS: FRONT YARD=20',SIDE/REAR=10' 43'20 TD BE PUMPED AND P��� �fq�y CENTERVILLE, MA 02632 BUILDING HEIGHT; 30' ✓ S 69� FILLED WITH SANE-' PETER T.McENTEE PROPOSED SEPTIC SYSTEM SITE PLAN CIVIL 9 BIRCHILL ROAD CENTERVILLE MA yh.39" i y 17.71 28 No. 35109 r , RfCI$lE��� �" Prepared for: Patrick Hill, 9 Birchill Road, Centerville, MA 02632 1Fi F�\D -••_' gf Engineering by: Surveying by: y 7,5.1 E qb EN SCALE DRAWN JOB. N0. U Englneed tjWpr,r Te"74 WarrrerP..�S 1"=20' P.T.M. 241-05 23 Deer HOIIOW Rood 22 Lon9-Road -i1 ' •� (/l Forestdole, MA 02644 Harwich, MA 02645 DATE CHECKED SHEET N0. -i' (508) 477-5313 (508) 432-6309 12/27/05 P.T.M. 1 of 2 Town of Barnstable RKC, HAn AWNSTABM 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-18-3555 Date Recieved: 10/26/2018 Job Location: 9 BIRCHILL ROAD, CENTERVILLE Permit For: Building-Family Apartment no Construction Contractor's Name: State Lic. No: Address: . , , Applicant Phone: (Home)Owner's Name: HILL,PATRICK R Phone: (Home)Owner's Address: 9 BIRCHILL RD, CENTERVILLE, MA 02632 Work Description: Amelio Fajardo Adult son of owner will reside in Apartment. Norma Martinez to reside in Single Family dwelling. Create Existing Family Apartment without Construction. /O Total Value Of Work To Be Performed: $100.00 O Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted oil the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: HILL,PATRICK R 10/26/2018 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $100.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $110.00 j 10/30/2018 $110.00 Cashj Total Permit Fee Paid: $110.00 1 1 THIS IS NOT A PERMIT L � No. Fee 50 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Rpplication for Mi5po!5a1 *paem Con0truction Permit Application for a Permit to Construct(repair( grade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Add and Tel.No. Assessor's Map/Parcels- 9 Installer's Nam ,Ad ss,and Tel.No.Sb8 y24—g7,fg' Designer's Name,Address and Tel.No. '00,, feAf,/l 23 0r C1- /Y //a u/ %� -5? Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairsor Alterati ns(Answer)vhen applicable) 4e l r.4 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 iss ed by th' Bo of lth. Signed � < Date Application Approved by 0 Date Application Disapproved for the following reason Permit No. Date Issued rt�V l T :x+ No. ,� ti ✓ Fee ` r ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:41 nYess _ is .e^^ fi *PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS � Rpplicatio&for -Mi2;po9;a1 *pgtem Construction Permit Application for a Permit to Construct(,c_ Repair( 4)-Hpg ade.( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 9' el/'G h l y/ /2O d Owner's Name,Address and Tel.No. 04rrl�k H,// Assessor's Map/Parcel / Installer's Name,Address,and Tel.No. S'03-y24-q7, 'g Designer's Name,Address and Tel.No. 5-08-4�77-53/3 as rvos ENG� -,��i hrJ cvdrk z e nel 144, M,M Type of Building: - Dwelling No.of Bedrooms Gf Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) r" 1 S-aa Gr//2S4 ,1,5 cJdH ., s f = Date last inspected-" _ i 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 issued by this Boar of lth. Signed 4 r, /1 _ Date v/Application Approved by !��� Date L� Application Disapproved for the following reasons v I Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS l BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTI that the On-site Sewage Disposal System Constructed( 4+Repaired ( c-TUpgraded( ) Abandoned( )by 4.5 r -, a i at . ' / %/"V,, /: has b n construct d i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated n.. 6 Installer ✓o�IQ�I i ��l� S Designer The issuance of is p rmit shall not be construed as a guarantee e that the sys ern wl 1 unction nod( Date_I �l U(o Inspector 4U! K — -- --1--------------- ---- No.