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Home My WebLink About0033 BRIARCLIFF LANE - Health 33 Briarcliff Lane Centerville A= 208-111 S M E A D *1 No.2-153LOR UPC IUU onmd com • Mob In UU �aumMwnNmuQut OIFI TOWN OF BARNSTABLF LOCATION 33 Bryyoi�r L.VNe, SEWAGE"# tO'� 1( t VILLAGE �1�T�Jlii` �l ASSESSOR'S MAP&PARCEL -� INSTALLER'S NAME&PHONE NO. 'f�oy1 S c CLV a�T� SEPTIC TANK CAPACITY 15o0/ 'roo LEACHING FACILITY:(type) A-Q S AkC 3 6 (size) 31(,q5 5 F NO.OF BEDROOMS OWNER PCL+ ;b c.,,. MV rD�� PERMIT DATE: a COMPLIANCE DATE: o Separation Distance Between the: Maximum Adjusted.Groundwater Table to the Bottom of Leaching Facility �,Q j Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) / j A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within n � 300 feet of leaching facility) / Feet FURNISHED BY 55 r 1 5 a 'I 9 31 o of , 65' �5 No.�2�1 V 3 " Fee Uv THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYitation for IDis oral *pstrm �Constr ion vermit XUpgrade Application for a Permit to Construct( ) Repai ( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. 33 `&1'4/'C(1 )F A. I- Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No.p� � ® �� Desi er's Name,Address,and Tel.No. s"o;�g/3e,)-dfW ,&� Type of Building: Dwelling No.of Bedrooms LoqSi e /4),9:;y/a sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 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 ode and not to place the system in operation until a Certificate of Compliance has been issued by this Board o Signe Date -.2 /J Application Approved by Date a —( 'Z Application Disapproved by Date for the following reasons Permit No. 2--U / a — U 3 Date Issued 2 No. 2G 1 2 — 03 , Fee THE COMMcomputer: ! UV .cat, JONW�-'-r�EALTH OF MASSACHUSETTS Entered in computer: .,/ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS- - Yes 01ppiication for Xis osaY 6pstem Constrw on Permit Application for a Permit to Construct( ) Repai ) Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. 33 Zniirc1t� fi. Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel / "k'y, Installer's Name,Address,and Tel.No.p� fatia �� Desig er's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) f ..g t Date last inspected: •, Agreement: ti 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 ode and not to place the system in operation until a Certificate of Compliance has been issued by this Board o e'd Signed Date Application Approved by i k, 0 C Date 1 -7-/2- Application Disapproved by Date for the following reasons - Permit No. 2.O j : - 0 3 / Date Issued 2 /7 - / -.-- --- - ---- --•-- - ---------------- - ---- ------------------ =-- -- ------- -------------------------------- p ne — ��/c� HE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by ate`? g`rG/�C� � 1,4, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.?o 1 31dated Installer O / 1 Designer �//�� Gl�/L7� SOoll #bedrooms (gip(� rp S �,i (,� Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will functionJas�designe . Q Date a 3 1 i 2. Inspector - -- - -- - _ - - -- - - --- - -- -- - ---- ----------------._ No. D o l t-0 3-q Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS - Bisposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. n Date ,.2 -1-7 1 -2- Approved by y . - Town of Barnstable �IME',��.� Regulatory Services 4t . Thomas F. Geller,Director WANMABLZ MAn ,�� Public Health Division Fe� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Z�l'L Sewage Permit# Assessor's MaP\Parcel Designer. Installer: Address: �✓a-►' �1�� Address: 0 0; � + .S'Gyn�lwtL� �Ylq ozS3� On was issued a permit to install a (date) 2 (installer) .septic system at 7� ��f� '��' based on a design drawn by / A^ (address) �1�^ /"'�+7i� dated (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. 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 f fflow. OF Mgss�y D N (Installer's Signature) 1140 RfG/SiE�O I � SANITAR\l'� (Designer's Signature) (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. Q: Health/Septic/Designer Certification Form 3-z6-04:.doc Bk 26089 Ps64 a8877 02-17-2012 aM 12 % 40F:3, NOTICE OF DEED RESTRICTION RESIDENTIAL The Town of Barnstable Board of Health requires, based on 310 CMR 15 . 