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Home My WebLink About0576 CRAIGVILLE BEACH ROAD - Health 576 Cr-aigville Beach Road Centerville A = 246 - 221 UPC'12534 ' .2153E �,, 0�6 � Commonwealth of Massachusetts ~0�~��W�� Official � Inspection �� Title �� y800�*0�� w�� oN°m Subsurface Sewage Disposal System Fornn - NotforVo|untoryAsnossmentn 57OCRA|GV/LLEBEACHR�AD � Pmpe��x�dmua �-�--- ---- MELANIE Owner '------- �H information is ~y required for everyCENTER _ MA 02633 6/4/2021 pogo City/Town State--' Zip Code Date of Inspection Inspection results must besubmitted on this form. Inspection forms may not be altered inany way. Please see completeness checklist ot the end of the form. Important:When A. K nmnoout�nn» ^^^ "ns��t�eU��U�� /i�c�im�� . , ~ ,~° on the computer, use only the tab -TrevorKellett � key m move your Name mInspector � | oumu, do not Cape Cod Septic use the return -_ Company Name 35OPNoiOGL _ �mpany Address `---� VVYarmouth _ MA 02673 City/Town State Zip Code 5O8'775'2825 �|'13744 � _-_ Telephone Number License Number �I certB. Certification ify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CK8R 15.000)| | have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my ' inspection; and the inspection was performed based on my training and experience in the proper function and maintenance ofon'oite sewage disposal systems. After conducting this inspection | have determined that the system: 1. Z Passes 2. [1 Conditionally Passes 3. E] Needs Further Evaluation by the Local Approving Authority 4. [] Fails ' 6/7C2U21 mspunmrs Signature Date The system aysham inspector shall submit copy of this inspection report to the Approving Authority (Board | of Health o/ DEP) within 30 days of completing this inspection. If the system has a design flow of 1O.00Ogpdorgreater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. Title"Official inspection Form:Subsurface Sewage Disposal oyswrn'Page Imiu Commonwealth of Massachusetts Title 5 Official Inspection Form —r^,I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments b' 576 CRAIGVILLE BEACH ROAD Property Address MELANIE CASSISTA_-10 JOS__IAHS PATH,_W_ BARNSTABLE MA 02668 Owner Owner's Name information is CENTERVILLE _ required for every MA_ 02632 6/4/2021 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: SYSTEM IS IN WORKING CONDITION 2) 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): t5insp doc•rev 7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of (Massachusetts Title 5 Official Inspection For = =- 1� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 576 CRAIGVILLE BEACH ROAD Property Address------------------------- — - MELANIE CASSIS_TA_-10 JOSIAHS PATH, W BARNSTABLE MA 02668 Owner Owner's Name — -- information is required for every CENTERVILLE MA 02632 _ 6/4/2021 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) 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. a. 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: t5insp.doc•rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts f.r- - ;t Title 5 Official Inspection For I Subsurface Sewage Disposal System Form - Not for Voluntary g p Y Assessments — 576 CRAIGVILLE BEACH ROAD Property Address --- MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 Owner Owner's Name information is CEN_T_ERVILLE _ MA_ 02632 6/4/2021 required for every -_ - _ page. City/Town _ State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool 15insp doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts ,71y=_ .T � Title 5 ^fficial Inspection Foy � Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 576 CRAIGVILLE BEACH ROAD _. Property Address --------------------------------------.---._ -- MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 ---....__._---___ ___---- -- ---_ ----------------------------.._..caner ---------------- Owner's Name information is CENTERVILLE required for ever MA _ _026_32 6/4/2021 _ page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® 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 water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA.-, 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts :7 `title 5 Official Inspection or 171, '' �[ ';,I System Subsurface Sewage Disposal stem Form - Not for Voluntary Assessments p Y 576 CRAIGVILLE BEACH ROAD - Property Address -------- ----------_--- - MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 _--------------...._--- --------------- ---- Owner Owner's Name Information is CENTERVILLE MA 02632 6/4/2021 required for every ____.._.-- -_-..__................ ...._ _._...... _-..--.------..__._. _...-____-- _ page City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes" to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no" for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health, ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 15insp aoc•rev 712 /2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts --- � Title 5 Official Inspection Form -t ^�I Subsurface Sewage Disposal System Form - Not for Voluritary Assessments 576 CRAIGVILLE BEACH ROAD -- - ----- ------------- Property Address ------�— — --- MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 Owner Owner's Name-- -- — ---- - - —` information is CENTERVILLE required for ever MA 02632 _6/4/2021 _ page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): .4---- Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 _ Description: Number of current residents: 5 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: —Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d '20- 131 GPD g ( y g (gp )) '19 - 169 GPD Detail: _ --- -- Sump pump? ❑ Yes ® No Last date of occupancy: CURRENT Date t5insp doc•rev 7)26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 `A. Colmmonwealth of Massachusetts Tide 5 Official Inspection For Subsurface Sewage Disposal System Form - Not for Voluntary Assessments T 576 CRAIGVILLE BEACH ROAD Property Address --- — -- MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 -- e.----- - --------- --------------------- Owner Owner's Name --------�-------------- ---required is CENTERVILLE MA 02632 6/4/2021 _ required for every --------- ---- -------- ---.... - ---- ------- page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: -- ----- - -- — Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: — -- - Last date of occupancy/use: date Other (describe below): -._- ------ ------- -- ------—- ---- ---- — 3. 