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Home My WebLink About0241 CAP'N CROSBY ROAD - Health 241. Cap'n Crosby Circle Centerville , A= 193-179 5 M E A D No.2-153LOR UPC 12W smeadAom • Made in Usn LW- 0- mmmim#m m SF� ar msi� s«au+o Town of Barnstable Bares ftCft Board of Health 1 b& �`0 200 Main Street, Hyannis MA 02601 2007 f8 MA'S Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. February 20, 2013 Mr. Philip and Ms. Doreen Fingado 241 Cap'n Crosby Road Centerville, MA 02632 RE, 241 Cap'n Crosby Road, Centerville u E_., ; A;= 193 Dear Mr. and Ms. Fingado, At the December 11, 2012 public meeting of the Board of Health, the Board voted unanimously to grant you an extension to replace or upgrade the hydraulically failed septic system located at 241 Cap'n Crosby Road, Centerville. This extension is granted for ninety (90) days,until March 11, 2013. _ L In the meantime, you are instructed to keep the system pumped as often as necessary to prevent sewage from overflowing onto the ground. 8 Sinc ly yours, , Wayne iller, M.D., Chairman Board of Health QAVariances 2013\ExtensionGranted241CapnCrosbyRoadFingado.doc Postal utCERTIFIED MAIL. RECEIPT ..n (DomesticOnly; . Inourance Qoverage Provided) informationFor delivery • n Ln m pdstage $ /. C3 WOW ee O Retum Receipt Fee Pdetmark 0 (Endorsement Required) Heie, C3 Restridted Delivery Fee r9 (Endorsement Required)cc �1c O Total Postage&Fees` s �✓ - -0 O N Ms. Amy Fingado 241 Cap'n Crosby Road Centerville, MA 02632 Codified Mail Provides: as�anaa)ZppZeunp'o09e uuo�Sd A mailing receipt • A unique identifier for yourrmaiipiece' ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®qr Priority Mail®. • 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 service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mallpiece"Return 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. IMPOIITANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to AM and Ms. i _ COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X(y ❑Agent ■ Print your name and address on the reverse Addressee so that we can return the card to you. R tved y(Printed ame). , Date D livery ■ Attach this card to the back of the mailpiece, .�l � 5, or on the front If space permits. \ A l D. Is delivery address different fro em 1? Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No Ms. Amy Fingado 241 Cap'n Crosby Road Centerville, MA 02632 3 Service Type p Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Ye I 2. Article Number (Transfer from service label) I ;t 1,17 0 0 6, 0 810 a:GO a'`3 5 2 4 6 7 6 5 h PS Form 3811,February 2004 Domestic Return Receipt 102* -02-M-1540 I UNITED STATES POSTAL SERVICE _ First-Class'Mail •; M lYlaw n{�ISs.,e.�..e.�,,ryr.'y:A.�+ • Sender: Please print your name, address, arid'=ZIP44 in ffia Town of Barnstable j Public Health Divisipn 200 Main Streety Hyannis, MA 02601 a lif,zI,Il Jill s,l ,,,tI:ii, ,IilL„li,1,r If ill IIflit!,;1!III , No- 261 — ar7 I-- , .i Fee I UU THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWWOF BARNSTABLE, MASSACHUSETTS 2pprication for Misposal *pstem Construction Vermit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System :Zdual Components Location Address or Lot No. AY j d4 p�j Ct26501 PUP Owner's Name,Address and Tel.No. Assessor's Map/Parcel i 93 l� �� PW G4p+q 6pzS6 ! P-D C.,a07z-X0 LLe Installer's Name,Address,and Tel.No. 509-LITI-9'61-1 Designer's Name,Address,and Tel.No. dApGA 0C LLC- `Te- CL-LI s PC-5tc<t3 dt SIC-7 PO 3 0 12 EV-3.s 76YZ. Type of Building: ' Dwelling No.of Bedrooms 4 Lot Size 3l� 4 o sq.8. Garbage Grinder( ) Other Type of Building R G5;(Df=-L (&L- No.of Persons Showers( ) Cafeteria( ) Other Fixtures �� Design Flow(min.required) 4L((p gpd Design flow provided i`&444 gpd Plan Date 1 'I�d �oZC)I a-- Number of sheets a- Revision Date Title 41 dAA fAj d RC5G Y A) G6-7L)78W1 LX- Size of Septic Tank i op® 64:L- Type of S.A.S. 3 5op 659 t. 0 (:1Ac&,d(A9 tr Description of Soil ixoD --- l V e- (0- a r5 om PLAj Nature of Repairs or Alterations(Answer when applicable) QS L oex:) qx4-L- i!�C1T1G T*k_)`� (-(UCkLk)xi eo'ZC ' Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe& Date 3-Z-.2® 1 3 Application Approved by _ Date - �0 /3 Application Disapproved by Date for the following reasons - Permit No. .�G - 0 0 / Date Issued 3 -.2 0 /7 ., i, v()No. 7 vs :. Fee THE COMMONWEALTWOF MASSACHUSETTS's Entered in computer. Yes PUBLIC HEALTH DIVISION TaOWNpF BARNSTABLE, MASSACHUSETTS 9ppfitation for Disposal Opstem Construction Permit Application for a Permit to Construct( ) Repair(� Upgrade( ) Abandon( ) ❑Complete System �hdiidual Components Location Address or Lot No. Ayl* C.$P i j <!R05p y 9-p Owner's Name,Address and Tel.No. Assessor's Map/Parcel .193 11-7 9 aW 64CI56Y A-D GEN J(LCS-- Installer's Name,Address,and Tel.No. $0g-117j_j-$j"1 Designer's Name,Address,and Tel.No.SDI-)�O ��2 d 'T Ca C��Ua4Qj_6164L ST v . 13A Cl+c 1S"702 - Type of Building: ' t Dwelling No.of Bedrooms !4 Lot Size 3� p sq.ft. Garbage Grinder( ) i Other Type of Building ( (r No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 440 gpd Design flow provided 4*4 gpd Plan Date I Z 1 -at t71 Number of sheets per. Revision Date I-1 1tOl Title dAp (iU dkn,54 y A , Ce-F)j7MV/C.C,( ,. Size of Septic Tank 606a, ra,4t� - Type of S.A.S. '3 5ck!p g5&(g1.o1V Description of So� F(u . 6" (0- Nature of Repairs for Alterations(Answer when applicable) QSc Qcll! 'rc�r I pot)�{-L 6 UT(G Tb P tW- b-NA6 T 0 �i�Ua C2*t U-) L&W AI&Ay C_i66t6@Z W IM451 0(5- �_.._., Date last inspected: . Agreement: ,,a The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of , Compliance has been issued by this Board of Health. Signed , Date 3-7-,2013 Application Approved by 41 _ aC Date :2 G- Application Disapproved by Date r for the following reasons Permit No. )_y i ? _ d 6 / Date Issued - ?o -1 T --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(�) Upgraded( ) Abandoned( )by (N p FLt.)