214, Title V, Nitrogen Loading Restrictions, the following restriction: Existing Dwelling Restricted to two (2) bedrooms Be placed on the property located at 33 Briarjiff Lane, Centerville, MA 02632, Assessors Map 208 Parcel 111 and .as described as follows : LOT 3A as shown on a plan entitled "Plan of Lots 3A & 4A, Centerville, Mass . Property of Allan Small", Scale 1" = 40 ' , dated Aug. 8, 1958, by Ed. Kellogg, C.E. , duly filed with Barnstable County Registry of Deeds in Plan Book 143 Page 41 . Meaning and intending the premises conveyed in a deed dated August 24, 1978 and recorded with Barnstable County Registry of Deeds Book 2771 Page 47. bJYhdhd P.r�. 500 775 1E4 T o:5086981 7 76 F.3%3 FEE-15-2012 11:13 Frorn:WYNII i I, PATRICIA M. MURPHY, as owner_ of the property referenced 3hove., acknowl�dgc the died restriction being placed on the pzcoperty- WITNESS My Hand and Seal this 1�`�� Day of FEBRUARY 2012 . PATRICIA M.. MURPHY' Commonwealth of' Massachusetts FEBRUARY 16, 2012 On the date first above written, before me, the under igned notary public, personally appeared PATRICIA M. DMPHY, a aforesaid, proved to ine 'through satisfactory evidenq:e of identification, whJ_C1.. were drivers license. (Source Qf i,�.et�ti ir�ation) tl� ? twe GrsC�J.1 (s) whosA name. is signed on the ` preceding or a.tta.chcd document., and acknowledged to me that he/she signed it voluntarily fear its. stated purpose. Notary Pub.1 c My Commission E Dea No lic My Commission Expires March 16,2012 Postal Coverage Provided) (DomesticOnly; For delivery information visit our website at www.usps.como Ln ru Ul Postage $ OCertified Fee p Return Receipt Fee D� Posama 7 p (Endorsement Required) O �` Here p Restricted Delivery Fee (Endorsement Required) y O Total Postage&Fees $ o Ms Patricia Murphy ` 1 r c/o Kathleen Finn YY 33 Briarcliff Lane Centerville, MA 02632 Certified Mail Novi`des: ■ A mailing receipt ■ A unique identifier for your nitll[piece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mails or Priority Mails. ■ Certified Mail Is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt seance,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpieee"Retum Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT,Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 SENDER- COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. ' nature item 4 if Restricted Delivery is desired. X ; ❑Agent ■ Print your name and address on the reverse C- )r. rl Addressee so that we can return the card to you. ec ived y( kited Name) C. Tkof elive ■ Attach this card to the back of the mailpiece, �n or on the front if space permits. i 1. Article Addressed to: D. Is delivery addmA different from item 1? Yes If YES,enter delivery address below: ❑ No .-AUT. t-icia Murphy a 6/.&Kathleen Finn 33 Briarcliff Lane Centerville, MA 02632 3. Service Type ❑Certified Mail ❑Express Mail I �- —— -- ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number F , V ; - ; c t (ftrisfer irom service labeq i I I i i i i 1 i i 1,7 0 l l i 0 4 7 0 ;D 0 01 g 4 5 2 5 f5 570 PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M`-1540 r I UNITED STATES POSTAI i'9046* ;as ::. first ►vl .. , ;.., .-:.: .... s F aid . Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • Town of Barnstable Public Health Division , 200 Main Street Hyannis, MA 02601 °FtKKE r Town of Barnstable Barnstable y Regulatory Services Department ;erlcaCfty nARWUABLE, v� MASS. t639gq. "$ Public Health Division ptFb m 0.1 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7011 0470 0001 4525 5570 February 6, 2012 Ms Patricia Murphy c/o Kathleen Finn 33 Briarcliff Lane Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5, The septic system located at 33 Briarcliff Lane, Centerville, MA, was last inspected on 1/17/2012, by Shawn Mcelroy, a certified