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HomeMy WebLinkAbout0527 CRAIGVILLE BEACH ROAD - Health 527 CRAIGVILLE BEACH ROAD 246-155 S"f CENTERVILLE I� 4 i No. 4210 1/3 ORA I renanaflexo ALOt ;.mot 10% I Town of Barnstable Barnstable Board of Health 9a"RMASS.�g 200 Main Street, Hyannis MA 02601 �iDtFa �0. 2007 Office: 508-862-4644 Paul Canniff,D.M.D. FAX: 508-790-6304 John T.Norman Donald Guadagnoli,M.D. July 19, 2018 Mr. Michael Pimentel JC Engineering, Inc. 2854 Cranberry Highway East Wareham, MA 02538 RE `, 527 Craigville Beach Roatl, Centeruille={ y yAs M 246 155, 27 152t Dear Mr. Pimentel, You are granted variances on behalf of your client, Richard Schott, to construct an onsite sewage disposal system at 527 Craigville Beach Road, Centerville. The variances granted are as follows: 310 CMR 15.211(1): To install the septic tank 5.1 feet away from the front property line. Section 360-1 of the Town of Barnstable Code To construct a soil absorption system 73 feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code To install a septic tank 75.9 feet away from a coastal bank, in lieu of the minimum 100 feet separation distance required. These variances are granted with the following conditions: (1) No more than four (4) bedrooms are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. Q:\WPFILES\Pimentel Schott 527 Craigville Beach Road Variances 2018.docx S ` (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The septic system shall be installed in strict accordance with the revised engineered plans dated July 11, 2018. (4) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised engineered plans dated July 11, 2018. These variances are granted because the proposed plan appears to meet the maximum feasible design standards contained within the State Environmental Code, Title 5 and local Health Regulations. The engineer designed the septic system to be located in an area to attempfto maximize setbacks to wetlands. Sincere) yours, , Pau . Ca i , D. Chairman Q;\WPFILES\Pimentel Schott 527 Craigville Beach Road Variances 2018.docx R SINE r r i 1/(�i-2�2'� DATE: ,• '� $95.00 FEE*: �LQ cr) " BARNSTABLE, y MARS. i6gq. a10 Town of Barnstable REc.BY: -- QED MA'tl , SCHED.DATE: Board of Health 200 Main Street, Hyannis MA 02601 r. Y Office: 508-862a1 6144 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald A.Guadagnoli,M.D. Alternate:Cecile Sullivan,RN,MSN VARIANCE REQUEST FORM LOCATION Property Address: 527 Craigville Beach Road,Centerville,MA Assessor's Map and Parcel Number: _Map 246,Parcel 155_ Size of Lot: 27,152 s.f. Wetlands Within 300 Ft. Yes X Business Name: No Subdivision Name: APPLICANT'S NAME: Richard E. Schott Trustee Phone Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: Richard E. Schott,Trustee Name: Michael Pimentel,EIT,CSE Address: 527 Craigville Beach Road, W.Hyannis Port,MA Address: 2854 Cranberry Highway,E.Wareham, MA 02538 Phone: Phone: 508-273-0377 EMAIL: mpimentel@jcengineerinpinc.com VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) _See attached Appendix A NATURE OF WORK: House Addition House Renovation _<'�Repair of Failed Septic System X Checklist (to be completed by office staff-person receiving variance request applica i Please submit copies in S separate,collated packets. Five(5)copies of the completed variance request form Five(5)copies of engineered plan submitted(e.g.septic system plans) Five(5)copies of MA DEP approval letter for Innovative/Alternative septic system(when proposing an I/A system,only). Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). *$95.00 variance request application fee collected (No fee for lifeguard modification renewals , grease trap variance renewals [same owner/lessee only],outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least IS days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Donald A.Guadagnoli,M.D. [Type here] PostalTM CERTIFIED o . ECEUPT Domestic Mail Only 0 For delivery information,visit our website at www.usps.com". o F� HF� ; .I Certified Mail Fee qLH $ F_xtra Services&Fees(check box add r �Retum ReceiptOterdcoPY) $o ❑Retum Receipt(electronic) tmerko ❑Certified Mail Restricted Deliveryereo ❑Adult Signature Required $ljAdult Sig cted DeliveryPostage1711 Ln Prop ID: 246071 r-a ' SANFORD,CHRISTOPHER T TR. iy2y o I THOMAS W SANFORD JR IRREV N 528 CRAIGVILLE BEACH ROAD --------= CENTERVILLE, MA 02632 Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. 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Adult signature restricted delivery service,-which ■Certified Mail service is notavailable for requires the signee to be at least 21 yeaars of age international mail. and provides delivery to the addressee specified in Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent. with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the in To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,It should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ■For an additional fee,and with a proper - this Certified Mail receipt,please present your ` endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: I postmarking.If you don't need a postmark on this -Return receipt service,which provides a record -Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTAIR.Save this receipt for your records. PS Forth 3800,April 2015(Reverse)PSN 7530-02-OOo9047 PostalTM CERTIFIED o RECEIPT D'omestic Mail Only Cr m For delivery information,visit our website at www.usps.come. OFFICh r e@ 0 Certified Mail Fee ¢j rq $ Extra Services&Fees(check box,add lee as propV0 _ '9 t'1 [IRetum Receipt(hardoopy) $ .� - p ❑Return Receipt(electronic) $ _ b Postmark Q ❑CoMed Mail Restricted Delivery $ 1 8 O ❑Adult Signature Required $ /) ❑Adults Restrl Delivery$Lrj ru $ stage m Prop ID: 246146 r-9 SULLIVAN,ELIZABETH E ELIZABETH E SULLIVAN DEC OF 6 "" 35480 WILLIAMS COURT "------ ---.-- WARRENVILLE,IL 60555 Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service'" Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. Important Reminder's. Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Servicee, available at retail). or Priority Maile service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified 0 Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail recent is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office"for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record - Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an . appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this recelpt for your records. PS Form 3800,April 2o15(Reverse)PSN 7530-02-000.9047 Postal CERTIFIED o RECEIPT Do-m---es-tic Mail Only For delivery information,visit our website at www.usps.comO. EoOFFICI Certified Mall Fee ^ co $ . Extra Services&Fees(check box add fee as ejipropdete) Pq ❑Return Receipt(hardcopy) $ }0 0 ❑Return Receipt(electronic) $ 141' �_ .3 U L A4. :.3 1 i p ❑Certified Mail Restricted Delivery $ Here O []Adult Signature Required $ il 1 Adult Signature Restricted Delivery$ ru Postage a AS-02 t_r.) Prop ID:246155 � CONNOLLY,BARBARA E o 1, %SCHOTT,RICHARD E TR 527 CRAIGVILLE BEACH ROAD HYANNISPORT,MA 02672 Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail labeq. for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipients retail associate. signature)that is retained by the Postal Service— Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. Important Reminders: Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically,included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the bamoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply ' - You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. ' electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Retum Receipt attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. Ps Form 31800,April 2015(Reverse)PSN 7530-02-000.9047 PostalTM CERTIFIED o RECEIPT ti Domestic Mail Oniy For delivery information,visit our website at www.usps.com". a f r) Certified Mail Fee ^ co $ Extra Services&Fees(check box,add lee" fppn ) ❑Retum Recelpt(herdoopy) $T C3 ❑ReWm Receipt(electrenk) $ Postmafk p ❑Certified Mail Restricted DelWery 0 r/y�HBfe" O ❑Adutt Signature Required $. 5� r [(Adult Signature RestsIted De ru N� IAA E Prop ID:246072003 � BIG YELLOW LP LSpS-0253! yZyS o %LYON,JEFFREY A&JENNIFER S P0 BOX 611 HYANNIS PORT,MA 02647 Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipients retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ' ■For an additional fee,and with a proper - this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mall receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records. PS Form SHOO,April 2015(Reverse)PSN 7530-02-000-9047 a Postal CERTIFIED MAIL@ RECEIPT p Domestic o^ m For delivery information,visit our website at www.usps.com". a � Certified Mail Fee 9 rl Fxtra Services&Fees(check bow add fee as eppro'ate) rq ❑Return Receipt(hardtop» $ - +� 0 ❑Return Receipt(electronic) $ J// Postmark )-3 ❑Certified Mall Restricted DelWery $ .t! "H1e ^�E ❑Adult Signature Required $ 4/ f ❑Adult Signature Restricted DeiWery$ e ru Postage Ln $ C61 Prop ID: 246154 s'OS,O'5._ , Ln r-qTACELLI,ELIZABETH J TR y ys r- ELIZABETH J TACELLI TRUST-2004 4 COOKS FARM ROAD FRANKLIN,MA 02038 Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece, associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted retum receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipients retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders: Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(nat First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age international mail. and provides delivery to the addressee specified ■Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office-for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mallpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt,attach PS Form 3811 to your mailpiece; IMPORTANE Save this receipt for your records. Ps Form 3800,April 2015(Reverse)PSN 7530-02-000-9047 i • •N ,� COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3. A. Sig ture ■ Print your name and address on the reverse X t ❑Agent so that we can return the card to you. O Addressee ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) a of e' ery or on the front if space permits. 