—— —— —— Fee �./ THE COMMONWEALTH OF MASSACHUSETTS ®� PUBLIC HEALTH DIVISION - BARNSTABLE, MASS.ACHUSETTS MisSpo5al *pgtem Construction hermit Permission is hereby granted to Construct( -)-Repair���,�jyy'Upg�rade )Abandon( ) System located at LE''s�2[.LL, �Z_ 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: Construct*b st be completed within three years of the date of this .e t Date:_ /I Approved by � 1 Town of Barnstable Replatory Services t 1 'Thomas P.Celkr,Director Public Health Division Tbous McKean,Director 200 Massa Ste,Hyannis,MA 02601 Olr". WS-962.4644 Fax: 3011490.6304 flats �6at D4Esils<ater�ertlt tioa Fum Date: �I Sewage PermitO ,2666:::(�, Asse9wr'd k61;\_? R � , ' , grce, 1q Designer: . 4-V Me E L" . �� Installer: J 0 e �.� ,,..'e"'.-4-k- As ,�✓c �� Address: av, C<`a ss�e lad_ -- Address: 491 . Ca mf"c ff � yy _ Nlars+cYi,) Neils M4 cz(, On ��c 6"o- was issued a permit to install a (date) (Instalier) septic system at 1 _ . based on a design drawn by (address) ?,e44- I��- e � .�. datest (designer) I Certify that the septic system referenced above was installed substantially according to the dtolp, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tactic. I certify that the septic system referenced above was installed with major chaages O'e, grater 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. IA OF PETER T. G (Installer's Signature) MCEN7FE CIVIL y -o No,35109 TEA�� k`Q (Resigner°s Signature) l (Affix Deli ere) °Xis..NOX Ag MU tJhM AM INS EURN NIP W QAR.AU >as r+xse�rts ny Tx ,n®n eIABLE FUND IL"111�eZ0 Q.HeWtKISrptic/rnsipu Cer iAmi m Form 3.26.04.doc TOWN OF BARNSTABLE !�:OCATION /20v,/ SEWAGE # 2006 —00 y VILLAGE ( _c!1rrrVi1Ic ASSESSOR'S MAP & LOT/� -DS9 &STALLER'S NAME&PHONE NO. .508-V29-9rff SEPTIC TANK CAPACITY /Soo LEACHING FACILITY: (type) (size) 3/.SX C,Z NO. OF BEDROOMS BUILDER OR OWNER_ Pi4r,-11c% PERMIT DATE: /-( —410 COMPLIANCE DATE: /-10-06 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 leachi g faci 'ty) Feet Furnished by r� W '6 / 3, �1 TOWN OF BARNSTABLE LOCATION iLOAA SEWAGE # q I ��54 VILLAGE ASSESSOR'S MAP & LOT ' �(/V INSTALLER'S NAME & PHONE NO. Q�',5c6 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) LZcLr ^ Q,T. (size) `,000 lld�.g NO. OF BEDROOMS _PRIVATE WELL OR PUBLIC WATER BUILDER O OWNER �d�h S�w�y � �0 DATE PERMIT ISSUED: (d DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No - �- i 1 r I ` �S, I � 1 Z ti� 6 `'e��� -. 1 'Z6' .. •:'� ASSESSORS MAP NO: PARCEL NO: No.._l!r':..L:� 910...... THE COMMONWEALTH OF MASSACHUSETTS Q V E D BOAR® OF HEALTH Barr - -.tionCo-' i—iOnTOWN OF BARNSTABLE �nedDisvviial Works Cnomitrurtiim Pruitt _� Application is hereby made for a Permit to Construct ( ) or Repair �() an Individual Sewage Disposal System at ' P ................ .. �`2 !._ ..... � ........(exroptAc .------------------------------------.. ..1 --......... -------- .ocatio A dress Lo 0 O Address W ..................•------••-•-•••••--•-•- --•-----.�aac._5 Bt staller Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.............. _.___Expansion Attic VVt Garba e Grinder Wo 04 Other—Type of Building ...�QUS.e-----_-- No. of persons............ Showers ( Cafeteria �) P4 Other W Design Flow....... ...............gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by........................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ --- -- •-- - -------------------------------- ----------------•- -----------------•--•----------- ODescription of Soil �tll ---------------••---------------------------------------•----•---------------------------...------------. x w x ----------------------------------------------------------•--•----------------------------------------------------------------------------------------------------•-------...----------........ U Nature of Repairs or Alterations—Answer when applicable--------------------------- _____. /.---_----------,� r ----------------------•----------------.-----.