septic inspector for the•State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • When any portion of the SAS, is below high groundwater. ,. You are ordered to repair or replace the septic system within one (1) year from the date you receive this notification. . Failure to repair/replace the septic system with the deadline period will result in future enforcement action PER ORDER OF THE OARD OF HEALTH as McKean, .S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures\Town of Barnstable.doc II • TOWN OF BARNSTABLE I; CATION 3� �/';4� cl; �� l SEWAGE s; VU.LAGE e'e•iAerv;6le t 1. ASSESSOR'S MAP& LGT INSTALPR'S NAME&PHONE NO. eel a- "TANK CAPACITY PEM ' / (Size) LEACI•iTNts 1"A.CILIT'Y: (�) BUILDER OR OWNER.. / /` ,10/2- ,'` PIER.MIT®ATE: .. Ca 'LIANCE DATE: Distance taaace Between the: I Maximum Adjusted Groundwater Fable to dldc Bottom of(reaching Facility Lev Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility)', Feel Edge of Welland and Leaching Facility(If any wetlands exist . within 300 feet of achinz k�ry) sec L t Furnished by '•'^ r i Y l �� ig� 1�� r T Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is Centerville' MA 02632 1-17-12 required for every • page. Cityrrown 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. A. General Information ,I 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services "=? Company Name id'3 29 Atwater Dr -j , Company Address - E. Falmouth MA i 02536 City/Town State Zip Code 1-508-495-6905 S13971 Telephone Number License Number o ry S 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 CM 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 1-17-12 Inspector's§ignature 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•11/10 Title 5 Official Inspection Form:Subsurface Sewag isposal System•Page 1 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The systems upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11/10 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 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 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: i D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 , Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ® ❑ Any portion-of the SAS,'cesspool or privy is below high ground water elevation. ❑ ® 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- 1 0,000g pd. ® ❑ 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 El El Area 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form =Not for Voluntary Assessments M 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): 220 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. City[Town State Zip Code Date of Inspection D. System Information Description: •r Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: , 8-2011Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 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: Owner--pumped summer 2011 Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance Type of System: ❑ Septic tank, distribution box, soil absorption system ® Single cesspool ` ® Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (f 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-11/10 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (f known) and source of information: 1962/1985 pit was added Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 30 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.): Good condition. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age:. years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins-11/10 TiUe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. City(rown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. Citylrown 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•11/10 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 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. City/Town 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 N/A Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.).- Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is Centerville MA 02632 1-17-12 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number ` 1-600 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology- Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit in good condition with stain line at 12" below inlet invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 Depth—top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool 5'x5' Materials of construction Block Indication of groundwater inflow ® Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Cesspool was empty at inspection with stain line at 12"below inlet invert. Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. CitylTown 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 61ZA Q o-Gp 6 -D- as ' gf4.� 0 t Lea�� P •� P `onne t,-h Cejs pro/ To rlec.e4 ; 4- iSno4 �; 1 54 Ir t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 l r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is required for every Centerville MA 02632 1-17-12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 65" feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database-explain: You must describe how you established the high ground water elevation: Design plans for neighboring property shows groundwater encountered at 65". Cesspool and leach pit both signs of groundwater infiltration. Grade to bottom of pit at 65". Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11110 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 33 Briarcliff Ln Property Address Kathleen Finn Owner Owner's Name information is Centerville MA 02632 1-17-12 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist E Inspection Summary: A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems) completed E System Information—Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 I Town of Ba"1111sta]ble P# Department of Re Watory Services / • ,,,gam Division Date Public Health 16356 tee$ 200 Main Street,Hy#nnis MA 02601 Ti.Date Scheduled Fee Pd. r O a • I Foil Suitability Assessment for SPwage Disposal , Performed By. \ /�A l��t/" Witnessed By:7 r. - j LOCATION & GENERAL INFORMATION Location Address ?)•3 jp 1� 1 b,�r Owner's Name YAT' J GIA fAV P-flA_f Wh'eU1 11e /v'"1 Address '1- S � Assessor's Map/P4rcel: / I I Engineer's Name�a,rt�N1 rr NEW CONS1RU(.NON REPAIR '` Telephone# Land Use 1 Slopes(30) Surface Stones /VO tie JU Distances from: Open Water Body Z O6 ft Possible Wet Area r 4U ft Drinking Water Well Z ft Drainage Way �� ft Property Line O- • ft Other ft SKETCH:($treet name,dimensious'of lot,exact locations of test holes&pere tests,locate wetlands in proximity to holes) g ry° 15.76 ft ,,,t• 00.02 ft� I tl. QC CP I � V' / F I 10 It \ ' � 101 It % / ,Q, I N'.4 iER 11 LINE _Z z I— J ILLto U o (n J O , m I II 20 n X W (L II `\I 1\ \\ z W C °W �S U U 1 \ III 0 I dA VED DRIVE'/l4\ R I \ 1 � " 1 n-- 11 N g8,50 ft • I Parent material(geologic) Depth to Bedrock q ti ti1q_ Depth to Groundwater. Standing Water in Hole: 2 ` i Weeping from Plt Face Estimated Seasonal Vigh Groundwater ! — DI TERMINATION FOR SEASONAL HIGH WATER TALE Method Used: ! In. Depth observed standing in obs.hole: _in. Depth td Sall mottlr ; it Depth toweeping from side of obs.hole: in. Oioundwatet Adjustment I ! A .fietor.� �� Adj.Otnundwnterlevel.,,,e .7 �1 Index Well#�. Reading Date Index Well lev�1 `�— Mt►J-29 t r� 3-'I VVV PERCOLATIONTEST . Ddtt L ° Tlnse• Observation / Time at9" Hole# l 30 IP64 Time at G" ........----- Depth of Pere �O L '� Time(9"-6') . Start Pre-soak Time.@ End Pre-soak Rate MinJInch L ! ssed Site Failed:' — Site Suitability Assessment: Site Pa Additional Testing Needed(YIN) Original:.Public l,e'�Ith Division Observation Hole Data To Be Completed on Back-- ***If percola#61a testis to be conducted within 100' of wetland,:you must first notify the Barnstable C4nservatien Division at least one (1) wedk prior to beginning. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. l Consistenc %Gravel r9" S �tm N l�!