(pG &V7a0JQK at g 4/e4p im Cl2 osgq Q D cc-V_ rExy LLL' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.Z o(3-0 7 dated Installer (.Ut- Designer Z C Ei t.1 b SIC,k) #bedrooms 4 Approved design flow 4 4r gpd j The issuance of this permit shall no be construed as a guarantee that the system-w ll-functio a3fe igned. Date � � Inspect ok --------------------------------------------------------------------------------------------------------------------------------------- AA No. 2-0 13 -U F7 Fee loo THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal �bpstem Construction Permit Permission is hereby granted to Construct( ) Repair( & Upgrade( ) Abandon( ) System located at )(�( C-0 (n/ dP_oSbV R,D ceJ'rn t u-C and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date � , D n - / Approved by . x-„ i■ ■■FROM R&J r PHONE NO. : 508 3e5 2328 Apr. 18 2013 06:58AM P1 ■ ■ ;■ 1Own UI Darnlaiauic Regulatory Services Thomas F. Ceiler,Director AKAM , r Public Health Division '39.6 Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office; 508-862-4644 fax: 508-790-6304 Date: A?Pu4. I0.2ot'6 Sewage Permit#.;LOO-OS 7 Assessor's Map/Parcel 1`l3 i7 Installer& Designer Certification Form Designer: s beSj� IC, , . Installer: ` (n�� tt31C�' �J.c..�r.R., Address: . O �x 215-Z Address: t5 ( ,o QataLr,S On 3 -ad -;10 CAPa.-)IVC EurW966 was issued a permit to install a (date) (installer) septic system at Zyl CA?,Nj C.IP,, r -, IK Tno based on a design drawn by (address) �CSi 6.> (Sb l . dated v. 4Ajv4 7 20 (designer) ZI 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. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & I ocal R ns. Plan revision or certified as-built by designer to follow. Stripout(if requi cted and the soils were found satisfactory. )ASON CHRISTOPHER ELLIS y No. 1126 aller's S' tune) 1 o FC+lS7E�� s'!NI rAR9P a (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 PCJBLIC HEALTH DIVISION. THANK YOU, y,1tlri:c fu,m3kiesignercertitication torm.doe i J.C. ELLIS DESIGN COMPANY, INC. SEPTIC SYSTEM DESIGN&ENGINEERING—SEPTIC INSPECTION— SITE PLANNING—WETLAND CONSULTATION&PERMITTING P.O.BOX 2152,BREWSTER,MA 02631 PHONE 508-240-2220 FAX 508-240-2221 ENIAlLjcellisdesign@verizon.net ***SEPTIC SYSTEM CERTIFICATE OF COMPLIANCE*** Town of Barnstable Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Dear Board, An inspection was performed of the newly installed septic system at: Property Address: 241 Cap'n Crosby Road Assessor's Map: 193 Parcel: 179 Owner: Phillip A. Fingado Installation Date: April 10, 2013 Installer: Capewide Enterprises It has been determined that this system, as installed, substantially meets the requirements of 310 CMR 15.000 (Title 5) and the Barnstable Board of Health Regulations. �j OF 4f4 Sin JASON cti� � RISTOPHER Q ELUS26 N J w 19-F S.I.T. Apri oft Subject: 241 Cap'n Crosby Rd Centerville,MA 02632 To Whom It May Concern: I lived at 241 Cap'n Crosby Rd Centerville from 1979 until 1989. The house was owned by my parents, Phil and Doreen Fingado until my mother's passing in 2008. 1 moved back to this address permanently in 2008. The additional bedroom(one large bedroom was converted into two small bedrooms)was completed approximately in 1991. If you have any questions,please feel free to contact me at 248-802-9928. Thank you. incerel -- Philip"Andy' Fingado rloo k "g iv am s P, y /V Sri ROB B v4,t LAV �5 1 'ol &IP lu Ve gA 5' �, Z/zs�-orgy I Sc- B Parcel Detail Page 1 of 3 j t 6 Yy CY} .CY'TJUn MASSa max. ,,..,. ._ - t j Logged In As: Pa rce I De la I I Monday, December 31 2012 Parcel Lookuo Parcel Info Parcel ID j 193-179 I Developer Lot LOT 50 I Location 241 CARN CROSBY ROAD I' Pri Frontage 1130 I Sec Road I I Sec I Frontage village,CENTERVILLE I Fire District!C-O-MM I Town sewer exists at this address!No Road Index 10227 �I 3 ssa{ Asbuilt Septic Scan: Interactive 193179_1 Owner Info R Owner!FINGADO, DOREEN G TR I Co-owner DOREEN G FINGADO LIVING TRUST I streetl 1241 CARN CROSBY ROAD I . Street2 � -- City rCENTERVILLE __ __ �I State FMA I zip 02632 Country Land Info Acres 0.79 use Single Fam MDL-01 ) zoning I'__' J Nghbd 0106�� Topography Level Road Paved Utilities IPublic Water,Gas,Septic I Location ,Lake/Pond Front I Construction Info Building 1 of 1 Year Roof - Ext Built 1979 A struct.Gable/Hip I wall JWood Shingle Living 1947 Roof AGIs/ Area I cover sph/F Cmp I Type I None I � _ Cape Cod I Int Style all i Drywall ms I Bed 4 Bedroo ' Wall! Rooms; Int Bath Model f Residentialarpet I3 Full I C ce�3Floor Rooms' I1 . 1 GradeAverage Rooms HeatRooms sT Heat Found- stories F 1/2 Stories _ I Fuel OII � ation Poured Conc. I is Gross,4566 Area I I http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13941 12/31/2012, Parcel Detail Page 2 of 3 Permit History Issue Date Purpose Permit# Amount Insp Date Comments 08/28/2006 Addition 20061868 $40,000 03/06/2007 00:00:00 12/13/2001 Window Replac 57794 $15,100 03/14/2002 00:00:00 02/01/1992 1 B34820 $2,000 01/15/1993 00:00:00 ICE DECK Visit History Date Who Purpose 06/26/2007 00:00:00 John Greene New Construction 03%06/2007 00:00:00 Martin Flynn Bldg Permit Completed 03/14/2002 00:00:00 Martin Flynn Permit/Hold as NewGrth . 