1. Article Addressed to:__ _ D. is delivery address different f item 1? Yei If YES,enter delivery address below: No Prop ID:246155 CONNOLLY,BARBARA E �1 L�f�� /kb- %SCHOTT,RICHARD E TR ` i I, h 527 CRAIGVILLE BEACH ROAD HYANNISPORT,MA 02672 II I'I'I�I I'II I'I I II I II I i IIIIIII( II I II IIIII I III 3. Service Type ❑Priority Mail Express® ❑Adult Signature ❑Registered MaiITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 9590 9402 1704 6053 7261 44 ❑Certified Mail® Delivery ❑Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise ❑-Coliecton Delivery Restricted Delivery ❑Signature ConfirmationTm )Mail ❑Signature Confirmation 7 015;i 15 2 0 i U 0 01 1`8 5 0 N 01-5- _ jMaiiRestricted Delivery Restricted Delivery —w—. Jool PS Form 3811,July 2015 PSN 7530-02-000-9053 'q2- 5 Domestic Return Receipt i I uses Pirst-Clafs-ulail Postage"'&'Vees,Paid USPS Permit No.G-10 j 9590 9402 1704 6053 7261 44 United States •Sender.Please print your name,address,and ZIP+4®in this box• Postal Service JC Engineering, ) ��F HAM M 2854 Cranberry � u- 14 East Wareham,Ma Z3 13 fi•--` :..� �.�� llifjilll►�iit�'?�'jt�,lt� 1�1}l�irtffr�i,�r1j#t�tar- ������,..� I ?;Y 1 SENbEk'COMP'LETE THIS SECT1,0N COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. A. Sign e ■ Print your name and address on the reverse X ❑Agent so that we can-return the card to you. ❑Addresses IN Attach this card to the back of the mailpiece, B. Received by rinted Name) C. ate f Delivery or on the front if space permits. 1. Article.Addressed to-:-- _ D. Is deli address different from item ? Yes � _A If :ES,@te°rap jve• address below: ❑No Pro ID,,_ 46146 SULLIVAN,ELIZABETH E TRUSTEE � � g �`i'p _7 EI,IZABL°;TH E SULLIVAN DEC OF !�0! � f �/ 1 k' 35480 WILLIAMS COURT u1 7) WARREIMLLE, IL 6 5555 �� 0 �— 3. Servi� yRP�Ib�, MaH ❑0 Ad Adult signature Restricted Resteliverj_ ❑Registered Mai 1pR Restricted El Certified Mail@Delive 9590 9402 1704 6053 7261 51 ❑Certified Mail Restricted Delivery ❑Return feceipt for ❑Collect on Delivery Merchandise _❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTm iil ❑Signature Confirmation 7015 1�5 2 0 0 0 01 -18 5 0 3 9 8 8 iil Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 604 °" 147,gS Domestic Return Receipt i USPS TRACKING# First-Class-Mail uses & q Permit No.G-10 9590 9402 '1704 6053 7261 51 `� >! Q18 United States •Sender.Please print your name,,address,an. ZIP+4®in this box•`, Postal Service JC Engineering, Inc. U�: 2854 Cranberry Highway 1)25 $ East Wareham,Ma 02538-1314 ��l�,�j,11��►�lrll:,��ljllfll����:1•la��ille1t11111l�1ti��a13111��1t I I r � e6MPLET"E THIS SECTION �OMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,,and 3. A. i t 'ht?. ■ Print your name and address on the reverse'"' so that we can return the card to you. jew�j&j A t ssee ■ Attach this card to the back of the mailpiece; b ( t me1 too Deli epJ or on the front if space permits. '— s delivery address Nerent from item i? ❑Yes Prop ID: 246072003 )BYES,enty ss below: ❑No BIG YELLOW LP %LYON,JEFFREY A&JENNIFER S I PO BOX 61.1 Al ✓(/ c y C% 0' HYANNIS PORT,MA 02647 ` ICV/B v 3.III'III�I I'II I'I I II I II I I I�IIIII i II I II it I I it III ❑Adult Service gn ture Rests A7alivery ' gistered Mail Restricted 9590 9402 1704 6053 7261 37 ❑Certified MaIIO WIvery ❑Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise _._ n_ronton Delivery Restricted Delivery ❑Signature ConfirrnationT'",e��� e. x e ❑Signature 7 0#15 1!5 2b l 0 0'b �18 5 0 4`,0 2 2 IMail Restricted Dei ve aci°° Mail Restricted DeliveryDelivery - _—over4$o00 PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt USPS TRACIWIG# IM, 11, First�Cla� Mail �lT l>PostaScf� Felts Paid .. Permit N8.G-10 9590 9402 N444D53 7261 37 United States •Sender:Please print your name,adds ss;andZ3440 in this box* Postal Service JC Engineering, Inc. 2854 Cranberry Highway SP East Wareham,Ma 02538-1314 I I ')lildjIh till'! r JC ENGINEERING, Inc. 4, lS Civil & Environmental Engineering �Q4 2854 Cranberry Highway East Wareham, Massachusetts 02538 Ph. 508-273-0377=Fax 508-273-0367 APPENDIX A Due to the physical constraints of the property and the existence of a Coastal Bank within 100 feet of the proposed work, the following Local Upgrade Approval and Local Variances are being requested. In accordance with 310 CMR 15.401 - 15.405, the following Local Upgrade Approval is requested from 310 CMR 15.211(1): (1.) A 4.9' waiver(10.0' - 5.1') for the setback from t e SAS t the front property line. .r The following Local Variances are requested from Article 1, Section 360-1: (L) A 27.0' variance (100.0' - 73.0') for the setback from the SAS to the Coastal Bank. (2.) A 24.P variance (100.0' - 75.9') for the setback from the tank to the Coastal Bank. r /V lqp ID AL � J v _ , � I tiK j0 T V V � 1 I Ai II c� � lAo 012 J � r v Town of Barnstable P# Departitnent of Regulatory Services Public Health Division Date idea �� 200 Main Street,Hyannis MA 02601 r� - r•� I /,t c:� Date Scheduled ltl! Time Fee Pd._ !�rb 0 _ray FD r^0'•y Soil Suitability Assessment for Se a e Disposal i 441 Performed•By:_�(CN1Qei Witnessed By! LOCATION&.GENERAL INFORMATION Location Address Owners Name (3Ap VAM C0AWCX<— 5a-7 �rC�ct� beet I��• ' `/ C� �1 4-Lc Address P0,30), 3 W, (4 Y P o-m—r Assessor's Map/Parcel: `\r^ �J Engineer's Name -7 C_ CNW AIL—fit & NEW CONSTRUCTION REP AIR1? Telephone# 5U� �3 — p 37 500-273-0377 Lund Use e �� �1 dw Ak(n q Slopes 96 �6-(5 P ( ) Surface Stones Distances from: Open Water Body 776 tt Possible Wet Aren 7v 't ft Drinking Water Well �L/4 ft Draihage Way 1 ft Property Line 7/0 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) � } etCV1, y p ew wrter as ©F fo-2(-I 8 ,��� �rutS�OI��L �c� ��• 1,�2sk I�y �s Qvr�t A Parent material(geologic) (�U Depth to Bedrock it Depth to Groundwater. Standing Water in Hole:_ �® Weeping from Pit Rea 89 Estimated Seasonal High Groundwater 77U t DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: �f0•iA1k41rJ• Depth Observed standing in obs.hole: 96r�— In, Depth io sell mottles: 78 In. Depth to weeping from side of obs.hole ,` ln, Groundwater Adjustment tt. Index Well-0 Reading Date: °' Index Well level Adj.Actor, ,". Adj.Groundwater Levdl,,v -- PERCOLATION TEST bate 4'7/0 Time Observation (�;3l<sm Hole# Time at 911 4 � c� Q Depth of Pere Z 3y Time at 6" Start Pre-soak Time 0 t t' (o l�vt Time(9"•6") End Pre-soak t (" Rate Min./Inch Site Suitability Assessment: Site Passed y Q's Site Palled: Additional Testing Needed(Y/N) I Original: Public Health Division Observation Hole Data To Be Completed on Back-------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:ISEPTICIPERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# , f 2 Depth from Soil Horizon Soil Texture Sdil Color Sol]. Other Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders. o tsistency.96'aravell t2, A IOi 311 t2- 5y � G S /0Yr �/� � • - � • 25 1 C . -76 " DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ConsisLeacy, DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon . f Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders._ Consistency. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Sall Other Surface(in.) (USDA) (Munsell) Mottling (Structure,SSopes;Boulders. a a • Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes ' I . Within 100 year flood boundary No. Yes Depth of Naturally Occurrina Pervious Material Does at least four feet of naturally occurring perviou mtiterial exist in all areas observed throughout the area proposed for the soil absorption system? e5 If not,what is the depth of naturally occurring pervious material? ...... Ceftification I certify that on 1.0 0 (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me,consistent with . the required training,exper' e and p rience described in 4 10 CMR 15.017. Signature Date Q:W".BPTIC\PBACPORM.DOC No. PA Fee � v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplicatiou for bisposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair Y) Upgrade( ) Abandon( ) )(Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. 5CWOTT Assessor's Map/Parcel a44 1.55 Qwwovet C"GyiLL6 - Installer's Name,Address,and Tel.No.&% 471-VT77 Designer's Name,Address,and Tel.No.5 D�-.27.7-C.7,77 6 flW_V LS1eS f AtaD Q-<- =toG l v Gz mat' ^4045 0405' 11254 U4 Yf 6, Type of Building: Dwelling No.of Bedrooms Lot Size A7, 15A4 sq.ft. Garbage Grinder( ) Other Type of Building Qt DC Teems No.of Persons Showers( ) Cafeteria( ) Other Fixtures ,s ``�� Design Flow(min.required) q4o gpd Design flow provided 458,8 gpd Plan Date -]'(6"a o i 2 Number of sheets I Revision Date "1- (( - Title 3 a7 "44&V,(4L.6 tS " ZZ r Size of Septic Tank 1 1'j 00 GsG' -�ELC�L./S Type of S.A.S. Description of Soil eZ 10 5 �62 S_4 rtJ5d257 A Nature of Repairs or Alterations(Answer when applicable) 24.J$Z{J. A)f-;tk j 14-1® 1500 C--f4-G.C.©0 T)t /tl _W NEW) D—j3 uIe. 7�0 (3) Lc?-(. C_6, c, 144 "�$ Loch+ 3,T a or . pid 5e " '14' 44 �J a&S 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 alth. Signed CDate T Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Pol '�-3 Date Issued mxs?r.r r • I�• ��l yy�� r 7 No. Fee �"�✓ t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1! PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes - fipfitation..for,Misposal *pstrm Construction 3pPrmit _ Application for a Permit to Construct( ) Repair,* Upgrade( ) Abandon( ) 'Complete System ❑Individual Components Location Address or Lot No. Soal 4 "T Owner's Name,Address,and Tel.No. =r -F.Sr 5C#40" ""i'Rs05*T&:F Assessor's Map/Parcel j t 3 5 C,"GM46 Ap4cv R.D ¢ Installer's Name,Address,and Tel.No.c1�g'1S" 7.- `77 Designer's Name,Address,and Tel.No. 57G$..1 «.p7a1,7 Type of Building: Dwelling No.of Bedrooms Lot Size A-7 sq.ft. Garbage Grinder( ) } Other Type of Building Q 4E1QD,F;ljr# 4,,w No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ` 4o ` gpd Design flow provided gpd Plan : Date '7 �6—AQ# Sd Number of sheets Revision Date u _ t Title Jc r "1 C4o(1&11l a& AE4" go" Size of Septic Tank -_ _�-15*0,7 G—AC�_QAj Type of S.A.S. 1 Description of Soil .