�26A filed• Surf 2.S �/ 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) ayal iv ►1 � '1 G �i• Z' �l DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel DEEP OBSERVATION HOLE LOG Hole# A Depth from Soil Horizon ' Texture Soil Color Sol] Other Surface(in.) (US (Munsell) Mottling (Structure,Stones.Boulders. Consisten Gravel) F Flood Insurance Rate Map: Above 500 year flood boundary' No_ Yes Within 500 year boundary No✓ Yes.�. Within 100 year flood boundary No `� Yes Depth 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 q I certify that on \ (date)I have passed the soil evaluator examination approved by the Department of Enviro mental Protection and that the above analysis was performed by me consistent with the required t inin ,exper ise and experience described in 3,10 CMR 15.017. Signature Date l Q:\.SEPTIC\PERCFORM.DOC LOCATION SEWAGE PERMIT N0. :3 .c y- AL - WILLAGE ��lickr�j A & B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA •02601 BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED s F,� � _\l i 1 S' 0 a �� 4��\ �� R, t.r Y►�-_ No........85:2&-& Flcs.....�...1.5..00.... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...................T own.---.--.....-OF..............Barnstable------------....---------------------------••••. ApplirFafinn for Dhipas al Works (filmitrttr#iun tirrutit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 3. Briarcliff Lane,...Cgntervillex..F..---•.....0263Z....... .... .._.._.. ..-- Location Address or Lot No. ....JOsePh..D:_.MurD!h'_----------•--•----•-••---------------••- S.Suffolk•-Rcad,...Sharon.,.&.....02067........... --- Owner Address A & B Cesspool_Service, Inc. 128 Bishops Terrace. Hyannis,-._YA_.....02601__•- Installer Address PQ V Type of Building Size Lot.............................Sq. feet Dwelling—No. of Bedrooms---..3....................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons..............2..... ..... Showers — Cafeteria Otherfixtures -----------------------------------------------------•••••••--•--•------•------------•------•-••-•-•••••-----••--•••---•-••--•--•-•----•-•-------•-- 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 ( ) Percolation Test Results Performed by........................................=................................. Date........................................ aTest Pit No. 1----------------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........................ . - ODescription of Soil---•-••••San---------------------------------------------------••-•--..........-----••-- .......................................................................... x w V Nature of Repairs or Alterations—Answer when applicable---ins_taj 1a.Uon...of..2•• loud ff.us.ors.....stone paake_d..xi.tL.approximate1y..12t.-of ►�azhad... t"e............................................................................................. Agreement: The undersigned agrees -to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the b ard`of It Signed./%.. .. Application Approved BY �.�.. >.. ...................... ......... -.....r 127L_8 ..------ Date Application Disapproved for the following reasons:....................................................: . p _ ,Z. ................................................................................................................................_....---......_.............---........--.----._....-----7--------------- Date Permit No85- —'T.. IssuecL--•-------------3 -27/85.. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................ Town-.....--......OF..............Barrastable........................................... ApplirFa#inn for Disposal Works Ton.strnrtion rumit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: ...3 ..Bxiarrli£f..Lane, Centervi.lZe, MQ+......0263Z................................................................................................ Location-Address or Lot No. .IQ La-g' ---------------------------------------------- ..Stiffa1-k.Blatt, Sparon► A•...J02Q6.7......