12/13/1999 00:00:00 Paul Talbot Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 09/17/2007 FINGADO, DOREEN G TR C184135 $1 2 04/18/2005 FINGADO, DOREEN G #D1013297 $0 3 08/12/1977 FINGADO, PHILIP C & DOREEN G C71481 $0 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2013 $161,500 $41,700 $7,600 $157,800 $368,600 2 2012 $165,100 $41,000 $6,000 $151,800 $363,900 3 2011 $195,400 $6,000 $0 $121,400 $322,800 4 2010 $195,000 $6,000 $0 $121,400 $322,400 5 2009 $198,200 $5,000 $0 $173,400 $376,600 6 2008 $209,800 $5,000 $0 $180,700 $395,500 8 2007 $232,300 $5,000 $0 $180,700 $418,000 9 2006 $213,400 $5,000 $0 $196,300 $414,700 10 2005 $191,800 $4,800 $0 $178,500 $375,100 11 2004 $153,100 $4,800 $0 $151,700 $309,600 12 2003 $136,400 $4,800 $0 $64,400 $205,600 13 2002 $130,800 $4,700 $0 $64,400 $199,900 14 2001 $130,800 $4,900 $0 $64,400 $200,100 15 2000 $93,100 $4,600 $0 $45,000 $142,700 16 1999 $93,100 $4,600 $0 $45,000 $142,700 17 1998 $93,100 $4,600 $0 $45,000 $142,700 18 1997 $103,600 $0 $0 $29,700 $133,300 19 1996 $103,600 $0 $0 $29,700 $133,300 20 1995 $103,600 $0 $0 $29,700 $133,300 21 1994 $100,900 $0 $0 $44,600 $1,45,500 22 1993 $96,900 $0 $0 $44,600 $141,500 23 1992 $110,300 $0 $0 $49,500 $159,800 24 1991 $111,400 $0 $0 $79,300 $190,700 25 1990 $111,400 $0 $0 $79,300 $190,700 26 1989 $111,400 $0 $0 $79,300 $110,700 27 1988 $86,700 $0 $0 $34,800 $121,500 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=13941 12/31/2012 •: '.:. 1 1 '.1 '.1 :I I •1 1 • •�• :• 11 1 1Sflu11 11 • tw � - @ a v �,f r'r� a' l'4 t x"sg(" 1" jn 3 •ra,. r � ' � x �� li d i�a91Q� 5 t�j?` i .-'x..a��"�Ct�`'r �� e�v � �{;r' T r}i� Y'• 3z'� �,�3�' �„ ?3tid ��Y:i "1 i � t ��}. '� "�i f , ss� � .�/�q�•.E .i�'��-��"'��+�Ils�,� �_ t6t,t � x ��t� �`Uwo t�n��,�'�� '�P �1�� 21 � ��'" R �•. � fix, ,s at; � lz- La ki r i� � W 5 .• ¢ + ��W^`��' �� gs ',� � �a+1 e� A F M"'. `KSr{„� "4' � �' k�.*_ �arrnreoon t M { ,. UO612007 aBS',ryS.+Gi33�5s's��h+p,'"'_` m�3!��'�w�� y "�'�` F�•,s "',�C� wH4... i � ��a•a'—,. • e��` _ ;`ens i�• +.,� � a � ' Y " t fit# .„j})t�i r��rl,� �PI� •YI i�1 i 1��.{fE 9�.` sty y"� �fr� yt"' � � ��1" { +{} � 63��•^k�.,�.�} ;, �:Y �i I'gIIoXI��;Ir! �E; <,.Ot161�t..�+-•x•-1- Xrj#ty a `�,�»,..»,,' I'{��'7: �'<+_' 1 �y4� �."-^«�:-.,.7 � .�.d�" � i a'(1��f •`� .� °x - - „R."'°� �. a9 @ :s. -rn^7+j�..�y ��s '�` 7j� 6 of "+y�"•� � r�1'�!`3 fl,{(,� �t y�' k# .4'��` ""'+�sti � "`�t�{ � ��`5 f � �X,i �tioo r Az �._ 5 kn S c, v jyk. 031 007 , b �E I TOWN OF BARNSTABLE LOR ATION 1 SEWAGE# Q I A VILLAGECe_ 1' bry f lie ASS SSOR'S MAP&PARCEL Lo'f j g INSTALLER'S NAME&PHONE NO.C- cDPwoe- onfei'prfSc_s Ur—_ 50-*7T�i77 SEPTIC TANK CAPACITY /000' LEACHING FACILITY:``(t/ype)(3 ,� bg 11w ,�f ,(size) NO.OF BEDROOMS T OWNER P A , PERMIT DATE: COMPLIANCE DATE: f Separation Distance Between the: ,t/® w-ir'o EVV_-cr-+ 0Q Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ed Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) /1�� Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 1 ,85 Feet FURNISHED BY d6®(RA)W45 8 Rkge L LC' �\ F TOWN OF BARNSTABLE •LOCATION � SEWAGE# •VILLAGE CL'4rbrv�14 ASSESS R'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I LEACHING FACILITY:(type) P tTs `�x<. (size) (a 00 6AI NO.OF BEDROO OWNER l^ PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY (Zl r 0 a- O O ay a y a ao� a9 3 ao 33 v November 12, 2012 Dear Mr McKean, I am writing to you to request and extension on getting my septic system in compliance at. address: 241 Cap'n Crosby Rd Centerville, MA 02632 I have contacted a number of companies and after careful review, have chosen to use J.C. Ellis Design Company, Inc. I will provide any documentation you may request if you need to verify this information. I have attached a copy of the original letter sent by the Town of Barnstable for your quick reference. Thank you for your consideration in this matter. Sincerely, Philip A. Fingado C) ._, �zl � A I Town of Barnstable Barnstable SHE Tp� Regulatory Services Department nsraet.e. 9�nn:�b;. Public Health Division ATE0 Mo+° 200 Main Street Hyannis annis MA 02601 2007 Office: 508-8624644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7006 0810 0000 3524 6765 October 3, 2012 Ms. Amy Fingado 241 Cap'n Crosby Road Centerville,MA 02632 The septic system located at 241 Cap'n Crosby Road,Centerville,MA was last inspected on 8/20/2012 by James M.Ford,a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed"under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Septic system is in hydraulic failure You are ordered to repair or replace the septic system within sixty(60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH s McKean, R.S. CHO Agent of the Board of Health ' r �FtHE Town of Barnstable Barnstable � Tp� hP� y� Regulatory Services Department eficaC 1 tLdLR CA6LE, �Q �^ m01 Public Health Division vA t63 fo— 200 Main Street, Hyannis MA 02601 �� Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7006 0810 0000 3524 6765 October 3, 2012 Ms. Amy Fingado 241 Cap'n Crosby Road Centerville, MA 02632 The septic system located at 241 Cap'n Crosby Road, Centerville, MA was last inspected on 8/20/2012 by James M. Ford, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00) due to the following: • Septic system is in hydraulic failure You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH �' as �nR.S, . CHO Agent of the Board of Health Documentl CSC Y 1 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS r DEPARTMENT OF ENVIRONMENTAL PROTECTION .TITLE 5 OFFICIAL INSPECTION FORM-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address 241.Cavt. CloSiw.ROad. Centerville.MA 02632 "I Owner's Name: Anu Finzado Owner's Address: Date of Inspection: AuQust 20. 2012 Name of I.nspector; (Please Print) James M.Ford Company Name:. James M,, Fold Mailing Address: . . P.O.Box 49 Osteiwille.MA 0?655-0049 Telephone Number: 008) 862-9400 CERTIFICATION STATEMENT . 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: °asses onditionally Passes . Beds Further Evaluation by,the Local Approving Authority ails Inspector's Signature: Date: AuQust 24, 2012 The system inspector shall:su it a copy o�this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of compl g 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. Notes and Comments ***.