---- 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 furthe agrees not to place the system in operation until a Certificate of Corn iance has n issu y the 1}pard of th. - Signed ----- _ - � ---------...------- Application Approved By ------------------------------------------- ..................... .............................................................................. ........................................ Date Application Disapproved for the following reasons- ----------------- ----------------------- - -------------------------------------------............................................ e Permit No. ............... Issued -------- CJ .`.. .' �..... , Dace Ifs f. N o I-FIA ffr C5, _\ 1�� .................... THE COMMONWEALTH OF MA SSACHUSETTS (,vBOARD OF- H'E)A!,LT`1H'4 TOWN OF BARNSTABLE �\ll_"ftrttfiun for Uhipmal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct-,", Repair 00,an Individual Sewage Disposal System at I,,\ e - �4 .................7­6 ........... 6...........................(mal io ; Addris' 0 S _/V I 4 � 1/� -) 7 f . . ........................................ ...............r " CX./ ............................ ...... .... ....6.4 /1.. ZI.........(��/Z/ ✓ Address .. ............................................... : s ......... 1&6------5- ?taller Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.__........... .........................Expansion Attic q110 Garbage Grinder (,vo �4 Pk Other—Type of Building ....$�ZuSze....... No. of persons............----_---___ Showers (1i)- Cafeteria 06) Other Dfi Design Flow_.__._.:!:! -_----_-_.-gallons per person per day. Total daily flow_`----- ... ...................gallons. 9 Septic Tank—Liquid capacity............gallons Length................ Width._.___.......... Diameter................ Depth............._.. Disposal Trench—No. .................... Width_..__............... Total Length_......_.._......... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter-______--___-....... Depth below inlet_....._............. Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit._.___.............. Depth to ground water..._............._.._... �-4 w Test Pit No. 2................minutes per inch Depth of,Test Pit._.................. Depth to ground water........._.............. Ix .................................................. !�: . ......................................................................................................... 0 Description of Soil..................................... W -;�' ---------------------------------------------------------------------I----------------------------------- U ................................................................................................................................................................................................... W ....................................................................................................................................................................................................... �4 . U Nature of Repairs or Alterations—Answer when applicable......................./_b� t"_,.......1492.�......................4,0_ ...................................................................................................................................................................................................... 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 not to place the system in operation until a Certificate of Com fiance has Veen issueny the Ward of bfj'44h. Signed------- .. ... . ...............4 z ....... --------- ---.............Date Daw . ......... Application Approved By ......................................... --------------------------------------------------------------------- ---------------------------------------- Dam Application Disapproved for the following reasons: ----------------------------------------------....................................................................................... --------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------- /01 17 -Daw Is -------------------------------------- Date Permit No. ..... sued ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Tie rtifirate of Contylianre THI S TO CERVFY, T the Individu 'towage Disposal System constructed or Repaired X by............... ------ ------- .. ..... ................. --------...It.. -------4-. ..................................