---••--•--. Owner Address exvine....Inc........................... ]2P.Bishops...Terraces,...H�rannis,...t�A....-Q?_h01,..... 1 Installer Address Type of Building Size Lot............................Sq. feet g— 3.....................................Expansion Attic ( ) Garbage Grinder ( ) I-. Dwelling No. of Bedrooms..... Other—T e of Building No. of,persons..............2--......... Showers a YP g ---------------------------- P - ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------•-•••----•••................---------------•---•---••-••---•-••-•--•............-•.........---- 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 0.4 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........................ P4 •-•-•••••••------------------•----••••-••-•••••-•--••-.....•••••••...........-•••••......---••-•••••......................................................... 0 Description of Soil......... and S .....................................•-------•------......------------------------------------------------------------------------------------....-•- W U -•••-••--------•---••-•-•----••••.......••-•••-••••••--•-•--•--•••••-•--••.........•••-••••---•-•-•--•-•...----•-••••--••-••--•-•-•-•----•-•---•--------•-••••--------•-•.............•-•----•-•-----•-- W ---------------------------------------------------------------------------------•------•----------------------------------------------------------.----------------------------------------------•--- V Nature of Repairs or Alterations—Answer when applicable...j:rj.5t.ej.jatlprt-_of-2---f-1-owdi f fug-j---st-one- packed--w-lta--apgraxilsately---e2-*--of--*awed--etote---------------------------•---------------•---.. ......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL% 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the and of It . ��ll / Signed . ........- �2 3t!z7< _-- D Application Approved By :t_" a......C� = f1 ----------------------••••••--- .......... 3 ?7a Date Application Disapproved for the following reasons---------------------------------------------------------------------------------------------------------••-••• 1 ;i Date Permit N05-...: .t------------------------------------ Issued.--------------..3/?V 5...................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........................T.Mn......OF.....Rarnata ble..................................................... (Inrtifirtttr of TnmpliFanrr THIS IS TO CERTIFY, That the Individual Sewagge Disposal System constructed ( ) or Repaired (X) by A & B Cesspool Services: Inc. 12 I?ishops Terraces Hyannis.e fSA 02bQ1 -•-•-•-••---••----.....-•-•-- I s at. 33 -13riareliff Land!- Centerville, NA I 2 - Joseph D. Murphy!..... has been installed in accordance with the provisions of TITIE 5.of The State Sanitary ode s described in the application for Disposal Works Construction Permit No............��-_IF-�S ................ dated_3�27/�5...............-............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CON ST ERAS G ANTE�EDTHAT THE a SYSTEM WILL FUNCTIO F DATE............. / . •-• --------••---•-...... Inspector.................................................................................... l r ' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH \�. g5 .� r:'. T n....,.i B rnstable 1 .00 ........ ... .OF.............a..............................-...........-......................... No.No� ................. - FEE..... ........... ;Disposal Works T-041notrurtionDprrmit Permission is hereby granted.............. & B Cesspool_Servicse, ............. to Construct R( ) or ReppaT (A ) an Individual Sewage Dispposal System at No.....33--:=riarcliff Lane, -Centerville A, 026 2- --.Joseph.D..._Murpt�_y....................................... Street as shown on the application for Disposal Works Construction Permit NAP7. z` ..... Dated........ A7/85 ........................................