*This report only describes conditions at the time of inspection and_under the to of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection.Fonn 6/15/2000 page 1 Page 2 of l l ' OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 241 Capt. Crosby Road Centerville,MA Owner: Aniv Finzado Date of Inspection: August 20, 2012 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more.system components as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if.it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or . obstructed pipe(s)or due'to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with.approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 241 Capt. Crosby Road Centerville,MA Owner: Amy Finzado Date of Inspection: Auzust 20. 2012 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 Boated 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 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 aseptic 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 coliforni bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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: Page 4 of 11 OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 241 Capt. Crosby Road Centerville,MA Owner: Anzy FinQado . .Date of Inspection: Auzust 20, 2012 D. System Failure Criteria applicable to all systems:. You must indicate.either"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 town overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than%z day,flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility 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.] Yes (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. . E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No _ the system is within 400 feet of a surface drinking water supply _ the systeut is within 200 feet of a tributary to a surface drinking water supply the system is located in a�nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone.II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR .15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 241 Capt. Crosby Road Centerville,MA Owner: Amy Fingado. Date of Inspection: August 20, 2012 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: Yes No ✓ . Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15..302(3)(b)]: 5 , Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 241 Cant. Crosby Road Centerville,MA Owner: Amv Fingado Date of Inspection: Auzust 20, 2012 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: " Z Does residence have a garbage grinder(yes or no): N/a Is laundry on a separate sewage system(yes or`no): N/a [if yes separate inspection required] Laundry system inspected(yes or no): no Seasonal use(yes or no): no Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sq/ft etc.)`. Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unavailable Was system pumped as part of the inspection(yes or 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Date of installation 611192 leach nit was added per as-built card Were sewage odors detected when arriving at the site(yes or no): No 6 i Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS_ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 241 Capt. Crosby Road Centerville,MA Owner: Am Fingado Date of Inspection: August 20, 2012 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction liner Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 3" _ Material of construction: ✓ concrete metal —fiberglass _polyethylene other.(explain) If tank is metal list age:. Is age confirmed by,a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal: Sludge depth: 2„ Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 10." 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: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.). The tees were present. The liquid level was even with the outlet invert There did not appear to be anv signs of leakage. GREASE TRAP: None (locate on site plan) " Depth below grade: 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: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,"structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 i .; Page 8 of I 1 OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 241 Capt. Crosby Road Centerville,MA Owner: Amy Finzado Date of Inspection: August 20, 2012 TIGHT or HOLDING TANK: None (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth.of liquid level above outlet invert: Even . 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.): The D-Boa.ivas normal PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): . 8 r _ Page 9 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 241 Capt. Crosby Road Centerville.MA Owner: Amy Finzado Date of Inspection: August 20. 2012 SOIL ABSORPTION SYSTEM(SAS):. ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 2- 4'x6'600 gal.pits leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: - overflow cesspool,number: Innovative/alternative system . Type/name of technology: Corn ments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): Both Pits ivere in failure. The liquid level was up above the inlet pipe CESSPOOLS: None (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 or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM.- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SY STEM INFORMATION (continued) Property Address: . 241 Capt: Groshv Road . Centerville.M.i Owner: Amy Finzado Date of Inspection: August 20. 2012 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 1.00 feel I..ocate where public water supply enters the building: 13 . I I 1 0 0 a ay a y a ao6 �:9 3 a0 33 y� 10e Y�" Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 241 Capt. Crosby Road Centerville.MA Owner: _ Anw.Finzado ` Date of Inspection: August 20. 