------------------------------------ Inst;Iler at ....... -- ----------_------------- .... ... . . ............................... ................................. --------------------------------7....... _ has been installed in accordance with the provisions of Tl�iLE 5 of The State-Environmental Code as described in the application for Disposal Works Construction Permit No. .... ..................�/.... dated --- f 1 /7 V THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS-A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. -21 L .......... ---y......./..............q DATE .........f�J ............................... Inspector ........... .... ....q-1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No... .........;...... . TOWN OF BARNSTABLE .. FEE........................ (9janii kudw' lt Mit ir ... ........................................................................Permission is hereby granted...... ........ .. .........7T, r �Repai a;- dr^dual �. ag.(to Construct z posal sem at ... . .............. . . ............ No.......... 7� ............................................................ 4 Street 9/ asshown on the application for Disposal Works Construction Perm' N) ed............41 .... .......... ......... DATE....../ Board of Health -- ----- ..........f..f.................... FORM 36508 HOBBS&WARREN,INC..PUBLISHERS Town of Barnstable P#—� = 4e -, ofI E Department of.Regulatory Services • AL Public ]Stealth Division Date ✓ L ✓" ' arent� WAIVIL 6.19. 200 Main Street,Hyannis MA 02601 • � �639. tee$ - �fD M�� 1 — Date Scheduled 1 Q- Time Fee Pd.--/�o i ,foil SuirtabiltY Assessment for Sewage D osal A Performed By: I Witnessed y Wi'l"LC ✓�� e 6 :�e LOCATION& GENERAL INFORMATION Location Address ` �� Owner's Name �GC `� �-�_ \1 /L 1 I AddressV�-� (�� Engineer's Name Assessor's Map/Psrcel: (f •-CJ li. NEW CONSTRUU 7ION REPAIR Telephone# �.�0�� �3 I q D �DY`2 Land Use O��c, Slopes Surface Stones Distances from: Open Water BodyC)ft Possible Wet Area �_ft Drinking Water We ft ll? U [O 0 ft Property Line [5L -- t Other fr nrainage Way . SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Ct , rn 'y <1CD cc L >C) -10 . N co co M X al ��},-�CAS'1 pk ( � / Parent material(gedlogie) '�A Deth to Bedroc C� j r Weeping from Pit Face__ . ---- Depth to Groundwater•. Standing Water in Hole: Estimated Seasonal Nigh Groundwater DtTERMINATION FOR SEASONAL HIGH WATER TABLE MIA 1 In. Method Used: in. Depth to spll MOltltjs; Depth observed standing in obs"hole: fr. in. ©roundwater AdJustment Depth toiweeping from side of obs.hole: - A {aelor,., Adj.Groundwater level Index Well# Reading Date: index Well level PERCOLATION TEST Date 2 2 Z}-� 60_`�u Observation i Tinte at 9" l Hole# u u„ TimeatV Depth of Perc (p Time(9"-6�) Start Pre-soak Time.@ y l End Pre-soak ' ^ Rate Min./Inch —�- Site Failed: Additional Testing Needed(Y/N) Site Suitability Assessment: Site Passed Observation Hole Data To Be Completed on Back Original: Public He$lth Division --------- ***If percolaAion test is to be conducted within 100' of wetland,you must first notify the Barnstable 6-0servation Division at least one (1)we&prior to begin ning• 'DEEP OBSERVATION HOLE LOG Hole# I Depth from Soil Horizon Soil Texture .Soil Color Soil ! Other Surface(in.) (USDA) (Munsell) Mottling (Struc re,Stones,Boulders. i Consisten % ravel 1 -12 A )2-y2 0y1ZS/8 Z. - 7 Z 0-' 1 M -C o s 0.4 10% Ak.v-e 1 CZ M-C Sclkj 2,s Y "/4- Loas-� :DEEP OBSERVATION HOLE LOG. Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel o - A p.31 q —3 D L 10 `�2 s` �`-,r�'�,t� le o rg y. C, M-c 5�,►,�1 to �� Lon �a .re c �l -► Zo C 2 Nl-C_ S�►v<u� l0 12 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, Gravel 'DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil , Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consisten Ora el Flood Insuran j e Rate Map: p Above 51D0 year flood boundary No____ Yes 4 Within 500 year boundary No� Yes Within 100 year flood boundary No Yes Depth of Natutafly Occurring Pervious Material Does at least fo r feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? occurring ervious material? depth of naturally g p � If not,what is the dep y occu Certification 1 ��- I certify that on• (date)I have passed the soil evaluator examination appr& by the Department of environmental Protection and that the above analysis was performed by tl>e consistent with . the required training,expertise and experience described in 310 CMR 15.017. Signature ' `�C Date Q:S.EPTICIPERCI.ORM.DOC o D Great Marsh ,� � - � LEGEND �� � � Ra Benchmark Set PROPOSED CONTOUR Right cor. laulkhea cl .1 1 � ~' x ma El.=98,4 4 (Assumed) 1 PROPOSED SPOT GRADE q CIL �; , a °. Ei l4 F'I�w' I F.f{� EXISTING CONTOUR and Or v,� 1IC. EXISTING SPOT GRADE °x H; , y v 9 53 � i. -. ,, ,. .,-� X°9 7: l9 TEST PIT n l A=55, 1 `'�. W EXISTING WATER SERVICE w r C ,1f11 .a y R-50.x� �/ tf? EXISTING WATER SERVICE < � Rad 2 1, ' p1 �,20 1 • y r O l�/ P s Wo Ln 90 z .. _ N �' �g,QO `� '� � 2° ,J �.s r . ;i �?9'05 Locus _ �4 C`��` r ` �"� LOCUS MAP N.T.S. ^ 7 GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 101 ..�� BOARD OF HEALTH AND THE DESIGN ENGINEER. W C), c A��PCISE?7 �! . < 2. ALL WORK AND MATERIALS SHALL CONFORM 70 THE REQUIREMENTS 1-B4OR0OM r `rp OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE Ca ' 1, ADDITiIIP LOCAL RULES AND REGULATIONS. (�-��a w( > ��a�- j P 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR Prop, Ir`)V, 95.77 I TO INSPECTION AND APPROVAL BY THE. BOARD OF HEALTH AND THE -Box ,' r` f, i t DESIGN ENGINEER. • EXISTING ,. vx' i 1� r"" I .µw �,} 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING � t �.'r � eG, 3 BE17RL70M „; i FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN �y ?' i ,HOUSE (#9)' , "fir ENGINEER BEFORE CONSTRUCTION CONTINUES. �(' I TOF=g8.44,A;' LC7T h- X o Q - ,,, 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. t � 151 R S,F • 1" " (Assur"►C'd� $ A `4 O o s. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF u�( „� 11 0,3 C, �7 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF -'' p ' ' ar )' �r HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION, iQ � , 6 Map 18 9 -_,. a Septic Parcel S9 { - 7. WATER SUPPLY 70 BE PROVIDED BY TOWN WATER. Tank r f .' ff' OF° ` l 8. THERE ARE NO PRIVATE WELLS LOCATED WITHIN 150' OF THE S.A,S. 9. SEPTIC SYSTEM COMPONENTS SHALL BE INSTALLED AS DESCRIBED s4 IN 310 CMR 15.000 SUBPART C. � 11�11\TP-1 {', �-^^, , i 10. ALL AREAS CLEARED FOR CONSTRUCTION ARE TO BE LOAAED AND 9 i 6 ; E7'ISTING CESSP OL r` SEEDED UPON COMPLETION OF CONSTRUCTION. 9 •�, 159) ` ,_ -- TO BE REMOVE I 11. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY , € !� i (SEE NOTE 11 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO STARTING I 1p' 6 CONSTRUCTION. j° � ` 12. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. F a \ 11 AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). OWNER OF RECORD ZONING CLASSIFICATION: ZONE RC , PATRICK HILL *, Ell p� 9 BIRCHILL ROAD SETBACKS: FRONT YARD=20', SIDE/REAR=10' 89, n �r1 EXISTING LEACH PIT ' 'A Rf f CENTERVILLE, MA 02632 BUILDING HEIGHT: 30' 69oa3 20 TD BE A NE ILLEDPWITHD SW,D;' ; oPETER T, 9��`� McENTEE PROPOSED SEPTIC SYSTEM SITE PLAN .r �, o CIVIL 9 BIRCHILL ROAD, CENTERVILLE, MA 6,'T? 2 �1 Prepared for: Patrick Hill, 9 Birchill Road, Centerville, MA 02632 E �� I.P,� I' N�� ���"'' .r� i <SS� ��` Engineering by: Surveying by: SCALE DRAWN JOB. N0. � � .. . `f u'$ >, 1 1 P.T.M. t J Enginesr�ny 1Porkr Terry. Wu»rerP.L.