-............................................................. ( X Board of Health DATE----- ` 'IJ ' --------------------------------------------- ' FORM 1255 A. M. SULKIN. INC.. BOSTON A LOCATION �- AGE PERMIT NO.. VILLAGE A & B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED i At V A CPss L,� 1 9 PROP. 1 ,500/50OG LEGEND CENTERYJLLE vP��' 2-COMPARTMENT SEPTIC TANK PROPOSED CONTOUR �, ® PROPOSED SPOT GRADE lv,` _— 98 —— EXISTING CONTOUR 100.02 ft� ty 45.76 ft ?� + 96.52 EXISTING SPOT GRADE 0 Q W— EXISTING WATER SERVICE TEST PITLii ono 0 �o LOCUS o ft % \O to ft ; P 6- � 33 BRIARCLIFF LN. \ \ A 0 WATER ` LINE LOCUS MAP _z z zN / LOCUS INFORMATION I— J o - 20 ft — W TITLE REF: BK 11862 PG 348 w X a II PARCEL ID: MAP 208 PAR. 111 j Lij O J i Q PROPERTY IS SUBJECT TO ESTUARIES RESTRICTION W 0 0 tiF _I SEPTIC SYSTEM 'g 1 REPAIR PLAN I LOCATED AT: inw '°" ; B gAVED DRIVEWAY 1 33 BRIARCLIFF LANE vot CENTERVILLE, MA o � { PREPARED FOR 98.80 ft �� PATRICIA M U R P H Y BENCH MARK EXIST. CESSPOOLS 1 FEBRUARY 2, 2012 PAINT SPOT ON see note 10 f BULKHEAD CORNER - ELEVATION = 30.1 5 4 SCALE: 1"=20' OF ,MgS�9 BARNSTABLE GIS DATUM D DESIGN CRITERIA "2 BR DEED RESTRICTION NEEDED" GENERAL NOTES: 1 No. 1140 DESIGN FLOW: 2 BEDROOM X 110 GAL/DAY/BR = 220 GPD 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 10. EXISTING LEACHING AND SPOILS TO BE PUMPED, CRUSHED, AND REMOVED si BOARD OF HEALTH AND THE DESIGN ENGINEER. PER TITLE 5. (LOCATED WITHIN PROPOSED FOOTPROOT OF NEW LEACHING) SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: . <2 MIN/IN 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS it. 48 HOUR NOTICE FOR ENGINEER CERTIFICATIONNITAR GARBAGE GRINDER: NO OF THE STATE ENVIRONMENTAL CODE, TITLE 5, AND ANY APPU(:ABLE LOCAL RULES AND REGULATIONS. 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY SEPTIC TANK: 220 gpd x 200% = 440 gpd : USE-NEW' 1,500/50OG 2-COMP. TANK 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFlLLED PRIOR AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 13. INSTALL 40 ml POLY LINER AS SHOWN AROUND SECTIONS OF SOIL REMOVAL PUMP CHAMBER: USE 50OG SECOND COMPARTMENT DESIGN ENGINEER. FROM EL. 31.0-28.0 TO PREVENT BREAKOUT. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING MEYER & SONS, INC. FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 14. NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING ( LEACHING AREA REQUIRED: (220) = 297.29 S.F. ENGINEER BEFORE CONSTRUCTION CONTINUES. 15. ALL PIPING TO BE 4" SCH 40 O 1/8-/FT (UNLESS SPECIFIED) 74 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. ' 16. REMOVE ALL UNSUITABLE SOILS 5 FT. AROUND LEACHING TO EL. 29.92 OR P.O. BOX 981 PRIMARY S.A.S. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF TOP OF "C" LAYER AND REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5. 3,y PROPER INSPECTIONS DURING CONSTRUCTION. -USE 1 TRENCH OF 11 - ADS ARC36 LP (3.8" INVERT) UNITS - NO STONE 7 HEALTH FOR WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. EAST SANDWICH, M A• 0 2 TRENCH DESIGN: (GENERAL USE APPROVAL FOR 5.79 SF/LF OF CHAMBER) e O AREAS C DITION AGREEDUUPON CONSTRUCTION OWNESHALL o CON��OR. (5 0 8)3 6 2-2 9 2 2 (CHAMBER) 11 UNITS x 5 LF x 5.79 SF/LF = 318.45 SF 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING TOTAL AREA = 318.45 SF CONSTRUCTION. DESIGN FLOW PROVIDED: 0.74GPD/SF(318.45) = 235.65 GPD > 220 GPD req'd SHEET 1 OF 2 J#1367 NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS TBM TOP OF PROPOSED TANK PUMP CHAMBER D-BOX { FOUNDATION INSTALL RISERS W/IN 6" OF FINISH GRADE INSTALL RISERS to FINISH GRADE INSTALL RISERS W/IN 6" OF FINISH GRADE EL. = 30.47 e EL.30.Ot, EL.30.Of - � I-� EL.30.Ot F.G. EL: 32.0f FINISH GRADE=32.00 VENT ` MIN. COVER OVER S.A.$. = 9" MAINTAIN 2% MIN SLOPE OVER LEACHING AREA SANITARY lEE INSTALL ONE INSPECTION PORTS(MIN.) L =10'(MAX) 2 SCH 40 WC 8" s 4" SCH 40 P LE 500 CELLAR FLOOR oSn2x 10• • 10. 00MPARTMENT FORCE tAp1N ® S= 1% (MIN.) 3NVER�- poly liner e • . (MIN.) t4 INV.=30.0 (eeenotet3) ' PVC 23" INV.= 30.20D-BO4' SCH 40 � Gp5 17" TEE SHALL NOT EXTEND 1 TRENCH OF 11. UNITS AT 5'/UNIT = 55'/ROW Exist. Invert':: 1'�MWr GMJ ON wOAFFIE PUMP OFF 12' BELOW FLOWcoMPARTUENt INV.ELEV.