2012 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 10+/- feet Please indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record -If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain:. Topographic and water contours maps Checked with local excavators,installers-(attach documentation_) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours inays the maps were showing aypr oxin.iately 10'+/ to gt ottna,vater at thts site. This report has been prepared only for the septic system and components described herein. This s septic systernm has been inspected and failed.as of the date of inspection. This report is not a warranty or guarantee that the system will f ttiction properly in the ftttttre. There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection; this report and/or any components of the septic system which have not been located and inspected. 11 IKKE Town of Barnstable Barnstable Board of Health jI1�`Ce .F SSS`' B1� 200 Main Street Hyannis MA 02601 39. Aye 2007 OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi ACKNOWLEDGEMENT OF RECEIPT: We.have received your submission to the Boarcfof Yfeafth. Re: 241 Cap'n Crosby Road, Centerrviffe, 9VIA. Thankyou. Your item will be heard at the Board of Health Meeting on the: Date of: Tuesday, December 11, 2012 You, or a representative for you, is expected to be present to answer questions the Board may have. Meeting Location: Town Hall, 367 Main St, Hyannis Hearing Room, Second Floor Time 3:00—6:00 P.M. Approximately three days prior to meeting, an agenda will be sent out to you- once it is available. It will also be available on line at the town website: www.town.barnstable.ma.us Go to ..."Boards & Committees > Board of Health - or- Go to Official Agendas QAAGENDAS BOH\let 241 Capn Crosby Rd Cent for DEC2012 BOH Receipt of BOH Submission 2012.doc No...gr�.......�.�. ,. Fss.... .....'- THE COMMONWEALTH OF MASSACHUSETTS i BOAR® OF HEALTH TOWN OF BARNSTABLE Appfiration for Biupuuttl Work.6 Tanstrurtiun Vamit i Application is hereby made for a Permit to Construct ( ) or Repair (li an Individual Sewage Disposal System at: ...............-........�........ ......................................................... ..............-------- --•.-----•...........--.... L on-Address or Lot No. aa -------------------.......................................... aC�� Address Installer Address Pq UType of Building Size Lot............................Sq. feet �t Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Pk Other—Type of Building ............................ No. of persons............................ 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........................................ ►-4 4 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 1� Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ a ----------••-------------•---••----•--•-•-•-•••-••--•-•---------•-•-----------.....-••-•-•-••-••----........---••------••-•---.._......--••--.._...--••....-- 0" Description of Soil................................................................................................................................................_...................... x c.� •-•-------------------------------•----------------------•---------•------------------------------------------------------•------------------------------•-------------•----------------•--------------- UW ----•-•....................•---- ------•---------------•••--------------------•••-•---•--------------------------•- �}} - - _t............ Nature of Repairs or Alterations—Answer when applicable.______._..��..�1(".____..6..o_..----.�r..'/ -_.__�l-%-•-••-•---- -•---------------------------------------------------------•------------------------....-------------------••---------------------------------------------------------------------------------....-•--•- 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 Complian has been issued by th oa of ea . Signed . ....... ..--- � -- ------------- Date Application Approved By ------------- ---- o"Z ... a e ... J Application Disapproved for the fo lowing reasons- --------------------- -------------------------------..............---------------------------------------- -------------- ---------------------- - -- -- -- ............ ......----------------------------............----------- -----.... ----- .............-------------------------- ------------------ - - ................ ..........-....-..--....--...-.-Date..... Permit No. -...-..-.. .` ._�... .`�.�. Issued Date No...qL-- = .................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Xpr ftratilan for Uiiipas al Vorkg Tnnitrnrtion Frrutit Application is hereby made for a Permit to Construct ( ) or Repair (Individual Sewage Disposal System ate. -"I ' ' ? T �v. ..s � ---T .�-7`� �z v� Lo—/n or Lot No. Ar,C, /9 ......................-- ••----......................--•------............................... ----......----•-............................ ......---................................. Address ' Installer Address U Type of Building Size Lot-- Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder q feet aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures -----------------------------------•--- 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--------................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 --------------------------------•----••-----------------------------••--••------•----•-•--....------......................................................... 0 Description of Soil---------------------------------------------------------------------------------------------------------------------------............................................ W U ......................................................-------------•----------------•-••---------------------•--------------------•-. ......................................................... --------------------------------------------------------------------------------------------------------------------------- _.. ---... ........... Nature of Repairs or Alterations—Answer when applicable.____________14e______ ........_....._..__.._._.__..._.__............_.. •------------------------------------------•----------------------------------------....--------------------•---. ------------------------------------------------------------------.......--••----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage DisposakSystem 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 Compliance has been issued by th oard of ea`l Signed?--------------"`----------------------------------- --- -/ f�'Z Date Application Approved By - .. ---- Date-------....'-- Application Disapproved for the fo lowing reasonr: ------------ -- ---- ----------------------------------------------------------------------------------------------------------- ................................----- ------------ PermitNo. ---------- -- -- --------------t---- r`c� � Issued ------------------------------- -- -- ----------- e..---- Date f! , THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate of Toralatiane THIS IS TO CERTIFY, T at he Individual Sewage Disposal System constructed ( ) orRepaired b ` y ...-- ----- ----- ---- ------------------------------------------------------- Installer T �2oS/3 y �c Tz v� �� at ------------------- -------------------- --- -----------------......---------------------------------------------------------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .......... -.0�........�a"... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------- --- ....... - - - ------------------------------------------- Inspector ............. ........--•---..........----------........ -- --. ------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE No...... _"_ FEE.. Elifivoli a1 rki T.�nifr tion rranit Permission is hereby granted.....................'_._�L G l� /f to Construct ( ) or Repair ( ") an Individ al Sewage Disposal System at No.. // 5 .y C � 7 �6zv� - ---- -- ------..... ......... Q^ as shown on the application for Disposal Works Construction Permit No _/_o_` .__ Dated.......................................... --'---------......................................................- •.-•-- Board of Health DATE.._..... p�'..'.. -`. °Z--------------- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS a TOWN OF BARNS ABLE LOC TI N CA, v;;vrp , y _ SEWAGE # I. VILLAGE A y i /j/C A&ESSOR'S MAP & LOT ?3- /7� � INSTALLER'S NAME & PHONE NO.A/Z SEPTIC TANK CAPACITY o 6h / d,ri s7 f � LEACHING:.FACILITY:(type) c p sr (size)4 Oo NO. OF BEDROOMS D PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER F ( /y �f DATE PERMIT ISSUED: °T — 77— q DATE COhPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� 7 CPU C1f� I� I ` `'7 I No.... .. D. ... - Fes..- I " THE COMMONWEALTH OF MASSACHUSETTS HEALTH BOARD OF SUBJECT TO APPROVAL 0F �^ BARNSTABLE CONSERVATIO- _ .D9A.►. ..............oF..... `. ' -----------•......------••...........••.... COMMISSION Apli iration for Disposal Works Tonstrnrtion Pumit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ........... .l? '1... ...C� 144-- ------------------------------------ ' - ----------........----- Location,Address or Lot No. ....................._141L:t.P.-. .i.N�:AP4P...............•----......�'. �aSd P"._�1 (�?c. _ . M��Aa.........------........-- Onet ................................Address J . nstall' Address d Type of Building Size Lot.__�, ,� -------Sq. feet U Dwelling No. of Bedrooms_-_-_---_---___ -Expansion Attic Garbage Grinder p., Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ............................ W Design Flow..................%..�?.....................gallons per person qer day. Total daily flow....................�;3� .............gallons. WSeptic Tank—Liquid capacityl0'00..gallons Length.2.--& _._ Width..4.'n(D_. Diameter................ Depth..14.J-&.`d x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.........._---------sq. ft. Seepage Pit No------------I-------- Diameter......... Depth below inlet.......6.......... Total leaching area•_•---Z00---sq. ft. Z Other Distribution box ( vj' Dosing tank ( ) pp I '-' Percolation Test Results Performed by. _ . _'t.aY&...Ili@L_- f? ...Fig Date---------4 _ ,.a Test -Pit No. 1...._.." ___minutes per inch Depth of Test Pit------I°7r........ Depth to ground water....L —S..._.._._. 44 Test Pit No. 2A ..._minutes per inch Depth of Test Pit.............•...... Depth to ground water........................ 94 -•••-•-----••----•--•--------•-•-•-•----------•--•-•-•--....-•--•-----•.............•-•-•-•-•-••...........-•-•---•-----•-••--•----•----•......•-••.._....._. 0 Description of Soil...........p-•lviv...`R?_.......mvm mv....S.X:fjp----------------------------------------------------------•---....................... x U .........---••••--•--••-••-•------•----.....•••-•-----------•-•-----•--•---•-•------•-........•--•------....••-•••••-•-•-•-•-•-•-••--•••-•••-••-•--•-•-••••-•----••••••..............•--•••-•-••-•••--••- w Z ----••••••..............•--•------------•••-•••--•••--••-•••----•--••--•-•-•--...••-•-.....-••••-•••--•••-•--•--------------------••--•••--•---•--•---•••••••-••••-••--••......-•-•-••-•................ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ----------------------- ............................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 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 board of health. Signed r •• ---4�- Application --�--l-i--Y----l--.