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: - ---- -- -- --- --. t5msp doc•rev 7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 f Commonwealth of Massachusetts Title 5 OffIci l Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 576 CRAIGVILLE BEACH ROAD Property Address -i------ -- MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 Owner --- --....-------------------------------------- Owner's Name information is CENTERVILLE required for every _..------..------_-------._.___._.--__..__----...----------_.--...._._-...-._ _ MA 02632 _ _ 6/4/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known) and source of information: 2005 PER BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer (locate on site plan): Depth below grade: 24 - ---------- feet Material of construction: ❑ cast iron ® 40 PVC ❑ other (explain): ---- -- -- Distance from private water supply well or suction line: 10'+-------- -- --- feet Comments (on condition of joints, venting, evidence of leakage, etc.): LINE CHECKED WITH SEWER CAMERA AND WAS FOUND TO BE CLEAN AND PROPERLY PITCHED .S i6p::o.:•1ev 71/26;2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts r-== Title Official Inspection Form l l Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5_7_6 CRA_IG_VILLE BEACH ROAD Property Address ------—_-- -- --_---- --- ' MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 Owner Owner's Name information is CENTERVILLE MA 02632 6/4/2021 required for every ____-___----._...— --------_..._---------------------- ------ ---------___. - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): 16" 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 GALLONS 2 Sludge depth: - --- -- Distance from top of sludge to bottom of outlet tee or baffle -------- 2" Scum thickness --- - -- Distance from top of scum to top of outlet tee or baffle - - -_ -------- -- Distance from bottom of scum to bottom of outlet tee or baffle ---- — — -- How were dimensions determined? ESTIMATED Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 1000 GALLON TANK IN GOOD CONDITION. PVC TEES IN PLACE AND CLEAN. TANK AT NORMAL OPERATING LEVEL. COVERS 2" BELOW GRADE 15insp doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts - , ' Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ' 576 C_RAIG_VILL_E_BEACH ROAD Property Address -- — MELANIE CASSISTA-10 JOSIAHS PATH W BA RNST ABLE MA 2 0 66 8 Owner Owner's Name information is I CENTERVLLE NIA 02632 6/4/2021 required for every . _..---.._._..._. -------,_-- page City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 — — ibinsp ooc.•rev 7/26120t8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pagel 1 of 18 Commonwealth of Massachusetts e. r, Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 576 CRAIGVILLE BEACH ROAD Property Address ----- M_ELANIE_CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 Owner Owner's Name _—_.. information is CENTERVILLE required for every _. --.-.----...._ _ .__ _ _ MA -- 02632 _ 6/4/2021 _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) Alarm present: ❑ Yes ❑ No Alarm level: ---------- -- --- Alarm in working order: ❑ Yes ❑ No Date of last pumping: pate Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No 9. Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert EVEN_ __--- — Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): DISTRIBUTION BOX LEVEL AND WATERTIGHT t5insp doc•rev 7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 r Commonwealth of Massachusetts JItle 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 576 CRAIGVILLE BEACH ROAD Property Address MELANIE CASSISTA-10 JOSIAHS PATH, W BARNS-TABLE MA 02668 ---- --- — - - ------ -----..._..-- --- - ---------- .. --- owner Owner's Name required tion is CENTERVILLE MA 02632 6/4/2021 equired for every - - ------ - -- - - ---- ------- - --- 02632---- page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: — - ® leaching chambers number: 3-500 GALLON ❑ leaching galleries number: — ❑ leaching trenches number, length: - -- ❑ leaching fields number, dimensions: — - ❑ overflow cesspool number. -- -- ❑ innovative/alternative system Type/name of technology: -- -------- — — :5insp doc•rev.7Y26I2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts Title 5 Official Inspection For . t Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 576 CRAIGVILLE BEACH ROAD _.. Property Address--------------- ---------- — ----- _. MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 Owner Owner's Name information is CENTERVILLE MA 02632 6/4/2021 required for every -•---- ------ -- _ - -..------------- - - -____----- --_.....__------ ---- page. City/Town State Zip Code Date of Inspection ®. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 3-500 GALLON H-20 RATED CHAMBERS FOUND IN OPERATING CONDITION DURING INSPECTION WITH NO EVIDENT STAINING 12. 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t51nsp dor.-rev ;/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18. Commonwealth of Massachusetts Title 5 Official Inspection For 32— MjSubsurface Sewage Disposal System Form - Not for Voluntary Assessments 1 �M. 576 CRAIGVILLE BEACH ROAD Property Address — MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 ------- --- -- __.......--.....--— --------- — ------- --------- -------— Owner Owner's Name --` — -- information is required for every _...CENTERVILLE MA 02632 6/4/2021 _ ...-----_.----_----_.._ _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.).. r i5insp;:a,•rev 't2Sr?01Ef Title 5 Official Inspection Form:Subswiface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts `title 5 Off oci s Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,.A 576 CRAIGVILLE BEACH ROAD Property Address --------- -—------------ ---- — MELANIE CASSISTA-10 JOS►AHS PATH, W BARNSTABLE MA 02668 Owner Owner's Name information ie CENTERVILLE MA 02632 6/4/2021 requiredfor every -_.._______.._- _._—_.__..- .......-------------__- ---- - ------ ------------.. _ page City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 I I �f`ry,�-" ..�..»d�l,��a,1 �,"alp •va,,.� ��, �;.. ' tl.,... ..,.., �.,,,,, .. (� I�� d RiIY {' Yam/} },rr�7 Q/Gg�C �.X YUb e 1-17 I I J7 i —of I d6 U'l,( i..,,:...., ......._t L 151nsp doc"rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 Commonwealth of Massachusetts `title 5 Official Inspection Form - `i Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 576 CRAIGVILLE BEACH ROAD _. Property Address — — MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 Owner Owner's Name -- - ---- - ------ -- information is CENTERVILLE MA 02632 6/4/2021 required for every -- ----------- ------------- ------ ----_..