=29.90 SOIL ABSORPTION SYSTEM (PROFILE) A INV.= 27. 114 @INV.= 27.66 m A � AM -M 66 INV.=26.20 RESTORE VEGETATIVE COVER INV.= 26.45 PROPOSED 1,500/500 GALLON 2-COMPARTMENT SEPTIC TANK BACKFILL WITH CLEAN PERC SAND NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING TO TOP OF CHAMBERS PIPE INVERTS PRIOR TO CONSTRUCTION. 2 TANK AND D-BOX SHALL BE SET TRUE TO BREAKOUT=TOP ELEV.=30 ' GRADE ON A MECHANICALLY COMPACTED SIX .25 INCH CRUSHED STONE BASE AS SPECIFIED INV. ELEV.=. 29.90 IN 310 CMR 15.221(2). BOTTOM ELEV.= 29.58 3) INSTALL INLET & OUTLET TEES AS REQUIRED, _ 2.83' 4) GAS BAFFLE W/ FILTER TO BE INSTALLED ON OUTLET TEE 5' MIN. ABOVE BOTTOM OF AS MANUFACTURED BY TUF-TITS, ZABEL OR EQUAL. SEPTIC SYSTEM PROFILE T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 1 x 2.83' = 2.83' 5) INSTALL SANITARY TEE IN D-BOX (5.03' PROVIDED) USE 1 TRENCH OF 11 UNITS-NO STONE N.T.S. ADJ. GROUNDWATER EL.=24.55 = INSTALL 1' PVC CONDUIT TO HOUSE FOR WIRING PROVIDE WATERTIGHT CONCRETE RISER TYPICAL SECTION WITH WATERTIGHT JOINTS. WIRE HIGH WATER ALARM WITH SECURED COVER TO GRADE SOIL LOG S FLOAT TO GP 2000 HIGH WATER ALARM PANAL ON N.TA P 13533 CIRCUIT SEPARATE FROM CIRCUIT TO THE PUMP. NEMA 4 JUNCTION BOX CORROSION RESISTANT # & LIQUID-TIGHT CABLE CONNECTORS SUPPORTED HOISTING CABLE 7x19 STAINLESS STEEL BY 1-1/4" PVC CONDUIT. JOINTS.TO BE MADE 1/8" DIAMETER. / 1,760 LB. STRENGTH. WATERTIGHT I DATE: JANUARY 30, 2012 2"BALL VALVE W/ UNIONS SCH: 80 PVC SOIL EVALUATOR: DARREN MEYER, R.S., CSE #1614 PC INV. IN)=26.20 GEORGE FISHER CO. MODEL NO. 560 OR EQUAL WITNESS: DON DESMARAIS, BARNS. BOH Elev. t TP-1 Depth Elev. TP-2 Depth 2"SCH. 40 DISCHARGE TO D-BOX ALARM ON EL: 24.14 2"SCH. 40 TEE w/ CLEAN-OUT CAP 31.50 A 0" 31.60 A 0" LOAMY SAND LOAMY SAND PUMP ON EL 23.64 PROVIDE 1/4" WEEP HOLE IN DISCHARGE 1.OYR 3/2 1OYR 3/2 PUMP OFF EL: 23.20 2J" PIPE FOR SELF-DRAINING FORCE MAIN 31.0 B 6" 31.20 7" 1 ''" B 12 2" BALL CHECK VALVE SCH. 80 PVC LOAMY SAND LOAMY SAND BOTTOM OF INT. P.C. EL. 2_20 100 P.S.I. FLOWMATIC MODEL No. 2085 tOYR 6/8 10YR 6/8 PROVIDE 2- WIDE ANGLE FLOATS: 2" SCH. 40 PVC DISCHARGE PIPE 29.92 19" 29.93 20" FLOAT NOA: PUMP ON/OFF (BARNES 073618 OR EQUAL) BARNES SEV412 PUMP .4 H.P. 115 V C C FLOAT N0.2: ALARM ACTIVATION (BARNES 073612 OR EQUAL) 2" DISCHARGE PASSING 2" SOLIDS OR EQUAL BUOYANCY CALCULATIONS PERC TEST MEDIUM SAND MEDIUM SAND NOTE: PUMP CHAMBER TO BE FACTORY WATERPROOFED AND SEALED WITH THOROSEAL OR EQUAL. 1 O 27.50 2.5Y 6/4 2.5Y 6/4 PUMP & ACCESSORIES AVAILABLE AS A UNIT THROUGH WIGGEN PRECAST CORP., BOURNE MA. (800) 564-6774 2 COMPARTMENT SEPnC TANK PUMP & ACCESSORIES AVAILABLE THROUGH NALUAMSON ELECTRIC (781) 444-6800 20=12' x 7' x 2.25 x 62.4 - 11,793 Ibs 20.75 1 129" 20.85 129" PUMP DETAIL Ground cover.12' x 7' x .75 x 120 7,560 Ibs empty tank = 14,000 Ibs FOR TESTHOLE A1: N.T.S. groundaover + empty tank > uplift: GROUNDWATER OBSERVED AT 129" EL. 20.75 GROUNDWATER OBSERVED AT 129" EL. 20.85 INDEX WELL- MIW-29 ZONE: D INDEX WELL: MIW-29 ZONE: D 7,560 + 14,000 m 21,560 Ibs > 11,793 Ibs LEVEL: 7.9 ADJUSTMENT: 3.7 ft. LEVEL: 7.9 ADJUSTMENT: 3.7 ft. DOSING & STORAGE REQUIREMENTS SEPTIC TANK BUOYANCY CHECK O.K. *'ADJUSTED GROUNDWATER: EL. 24.450• "ADJUSTED GROUNDWATER: EL. 24.55*s OF ( DAILY FLOW: 220 GPD DOSING REQUIRED: 4 CYCLES/DAY (SAND) PROPOSED SEPTIC SYSTEM UPGRADE PLAN DARR G 220 - 4 = 55 GALLONS/CYCLE ME , W, DISTANCE REQUIRED BETWEEN PUMP 33 BRIARCLIFF LANE, CENTERVILLE, MA No. f140 "' ON AND PUMP OFF FLOATS: 55 GAL/CYCLE _ 125 GAL/FT = 0.44. FT/CYCLE (5") Prepared for: Patricia Murphy AEA/�E STORAGE REQUIRED ABOVE WORKING LEVEL: 220 GALLONS y Engineering by: Surveying by: SCALE DRAWN DATE NITAR�a STORAGE PROVIDED: MEYER&SONS,INC. Macblougal Survey N.T.S. DMM 02/02/12 PO BOXl INV. IN EL:26.20 - ALARM ON EL: 24.14 =2.06' sf I� ( ) E EAST SA4STSA NDWICH,MA 02537 (508) 419-1086 REV• DATE CHECKED SHEET NO. STORAGE PROVIDED = 2.06' X 125 GAL/FT = 257.50 GALLONS 508-M2.2922 DMM 2 Of 2