✓ P"4V Nature of Repairs or Alterations(Answer when applicable) E S4o® L444) * R Lm(M 3,T Q &-1 t..c -m, oW S(&jK A,ruT 61 r b M S 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. ^yam Signed i Date Application roved b PP PP Y Date�� U Application Disapproved by � Date u....... for the following reasons Permit No. �y i � '� �"" Date Issued 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 t... AAG—W1,06 71_ Pj&0Zf,Ak �t t III; at C G:�J a� , (�W�E,i..E &V-C !/i has been constructed in accordance with the prroov_isions of Title 5 and the for Disposal System Construction Permit No.aL �c�7 dated r �� Installer C4� n& AdtS l � Designer �l�k�:(rA X.n►1�4-, �A , #bedrooms Approved design flow L gpd The issuance of this permit shall not be construed as a guarantee that the system ill function as desiggne& j Date Inspector �, _.1 -CC . 2 ---- -------- ------- -------------------/-- -- ----- -- - -- - No. �O t O 2-3%�L Fee ( �(J THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction permit Permission is hereby granted to Construct( ) Repair(X) Upgrade( ) Abandon( ) System located at a,"f1Q1( � !'� �( O•CA 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.f Date Approved by ��✓ . 1 Aug. 9. 1016 5.41FM No. 2493 1 Town of Barnstable Regulatory Services �AJIR. = Richard V. Scali,Interim Director BARMMM NAM Public Health Division owe 'Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790.6304 Installer&Designer CertiDcation Form Date: "9"/8 Sewage Permit# o1®1$ 337 Assessor's MaplParcei 2'/6 1 -511 Designer: C Eno�t.neerirtS, nc Installer: Gg4,wi(k On eraoe.s Address: Address: 15b Czmwe,-tla( -Shrec Ea5.4 wareJnam h 0 Z5�a YIus4� 62 On was issued a permit to install a (date) installer septic system at 5 Z7 Crai�Vtller ( cad based on a design drawn by (address) `�'G �n`gin 'loc . dated SUty (a Zc16 ( Rw,I (designer) V I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed i iance with the terms of the I1A approval letters (if applicable) o tµ OF MRsy ' JOHN L GSM v° CHURCHILL, nstaller's atnre) CML At .41 4� M(Drier's Signature (Affix De t p Here) PLETURN TO ARNSTA1gLE PUBLIC HEALTH D SION. CERTIFICATE OF_COMPLIANCE WILL NOT BE ISSUED UNTII. BOT)EI THIS FOWW AND AS - BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION THANK YOU. QASepticlDesigner Certification Form Rev 8-14-13.doc v } TOWN OF BARNSTABLE LOCATION 5X1'(1Z,41C%Vt(LE Bac P� SEWAGE# �c�t� 'A37 VILLAGE �C�f"I" Y(G�l.� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO SEPTIC TANK CAPACITY ,50 0 QAClO� LEACHING FACILITY: a ) f 6' X 543 f (tYP ��,� L�—� C (size)NO.OF BEDROOMS OWNER PERMIT DATE: J.®(j COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 411 Feet Private Water Supply Well and Leaching Facility(If any wells exist on ,,,/ site or within 200 feet of leaching facility) /sir Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) �� Feet FURNISHEDBY `AFEaxoC r r. cio A 2 � , • t�~2 R 33.3' 3a.34 -3F 40A a 3 A'.3 0 o; 0 Doct lr3SIP23L 07-26-2418 1041 BARNSTABLE LAND COURT REGISTRY DEED RESTRICTION WHEREAS, RICHARD E. SCHOTT, Trustee of the Craigville Feaeh Road Realty Trust,under a declaration of trust dated June 21,2018(see Trust Abstract registered as Document No.-t;-44 45 and referred to herein as the "Trust) is the owner of the land located at 527 Craigville Reach Road, West Hyannisport, Barnstable County,MA (hereinafter referred to as the "Property")and being shown as LOT i on Land Court Plan 18869-B. For title see Certificate of Title No.216521. WHERM the said owners of the-Property-have agreed with the Town of Bams%le Board of Health to a restriction as to the number of bedrooms which can be ineluded in any home located on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code,Title V,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; b WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200,State Environmental Code, Title 5, Minimum Requirements for the Subsurface Disposal of Sanitary 0 Sewage, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, F NOW, THEREFORE, the said owners do hereby place the following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding upon all successors in title: 1. The dwelling located or to be located on the Property may have no more than four(4) bedrooms. 2. It is agreed that this shall be a permanent deed restriction affecting the Property. 3. It is further agreed that this restriction will terminate upon the connection of the Property to municipal sewer or when the Property is enlarged by acquisition of adjoining land allowing, additional bedrooms under the then applicable provisions of the said State Environmental Code. I,the undersigned Richard E.Schott,hereby certify that: 1.I am the sole Trustee of the Trust; 2.The Trust is in full force and effect and has not been modified or amended; 3. 1 have full power and authority to execute and deliver the within restriction; 4. I have been authorized and directed to take the above action by all of the beneficiaries of the Tmst;and 5. All of the beneficiaries of the Trust are of full age and competent to act. G � Executed as a sealed instrument this d`^day of July,2018 RICHARD E. SCHOTT,TRUSTEE �^ COMMONWEALTH OF MASSACHUSETTS Barnstable, ss: On this day of July,2018,before me,the undersigned notary public,personally appeared RICHA.RD E. SCHOTT, Trustee as aforesaid, and proved to me through satisfactory evidence of identification, which was a Massachusetts driver's license, to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose. Notary Public B t R N A R D T.-:K1i.�0Y : My commission expires: Notary Public'. C coMMONWEALTM OF my canumssion Expxls August 12. 2= Town of Barnstable Barnstable dos Regulatory Services Department 1 v i of .AxNSfw91.E. ""' . Public Health Division�j i6gq. ♦4' m n Mp+A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 5035 July 17, 2018 CONNOLLY, BARBARA E 527 CRAIGVILLE BEACH ROAD HYANNISPORT, MA 02672 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 527 Craigville Beach Road, Centerville, MA was inspected on 06/26/2018 by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Leaching pit was holding water at 16" below inlet invert. The leaching pit had dark, black stain lines above inlet invert caused by long term effluent exposure. Effluent had risen above the inlet invert and stayed for a long time. You are ordered to repair or replace the septic system within two (2)years 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 I' T omas cKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Furt}er Evaluation Letters\527 Craigville Beach Road Centerville.doc Town of Barnstable Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA'02601 Office: 508-862-4644 Richard Scab,Director FAX 508-790-6304 Thomas A-McKcar�CEO Feb 6, 2007 Rev. 5111116 DEADLMS 'I'O"REPA IR FAMED.SYSTEMS (Town Code §360-44 and Title V: 310 CNR 15.000) _ An"Z'marked in the o is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or pondiag of effluent to the surface of the round ❑Pumping more than 4 times during the last year not due to clogged or obstructed pipe o Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA ❑Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑Any portion of the cesspool within a Zone 1 to a public well ❑Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA q Single-Cesspool o Any"conditio'n.Kly passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components, etc) bi=U4.1A Or cesspool with high liquid level, <12"below inlet(per Town Code §360-9.1) Leaching facility with standing liquid level at or above the invert pipe (per Town. Code §360-20 h) OTHER Repair deadline: Q:ISEFTIMDEADLWES TO REPAIR FAILED SYS T EMS.doc t r �L�i✓��r Commonwealth of MassachusL_.s - Title 5 Official Inspection Form } �,�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ; 1z,_T 527 Craigville Beach Rd Property Address " >•.,;� Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 r page, City/Town - State Zip Code Date of Inspection SJ 1 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 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I'have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems..) am a DEP approved system inspector.pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑- Needs her Evalu Local Approving Authority 6-26-18 Inspector's Signature Date ' The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 ' 3 J s Commonwealth of Massachusetts y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ 1 have noffound any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑N ❑ ND (Explain below): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts a ,5 Title 5 Official Inspection Form rat Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) - ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (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 El ❑ 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 El ❑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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 ` r Commonwealth of Massachusetts Title 5 Official Inspection Form C�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' 527 Crai ville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. []The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. El The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool El ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® 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 Y2 day flow t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts y Title 5 Official Inspection Form c�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd J' Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 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 ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 s Commonwealth of Massachusetts r� Title 5 Official Inspection Form w, t r� Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r� r 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is Centerville MA 02632 6-26-18 required for every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® E 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? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 s Commonwealth of Massachusetts fw Title 5 Official Inspection Form ? i'i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is Centerville MA 02632 6-26-18 required for every ' page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ❑ No Last date of occupancy: 6-2018Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day d p Y�9P ) 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts p Title 5 Official- Inspection. Form C�'l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no)•(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ® Other(describe): 1000 gallon leach pit acting as main tank with 1000 gallon leach pit. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts j� Title 5 Official Inspection Form it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r ,"_P . . ? 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is Centerville MA 02632 6-26-1$ required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1985 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 36"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: 30"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: 1000 gal leach pit Sludge depth: 12" t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts r� Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 40" n Scum thickness 4 Distance from top of scum to top of outlet tee or baffle 10" Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Leach pit acting as main tank had baffles installed. 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts fits �- Title 5 Official Inspection Form �f 0 Subsurface Sewage Disposal System Form;Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) R , 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 L Commonwealth of Massachusetts Title 5 Official Inspection Form i�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd `r- Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 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: ❑ El No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts f Title 5 Official Inspection Form YN Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town _ State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1-1000 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 was holding water at 16" below inlet invert. Pit had dark black stain lines above inet invert caused by long term effluent exposure. Effluent had risen above inlet invert and stayed for a long time. Not the result of a one time event. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts ,w Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 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.): 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 s , Commonwealth of Massachusetts , .� Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ! ` 527 Craigville Beach Rd J Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately r , t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts ,(� Title 5 Official Inspection Form ter Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 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: 12 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 " Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN .11 B ST Y:OCA'ICiOI+t J c9 7 erg -e ASVMLA 5ES5bR'S D�STA�LL.En`5 NAlI��'EititOIJB Y+I4 _ sic CAPMc (size). N4:G���SD�'t�C3MIS ESE QR 4 ..,. �ap�arratioa�9esPunG�8alvie t}Abe. `: Maxir�umAd1 stoiniiwate�ThWinstheBnttatnnt h€M iliEY t�eei r lvaev r S ►y WcsU asid *hial l acttety:O any i".s a sc as ct�sets oe wttluri 2A0 gent a tclairl fstcs11t3,) Frig v#9N AW wind Lanc�Intt��Uity of any w�t{antl�a 5Q rl}thin?�QQ€eet fn aaill � �.--CAM ` c 1C�uitishr. �)Y, o I � a / -Ilk Commonwealth of Massachusetts t "� Title 5 Official Inspection Form 0 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments { .r_ 527 Craigville Beach Rdh Property Address — —� Barbara Connolly Owner Owner's Name �7 information is / required for every Centerville V MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection t-m 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 41'I 131ay 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Eval y the Local Approving Authority 6-26-18 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form ' +� w. .•wC'I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6=26-18 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes:. . ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y El ❑ ND (Explain below): t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts 1a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) - ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (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 El ❑ 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts , , Title 5 Official Inspection Form :yak Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water.supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections: Yes No ® El clogged 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 Y2 day flow t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form -1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 527 Craigville Beach Rd �tl Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ , ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® 'Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.) ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The . system owner should contact the Board of Health to determine what will be • necessary to correct the failure. E) Large Systems:To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. . Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone 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.doc•rev.6/16 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 >" 527 Craigville Beach Rd J: Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 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 in for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form w_ +N Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ❑ No Last date of occupancy: 6-2018Date 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a•copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ® Other(describe): 1000 gallon leach pit acting as main tank with 1000 gallon leach pit. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form C�i Subsurface Sewage Disposal System Form -Not for-Voluntary Assessments ._�„? 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1985 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 36"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): 30" 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: 1000 gal leach pit Sludge depth: 12" t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 c Commonwealth of Massachusetts ,w Title 5 Official Inspection Form r�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r a • >" 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 40" Scum thickness 4" Distance from top of scum to top of outlet tee or baffle 1001 , Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Leach pit acting as main tank had baffles installed. 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.doc rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form i Sri Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglasspolyethylene other(explain): 9 ❑ ❑ 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.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 I. Commonwealth of Massachusetts ;w^. Title 5 Official Inspection Form hF Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � ;> 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 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.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 f C Commonwealth of Massachusetts Title 5 Official Inspection Form K�I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1-1000 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 was holding water at 16" below inlet invert with stain lines above inlet invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 � .° Commonwealth of Massachusetts r� Title 5 Official Inspection Form 'Ni Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 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.): 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.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts 4. 011, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) - Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately { • ipY F: r t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 c Commonwealth of Massachusetts ,l Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ' 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 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: 12 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database - explain: You must describe how you established the high ground water elevation: USGS and town maps show groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 527 Craigville Beach Rd Property Address Barbara Connolly Owner Owner's Name information is required for every Centerville MA 02632 6-26-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 I RICHARD E. SCHOTT 1.83 Baxter Avenue West Yarmouth, MA 02673 July 5, 2018 Board of Health Town of Barnstable 200 Main Street Hyannis, MA 02601 Re: Declaration of Authorization 527 Craigville Beach Road, Centerville, MA Dear Members of the Board: Let it be known that I,Richard E. Schott, Trustee of the Craigville Beach Road, Realty Trust(owner of 527 Craigville Beach Road, Centerville, Massachusetts), do hereby authorize JC Engineering, Inc. of East Wareham-, MA 02538 to represent my interest regarding the upgrade of the septic system located at 527 Craigville Beach Road, Centerville, Massachusetts in meetings both public and private. Sincerely, TP RICHARD E. SCHOTT. Trustee �� 5EWA G E PERPAJT PIS. YiLLP�GE I SSA LLER'5 NAME i ADDRESS 114 R U I L D E A OR OWN ER DATE PERMIT 1.. SSVED DATE GQMPLIANcE ISSUED -- t3 �J� No s.�...(0- F>s........1.................... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH L.otti ................OF..... � .Z.��rt.✓.s'ry. --.--....----....................... ApplirFation for Biiipwi al Works Tnnstxnrtion 1hrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...eBPOC4.E4 ..............................................................•................................... Lbcation-Address ---------------------•----•-•---•--••-•---or.Lot No. ...c . ..� ....................................... •----• -- Owne Address �j'�� V.G SCE '3 vY. ....�'�. Z�! 47.. • ............. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' 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 ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-.-__--._____-__---___-. 0-4 rXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 94 --••---•--•----------------------------•-----••-•--•----•---•--.....--•----•------...-•----•-•--•........................................................... 0 Description of Soil....................................................................................................................................................................... x V .....•-•-------•----------------------•--....-•--.....-•----•---....._...--•••---••-------•--••----•-------•-•------••-•----•-----•---------•••-----------------••-•-•----•-•-•-••-•-------•-••--•-••---- ----------- ---- ----------------- ------ --------- ------------------- ---------............ U Nature of epairs o Alterations—Answer when applicable____._.1,.'./OOQ-_-_--_„� --�.�_�_ ----------------------------•-------------------------------------------------------........-•--------------•---------------------------------•-----------------------------------------•----•-...--•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIi: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be is ed bLt e d of health. .. . Sign .--•• .....--•-• .- . ...... --•--•---•---------- ................................ Date Application Approved By.......... _ -. -•----_:............. ------•--• ............................. ---- zi ass -------------- Date Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------------------•-... --------------------------------------------•------•-------------•---....----------•-•----------•----------....._........------------------•---•---------------------------•---•--------•------•------•. Date PermitNo......................................................... Issued----------------------------------------•••-•-••-•----• Date rrwrw�aaa� -a�.� rr Naf t.....� F�s......j.. '........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH J -` ..........................OF. .r...`..... ................ �..,... Applira#ion for Disposal Works Tonstrnrtinn "rani# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ......_. .... ....... ... ................................••---.....----•-.... •-••--•- Location-Address or Lot No. ....................................... -•--••--••••••-•-•....------•-----••-.---- ----•---••-•..... 011.1t .�,d Vress - - a `r / ... ................................................._.,......... Installer Address VType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QI Other fixtures .................................. WDesign 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................. Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 •••••--•----•--•••--•--•••--•-------•••-•-•---•••--•-•••--•-----•-••-••--••-•-......••---••-•_-••................... -••....... -.......... -------------------- 0 Description of Soil..............................................................................-------------- ---•--------------....------------------------------.........-----••- x Uw ••••. --- ------------- ----- Nature o Repairs 9V Alterations—Answer when applicable....... !l................. ----------------------------•---------------•-----------....------•-------------=---......------------.........------------------------------------------------......_.................................. 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 place the system in operation until a Certificate of Compliance has be ed b e oalyd of health. Sign t :..`�,--,, ..... Application Approved By�........ `?.�— /� . � �iS . /- /---- -•-----•----------- Date Application Disapproved for the following reasons:................................................... ............................................................ --------------•--••-----------------..........••-•-----•..............................................................--••••-----••-•-----•-•••--•-•---••••-••----------------------------_..... Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH` ..........................................OF..................................................................................... Trrttif irat a of Toutplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by---------- --`--c z> -- --•-----------•------.-.-(-------•-------•--,---------•--------••------------------------------•------•-----•----•------------------•--------------------------•------------- Insta- at � (... J�� ----- has been installed in accordance with the provisions of TIm -r- 5 of The State Sanitary C de'as described in the application for Disposal Works Construction Permit No.___ ?__. :` .. __..____ dated___._. >_ _i...?..�......_..._.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---•--•.............................................................•••••-•---• Inspector..................................................................................... TH'E.;'COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................OF ........---...................................................................... FEE..._ No. 'err- ...... �...:..._.. �o-,�,�r�_y �i���a��tl, nrk� ��an�trnrttirrn rrmit <;�^+ Permission is hereby granted----------------------•-•-.................................................................-..................................................... to Construct ( ) or Repair ( ) a. Indivi. 1 Se rage Dis os System `._ tp V atNo_ '" /.._..G..... ."-•-`--`................C------------. ..................... Street as shown on the application for Disposal Works Construction Permit N_o _... � _.. Dated.... ! ' �` '- ...... zf� � .1 --------------------------------- ---................................................................... Board of Health '�6 FORM 1255•,A. M. SULKIN, INC., BOSTON - IL0CATION SEWAGE PERMIT HD. V L L A G E INSTA LLER'S HAKE ADDRESS _ G2 � C = I U I L D E R OR OWN ER a lz N. o 4 DATE PERMIT ISSJED DATE COMPLIANCE IS.SUEDr � Ao es- �6 2C'� �- r ` �� ` Pam'c� c...�_ TOF - 14,4'-i_- FINISH GRADE OVER D-BOX= 13.2'± FINISH GRADE OVER CHAMBERS = 12.4' - 14.0' PROVIDE EXTENSION RISER r � FSLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED WITH COVER OVER INLET& FINISH GRADE OVER TANKtL.` !-REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE-, 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION RISER TO WITHIN 6 OF FINISHED GRADE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISHED GRADE OUTLET TO WITHIN 6"OF F.G. , 4" SCHEDULE 40 PVC INSPECTION PORT w/ACCESS BOX WITH f @FOUNDATION - 13.0'± 14.0 ± 5" DIA. OUTLETS) MIN SLOPE 1% COVER TO GRADE (SEE NOTE#20) 2"OF 1/8"TO 1/2" DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. - STONE OR GEOTEXTILE FILTER FABRIC 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 20"MIN.ACCESS COVER (3 TYP.) 9 MIN. i PLACE RISERS ON ALL DESIGN ENGINEER. PROP. SCH. 40 36" MAX. 9" MIN TOP OF SAS= 11 .43' CHAMBERS WITH 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL < < 01PROP. SCH. 40 36" MAX. 9" MIN. .�� r-T T„ ,,.,ter.- . , T PVC SEWER- 10 60 I �c r r+r�S r v 0' yr, r J r J STEM UNLESS O i HERv1/ISE NOTED. PVC SEWER i 36" MAX. BREAKOUT EL = 1 1 .10' i _� 1 I FINISHED GRADE 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 2" DROP MIN. IN SLOPE@ r , 6" 3" 3" DROP MAX. 3" 9" - L=26'± 1 ELEVATION = 11.10' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A MIN.SLGPE�'1%, PROVIDE WATERTIGHT 13" 4" PVC IN FROM JOINTS (TYP.) o o ��o 0 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 14" 11 .50' SEPTIC TANK 4" PVC OUT TO 0 O 0 0 0 = = O THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. t 0 LEACHING FACILITY C) �� 0 0 00 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. CD 11 .75' 12" 6" oo O -� o o 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 48" LIQUID LEVEL OUTLET TEE 11 .17' MIN. 1 1 .00' 1 0 00 � 0 0 0> 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK 00 0 o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS GAS BAFFLE 6"CRUSHED STONE o 0 0 C� 0 0 0 00 000 0 0 0 0 o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 21.0' OFFSET TO FND OVER MECHANICALLY o 1 I AND DESIGN ENGINEER. COMPACTED BASE i !� 4 0' ! I 4.0' 1 1 ! 3.5' I 1 3.5 6" CRUSHED STONE i 5 OUTLET DISTRIBUTION BOX 6 0 ��P� ' I 3.0 (Typ' 1 8. ELEVATIONS BASED ON N.A.V.D. 88 DATUM. BENCHMARK ELEVATION OF 13.26' OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE 50.0' 10.0' ESTABLISHED ON TOP OF A HYDRANT BONNET BOLT AS SHOWN ON PLAN. COMPACTED BASE C C C C BASE. FIRST TWO FEET OF OUTLET 9 60, GROUND WATER ELEV= 5.50' mottlin 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PROPOSED 1 ,500 GALLON H-10 CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT LENGTH 10'-6" WIDTH 5'-8" DEPTH 5'-8" (Dimensions per ACME Shorey) LC-6 LEACHING CHHIVIt�tn� 4' MIN. CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES CROSS SECTION VIEW TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. U t �� I �� ( j!'w� " 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOT TO SCALE NOT TO SCALE NOT TO SCALE - --- -----.-----l- 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING -- ,.• ��_ r , . ` `r ST P iT �`,+ REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. PERC NO. 15686 • : 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS •_.. rr° �:� t •ti r, •; ••. INSPECTOR: Donald Desmarais, RS Benchmark ¢ '!�' �. -'••• - t LOCATED UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, PROPOSED SEVEN (7) LC-6 Hydrant Bonnet Bolt '• �j �i��;�li �� ✓ - .oil EVALUATOR: Michael Pimentel, EIT, CSE DRIVES, OR TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. LEACHING CHAMBERS Elev. = 13.26' { ` •:I•;' : • .j{,; ✓'' . '. �. + ,�o . r ;. C.S.E. APPROVAL DATE: Oct. 27, 1999 I ; ..�• • i • tip.••1c''\ • `>;•' 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. PROPOSED INSPECTION PORT WITH AGGREGATE PROPOSED NAVD 88 . ►°/ `j �� � f• '�'•, * " C' ' •f• ••��'•1 < • • ' DATE: June 7, 2018 DISTRIBUTION BOX • • « • l--- . ,4 • • ••' 1 - •ram� 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE _ PROPOSED 1,500 CR - �- • •r • ` ' I''•- TEST PIT#: MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. GAL. SEPT C TANK AIGVIL .,, ,< .