--- -- 2021 - - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. 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: 10/6/2005—_ 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: TEST HOLE DATA PER PLAN DATED 10/6/2005 SHOWS NO GROUNDWATER ENCOUNTERED AT 120". BOTTOM OF SAS AT 7' Before filing this Inspection Report, please see Report Completeness Checklist on next page. iS,,isp ooc-rev 7;26/2016 'rite 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Nk Title Official Inspection For ,b Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 576 CRAIGVILLE BEACH ROAD Property Address------- -------- ---—..-- — - --- ---- MELANIE CASSISTA-10 JOSIAHS PATH, W BARNSTABLE MA 02668 Owner Owner's Name -- information is required for every CENTERVILLE MA 02632 _ 6/4/2021- --- -- -- ------- --._ ...- -...--- page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked Z C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank- Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev 7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 No. � Fee O� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es Rpplication for Zi5po5aY *p5tem Construction Permit Application for a Permit to Construct( ) Repair Q6 Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. S 7C CA0r rri t'IpGlh oq Owner's Name,Address,and Tel.No. �FdN ��tr Cc.�so5t� [ l Assessor's Map/Parcel a--146 5,Q_% 5 7C. C eft J �� p �&c<CVl RV Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ` dv�14� �3vn�N 00-71S`q Irs�t°Y W:+r- V C'o�d,�� 5c -833-Gc®o Type of Building: Dwelling No.of Bedrooms W Lot Size 16 40-11 1 sq.ft. Garbage Grinder (kje> Other Type of Building gat, x No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) LA 40, gpd Design flow provided y%_7 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 1GJ✓ C ISM nl` Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �- a*A PcJ► S -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 thipRoard of Health. Sign - Date l ,. Application Approved by Date Application Disapproved by: 6Z Date for the following reasons Permit No. _ (21 Date Issued No. �'/C Fee O� in comp p THE COMMONWEALTH OF MASSACHUSETTS Enteredcomputer: P11.1BLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ` �-- 01pplicdtionifor Mi�po$a[6p$tem Con.5trUCtton j3ermit Application for a Permit to Construct( ) _Repair(,V Upgrade O Abandon O ❑ Complete System ❑Individual Components e. Location Address or Lot No. 5 7 G C/U ijv/��>'�)PG!f? Owner's Name,Address,and Tel.No. •)P�Nt-}af CG-.,t,,I si a Assessor's Map/Parcel a 1l6 0,!Z 1 S-1 G C J a,3 il i I 1 p Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. &too(J !,Type of Building: j Dwelling No.of Bedrooms L( r Lot Size l G LlQi14 It!sq. ft. Garbage Grinder (n1Cp Other Type of Building ��<, �_ No.of Persons r Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) l-14 gpd Design flow provided Ll S 7 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank ICW C-Y ISi t 1\)� Type of S.A.S. Description of Soil v l x;i Nature of Repairs or Alterations(Answer when applicable) Z<� �c.<P <,c��P� S .A `Z2 ` 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/ooff Health. Signe ^aG (/ - Date -2-h-, O S/ Application Approved by /� Date i Application Disapproved by: Date for the following reasons h Permit No. ! Date Issued,' _ k THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (,k") Upgraded ( ) Abandoned( )by n.)r�r, A 1 t cJv�r�) at S'7 C, C t a i c v tO,(P has been jcons trycited in aaccj ordance i with the provisions of Title 5 and the for Disposal.System Construction Permit No. /'/ dated Installer �a0,1Ou 5 A 1 0.� Designer IAv(S-Y ��•E C-1J Gf of l #bedrooms H Approved design flow U gpd The issuance of this permit shall not be)co�nsstruueed as as guarantee that the system wAl-fun to as esigned. Date j ( ''1`D- Inspector 0 i' ——————�j——————— ------------------- NO. ✓ �0 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS 1=i!9po.5a1 ,p$tem Con.5trurtton Permit Permission is hereby granted to Construct ( t ) Repair ( x) Upgra ( ) 'Abandorl � ��` ( ) System located at 7 G c : t�ac�n C\\ � and as described in the above Application for Disposal System Construction Permit.The'applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of thi pe it. Date 1 a` ` Approved by r � .; µ f Town of Barnstable Regulatory Services Thomas F.Geiler,Director ~ ?&rA Public Health Division ' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 - Fax: 508-790-6304 Installer &Designer Certification Form Date: Sewage Permit# c2 MSS Assessor's Map\Parcel MuT%(a Designer: r51& f('4 Installer: 5 I �4�1-Dy/N) Address: Address: ?(7n l On-4, S r � ,� %�Gv�� was issued a permit to install a (d te) (installer) septic system at STG �r� t� u tl�'r based on a design drawn by (address) 4 dated 10 C, (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. 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. A FAT PN - ( staller's Signature) f CrAL ; 'a'ara�e� (D igner's Signature) (Affix Des tamp Here) PLE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc TOWN OF BARNSTABLE `6CATION 5 7G C P``cs a v �1� I��c�we\\ )R(�) SEWAGE # VILLAGE �c°' rCt t1�c� ASSESSOR'S MAP & LOT AJ _ INSTALLER'S NAME&PHONE NO. -190MA&S k SEPTIC TANK CAPACITY S LEACHING FACILITY: (type) 'b H '0 &QQC40 (size) Q R NO. OF BEDROOMS BUILDER OR OWNER C PERMIT DATE: 1 Z 0 COMPLIANCE DATE:/��US Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom-of Leaching Facility pkr,w Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Sew �J`rgl Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet.of leaching facility) 'E T Feet Furnished by -3 3-37' -313 S-35611/ gibe/ i F��a� rr1 (Domestic Mail Only; . Insurance Coverage Provided) m For delivery information visit our website at www.usps.como ul ... `A ::� ' f ul Postage $ . 37 S p Certified Fee O Q Return Reclept Fee Postmark Here (Endorsement Required) /J O Restricted Delivery Fee rO (Endorsement Required) rD 17-9 Total Postage&Fees $ -—/ m O Sent To o Te hn•` r CU SS __ 3Yreet,Apf NO., -- `1p^ -^-^ s/^ --------------- or PO Box No. S7 -:.