�£ 1"=20' 241-05 fz r'y/ 23 Deer Hollow Road 22. Long Road DATE CHECKED SHEET N0: V Forestdole, MA 02644 Harwich, MA 02645 �. �1_ (508) -477-5313 (508) 432-8309 1 2/27/05 P.T.M. 1 Of 2 I PROVIDE" 6 ❑F FINISH GRADE VIDE RISER OVER D-BOX NOTE: TO PREVENT BREAKOUT, THE PROPOSED T❑ } TOP OF FOUNDATION 1 F.G. EL: 96.3t FINISH GRADE SHALL NOT BE < EL:93.5 FOR A DISTANCE OF 15' AROUND THE EL:98.44 F.G. EL: 97.0 F.G. EL: 97.2t F.G. EL: 96.5t PERIMETER OF THE S.A.S. _ MAINTAIN 2% MIN SLOPE OVER S.A.S. INSTALL RISERS W/COVERS OVER INLET INSTALL RISER OVER ONE CHAMBER & OUTLET TO WITHIN 6" OF FINISH GRADE WITH HEAVY DUTY FRAME & COVER L =30' SET TO FINISH GRADE 4" SCH 40 PVC L -28' L -23'(MAX) 4" SCH 40 PVC @ S= 1% (MIN.)-T6 4' SCH 40 PVC e' @ S= 2% (MIN) - - •�+----�-2' LAYER OF 1/8' TO 1/2' �o ` 14" @ S- 1% (MIN.) 71Ar 2313 �® DOUBLE WASHED STONE d; INV.EL:95.00 oa IauiO INV. ELEV.=93.67 INV. ELEV.=93.50 2' EFF, DEPTH �� 3/4"-1 1/2' a... BEVEL ������ 8A PROPOSED D-. OX 4' S.2' 4 STONEDOUBLS WASHED INV.EL:94.75 FFECTIVE WIDTH - 13.2' INV.EL: 95.77 (EXISTING) INV. ELEV.=93.00 ,Oo GA ON nCHIN�t caM®ems PRO OSED 150Q GALLON SEPTIC TANK 1IY~S�IES•�ITk1 �T1?�1t P`� `UPS NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING TOP CONC. ELEV.=93.8 10 , BREAKOUT ELEV.=93.5 PIPE INVERTS PRIOR TO CONSTRUCTION. INV. ELEV•=93.00 ®®��� 2) SEPTIC TANK AND D-BOX SHALL BE SETT LEVEL ®ri � AND TRUE TO GRADE ON A MECHANICALLY COMPACTED! BOTTOM ELEV.=91.00 3' 3 x 8.5' 25,5' 3' SIX INCH CRUSHED STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 5' MIN, ABOVE MAX, SEASONAL EFFECTIVE LENGTH = 31,5' 3) INSTALL INLET & OUTLET TEES AS REQUIRED. HIGH GROUNDWATER ELEVATION (3) 5" DIA.OUTLETS 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE LEACHING SYSTEM SECTION 15. ' 16' 2" AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL, NO G•W, ENCOUNTERED Ir--• --� "� BOTTOM OF TP-1, EL,=86.0 SEPTIC SYSTEM PROFILE 8' N,T•S, 6' DESIGN CRITERIA NUMBER OF BEDROOMS: 3 (EXISTING) + 1 (PROPOSED) = 4 TOTAL SIL TYPE: D-BOX \ `� R,•z \EXIST. NG,l ` DESIGN PERCOLATION RATE: <2 SMINI./IN,'2 DQRCOM HOUSE C#9� © PETER T. DAILY FLOW: 440 G.P.D. SOIL DESIGN FLOW: 440 G.P.D. McENTEE v DATE: DECEMBER 27, 2005 (Ref.# P-11198) GARBAGE GRINDER: NO CIVIL .,,�.... No. 35109 SOIL EVALUATOR: PETER T. McENTEE C.S.E. LEACHING AREA REQUIRED: (440) = 594.6 S.F. v INSPECTOR: I' DONALD DES MARAIS, BARNSTABLE B.O.H. INVERT r6448 � ® lE�®®� ...,.... � ,74 0000W I®0 33" .t�l'&'C.k E3lt�®0�®IR� ti PROPOSD SEPTIC TANK: 1500 GALLONElev, TP ' 1 De th TP-224" ®ER ER 0 E I®ER� \ � EI a V. 102" —" a 96.5 FILL oo 6„ 96.4 A SANDY LOAM 011USE 3-500 GALLON LEACHING CHAMBERS IN SERIES IZI�7 95.6SECTION * 10YR 3/3 go, A SANDY 10YR 3/3M B SANDY LOAM SIDEWALL AREA: 2(13.2' + 315) X 2 = 178.8 S.F. 96.0 12 10YR 5/8 "— B SANDY LOAM 93.9 30" BOTTOM AREA: 13.2' x 31.5' = 415.8 S.F. 4" KNOCKOUT � 93 5 1OYR 5/8 42„ C1 44" TOTAL AREA: 594.E S,F, 20" DiA• COVER 48�� C1 M-C SAND W 4" KNOCKOUT 4" KNOCKOUT b1, i OYR 5/6 a 0 62" M-C SAND E, 10%GRAVEL 56" DESIGN FLOW PROVIDED: 0.74(594.6) = 440,0 G.P.D. 10YR 5/4 a. 4" KNOCKOUT 1 10%GRAVEL 60" 88.4 C2 84" PROPOSED SEPTIC SYSTEM/SITE PLAN - S,A'S '� 91.0 C2 72" ' N ; ppopOSED M-C SAND M-C SAND 59 MASTHEAD ROAD, CENTERVILLE, MA M 10YR 6/4 Prepared for: Barry Fraser, 59 Masthead Road, Centerville, MA 02632 2.5Y 6/4 500 GALLON CAPACITY, H-10 LOADING �`_. 31,5 Engineering by: Surveying by: SCALE DRAWN JOB. NO, CHAMBERS r S.A.S. LAYOUT 86.0 132' 86.4 120" Eng/needng)VVr& Terry�d. WarnerP.L.S. N.T.S. 136-05 ar.s NJA NO G.W. ENCOUNTERED 23 Deer Hollow Road 22 Long Road DATE CHECKED SHEET N0. PERC RATES < 2 MIN/IN. Forestdole, MA 02644 Harwich, MA 02645 1 1 05 2 (508) 477-5313 (508) 432-8309 / / P.T.M. 2 Of 2