•• •, 1 .��• .� • _ _ � (�,� ,,. . • �1 ( ., « . , REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, . (� (,l� . ,. •`; . ; `�r �. .`'• ..-- � •,t` ELEV TOP= 1200' EACH ROAD . . ;.� , ;;�. r+�.�l; ' 1r ° I•� ••. •� ••'�! FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). r • • :! •PIA �, �- •'(� ELEV WATER= 5.50' (mottling) ` -- _ _ �.. � •„ . • .• ," • . t • �' 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN 100' CB OFFSET �i ' • PERC RATE _ ��'`""`-----..� 1'>!=--- "°�12 m M • • !_ �_� • � �» ; , I •-•--�-' , `"'� � '`` 3 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. � --- 14 LOCUS - 16 PROPOSED PROJECT IS LOCATED WITHIN: - 1 i TP 2 0 C / S82'07'00"E OF PAVEMENT. o0D0 '/ •. t+� •• •. .• DEPTH OF PERC= - 30 12' REMOVE ALL UNSUITABLE �1�x0' ("'�_ 2�- t- ♦ % -a. • --^ ASSESSORS MAP 246 BLOCK - PARCEL 155 12 - `__. ._ �_-- ` 30.9' / '�.03' - z aI+ •. a =j + 3 7•+i`. -- =_ - TEXTURAL CLASS: 1 MATERIAL DOWN TO B" SOIL & _ : • .;; , 000 1 -'r-� so REPLACE w/CLEAN COARSE 1 / f •• e • ---- ,`��` r•�y a OWNER OF RECORD: RICHARD E. SCHOTT, TRUSTEE SAND PER 310 CMR 255 3 / / �' i34Vw' ' i ' `�_! _- "'� • . •• • O d \ TP 1 1 C: 0..i / / i U Q , . .•`•" ( (f ( ADDRESS: 527 CRAIGVILLE BEACH ROAD / 12x0' N j Nt` r / • r` ; +�; S: ..r .r:• 0� / _ . • LAG t f i .•��- -� •�l• ''' " 12.0 ' WEST HYANNISPORT, MA 02672 CLd // r y-Gll(I w- }' } �' {^"i1 s• •a , 4 •t t 0 0 75' CB OFFSET N� 0 �1 I / l / �' / ___-- r• , : li • C ;.(.• • •� • .1 • .41. A Loamy Sand �) �, ) FEMA FLOOD ZONE AE (EL.12)&X 0> Cr2 yr �. •.:�•' •. `'t =.� •1•• 10Yr 3/1 12' 11.00, COMMUNITY PANEL# 25001 C0564J O j r/ / I r 3? .�� '� I €i " •�• • • }+ 0 17. DEED REFERENCE: L.C.C. #216521 HAYBALE LINE .r....-- / �' �- "1 - 'i' '_ ;i.;a � r • i • Y • Pen. 50' CB OFFSET #527 / 1 / �p , / I ,�, Oit »►i -tt I' • ,� • •_ '� EXISTING / / y I 'y t' •:I +, !, ?l t •' '- •' 1•: , 3' MAP 246 a / `j 4-BEDROOM y / B\rry 2 / . alit �fl ; r 4 :�• �l i�'� ` .�� Loamy Sand18, PLAN REFERENCE: L.C. PLAN 18869-B /� 1 L y '/ • •�1 al :f • .• r I B 10Yr 5/6 o o / c � IN`d =1 3'+ - DWELLING , -- P PARCEL 154 i+� o / \ �� / / / 6 aCh . •!•' �i ` 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. (391 Green Dunes Dr.) 0 o '1 J w • I i. •\ i TOF=14-4' Q�� / / L, �jt� ;.� •; ,J 54" 7.50 Z / \ j �` / I j r •�` .I•• , ,,,!!! . A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A Uj 20 r' \ rrl / / �' tr `( �� • DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A \ Q I\ / 1 J / / _�'j r°) '.' G Medium Sand REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. FLOOD ZONE LINE DIVIDING ZONE _ i 10- / BVW •" 2.5Y 6/2 9� `' MAP 246 © 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY (<500) FROM ZONE AE (EL.12) BASED ON j \ FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY J4 /� PARCEL 155 W Mottling 78"ACTUAL ON-THE-GROUND FIELD r C7 `"" - - --9 @ -- :, 50' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. INSTRUMENT SURVEY (PER FEMA MAP o \ / ,` 27,152± S.F. #25001 C0564J; EFFECTIVE JULY 16, 2014) -= r v ry Weeping 82" ^- TREEU BVW 4 j 82" --P 9 @-- -` I ; 17' 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL NE 0 Z�,."' / REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. LOCUS PLAN Standing @90" STATE DEFINED `► ` _ --- ---- '1 50' 23. IN ACCORDANCE WITH 310 CMR 15.401 -16.405, THE FOLLOWING LOCAL UPGRADE COASTAL BANK(CB) -� - -9 SCALE: 1"- 1000' APPROVAL IS REQUESTED FROM 310 CMR 15.211(1): VW 9 �/ FLOOD ZONE LINE DIGITIZED 120" 2.00' (1.) A 4.9'WAIVER (10.0' -5.1') FOR THE SETBACK FROM TANK TO FRONT PROPERTY LINE. / - BVW - FROM FEMA MAP#25001C0564J; `-- / EFFECTIVE JULY 16, 2014 - 8 24. THE FOLLOWING LOCAL VARIANCES ARE REQUESTED FROM ARTICLE 1, SECTION 360-1: S820 07'00,,E (1.) A 27.0' VARIANCE (100.0' - 73.0') FOR THE SETBACK FROM THE SAS TO COASTAL BANK. �•,=":7 - -� 268 00, j DESIGN DATA (2.) A 24.1' VARIANCE (100.0' - 75.9') FOR THE SETBACK FROM THE TANK TO COASTAL BANK. r PERC NO. 15686 \" 6 BVW 9A -� S_ / / /BVW 6 _ INSPECTOR: Donald Desmarais, RS I / / I NUMBER OF BEDROOMS (DESIGN) 4 EVALUATOR: Michael Pimentel, EIT, CSE BVW 9E / B -_ -5 EDGE OF BORDERING VEGE I ATIVE WETLANDS j DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E. APPROVAL DATE: Oct. 27, 1999 50xO' EXISTING SPOT GRADE BVW 1 THROUGH BVW 11 WERE FLAGGED ON June 7 2018 ( ) TOTAL DESIGN FLOW 440 GAUDAY DATE: 50 EXISTING CONTOUR •,• BVW 7 JUNE 11, 2018 BY SABATIA INC. j BVW 9F _ TEST PIT#: ` � DESIGN FLOW x 200 % - 880 GAUDAY � 50 PROPOSED CONTOUR BVW 10 BVW 8 USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV TOP= 12.00' ELEV WATER = 5.50' (mottling) EXISTING OVERHEAD UTILITIES EXISTING GAS SERVICE LINE !� PERC RATE = � BVW 11 DEPTH OF PERC = EXISTING WATER LINE j INSTALL SEVEN (7) LC-6 LEACHING CHAMBERS I TEXTURAL CLASS: 1 % TEST PIT LOCATION 0 6) CRAIGVILLE BEAC SIDEWALL CAPACITY rt� (2 N ROAD (LENGTH + WIDTH) (2 SIDES) (1' HIGH) (0.74 GPD/S.F.) = GAUDAY O O O PROPOSED 1,500 GALLON H-10 SEPTIC TANK o 0�'''""----....�� (3 � (50.0' + 10.0') ( 2 ) ( 1' ) ( 0.74 GPD/S.F.) = 88.8 GAL/DAY O 0 0 - A 0 Loamy Sand 12.00' PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE O 0 O 10.0 BOTTOM CAPACITY 10Yr 3/1 0 1) a 5) 12" 11. [] PROPOSED H-10 DISTRIBUTION BOX (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY ` � (50.0' x 10.0') (0.74 GPD/S.F.) = 370.0 GAUDAY PROPOSED LC-6 LEACHING CHAMBER (4Y 200.2'TO RIVERLoamy Sand S�� oSWING-TIES B 10Yr 5/6 1 7-11-18 MCP JLC BOH Agent comments (tp#s; design data&variance) \ ti1C C-2 TOTALS: REV. DATE BY APP'D. DESCRIPTION DESCRIPTION HC-1 HC-2 TOTAL NUMBER OF CHAMBERS 7 54' 7.50 C / #527 / SEPTIC COVER IN (1) 36.1' 22.6' TOTAL LEACHING AREA 620-0 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE EXISTING � TOTAL LEACHING CAPACITY 458.8 GAL./DAY Medium Sand PREPARED FOR: 4-BEDROOM I SEPTIC COVER OUT(2) 42.9' 30.6' NOTES: C 2.5Y 6/2 ' RICHARD E. SCHOTT TRUSTEE b ^ - DWELLING CORNER OF STONE (3) 38.1' 32.5' 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE I ' TOF=14.4' TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT Mottling @ 78" CORNER OF STONE (4) 28.1' 25.3' ---------' 5.50' LOCATED AT 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE Weeping @ 82"y ✓� CORNER OF STONE (5) 55.4' 71.4' 82" - 5.17' j� ' LOCATION OF THE PROPOSED LEACHING SYSTEM TO 527 CRAIGVILLE BEACH ROAD ti ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS to EDGE OF BORDERINGCORNER OF STONE (6) 61.1' 74.3' Standing @ 90_ CENTERVILLE, MA VEGETATIVE WETLAND;_ .000, PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH 901, - - 4.50' is / IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. SCALE: 1 INCH = 20 FT. DATE: JULY 6, 2018 (BVW 1 THROUGH BVW 11) STATE DEFINED w WERE FLAGGED ON JUNE 120" 2•�' 0 10 20 40 80 FEET COASTAL BANK(CB) 11, 2018 BY SA$ATIA INC.- / I 3.) PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED ���" °� MAss� / ZONE 2, BARNSTABLE DESIGNATED ZONE OF CONTRIBUTION, c i OR THE ESTUARINE WATERSHEDS. �� JOHN L. yes PREPARED BY: "� s _ _ ��.. `� RESERVED FOR BOARD OF HEALTH USE CHu 'LL JR. 4 JC ENGINEERING, INC. 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY 2854 CRANBERRY HIGHWAY N 4' , AS A COURTESY FOR THE INSTALLER. INSTALLER SHALL FL 77 - --- - _- --- - VERIFY SWING TIE MEASUREMENTS IN THE FIELD PRIOR TO EAST WAREHAM, MA 02538 SWING-TIES & DIMENSIONS PLAN SITE PLAN INSTALLING THE SYSTEM. CONTRACTOR SHALL NOTIFY l`, 508.273.0377 SCALE: 1 +� + SCALE. 1 -20 ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT= 20 . Drawn By: MCP Designed By: MCP Checked By JLC JOB No. 4245 TOF = 14.4'± FINISH GRADE OVER D-BOX= 13.2'± FINISH GRADE OVER CHAMBERS = 12.4' - 14.0' PROVIDE EXTENSION RISER FSLOPE @ 2°lo MIN. OVER SYSTEM 3/4"TO 1-112" DOUBLE WASHED WITH COVER OVER !NEST& r-REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE OVER TANK EL.= RISER TO WITHIN 6"OF FINISHED GRADE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISHED GRADE OUTLET TO WITHIN 6"OF F.G. , 4" SCHEDULE 40 PVC INSPECTION PORT w/ACCESS BOX WITH @ FOUNDATION - 13.0�± 14.0 ± 5" DIA. OUTLETS) MIN SLOPE 1% COVER TO GRADE (SEE NOTE#20} STON OR GEOTEXTILDEOFIBLE WASHED TER FABRIC CODE AND ANY APPLICABLE LOCAL RULES. _ I 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 20"MIN.ACCESS 9 MIN. DESIGN ENGINEER. COVER (3 TYP.) PLACE RISERS ON ALL 136" MAX. TOP OF SAS= 1 1 .43'N. �� PROP. SCH. 40 9' MIN. CHAMBERS WITH 3. 4 SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PVC SEWER- PROP. SCH. 40 36" MAX- 10.60� 36' MAX.IrT PIPES,•, ^r ^.,^T''ii��e, i" c6" yr S T S I EM UNLESS OTHERWISE NOTED. �- PVC SEWER ; BREAKOUT EL = 11 .1 O� FINISHED GRADE1 �� 2" DROP MIN. 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN MIN s�oaE „ 6" 3" 3" DROP MAX. 3„ 9„ L=26'± ELEVATION = 11.10' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A _ MIN s�oaE @�i, PROVIDE WATERTIGHT 13" 4" PVC IN FROM IJ,,----- JOINTS (TYP.} 0 0 doge o 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF 14" 11 .50' SEPTIC TANK 4" PVC OUT TO 0 ❑ O ❑ 0 0 00 ❑ 0 0 oo THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 71 0_ LEACHING FACILITY po r--, �--i 00 00 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. 11 .75' 12" 6" CD oo 00 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. ' 11 .00 o 0 48" LIQUID LEVEL OUTLET TEE 11 .17 MIN. 0 0 o00 0 o0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK GAS BAFFLE R INSPECTION. SYSTEM IS 6" CRUSHED STONE o 0 0 0 0o C� 0 0 oo NOT FILLITO BENG BACKFILLEDEN SYSTEM WIN HOUT FIRSTEARLY OBTAINING A APPRLETE AND READY OVAL FROM BOARD OF HEALTH OVER MECHANICALLY o _ 21.0' OFFSET TO FND COMPACTED BASE 1 4 0i 1 1 4.0' I ( 1 3.5' I I 3 5, AND DESIGN ENGINEER. 