-.r`"�"'�� .t7e�s e�a_ sl------------------ Ciry,State,ZIP+4 ,' 0 a 3a �S Form :00 Ame 2002 Certified Mail Provides: (as�ana'y)ZOOZeu?ilooesw1o�Sd ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811�to the article and add applicable postage to cover the fee.Endorse mailpiece'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". e If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sign fure - item 4 if Restricted delivery is desired. Agent ■ Print your name and address on the reverse v ❑Addressee so that we can return the card to you. B Received b (Print Name) C. a of D ive ■ Attach this card to the back of the mailpiece, + 7 or on the front if space permits. tit C- d-1 d . D. Is delivery address different from item ? ❑ s 1. Article Addressed to: If YES,enter delivery address below: ❑ No �eol✓Ir`�� CNffrl��f A N�` �} 0�6302 3. Service Type / Certified Mail ❑ Express Mail ❑ Registered CK Return Receipt for Merchandise i ❑ Insured Mail ❑C.O.D. i 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number ?�n 7 p 03 16"8 0 0004 54 5 8 3 36 7 (Transfer from service label) I: •' 0 PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail, Postage&Fees Paid LISPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • Public Health Division Town of Bamstable 200 Main St Hyannis,Massachusetts 02601 -'Will id.,lilffi/IItI,'illii illill lleflbii lit!i?hh - Certified mail: 7003 1680 0004 5458 3367 Town of Barnstable ` Regulatory Services SAWSCAUM MASS. $ Thomas F. Geiler,Director A Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 15, 2005 Jennifer Cassista 576 Craigville Beach Road Centerville, MA 02632 NOTICE OF VIOLATIONS OF 310 CMR: 15.00 THE STATE ENVIRONMENTAL CODE TITLE V: MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND TOWN OF BARNSTABLE CODE &353-9-DISCHARGE ONTO GROUND PROHIBITED. On August 11, 2005, Health Inspector David W. Stanton, R.S. investigated a complaint regarding sewage odors at the property owned by you located at 576 Craigville Beach Road, Centerville. The following violations of 310 CMR 15.00, the State Environmental Code, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage and the Town of Barnstable Code were observed: 310 CMR 15.303(1) (a): Septic system is in hydraulic failure. Sewage was observed overflowing onto the ground. Town of Barnstable Code &353-9: Discharge of sewage onto the ground. (1) You are directed to keep the on-site sewage disposal system pumped as many times as necessary(daily if needed)to keep it from overflowing onto the ground. (2) You are ordered to obtain a septic design engineer to design the repair plans for the failed .septic system at said location and apply for a septic permit with the Health Division within thirty (30) days of your receipt of this letter. (3) The septic system shall be installed in strict accordance with the approved engineered plans within sixty (60) days of your receipt of this letter. You may request a hearing before the Board of Health if written petition requesting same is received within ten(10) days after the date the order is served. Q:\Order letters\Septic\576 Craigville Beach Road.doc Non-compliance will result in the issuance of a non-criminal ticket citation of $100. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH ALT omas A. McKean, CHO, RS Director of Public Health Q:\Order letters\Septic\576 Craigville Beach Road.doc Al ate...• Home: Departments:Assessors Division: Property Assessment Search Results 576 CRAIGVILLE BEACH ROAD Owner: CASSISTA,JENNEFER J Property Sketch Legend I Map/Parcel/Parcel Extension 246 /221/ ✓f4� _aV v Mailing Address x ID[W tN .30do CASSISTA, JENNEFER J C n 72 576 CRAIGVILLE BEACH RDJ`a��} I( hL CENTERVILLE MA. 02632 ✓ �� 2005 Assessed Values: Appraised Value Assessed Value Altq Building Value: $ 102,500 $ 102,500 1 Extra Features: $0 $0 Outbuildings: $2,900 $2,900h� Land Value: $ 172,100 $ 172,100 Interactive Property Map: ap requires Plug in: I( Totals:$277,500 $277,500 1 have visited the maps before First time users Show Me The Man Click Here April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: CASSISTA, JENNEFER J 1/13/1999 C151685 $ 110,000 AMANTEA, LOUIS L&CATHRYN 1/15/1985 C99817 $68,000 SHEARER, K G &TRAYWICK, M 6/15/1984 C97454 $ 125,000 2005 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Land Bank Tax $50.37 Town Fire District Rates Other Rates $6.05 Barnstable-Residential $2.12 Land Bank 3%of Town Barnstable-Commercial $2.80 C.O.M.M. FD Tax(Residential) $280.28 C.O.M.M.-All Classes $1.01 Cotuit FD-All Classes $1.28 Town Tax(Residential) $ 1,678.88 Hyannis-Residential $1.52 Hyannis-Commercial $2.39 W Barnstable-Residential $1.44 W Barnstable-Commercial $2.10 Total: $2,009.53 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.38 Year Built 1921 Appraised Value $ 172,100 Living Area 1390 Assessed Value $ 172,100 Replacement Cost$ 136,684 Depreciation 25 Building Value 102,500 Construction Details Style Conventional Interior Floors Carpet Model Residential Interior Walls Drywall Grade Average Heat Fuel Gas Stories 1 1/2 Stories Heat Type Steam Exterior Walls Wood Shingle AC Type None Roof Structure Gable/Hip Bedrooms 4 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 Bathroom Total Rooms 7 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FGR6 Gar w/Lft Avg 320 $2,900 $2,900 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second'Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) _ W Pennitnumbv � TOWN OF BARNSTABLE DEPARTMENT OF HEALTH,SAFETY AND ENVIRONMENTAL SERVICES HEALTH DIVISION/ crf hl�ct'td' - /V P[Culp,/ P uY�E �•1�.� t� P i tlr h� G y U?ftlV li0 5tfl I 'A Ri E CONTACT HEALTH DEPARTMENT BEFORE ENTRY OR REPAIR PHONE:(508)862-4644 Address Health Official i Lo } °� CG�"'Pti��y"� �iyR�L�1^f �� ,� r, t� r.. r�. r.r ice.:, "� 3-/.ti��+�+ ,}�:�,,{�,i }�M�fr `r•��+,,,>ef �{ t . `Jriw� ia �a a r ` ✓fit ,, 4 �1Ai N` � a !' .`Fr ;`�`qt+ . ice` ~ t $ A •�,� �fk` t �'`4rtl°n +};• " ' 7irV .f ii �'y � i �+,ds t F� �+ ,�f�r''• } F 1 �may.. r�`�e 3 '7� ..M ,�',!.'�,� � =d'y�,r• " - r," '� r ,.Y 8' +yf'Jy� ;,,•r�_ , -. •f` rrfri +y + 1 /j� �, R. r 1 f':t `•!' t'!i° ln�3: y Iyaq. # �5w Iry'//P �." �. ,�' �* '.�r r.� ' �• ;� ter' t i ,y ,-r'f".i• r`i,-r f ,.�� >.-t ;t.�'f„y9 �`.�'� y t...fl :,A { .!x'!.• t ci R. 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P' a �,• p ,� f its„� <r�}+ fN 7{��/., 1�~'+.i / � tS �� ' •�'`. .{ ,( ,t 3 � '4 ,l,JJ r77 � .��e � ll�,ry�(}rt f. .ti',i"1 f.�4� '_•• ,• r ' q A _ ,�,�a. \`•1 #^*qy�..'I'.