-L---------------•......------.........---•--. Date APProved BY - ... ...... � Date......-•-••-•-•- Applieation Disapproved for the following reasons:........................................ ..... ....................•--•-•-------....----....._.....---------...-------•---------........-------•----.....---•-•-----•---•-------•------------------------------------------------------...-----......._. Date PermitNo......................................................... Issued--- ,. -'-S- —�- --•-•-•-------------------- 70 THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH 1 aW 1...............'OF.......RpZ.tYITA:5 ...........--------....................... Appliration for DhiposFal Works Tomitrnrtiun Famit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ` CAN t..os Ag ..�t.)r Iz.IN. LOT �v Location Address P t t t�t f� 1-t tJ(q , _'Z.'y .Si Ot i ll e N. i s gilts......................... Owner Address W Installer Address Pq UType of Building Size Lot... 0 ------Sq. feet �_. Dwelling—No. of Bedrooms.................. .......................Expansion Attic ( ) Garbage Grinder ( ) a4 Other—Type T e of Building No. of persons............................ Showers ,• yP g ---------------------------- P ( ) — Cafeteria ( ) dOther fixtu. es -••-•--•---•.---•--•••----•------•-•----•-•-••-••-------------••••-•-•-�.... ......--•-•-...........-- W Design Flow.................I= '�.....................gallons per person per day. Total daily flow_............__..:._...3e>.............gallons: WSeptic Tank—Liquid capacity!vot�_gallons Length_�'_CP"_.... Width__:` :."�_�__ Diameter................ Depth..A.-,&'''. x Disposal Trench—No..................... Width_.•._............... Total Lenth................... Total leaching area.............___....sq. ft. Seepage Pit No............�-----... Diameter........fop...... Depth below inlet....... ....._.. Total leaching area..._Ia.4�...sq. ft. Z Other Distribution box Dosin tank '-' Percolation Test Results Performed by. � - '_ ?._�i _'.. .'_ 1� ...4; Date...._...10..1_13 1-1-1 W -¢---------------- Test Pit No. 1..... r_..minutes per inch Depth of Test Pit_____kz.....__.. Depth to ground water....(i m`_ __....._.. f= Test Pit No. 2rL ....minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ...-------•-----------------•-•------•-------•-•---•-•------•----------...........--.............--•......................................................... 0 Description of Soil----••••-• -10 cl -W W tit�.r,.- t t.�VA ��1 Njip x .................... ------------------------------------------•-----. ----•----------------••-•-••-•---•-- U -•--------------------- -------- •------------------- •----------------------- ...._..------------------------ •--------------------------------------------- •----------------------------------------------- --------------------------------------------------------------------------------------W U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ....................•---......-----------...----------------------------------------------------------...---------•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ..,'the provisions of TITIL- 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 board of health. Signe ---•---b........................................................ •---••......--------.....__.... fDate Application Approved By... Date Application Disapproved for the following reasons:.. .......--. Date «t PermitNo......................................................... Issued-....................................................... Date S THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALT .. .. .OF....... .....0.............. Tertifiratr of Tomplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (4-ror Repaired ( ) by - .....................- -----...._. -----i------ ------/---------------------------- W s Iler has been installed in accordance with the provisions of T 5 of The State. Sanitary Code as described in the application for Disposal Works Construction Permit No.__........V.-I................... dated_../�_" ............................. THE ISSUANCE..OF THIS CERTIFICATE SHALL.NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM wiLL FUNCTION SATISFACTORY. DATE......:........................•-------•---•-------.......-•------•----•-----._. Inspector.............................................,...._..._....------•--•----•---........ THE COMMONWEALTH OF MASSACHUSETTS BOARD 9F HEALTH �Crr)ez .......... ... ..t �...........OF........ . ...Z�.y/............._ t�JNo. �� FEE..� �i��a�tt1 nrk� �nn.�� tUan �erntit Permission ',,liereby granted.................................................:--------------------------------------------------------•--..........--..................... to Construct ( or Zqpair ( an Individ 1 Sewage isposal S tem at No. v. D• Street � .....t -'�- as shown on the application for Disposal Works Construction Vefynit ....__= Dated" :'` '. `'- Board of'H DATE_.;............ .......................... ................................... ` FORA 1255 HOBBS & WARREN. INC.. PUBLISHERS TOWN OF BARNSTA,B�LE LOC TIfzN" ( / ,��:✓��o 1 y�� SEWAGE A$aE3SOR'S MAP 6i LOT - 17/ INSTALLER'S NAME PHONE NO./0,L /Y Co s6.j-T S'13 C -Z SEPTIC TANK CAPACITY b ®06, LEACHING boo G.�L .FACILITY:(type) P4 E 'Ca sr (size)e po NO. OF.BEDR60MS PRIVATE WELL OR PUBLIC WATER��j 4 c BUILDER OR OWNER DATE PERMIT ISSUED,: — — DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �� C—d?�`W 6PU S t Y C A c-/e �7 26 1 s LOCUS MAP PLAN REFERENCE: L.C.P. 385078 SHEET 2 a OAK ST I� LOCU S RD o \ CROSBY o \ CAP N a ,o a 7A �� N PCL. 177 3 PONDS RO NOT TO SCALE C A D N CROSBY R ROAD PROPOSED S.A.S. DISTRIBUTION PCL. 176 / • 63 LINE TYP. / a DISTRIBUTION LEACH N BOX , \ CHAMBER TYP. / R/142 77. I pRIVEW :.. .:64 I,"A30. 