5 1 6.0 (TYP) T -----11 3.0' (TYP) 8. ELEVATIONS BASED ON N.A.V.D. 88 DATUM. BENCHMARK ELEVATION OF 13.26' 6" CRUSHED STONE + I OUTLET DISTRIBUTION BOX I I I OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE 50.0' 10.0' ESTABLISHED ON TOP OF A HYDRANT BONNET BOLT AS SHOWN ON PLAN. COMPACTED BASE C C BASE. FIRST TWO FEET OF OUTLET 9 60, GROUND WATER ELEV= 5.50 mottlin 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION PROPOSED 1 ,500 GALLON H-10 CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT LENGTH 0''6'� WIDTH 5�-$�� DEPTH 5�-8'� (Dimensions per ACME Shorey) LC-6 LEACHING CHAIVIbt 4' MIN. CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES CROSS SECTION VIEW TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER. I 1 I 4 i4 l k i II 4 If( ( I' i( U t I Al r,j) 3 H� + , ";`'� 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. NOT TO SCALE NOT TO SCALE I NOT TO SCALE -_ _ _ 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING T�CT IT 1'1 /1 T REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM �I APPROPRIATE AUTHORITY. / �, •J ►ii t PERC NO. 15686 r' • a' ,` • y�f � ��yis' • 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS If ► .. a , 1 f t/ •• . INSPECTOR: Donald Desmarais, IRS R OR LOCATED UNDER PAVEMENT Benchmark j '.`ti ••• • t.: LOCATED UNDER MORE THAN 3 FEET OF COVE � '' • "'-�' •' t •i ONF n EVALUATOR: Michael Pimentel, SIT, CSE PROPOSED SEVEN (7) LC-6 Hydrant Bonnet Bolt ••t ;;r >., s rY, •.;:.-�' . , DRIVES, OR TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. LEACHING CHAMBERS Elev. = 13.26' •:�;;��: • ; • . " • ,'f ,u• •tip Oct. 27, 1999 PROPOSED INSPECTION PORT WITH AGGREGATEV NAVD 88 ! , •.I• �` 3.• �, - r •�`' • Q �� C.S.E. APPROVAL DATE: 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. PROPOSED t, r -. • + 4 •. . ( •�I` • DATE: June 7, 2018 DISTRIBUTION BOX y • • • • • • it 3 �.� `• 1 • 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE _.__. PROPOSED 1,500 .v, M _ .��.i ••�� �l.i ago . t• •�. r . . - `%M�_"--"J /�'! . TEST PIT#: 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. GAL. SEPTIC TANK CRAIGVILLE t, • `A r:-,, .T , i1 .'}�• . .• i L •j.. ,; : ; ], ,,. �._l, ,,,, REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, - - ... B� s . . ,,• •;L_ •• ELEV TOP= 12.00' I �a � / ACH ROAD . •*.� • �;�, ��..��; y J ) ' `II• .. �• • •�! E FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). ``- Io ;• :•; : .11� a 1 ;f _ - ; .1Cr;� ELEV WATER = 5.50' (mottling) 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN 7 100' CB OFFSET ~+`"�--�-- `� , •• • • •• , Y' �1 , ' ---`,�-j� �• SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. • • t• ' 1 '�' PERC RATE = 3 min./inch O _ EDGE AV _ , • �� .;,, - 16. PROPOSED PROJECT IS LOCATED WITHIN: ° S82° ��` �F P PAVEMENT ao •. DEPTH OF PERC= 12' - 30 - TP 2 O r �'1 C' w p7� .,E t LOCUS • 0p • • ASSESSOR'S MAP 246 BLOCK _ PARCEL 155 REMOVE ALL UNSUITABLE �' • ;'a :i 37'�`•i -=-`"=�- TEXTURAL CLASS: 1 %1,)x0 �`''�� 275.03' - - `'--Y-� z ; .�• . •,• r. •• MATERIAL DOWN TO "B" SOIL & 12 -`r - -'� _ 30 9" / / ��'`""` Q t - s • . ; • • * `� REPLACE w/ CLEAN COARSE 11 �"- W c / cv r a J ':: ; _� • � `� "1}�• I' 1 ' -� ("� • • OWNER OF RECORD: RICHARD E. SCHOTT, TRUSTEE SAND PER 310 CMR 255 3 �/ f' 2 *•. J / BV/�''_ - �C .: n'y' •�. 8 . '� �` •►` . I O -10 .� - \ % TP 1' t ^ N / / / / `y .• •� r j.._- ,/,�{=: •W ,• 1 # ( ADDRESS: 527 CRAIGVILLE BEACH ROAD A 12x0 v. _ • ,, _ r �>�.� t; ' } �•sL!��ti-'�,r . 1 , L WEST HYANNISPORT, MA 02672 � \ 0 12.00 „ 14 ! (' /i a �- / s pjG � t�3 j ♦ . :��• .t;• . .'ij� A Loamy Sand 75' CB OFFSET, ;�N �`O / �-" ,'` +'r-'1 �) $ O> cn 2 ?� ✓ // '� / / / w;• • ' •:���; r • '�• -1•. 10Yr 3/1 FEMA FLOOD ZONE AE (EL.12) &X e ,1 1 ,��� •• , •;�• , 12 11.00, COMMUNITY PANEL# 25001CO564J it tr1( I ►i r •• + •r . . • 0 i.11 - Perk �n HAYBALE LINE - #527 p l/ L / , .�ti N tf• �: ; • , ,: 50' CB OFFSET--� j 11 / �l '• it -tl � � ' � � �._ • � • _� 17. DEED REFERENCE: L.C.C. #216521 EXISTING / / •tl, N • Ulf ii ii I' li -ti o 3, w Y -� � BVVv 2 •fi :;ll f j° t • 1 : E•_-' Loamy Sand 4-BEDROOM / / �� ;• i. i f • ' •�t;; 1� 18. PLAN REFERENCE: L.C. PLAN 18869-B MAP 246 0 ,, -i / / 'I ,�, t ,�s: • B 10Yr 5/6 0 0 / _. C 7 IN, =12 ,;f DWELLING p PARCEL 154 m o j� r �J�� 6 ach (I I .1t• ; 391 Green Dunes Dr. LO o TOF=14.4' 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. Z \ , � / / , / -' I � '`--'rUl �� ` +°,(~•'.'I. 20. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A Qj co DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A 1` O \ / / BVJ1 7 Medium Sand REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. 4.. FLOOD ZONE LINE DIVIDING ZONE X 10- ( i •11' 2.5Y 6/2 cw \ 9� MAP 246 pG' 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY (<500) FROM ZONE AE (EL12) BASED ON \T / r FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY 0 /� a PARCEL 155 W , Mottling78' ACTUAL ON-THE-GROUND FIELD i f C7 '• ---- --- FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. f. INSTRUMENT SURVEY (PER FEMA MAP o \ 27,152± S.F. __- -- #25001C0564J; EFFECTIVE JULY 16, 2014 / `� ✓ /`�`� �' Weeping @ 82_ I 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL r- y � ._ TREES.;",'r / ®Z`^�����/ BVW 4 / 82" - y.17 - / � ^row�'/ LOCUS PLAN Standing @ 90" I REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. STATE DEFINED 8 ` / /¢� �` m 90" -------- 1450, 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE APPROVAL IS REQUESTED FROM 310 CMR 15.211(1): COASTAL BANK(CB) - '- / f j �' -FLOOD ZONE LINE DIGITIZED SCALE: 1"= 1000' 1 A 4.9'WAIVER (10.0' -5.1') FOR THE SETBACK FROM TANK TO FRONT PROPERTY LINE. \Z ` -•� / BVW 5 FROM FEMA MAP#25001C0564J; 120" 2.00' ( ) EFFECTIVE JULY 16, 2014 _ 24. THE FOLLOWING LOCAL VARIANCES ARE REQUESTED FROM ARTICLE 1, SECTION 360-1: COASTAL � Ss2°07 pp E l `:�ES I G N DATA (2.) A 24.V VARIANCE (100.0' - 75.9') FOR THE SETBACK FROM THE TANK TOO COASTAL BANK. �V'JU 9D �� �- -7 - / 268.00, J 1 PERC NO. 5686 6! BVW 9A % -6- BVW 6 d ` INSPECTOR: Donald Desmarais, IRS NUMBER OF BEDROOMS (DESIGN) 4 EVALUATOR: Michael Pimentel, EIT, CSE BVW 9E / B -.5- \-EDGE OF BORDERING VEGETATIVE WETLANDS DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E. APPROVAL DATE: Oct. 27, 1999 50x0' EXISTING SPOT GRADE h ti (BVW 1 THROUGH BVW 11)WERE FLAGGED ON # TOTAL DESIGN FLOW 440 GAUDAY DATE: June 7, 2018 50 EXISTING CONTOUR ♦ �, BVW 7 JUNE 11; 2018 BY SABATIA INC. BVW 9F TEST PIT#: 2 DESIGN FLOW x 200 % = 880 GAUDAY --�� ,=i0 � PROPOSED CONTOUR BVW 10 BVW 8 USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV TOP=_ 12.50' EXISTING OVERHEAD UTILITIES ELEV WATER = 5.50' (mottling)_ PERC RATE = EXISTING GAS SERVICE LINE BVW 11 DEPTH OF PERC - EXISTING WATER LINE INSTALL SEVEN (7) LC-6 LEACHING CHAMBERS TEXTURAL CLASS: 1 % TEST PIT LOCATION o CRAIGVILLE BEA SIDEWALL CAPACITY 6) CH LL-10 PROPOSED 1,500 GALLON H-10 SEPTIC TANK (2 ROA(� (LENGTH + WIDTH) (2 SIDES) (1 HIGH) (0.74 GPD/S.F.) = GAUDAY o r (3 1A (50.0' + 10.0') ( 2 ) ( 1' ) ( 0.74 GPD/S.F.) = 88.8 GAUDAY „ O 0 Loam Sand 12.00 PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE �.° ° � O O O �� A 10Yr3/1 10.0' ° ° BOTTOM CAPACITY 12" 11.00' 0. --�� DISTRIBUTION BOX (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY ❑ PROP H-10 4 2002. (50.0' x 10.0') (0.74 GPD/S.F } 370.0 GAUDAY `OU PROPOSED LC-6 LEACHING CHAMBER RIVERLoamy Sand sue' SWING-TIES B 10Yr 5/6 1 7-11-18 MCP JLC BOH Agent comments (tp#s; design data&variance) C-2 TOTALS: REV. DATE BY APP'D. DESCRIPTION DESCRIPTION HC-1 HC-2 „•,�r TOTAL NUMBER OF CHAMBERS 7 54" 7.50' C j #527 SEPTIC COVER IN (1) 36.1' 22.6' TOTAL LEACHING AREA 620.0 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE EXISTING , NOTES: TOTAL LEACHING CAPACITY 458.8 GAL./DAY C Medium Sand PREPARED FOR: k' 4-BEDROOM SEPTIC COVER OUT(2) 42.9' 30.6' 2.5Y 6/2 RICHARD E. SCHOTT, TRUSTEE o / DWELLING CORNER OF STONE (3) 38.1' 32.5' 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE ! TOF=14.4' TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT. Mottling @ 78" ` CORNER OF STONE (4) 28.1' 25.3' 78" - - ----- 5.50' LOCATED AT f- 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE -Weeping @ 82- - 15 17' !� CORNER OF STONE (5) 55.4' 71.4' LOCATION OF THE PROPOSED LEACHING SYSTEM TO 527 CRAIGVILLE BEACH ROAD ENSURE CONSISTENCY WITH TEST PIT DATA SHOWN ON THIS Standing-90 /© EDGE OF BORDERING CORNER OF STONE (6} 61.1' 74.3' PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH - g �° --- - 4.50' CENTERVILLE, MA ,� VEGETATIVE WETLAND, IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. (BVW 1 THROUGH BVW 11 SCALE: 1 INCH = 20 FT. DATE: JULY 6, 2018 STATE DEFINED WERE FLAGGED ON JUN1 120" 900, 0 10 20 40 so FEET COASTAL BANK(CB) i 1, 201$ BY SABATIA INC. / 3.) PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED �N OF kgsr, ZONE 2, BARNSTABLE DESIGNATED ZONE OF CONTRIBUTION, �� °�yG OR THE ESTUARINE WATERSHEDS. RESERVED FOR BOARD OF HEALTH USE ° JOHN L. �� PREPARED BY- OR CHU ILL JR. a� JC ENGINEERING, INC. �- ...� 4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY N 4•` > 2854 CRANBERRY HIGHWAY AS A COURTESY FOR THE INSTALLER. INSTALLER SHALL - -- -- ----- VERIFY SWING TIE MEASUREMENTS IN THE FIELD PRIOR TO EAST WAREHAM, MA 02538 SWING-TIES & DIMENSIONS PLAN SITE PLAN INSTALLING THE SYSTEM. CONTRACTOR SHALL NOTIFY ,��p / 508.273.0377 SCALE: 1 _ 20' SCALE: 1"= 20' ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. y 9 Drawn B MCP Designed By: MCP Checked By: JLC JOB No. 4245 TOF= 14.4't FINISH GRADE OVER D-BOX= 13.2'f FINISH GRADE OVER CHAMBERS = 12.4' - 14.0' I GENERAL NOTES PROVIDE EXTENSION RISER SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& FINISH GRADE OVER TANK EL.= RISER TO WITHIN 6"OF FINISHED GRADE ++ SCHEDULE 40 PVC METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISHED GRADE OUTLET TO WITHIN 6"OF F.G. 140�� INSPECTION PORT w/ACCESS BOX WITH 2"OF 1/8"TO 1/2"DOUBLE WASHED f @ FOUNDATION = 13.01 . t [5" 4 DIA. OUTLET(S) MIN SLOPE 1% COVER TO GRADE (SEE NOTE#20) STONE OR GEOTEXTILE FILTER FABRIC CODE AND ANY APPLICABLE LOCAL RULES. -- _ 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 20"MIN.ACCESS 9"MIN. DESIGN ENGINEER. COVER(3 TYP.) 36" MAX TOP OF SAS= 11.43� PLACE RISERS ON ALL PROP. SCH. 40 9"MIN. +, CHAMBERS WITH 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PROP. SCH. 40 36 MAX. , 9 MIN. „ PVC SEWER PVC SEWER 10.60 36" MAX. BREAKOUT EL- 11 .1 O� INLET PIPES TO I OF SYSTEM UNLESS OTHERWISE NOTED. FINISHED GRADE -� 2" DROP MIN. ! 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN _.__.._ MIN.SLOPE @ 1% 6" 3" ++ 3" 9" L=26't = 3 DROP MAX. MIN.SLOPEQ,% ELEVATION = 11.10' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A PROVIDE WATERTIGHT 13" 4" PVC IN FROM JOINTS (TYP.) 002 So4,o rC;c, 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF \ *12.3'� 14" 11 .50' SEPTIC TANK 4" PVC OUT TO 0 0 O 0 0 0 C� 0 00 0 Q THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. • LEACHING FACILITY CD 0 0 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. 11 .75' 12" oo 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. ++ OUTLET TEE 11.17' MIN. 11 .00, 0048 LIQUID LEVEL � 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK 6"CRUSHED STONE °° o o � IFILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM ISGAS BAFFLE OVER MECHANICALLY o00 0 NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 21.0' OFFSET TO FND COMPACTED BASE -" AND DESIGN ENGINEER. 5 4 0' 6 0' (TYP) 4.0' 3.5' 3.0' (TYP) 13.5' 8. ELEVATIONS BASED ON N.A.V.D. 88 DATUM. BENCHMARK ELEVATION OF 13.26' 6"CRUSHED STONE OUTLET DISTRIBUTION BOX ESTABLISHED ON TOP OF A HYDRANT BONNET BOLT AS SHOWN ON PLAN. TO BE INSTALLED ON A LEVEL STABLE 50.0 10.0 � OVER MECHANICALLY BASE. FIRST TWO FEET OF OUTLET , GROUND WATER ELEV.= 5.50' mOttlln 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION I COMPACTED BASE PIPES TO BE LAID LEVEL. 9.60 THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT I PROPOSED 1 ,500 GALLON H-10 CONCRETE SEPTIC TANK LC-6 LEACHING CHAMBERS 4' MIN. CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES 5 -8 DEPTH 5 -8 (Dimensions per ACME Shorey) _ _ TYPICAL CHAMBER PROFILE `GONTRAc T OR TO VERIFY EXISTINiC LENGTH 10 -6 WIDTH CROSS SECTION VIEW {� ! (''� �+ TO THE DESIGN ENGINEER. i ELEVATION PRIOR TO ANY WORK & C:. '" 1 .✓ T i LJ I IL) D S I t 1 C7 U i it .o ..J-TAIL C H � � A�►- � � ETAI LS V 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT. I NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE - - 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING f7 �} �,� � �` c-- - I TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM 'I `��`f� `~-' ' • t� ! APPROPRIATE AUTHORITY. f - �UJr� I PERC NO. 15686 t� i )t / ri '°' � �� •� ••: INSPECTOR: Donald Desmarais, RS 12. ALL SEP'YIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS Benchmark v �- • ,� +• ± j (mN . ONF I LOCATED UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, PROPOSED SEVEN (7) LC-6 Hydrant Bonnet Bolt - •, 2 EVALUATOR: Michael Pimentel, EIT, CSE i DRIVES, OR TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. EXIST CESSPOOL TO BE PUMPED e ` •' ' ' •`�' • . %, C.S.E. APPROVAL DATE: Oct. 27, 1999 LEACHING CHAMBERS Elev. = 13.26 .• • • . r ,* r' 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. PROPOSED INSPECTION PORT WITH AGGREGATE RFM0%F=I PFR TITLE 5 i7-/D ^F 2) NAVD 88 ' ' '• • ' ' !�• •• ' PROPOSED �_ � �� ( . : . • • ' DATE: June 7, 2018 DISTRIBUTION BOX f 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE PROPOSED 1,500 � � • •• ti • � •S ' ••• • ' "` • � TEST PIT#: 1 / Cpp� -- ,• s r • • MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. GAL. SEPTIC TANK v1IGV IL r 1.' ' ° £ ,. (� • • •' ' _ REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, PROPOSED 40 MIL. IMPERVIOUS .�_ �„® � . - - sL� BEA ,(,� ., . ;� s't{' , �'� • ' .• I ` ELEV TOP- 12.00' ® CH ROAD ++ • ' �� �' ` __ •• '' " 1 FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). GEOMEMBRANE LINER; 1 �/�"c- •• 13 /q0 • .il. +� • ! 1.. t; 1. • TOP EL '°"-'�-� _ • + • • t ', ��:.--' • , ELEV WATER= 5.50' (mottling) - 12 .� �-- -� �-- _ • �, * ! ,( t • 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN 100' CB OFFSET "° -- -14 ``---- �2 m M ,� \ ��y� "yam " j • . �± SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. • t r_ 0 � . -�-- - � •' �� LOCUS • • '' ER RATE_ - min./inch EDGE OF p4 �, F'_.T } l t 3 3 _ , r * 16. PROPOSED PROJECT IS LOCATED WITHIN: O S82 _ VEMENT .• _�_ 4 •► . , DEPTH OF PERC- - _ 3 5.03' E 7 z �i. r 37 •, •-�._ P' 07 �- . •�... •. '' ASSESSOR'S MAP 246 BLOCK PARCEL 155 REMOVE ALL UNSUITABLE ---. 2xV 1 27 • • - - / TEXTURAL CLASS- 1 11 12 0. k o 1 r L < s 'h• y #,1 • r. • • OWNER OF RECORD- RICHARD E. SCHOTT, TRUSTEE MATERIAL DOWN TO"B"SOIL & ... REPLACE w/CLEAN COARSE 4� 400 SAND PER 310 CMR 255(3) - -10 --�'�/ \ TP 1 ` r 2 j/Z •+ .• ' 'i •r ;: . • ° -- _ / •• • ADDRESS: 527 CRAIGVILLE BEACH ROAD / \\ \1 jjjj do 12x0' f / N N� / -� / 8 / _ _ d r+ ujl +� ' ' ' ' \ 0" 12.00' WEST HYANNISPORT, MA 02672 14 / ' "r / / co / �' / _ tt tt 11 30 41 . .. Loamy Sand 75' CB OFFSET �� ^, �� �' ;• •' • G, 3 / ''� / �1 ] • ,• , A 10Yr 3/1 FEMA FLOOD ZONE AE (EL.12)&X - l / j (t•�,• r• ' ' ;' 12 11.00 COMMUNITY PANEL# 25001 C0564J HAYBALE LINE ` ` �' k. PefL #527 / '` / o /// ' /,. ,1 ' / -�- it µ 'ti j- • . •• _. 50' CB OFFSET / 1 EXISTING F I 11 »+ 01I ll 11 II -- 30 9.50' w 17. DEED REFERENCE: L.C.C.#216521 MAP 246 - / `, 4-BEDROOM / / r BVW 2 • , :)14 III II j t r • • r : Loamy Sand 18. PLAN REFERENCE: L.C. PLAN 18869-B 0 0 / INV=12 3'± DWELLING P / / • 1l I ' �� B 10Yr 5/6 PARCEL 154 o �0 �� / Ch 'U .� • • • 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. Z TOF=14.4' / / . ) -' r (391 Green Dunes Dr.) ^ a �9 �Q- / / / ; . " 7.50' Z j �<< / / :fit;, U "' ' 4� 20. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A •`" t, DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A i g g / ( r°' ' i• C Medium Sar.d REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP SD A%-LOW W FOR 4�tSPECTIONS. FLOOD ZONE LINE DIVIDING ZONE X 10- 2.5Y 6/2 w \ /�9� / MAP 246 p " ~� 21. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY (<500) FROM ZONE AE (EL.12) BASED ON THE GROUND F ELD tr \ / 0 - _ .:: ,:y - _: - 78„ Mottling @ 78" FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY I (ABILITY �D / �4> PARCEL 155 W _ S7 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. INSTRUMENT SURVEY (PER FEMA MAP o \ � ,` � 27,152t S.F. W --- _ 5.50' j 82" weeping@ 82� � 5.17' 22• OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL #25001C0564J; EFFECTIVE JULY 16, 2014) ! ` "' ^ry f-- y TREEIfNE �02�^�` BVW 4 / REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. _ 014 f LOCUS PLAN " i _ Standing @ 90 STATE DEFINED rO 90" - - -- -- 9 4.50' 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE COASTAL BANK(CB) �. - -� ` - g SCALE: 1"- 1000' APPROVAL IS REQUESTED FROM 310 CMR 15.211(1): BVW 9r, `7 // FLOOD ZONE LINE DIGITIZED 120" 2 00' + (1.) A 4.9 WAIVER (10.0'-5.1 ) FOR THE SETBACK FROM TANK TO FRONT PROPERTY LINE. , ` / / BVW 5 FROM FEMA MAP#2500iC0564J, v. J B, - tB_ -8 EFFECTIVE JULY 16, 2014 - _ 24. THE FOLLOWING LOCAL VARIANCES ARE REQUESTED FROM ARTICLE 1, SECTION 360-1: .7 / S82o 07r 00"E ° n E S I G N DATA TEST PIT DATA (2.) A 24.10' VARIANCE (100.0' -710") FOR THE SETBACK FROM THE SAS' VARIANCE (100.0' -75.9') FOR THE SETBACK FROM THE TANK TO COASTAL O COASTAL BANK. ? / 268.00' j BVW 9D \ 6 �� PERC NO. 15686 - -- -- BVW 9A 6- / BVW 6 INSPECTOR: Donald Desmarais, IRS NUMBER OF BEDROOMS(DESIGN) 4 EVALUATOR: Michael Pimentel, EIT, CSE L E G E N C` g gE / B ^� 'S \-EDGE OF BORDERING VEGETATIVE WETLANDS j DESIGN FLOW 110 GAUDAY/BEDROOM C.S.E. APPROVAL DATE: Oct. 27, 1999 50xO' EXISTING SPOT GRADE (BVW 1 THROUGH BVW 11)WERE FLAGGED ON TOTAL DESIGN FLOW 440 GAUDAY DATE: June 7, 2018 50 - - EXISTING CONTOUR BVW 9F ♦ � BVW ✓ JUNE 11, 2018 BY SABATIA INC. j / DESIGN FLOW x 200 % = 880 GAUDAY TEST PIT#: 2 .` 50 PROPOSED CONTOUR BVW 10 BVW 8 USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV TOP= 12.00' / ELEV WATER - 5.50' (mottling) - - EXISTING OVERHEAD UTILITIES / GAS EXISTING GAS SERVICE LINE PERC RATE _ -- --- i INSTALL SEVEN (7) LC-6 LEACHING CHAMBERS DEPTH OF PERC = W W EXISTING WATER LINE TEXTURAL CLASS: 1j TEST PIT LOCATION CRAIGVILLE BE SIDEWALL CAPACITY �. s> qCH - (2 ROAD (LENGTH + WIDTH) (2 SIDES) (1' HIGH) (0.74 GPD/S.F.) = GAUDAY O O PROPOSED 1,500 GALLON H-10 SEPTIC TANK i o -• (3 (50.0' + 10.0') (2 ) ( 1' ) ( 0.74 GPD/S.F.) = 88.8 GAUDAY 0 12.00 o O O Loamy Sand PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE BOTTOM CAPACITY " O O A 10Yr 3/1 L., O O O 10.0 O 1) 12 11.00 ❑ PROPOSED H-10 DISTRIBUTION BOX (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY (50.0' x 10.0') (0.74 GPD/S.F.) = 370.0 GAUDAY 0 PROPOSED LC-6 LEACHING CHAMBER (4 "' 200.2'TO RIVER � Loamy Sand s�\ SWING-TIES B 10Yr 5/6 1 7-11-18 MCP JLC BON Agent comments (tp#s; design data&variance) TOTALS: �C-2 REV. DATE BY APP'D. DESCRIPTION DESCRIPTION HCA HC-2 7 54�� 7.50' j TOTAL NUMBER OF CHAMBERS - - C j #527 SEPTIC COVER IN (1) 36.1' 22.6' TOTAL LEACHING AREA 620.0 SQ.FT. PROPOSED SEPTIC SYSTEM UPGRADE _ EXISTING / TOTAL LEACHING CAPACITY 458.8 GAL./DAY C Medium Sand PREPARED FOR: 4-BEDROOM / SEPTIC COVER OUT(2) 42.9' 30.6' NOTES: 2.5Y 6/2 o °� DWELLING RICHARD E. SCHOTT TRUSTEE � CORNER OF STONE (3) 38.1' 32.5' 1.) MAGNETIC MARKING TAPE SHALL 3E PLACED ALONG THE ' TOP EDGE OF EACH SEPTIC SYSTEM COMPONENT. " ►� ;: TOF=14.4 CORNER OF STONE (4) 28.1' 25.3' 78„ Mottling @ 78_S 50' LOCATED AT 2.) CONTRACTOR SHALL VERIFY SOILCONDITIONS IN THE Weeping @ 82" CORNER OF STONE (5) 55.4' 71.4' LOCATION OF THE PROPOSED LEACHNG SYSTEM TO 82 5 17' 527 CRAIGVILLE BEACH ROAD ENSURE CONSISTENCY WITH TEST PI-DATA SHOWN ON THIS CENTERVILLE MA /0 EDGE OF BORDERING CORNER OF STONE (6) 61.1' 74.3 Standing @ 90" VEGETATIVE WETLANDS PLAN. REPORT TO ENGINEER AND LC�AL BOARD OF HEALTH 9(' - - - 4 50' .� {BVW 1 THROUGH BVW 11} � IF SOILS ARE NOT CONSISTENT WITH-EST PIT DATA. SCALE: 1 INCH = 20 FT. DATE: JULY 6, 2018 STATE DEFINED �Y WERE FLAGGED ON JUNE 120" 2.00' 0 10 20 40 so FEET COASTAL BANK(CB) © 3.) PROPERTY IS NOT LOCATED WITHN A DEP APPROVED H of +0 11, 2018 BY SABATIA INC. ZONE 2, BARNSTABLE DESIGNATED ZONE OF CONTRIBUTION, Q'� ems' WINEIIIII OR THE ESTUARINE WATERSHEDS. RESERVED FOR BOARD OF HEALTH USE M oHu ILL JR �� PREPARED BY: �� U JOHNLL. H JC ENGINEERING, INC. ""� �--_ 4.) SWING TIES SHOWN ON THIS PLAT ARE PROVIDED ONLY N a1 , 2854 CRANBERRY HIGHWAY AS A COURTESY FOR THE INSTALLER INSTALLER SHALL - --- - VERIFY SWING TIE MEASUREMENTS 14 THE FIELD PRIOR TO EAST WAREHAM, MA 02538 SWING-TIES & DIMENSIONS PLAN SITE PLAN INSTALLING THE SYSTEM. CONTRACTOR SHALL NOTIFY 3.0377 �� _ SCALE: 1"=20' ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. -- 50 . SCALE: 1 - 20 Drawn By: MCP Designed By: MCP Checked By: JLC JOB No. 4245