+Y 4 �� S 14• (_to .J \ ; � . • �7 Health Complaints 16-Aug-05 Time: 12:30:00 PM Date: 8/5/2005 C mplaint Number: 18329 Referred To: DONALD DESMARA Taken By: SHARON CROCKER Complaint Type: TITLE V SEWAGE Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 576 Street: CRAIGVILLE BEACH RD Village: CENTERVILLE Assessors Map-Parcel: Complaint Description: facing house from street, septic is on left in back yard. Septic is overflowing and has been since Jun. Was told they were fixing it. Still wet and smelling. House has many people visiting at times. On 8/11/2005 a follow-up call was placed for status on 8/11/2005. Complaint was given to Dale Saad in Tom's absence. Actions Taken/Results: DS WENT TO SAID LOCATION AS ANOTHER COMPLAINT CAME IN. DD HAD ALSO BEEN TO THE PROPERTY EARLIER, AND LEFT WITH DS TO SEND A LETTER , BUT DS HASN'T AHD TIME YET TO SEND A LETTER. NO ONE WAS HOME WHEN DS WENT TO SAID LOCATION, BUT THERE WAS A SMALL PUDDLE OF LIQUID. PRESENT. DS PLACED AN ORANGE STICKER ON THE DOOR OF THE HOUSE LETTING THE PEOPLE KNOW THEY MUST PUMP AS OFTEN AS NECESSARY, OR $100.00\DAY TICKETS WOULD BE ISSUED. DS WILL SEND AN ORDER LETTER TO UPGRADE WHEN HE GETS TIME. DS CONDUCTED A FOLLOW UP ON 8/15/05. STILL NO ONE HOME. AN ORDER LETTER 1 Health Complaints 16-Aug-05 HAS BEEN SENT. IT APPEARS THE SYSTEM HAS BEEN PUMPED AS THERE WAS A HOLE DUG AROUND THE AREA THAT WAS WET BEFORE, AND THE AREA IS NOW DRY. Investigation Date: 8/11/2005 Investigation Time: 1:45:00 PM 2 30 .00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Diu.Vuuttl Wortai Tomitrurtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: 576 Craigville Beach Rd- Centerville .............................................................---•-----•-•----------------------- --------••----•-•------•-----------•-----------•-----------•-•------------------......------------ Location\ddress or Lot No. Louis Amentea ......................_.......................................................................... ..........------------------•-----...........------------.....----...--------•-------------....-- Owner Address aW.E. Robinson Septic Service_____________ P.O. Box 1089 Centerville Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms---------------- 3-.-......------.-..------Expansion Attic ( ) Garbage Grinder ( ) P4 Other—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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ ,.a Test Pit No. I----------------minutes per inch Depth of Test Pit..........---.----_ Depth to ground water......-.-------------- . (14 Test Pit No. 2................minutes per inch Depth of Test Pit---------------..... Depth to ground water........................ 1:4 --------------------------------------------------------------------------------------- -------------------------------------------------------------------- O. Description of Soil....,sand-----------------------------------------•------ -------•----•-----------------------------------------•-•-•--••---------------•-•--•-•••--•------------- x U .-----------------------------------•--------------------------•--•-----------------•-•----•-•------•---------------..........------------•--•---•------......----------------------........-------••-•-. w .......................----.................................--------------........-----------•---•-----•----•---------------------.....------------....----- ---------------------•••............----- U Nature of Repairs or Alterations—Answer when applica le...i. s ta.l 1---a-.-�-,Q II---g-a---- -ank---•-------------------- d-box & stone-packed leachpit_......._P ® " Agreement. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The u ndersig furt agrees not to place the system in operation until a Certificate of Compliance has been ' ed b b of ealth. Signed - :C/Date. .�/ Application Approved BY � D. .......... '`" Date Application Disapproved for the following reasons: ............................................. .......... ............................ ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ........................................ Dace Permit No. --.-�Y.- 63c)--------------------------- Issued .................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Dijrpoiial Work.5 Tomitrnr#ion Prrntit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: 576 Craigville Beach Rd.- Centerville ................-................................................................................ ------•-----•------••----•-----•-•-------...-----------•--.....----------•----------------....---- Locatim-Address or Lot No. Louis Amentea Owner Address a W.E. Robinson Septic Service P.O. Box 1089 Centerville M Installer Address d Type of Building Size Lot............................Sq. feet DwellingNo. of Bedrooms.::.....:.......3------______-__--._-.-__Ex Expansion Attic Showers Garbage Grinder ( ) — P ( ) g ( ) aOther—Type of Building No. of persons.................. ( ) Cafeteria dOther fixtures -----------•-------•.......................................---------------....-----........_..............---••-•-----_--------........_.........._... W Design Flow......................... g P P P Y Y 1 it -- ------------- Width---------------- Diameter_.. ----•---.... Depth---------------- a gallons per person per day. Total daily flow..................................... WSeptic Tank—Liquid capacity....___.____gallons Length___ •---••gallons. III 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........................................ a Test Pit No. I................minutes per inch Depth of Test Pit.-.---___-_____--- _ Depth to ground water-.--_-._-__---___-_--_.. 4 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ P4 ._...---•-------------------------------------------------------------•-------------•.......--------....................................... ---_.............. DDescription of Soil----sa.md................•-----•--•--------------------••.....•-•------------..._.----•-.....---------••-------------------- .................................... W V .---------------------------------------•--•---•--------------------------•----------------------....-----•--------••--------•-••--------•----•------------------------................................. W x -- -------- - ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Re airs or Alterations—Answer when applicable.--install---a._.1_,0ISO__--CT;R. ...ta,nk.......................... d.