17 0 /#2 #1 AYf o / /VENT a' O O O TREES 3 0 0 ;. / ;.;: 1p CATCH 25' BASIN \ o sNG\ 3.75'J .3.5' EXISTING / 3 G ' I'^er BENCHMARK FLOW TYP. TYP. LEACH PITS / FENCE ARACE TOP OF CONC. BOUND BARRIER 40' (ABANDON) 61 / / EL. 64.0' M.S.L.± WORK ( � 63 LIMIT — — _ S.A.S. DETAIL 61 EXISTING EXISTING. / ` 6WELLING — — - 62 SEPTIC TANK PARCH E�'6�N.=' o PCL. 178 60 _ — _ FN LE\ _ — — pN) 61 �G EXISTING �!FENCES i PCL. 180 60 0 59 �o DECK DECK Zm N 59 LOT 50 57 / 34.496 S.F.± / _n — 56 i 57 / o _ — — — — — 55 rn 53 55 52 ;- 54 �� / / — BORDERING— — _ — 51 •7 - / / - VEGETATED— _— 53 j / i _ 50 / �/j /j I WETLAND = 49 52 / // / � � � — �—�--_ — 48 47 51 EDGE OF WATER 50 VARIANCE REQUESTS / / / /j i (11/29/2012) 49 / / � WATER LEVEL EL. 46.6' 310 CMR 15.211 1. PROPOSED LEACH AREA IS 19' FROM 48 / FOUNDATION WALL. 310CMR 5.248 47 /�/ N 2. NO RESERVE AREA PROVIDED. i POND 6`L PCL. 181 t 90.54' PCL. 182 PCL. 184 PCL 51 SEPTIC SYSTEM UPGRADE PLAN J.C. ELLIS DESIGN SUBJECT: 241 CAPON CROSBY ROAD H O Mqs BARNSTABLE, MA ZF JA ON S9CyG PREPARED FOR: PHILIP A. FINGADO U HR TOPH LL 241 CAP'N CROSBY ROAD o. 126 CENTERVILLE, MA 02632 SgNITAR P� PROPERTY OWNER AND P.O. BOX 5 ASSESSOR'S MAP 193 PARCEL 179 SCALE: 1"= 30' CONTRACTORS TO VERIFY BREWSTER, MAA O2631 ALL WATER LINES AND GAS (508)240-2220 JASON C. ELLIS, R.S. UTILITIES ON PROPERTY. Email: jcellisdesignOverizon.net DATE: DECEMBER 18, 2012 SHEET OF 2 REVISED: ;. SECTION DETAIL COMPONENTS NOT TO PROPOSED PROPOSED TOP of FOUNDATION EXISTING EL. 62.5't SOIL ABSORPTION SYSTEM EL. s3.5't p SEPTIC TANK PROPOSED (3) 500 GALLON LEACH CHAMBERS EL. s4.7' F,_F I_I _I I_ _I;_I;I_I;_I �_I I=1�I_� LI 1 L,I�L_ L,I DISTRIBUTION BOX 1-1 1=1 I III III-1 11=1 I i III i I I i i, i, 1=1 I I-1 I I-1 -1 11=1 11=1 i-1 I I I „ . • J 2- OF 1/8" TO 1/2 EL. EXIST. DOUBLE WASHED PEASTONE-----i EL. 60.76' EXISTING 1000 GALLON " SEPTIC TANK EL. 59.92' EL. 59.75' EL. 2.0 �^ INSTALL GAS BAFFLE AT OUTLET 60.51'/ EL. 59.5' ' 40' LONG x 10' WIDE x 2' DEEP • - EL 57.5' 3/4" TO 1 1/2" 8.5' DOUBLE WASHED STONE EL. OBS. = 46.6' (POND) EL. ADJ. = 49.0' GROUND WATER ELEVATION REFERENCE WELL = SOW-252 ZONE C t NOVEMBER 2012 LEVEL = 47.43' } ADJUSTMENT FACTOR = 2.4' (ASSUMED) DEEP HOLE DATA NOTES 1.1'ALL PRECAST COMPONENTS LOCATED UNDER DRIVEWAY PERFORMED BY: JASON C. ELLIS, R.S., S.E. PTO BE H-20 RATED.' WITNESSED BY: DAVE STANTON, BARNSTABLE BOH 2. ELEVATION DATUM IS FROM USGS QUAD MAP. TEST DATE: DECEMBER 18, 2012 3. MUNICIPAL WATER IS AVAILABLE. 4. ALL CONSTRUCTION TO CONFORM WITH 310 CMR 15.000 DEPTH # ELEV. DEPTH #2 ELEV. AND-ALL OTHER APPLICABLE LOCAL, STATE AND FEDERAL CODES AND REGULATIONS. 0.00, 63.2' 0.00' 63.5' 5. INSTALLER/CONTRACTOR TO REVIEW & VERIFY ALL DESIGN CALCULATIONS A A LOAMY SAND LOAMY SAND ELEVATIONS AND DETAILS AND REPORT ANY DISCREPANCIES 10YR2/2 10YR23/2 TO DESIGNER PRIOR TO CONSTRUCTION OR ASSUME ALL 0.83' 62.37' 0.83' 62.67" RESPONSIBILITY. FLOW RATE: 6. INSTALLER/CONTRACTOR IS RESPONSIBLE FOR MAINTAINING 4 BEDROOM DWELLING = 440 G/P/D REQUIRED B B LOAMY SAND LOAMY SAND SAFE WORK AREA, VERIFING ALL UTILITIES AND NOTIFYING (110 G/P/D PER BEDROOM x 4 BEDROOMS) 10YR4/6 10YR4/6 DIG SAFE PRIOR TO CONSTRUCTION. NO GARBAGE GRINDER ALLOWED 7. ANY CHANGES TO OR DEVIATIONS FROM THIS PLAN MUST 2.33' 60.87' 2.33' 61.17' BE APPROVED IN WRITING BY J.C. ELLIS DESIGN CO. AND SEPTIC TANK: BOARD OF HEALTH. C C 8. FINISH COVER OVER COMPONENTS IS NOT TO EXCEED 3' 440 G/P/D x 2 = 880 G/P/D REQUIRED MEDIUM - MEDIUM - PER 310 CMR 15.000. USE EXISTING 1000 GALLON SEPTIC TANK FINE SAND FINE SAND. 9. ALL ABANDONED SEPTIC SYSTEM COMPONENTS TO BE 2.5Y6/4 2.5Y6/4 PUMPED DRY AND FILLED WITH CLEAN SAND OR REMOVED SOIL ABSORPTION SYSTEM: PERC ® 126' PERC RATE AND REPLACED WITH CLEAN SAND. PERC RATE _ <2 MIN/IN CLASS I SOIL <2 MIN/IN <2 MIN/IN 10. ALL COMPONENTS TO BE PROVIDED WITH WATERTIGHT SIDEWALL = (40 + 10)(2)(2) = 200 S.F. 10.5' 52.7' 10.5' 53.0, ACCESS PORTS WITHIN 6" OF FINISH GRADE. NO WATER ENCOUNTERED NO WATER ENCOUNTERED 11. ALL SEPTIC TANKS, DISTRIBUTION BOXES AND PIPING TO BOTTOM: (40)(10) = 400 S.F. BE INSTALLED WATERTIGHT. (200 + 400)(0.74) = 444 G/P/D PROVIDED 12. NO KNOWN WELLS EXIST WITHIN 100' OF PROPOSED LEACH AREA. f USE: (3) 500 GALLON LEACH CHAMBERS W/ STONE 13. ALL COMPONENTS.LOCATED UNDER DRIVEWAY TO BE INSTALLED AS SHOWN IN DETAIL. WITH WATERTIGHT H-20 STEEL COVERS TO GRADE. 14.•PROVIDE 40 MIL POLY FLOW BARRIER AS SHOWN AROUND rLEACH AREA WHERE LEACH AREA�IS LESS THAN 20' FROM FOUNDATION WALL, FROM EL. 51.f DOWN TO EL. BELOW BASEMENT FLOOR LEVEL-. 1 15. WATER LINE TO BE RELOCATED AS NECESSARY-TO BE 10' MINIMUM FROM PROPOSED LEACH, AREA:-WATER LINE AND SEWER LINE TO BE SI&VED WITH"150 PRESSURE PIPE SEPTIC SYSTEM UPGRADE PLAN AND SHALL. BE PRESSURE TESTED TO ASSURE WATERTIGHTNESS J.C. ELLIS DESIGN PER 310 CMR 15.211 (1)(1). f SUBJECT: 16. WORK LIMIT STAKEDLT 17. CONTRACTORTTOBVERIFY THATIALL BUILDING SEWERS ARE ACCOUNTED 241 CAPON CROSBY ROAD FOR. ALL SEWER LINES TO BE PLUMBED INTO EXISTING SEPTIC BARNSTABLE, MA TANK IF NECESSARY. OF gSS9 PREPARED FOR: .�n'AS N �y , PHILIP A. FINGADO PHER G� l 241 CAP'N CROSBY ROAD ..`� _IS CA j i CENTERVILLE, MA 02632 E 'JSTEVL� P.O. BOX 2152 ASSESSOR'S 1��ITgR1 BREWSTER, MA 02631 MAP 193 PARCEL 179 " sue ' Email: j elliisdes g®verizon.net DATE: DECEMBER 18, 2012 JASON C. ELLIS, R.S. SHEET 2 of 2 - REVISED: r7 AP tA .4 oft 14V Pkme -MOW 1 L T S�' 14, 15 LZ, -L-T Z D 2 ?--1 '7F f Po k-JP 4, 4 cl F -rc-)TA, 4-d- e 407 7ZZ T- IV6ZOG7 *4, I r�A\bi. 4'GleAl Me AAV Alep i LA%4 WA iN ts, t., (77 iE S Q r- L I-- F-t, I Wl,j i AM L- -IL t V) %T 615F 6 P b A S QC719D 4 ,z- 7 0 741 fz' L-cj\^J 2-47C— c-� + A s 5, ZZ