-box &� stonepacked leachpit r-/, '' y `........................,, Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersig�ne, further agrees not to place the system in operation until a Certificate of Compliance has been 's's ed b tpe b rd-of -ealth. AwSigned . `- ------------------- ........ - ------ . � Dace ApplicationApproved BY ----------- ... .... ..... ................................................ ------ Application Disapproved for the following reasons- ------------------- ----------------------------------------------------------------------------------------------------------------- ................ ............................................................................................................................................................................................ . . ......................... Permit No. ........- /', -! �r l �� Issued ......................... are D �- --------------- .--------------------------------------------------- --- -- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE 01Er#tfira e of Q-11oxnpliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( x ) b W E Robinson Septic Service __........_.... Y ....................................................... lwal le, at ..576 Craigville...Beach...Rd.. Centerville. - has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .._ef.`�.. �� -------- dated .. .._.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE '� /� " Z Inspector ----� L _..�.... �-- - - -------------------------------r r � THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No... 6 FEE. TOWN OF BARNSTABLE 30.00. ...:....G..: .......... �i��n��t1 nrk� �un¢trttr#ilan �rrmit �I -....RobinsonE Septic- Service Permission is hereby granted..... ..................._....__.._... ........ to Const•ttct ( o; Repair (x) an Individual Sewage Disposal System at Craigville Beach Rd Centerville atNo. ------------••----- --------_ -•-•-------- Street as shown on the application for Disposal Works Construction Permit No.__(_cc�� _.l_7�k) Dated-_-_ ----...-•--------•---•------------•--...._ = ---------------------------------------•--- Board of Health DATE -/n = '��_ FORM 36508 HOODS&WARREN,INC..PUBLISHERS LOCATION TOWN OF BARNSTABLE •� Z�; hcN Old . VILLAGE ;. .� SEWAGE ASSESSOR'S MAP G LOT INSTALLER'S NAME G PHONE No. �� SEPTIC TANK CAPACITY , LEACjUNG FACILI 'Y4t YPe) t2 � A NO. OF BEDROOMS -`PRIVATE WELL OR PUBLIC WATER auu-mDeR OR OWNER ,rUt DATE PERMIT ISSUED: 16 -- DATE .. COMPLIANCE ISSUED: VARIANCE GRANTED: Yes I i i - ;3 1 .� TOWN OF BARNSTABLE d LOCATION z�; �_ [r5 i �G�.� SEWAGEg of VILLAGE 1• ) ASSESSOR'S MAP & LOT 4�v'Z:ZZ INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY d w LEACHING FACILITY:(type) ?i? & G A 4 \ t o AsAe)& e f. Ce NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER ODU-A)ER OR OWNER 1 4,C/1 4 DATE PERMIT ISSUED: JG -- DATE COMPLIANCE ISSUED: IO VARIANCE GRANTED: Yes No n' f r V r'q f G�° 3 i i f g . COMMONWEALTH OF MASSACHUSETTS f EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ` ONE WINTER STREET: BOSTON. MA 02108 617-292-5500 �y V,5� y WILLIAM F.WELD TRUDY COXE Governor Secretary Lewis Amantea ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner PART A CERTIFICATION Property Address:576 Craigville Beach Rd.. Address of Owner: Date of Inspection: )r_'-/—Q' 7— Centerville , DU different) Name of Inspector: WM E Robinson Sr I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: WIR E Robinson Septic Service Mailing Address: PO BOX 1089 , Cent-ervi 1 1 a r NIA 02632 Telephone Number, 5 0 8 7 7 5—8 7 7 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: t/Paasses — Conditionally Passes — Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: fit/ LLe,,.`..=-�=-� Date: '- f The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTE PASSES: 7I have not found an information which indicates that the system violates an of the failure criteria as defined in 310 CMR 15.303. Y Y Y Any failure criteria not evaluated are indicated below. COMMENTS: BJ S STEM 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. Indicat yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (re iced 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:Nwww.magnet.state.ma.us/dep e'j Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 576 Craigville Reach Rd., , Centerville , MA 02632 Owner: Lewis Aman ea Date of Inspection: B) SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed CJ FU HER 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) YSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT HE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE NVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) THER (revised 04/25/97) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 576 Craigville Beach. Rd. , Centerville , MA 02632 Owner: Lewis Amantea Date of Inspection: D] I AILS:Youcate ei;!,er "Yes" or "No" as to each of the following: ve determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis his determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct ailure. Yes Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. _ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped _. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a 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 I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE YSTEM FAILS: You mus indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The ner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program require t of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 SYSTEM INSPECTION SUBSURFACE SE WAGE DISPOSAL CTIO FORM PART B CHECKLIST Property Address: 576 Craigville Beach Rd.. , Centerville , MA 02632 Owner: Lewis Amant a Date of Inspection: ) aL Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No 1/ _ Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large.volumes of water have not been introduced into the system recently or as part of this inspection. _ As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. All.system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. / The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. _ Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)] (revised 04/25/97) page 4 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 576 Craigville .Beach Rd.. ,. Centerville , MA 02632 Owner: Lewis Amantea Date of Inspection: )OIL-1..1 FLOW CONDITIONS RESIDENTIAL: Design flow: 3-7 0 p.d./bedroom for S.A.S. Number of bedrooms:. Number of current residents:L Garbage grinder (yes or no): ALI c) Laundry connected to system (yes or no):w Seasonal use (yes or no): A.,0 Water meter readings, if available (last two (2)year usage (gpd): 1996 36, 000 gal Sump Pump (yes or no):-/---d gal 1998 24.000 gal ( 6 mos ) Last date of occupancy:f✓/.tl COA MERCIAUINDUSTRIAL: Type f establishment: Design flow: gallons/day Grease rap present: (yes or no)_ Industri I Waste Holding Tank present: (yes or no)_ Non-sa nary waste discharged to the Title 5 system: (yes or no)_ Water eter readings, if available. Last to of occupancy: OT ER: (Describe) Las f occupancy: r�F . GENERAL INFORMATION PUMPING RECORD and source of information: System pumped as part of inspection: (yes or no)_ If yes, volume pumped: Qallons Reason for pumping: TYPE /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) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: /Cf, 1)- 9 G/ 30 Sewage odors detected when arriving at the.site: (yes or no) (revised 04/25/97) Page 5 of 10 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 576 Craigville Beach Rd..: , Centerville , MA 02632 Owner: Lewis Amantea Date of Inspection: B ILDING SEWER: (Lo to on site plan) Dep below grade: Mat rial of construction: _cast iron _40 PVC_other (explain) Dis nce from private water supply well or suction line Di eter C ments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:_ (locate on site plan) Depth below grade. Material of construction: concrete _metal _Fiberglass _Polyethylene —other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: Sludge depth: `3 " Distance from top of sludge to bottom of outlet tee or baffle:, Scum thickness: ;2- ,' i Distance from top of scum to top of outlet tee or baffle:_ Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or battles, deed. of liquid level in relation tg,�tlet invert, structural integrity, evidence of leakage, etc.) l(�>�-�� 22 4-) �L %'• 1✓ "' GREA E TRAP: (locate on site plan) Depth low grade: Materia of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimen ions: Scum t ickness: Dista a from top of scum to top of outlet tee or baffle: Dista ce from bottom of scum to bottom of outlet tee or baffle: Dat of last pumping: Com nts: (recom endation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integri , evidence of leakage, etc.) (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 576 Craigville. Beach. Rd.. , Centerville , MA 02632 Owner: Lewis Amantea Date of Inspection: TI TOR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (local on site plan) Depth low grade: Materi I of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimen ions: Capaci gallons Design flow: gallons/day Alarm level: Alarm in working order_Yes; _ No Dat of previous pumping: Com nts: (condit on of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: 1/ (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal evidence olids carryover, evidence of leakage into or out of box, etc.) o � • PUM)on BER:_ (locate plan) Pumrking order: (Yes or No)Alarmrking order (Yes or No) Com(noten of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97) Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 576 Craigville Beach Rd.. , Centerville , MA 02632 Owner: Lewis Amantea Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failu level of ponding, condition of vegetation, tc.) CESSPO S: _ (locate on ite plan) Number an configuration: Depth-top f liquid to inlet invert: Depth of so ids layer: Depth of sc m layer. Dimension of cesspool: Materials o construction: Indication f groundwater: flow (cesspool must be pumped as part of inspection) Com ents: (note ondition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY: (locate on site plan) Materials f construction: Dimensions: Depth of solids- Comme ts: (note ndition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: ?6 ( raicville Beach Rd:. , Centerville , MA 02632 Owner: Le S man ea Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (LocatO where public/water supply comes into house) .12—��,r,•�•_ µ� -Jc� ) l �fl (revised 04/25/97) Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ` PART C SYSTEM INFORMATION (continued) Property Address: 576 Craigville Beach Rd.. , Centerville , MA 02632 Owner: Lewis Amantea Date of Inspection: /;--r- �k. Depth to Groundwater 1�h�Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record y Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records r Check local excavators, installers Use USGS Data Desch e in your own words how you established the High Groundwater Elevation. Must be completed) (revised 04/25/97) ?age 10 of 10 SHEET 1 OF 1 TOP of FOUNDATION = 20.3' GENERAL NOTES FINISH GRADE OVER CHAMBERS = 17.5' - 18.5' 3/4" TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE PROVIDE HIGH DENSITY POLYELYLENE RISER WITH CONCRETE 4" SCHEDULE 40 PVC SLOPE ® 2% MIN. OVER SYSTEM COVER TO WITHIN 6" OF FINISH GRADE WHEN NECESSARY. MIN SLOPE 1Z 2" OF 1/8" TO 1/2" DOUBLE WASHED STONE 1• UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL CODE. y FINISHED GRADE PLACE RISERS ON ALL CHAMBERS WITH PIPED INLETS FINAL GRADE OVER D-BOX = 17.8' TO WITHIN 6 of FINISHED GRADE ® FOUNDATION =18.0' _ 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BARNSTABLE BOARD OF HEALTH. ' FINISH GRADE OVER TANK EL.= 17.0' - - - - - - - - - - - PROVIDE RISER TO WITHIN TOP of SAS = 15.50 3. USE 4 IN. SCH. 40 PVC PIPING WITH WATERTIGHT JOINTS UNLESS OTHERWISE NOTED ON PLAN. 6" OF FINAL GRADE 9" MIN. S" DIA. OUTLET(S) 14.50 36" MAX. 9" MIN. BREAKOUT EL = '5.00' 4. SLOPE ALL SOLID PIPE A MINIMUM OF 1.07.. CLEAN BACKFILL 36" MAX. _ 5 ON-SITE WASTEWATER TREATMENT SYSTEM IS NOT DESIGNED FOR USE WITH A GARBAGE < .r f, T- •-•.. HIS ON S _ .. .. ..'r .. y ...,: '•'�,-•• `y;{•�a.w�, s-:a :i_.,y -..sj }yetis ,_� •r. .r:•Y::. _ ^.?.• - _ ///�-•• �• 9" MIN. r 1 'z,•;:, 'i `il , :':t,�-T i;. '{�•r ,.Y, �:., *`s ':_.•s.,-?'«.•i. r4s�s r,...: w:."'- ,`. • " - - DISPOSAL ....-. 36 MAX. - . . �_. .��,Y . .; - .: � a ;s czr:^; ter.• PROVIDE WATERTIGHT ; �. . �- ,,,,, .._. a.��: ='•�•�' x� •�!'w•�i:�•i: ,�• ,...<� .'i.,'�4u E r' �;,..- .:•� n1 ra�.....><fi.;��:,.;� �`gyp JOINTS (TYP.) r' .w.x•, �..f•a;• - - :•,,.. .,. ��•.�.... ,v...'�'��„�,n�r,-•��-",;. _ �x,:..,'c~: ,.•�r' •�+- ': :.r....•�i. ELEVATIONS BASED N T ,..-•,,.9. „Y ._,; .,ram«-s-,_ x :�. >.,.r• �x. _�_.;. . t 6. 0 HE TOWN OF BARNSTABLE GIS TOPOGRAPHY AND FIELD SURVEY BY LOW FLOW J+. - •. ..;... _�,. 'S`,:it=-`�'•',..•.•.i.•.-;v,+i•. �• :s•, £- •>-,Y''.Y.� •v ..f�r..z. _ ..Avt�J,. £ .,�,-:�. y.;� r: 14» _ O =� • : +f• ��. = '`: HORSLEY WITTEN. `•�%.'T•1�: `:�-a ,:-Tait'-'.%• .�--.. ,µ._'�r...K�; '.?C1.3:-, ',".+i,< •;� 't---' � =;;,�;;.-!??;�'#i, tY': �%t#a,�': r�.,?:F: :':;::ti•..-�;?..`;,?�, '°�;• 15. 15 -, '` =•' "'' 7. CALL DIGSAFE AT LEAST 72 HOURS PRIOR TO COMMENCING CONSTRUCTION AT 1-888-DIG-SAFE to' MIN. 14.90 h= <#- "• •- .' :. ;� -- MINIMUM 2' ,•t � '�. ;.. :5. � ..,::. .,� :� �: .y ��: .,,- s•, 14.73 tires :f.. a ... -.., k.r_,.:,. •* s3.v.c..�,. .._ _.., ^,r.l .. AND ANY OTHER APPLICABLE AGENCIES NECESSARY TO FIELD VERIFY LOCATION OF EXISTING 3 DROP OUTLET TEE r� - s,•,r cslcx, 3. t :• a t<.". w� .. S,M:. _ ...,.'t!.-'1•��..+.=:-•C<n f�'.'k+cts.- .��:^'i; 5?- r.` ^p>'J�LCw .hY•:?: . .,�.`•,t., ,-: l•!ZK� ..w-i ,,-,7 t 22" ZABEL FILTER .x •F ` _ - _�;`• �• ; =:V .,; - _ .4 UTILITIES. •`e `� Y _ =:M._-- ':{ '�.:- _i + f:_ ''. .� -,�t. X i. �,. $Cva ,^Ztv.+.. ......t ��.•�•i-�. •' _L�'�- r•,'Yta -;i: �•^.• •.r-. . _, .�C�.- •.y.•- ;�. �� CONTRACTOR I VERIFY ; MODEL # A18ot - 8. PROVIDE WATERTIGHT SEALS BY USE OF NON-SHRINK GROUT AT ALL POINTS WHERE PIPES ENTER CONDITION OF EXISTING TEE'S HIP (GAS BAFFLE 6" OF 3/4" CRUSHED 4.0' 8.5' (typ) 4.0' 4.0' 4.0' OR LEAVE ANY CONCRETE STRUCTURES. t>_. -- ON BOTTOM) STONE 33.5' 6" of 3/4" CRUSHED STONE (n'P•) 9. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. UNDISTURBED EARTH OR COMPACTED BACKFILL CROSS SECTION VIEW 12.50' GROUND WATER = < ELEV. 7.0' * 12.9' OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 5' MIN. 10• PROVIDE SEPTIC SYSTEM COMPONENTS CAPABLE OF WITHSTANDING H-20 LOADING. EXISTING 1000 GALLON CONCRETE SEPTIC TANK PROVIDE 5 OUTLET DISTRIBUTION BOX INSTALLED ON 3-500 GAL. CHAMBERS CHAMBER END VIEW LEVEL STABLE BASE TYPICAL CHAMBER PROFILE INSTALL FIRST TWO FEET 11. ALL STONE TO BE DOUBLE WASHED AND FREE OF DIRT, DUST AND FINES. OF OUTLET PIPES LEVEL. EXISTING 1000 GALLON SEPTIC TANK PROFILE DISTRIBUTION BOX DETAIL (H-20) CHAMBER DETAILS DETAILS (H-20) * GROUNDWATER ELEVATION RECORDED TO BE ELEV. 6.0'AS PER 12• THE CONTRACTOR IS RESPONSIBLE TO REPORT ANY DISCREPANCIES FOUND IN SITE CONDITIONS NOT-TO-SCALE NOT-TO-SCALE NOT-TO-SCALE TOWN OF BARNSTABLE OBSERVED WATER TABLE CONTOURS FROM THOSE SHOWN ON THE PLAN TO THE DESIGN ENGINEER. 13. THE PROPOSED PROJECT IS LOCATED WITHIN FEMA FLOODZONE C AS SHOWN ON COMMUNITY PANEL / I 1 DESIGN DATA 250001 0008 D DATED JULY 2, 1992. # 34 / X % _ TITLE 5 DE51GN CRITERIA ZONING & RESOURCE PROTECTION NOTES / MAP 246 EXISTING v X STRUCTURE / LOT 238 I ;FLOW FOR 4 BEDROOM DWELLING # 550 _ 1. OWNER OF RECORD: JENNIFER CASSISTA x # 578 I USE: RESIDENTIAL ADDRESS: 576 CRAIGVILLE BEACH ROAD BARNSTABLE, MA 02632 TEST PIT DATA � �' I MAP 246 NUMBER OF BEDROOMS: 4 DESIGN FLOW: I 10 GPD/BEDROOM AGENT: Donald Desmarais (R.S.)(B.O.H) C LOT 36 _ _ TOTAL DAILY FLOW: 440 GPD 2• THERE ARE NO SURFACE WATER SUPPLY OR GRAVEL PACKED WELLS WITHIN 400', NO TUBULAR PUBLIC GARBAGE DISPOSAL: NO WELLS WITHIN 250' AND NO PRIVATE POTABLE WELLS WITHIN 150' OF THE PROPOSED SANITARY SEWAGE EVALUATOR: Justin Lamoureux, E.I.T. r - DISPOSAL SYSTEM. DATE: September 7, 2005 'SEPTIC TANK i �r I 3. SITE IS NOT LOCATED IN A GROUNDWATER OR WELLHEAD PROTECTION OVERLAY DISTRICT. TEST PIT#: 1 `C I r 200% OF TOTAL DAILY FLOW ELEV TOP = 17.0' 1 I 2 X 440 GFD: 660 MIN. 4 I I EXISTING I ,000 GALLON TANK TO REMAIN INSPECTION NOTES ELEV WATER= < 7.0' ^ � I PERC RATE - < 2 Min/In !SOIL ABSORPTION SYSTEM FINAL CONSTRUCTION INSPECTION OF ALL SYSTEM COMPONENTS AND INVERT ELEVATIONS ARE TO BE MAP 246 CONDUCTED BY THE DESIGN ENGINEER AND THE TOWN OF BARNSTABLE BOARD OF HEALTH. DEPTH OF PERC - 32"-47" / � LEACHING SYSTEM USED: TRENCHES LOT 22 . I SOIL CLASS: I SAND LEGEND TEXTURAL CLASS: 1 i / I FIELD PERCOLATION RATE: <2 MIN./IN. LONG TERM ACCEPTANCE RATE(LTAR): 0.74 GPD/S.F. EXISTING LEACHING PIT TO BE S87.44'42"W EXISTING TP1 0 17.0' PUMPED, FILLED WITH CLEAN 'j I TOTAL AREA REQUIRED - LOCAL CODE: 595 S.F. SAND AND ABANDONED / 1� 104.97 STRUCTURE SEPPIC TANK O O Sand Loam I TOTAL AREA REQUIRED-TITLE 5: 595 S.F. I � SOIL TEST PIT A/O 1OYR 4/1 / \ MAP 246 �- - TOTAL AREA PROPOSED: LEACHING CHAMBER (H-20) TREE LINE '��.- 16.8' TP1 I L❑T 221 �, - - -X-X-X-X-X "D" BOX (H-20) ❑ FENCE LINE -X-X-X-X-X-X- 2° s r F'DFIA'AIL C4PACITY M ENGTH WIDTH)(2) (HEIGHT))= 185.G S.F. N 17 0 I AREA = 16, 424 SQ. FT. ± N BOTTOM CAPACITY(LENGTH x WIDTH): 432.2 S.F. EDGE OF PAVEMENT Sandy Loam N © EXISTING CONTOUR 95 B 1OYR 5/6 EXISTING OUTLET TO BE o �� I EXISTING TOTAL CAPACITY(SIDEWALL + BOTTOM): G 1 7.6 S.F. PLUGGED AND WATER TIGHT 0° TOTAL ALLowABLE FLow: 457 GPD EXISTING STRUCTURE 30 14.5 TP2 MINIMUM DESIGN FLOW: 440 GPD 32" 14.3' I 1 �- Loamy Sand EXISTING 1000-GALLON 18.0 GARAGE BM : Perc C-1 >-� 10YR 5/6 SEPTIC TANK I ' 15.0� t - EXISTING I U5E 3-500 GALLON LEACHING CHAMBERS W/ 4' STONE 3' f 33 5 NAIL IN PAVEMENT ia-�` / 40" = 8 - - 13.T - Y; STRUCTURE f 47" ""`' 13.1' - o � (ASSUMED) -- � �� •'. � , )`• . , �- ,, . J �_�y Loamy Sand o o :�. TREE I C-2 10YR 6/6 - 4_jY=, SCHEDULE OF ELEVATIONS ,. ✓ -- �_ o - --- Ghld�b� 51 12.s I o �� - - - SQ8EDULE OE.ELEVA IONS Gr Loamy Sand •• • j.' � C-3 1 OYR 7/6 a v \ r I E_L. Run SI ?::+ 'y 1, � �` • • '• �, j 12 MAP 246 I ••: 69 11.3 TREE w SEPTIC TANK-INLET - ':" • • 3� '••• a I~.'• •°A 'r �' ` C-4 Loamy Sand LOT 35 SEPTIC TANK-OUTLET 15.15 j +•' �,�1 A 'r• C'', , 1OYR 8/2 L� I Q / 12.5 2.00% • �� ' v I "D"BOX-INLET 14.90120" - / D BOX-OUTLET 14.73 i a ~� EXISTING / _ 19.5 1.20% -a_ "�'�" ,.°��'." , '• ' , . t `� PROPOSED 3-500 GALLON _ i - ,STRUCTURE 1 LEACH CHAMBER-INLET 14.50 TEST PIT DATA LEACHING CHAMBERS (H-20) _ - -\ , LEACH CHAMBER-BOTTOM 12.50L' r QQ EXISTING BREAK OUT 15.00 - ,;' � `�fira► * -, AGENT: Donald Desmarais(R.S.)(B.O.H) �,, o STRUCTURE PROPOSED D BOX (H-20) TOP OF SAS 15.50 ! � , EVALUATOR: Justin Lamoureux, E.I.T. I 1 cc- w I G.W. SEPARATION 5.50-_ _ •` �` '. 1 DATE: September 7, 2005 - is I # 576 1 � ES"Gw• ' - '°° - LOCUS PLAN TEST PIT#: 2 MAP 246 �; _ ELEV TOP = 18.0' LOT 223 EXISTING X X X X- _ - - r - - y 4-BEDROOM SCALE: 1"=2000' � DWELLING � ELEV WATER= < 8.0' 1 �•' - -- - - I VARIANCES PERC RATE _ < 2 Min/In _ LocaicoDE_wan�ERs _^-- 576 CRAIGVILLE BEACH ROAD SEWAGE DEPTH OF PERC = 44"-59" �t ��, I I / __ Iv - - REGULATION-- ------ REQUIRED PROPOSED- TEXTURAL CLASS: 1 - _ ,ONE _;_--- - DISPOSAL SYSTEM REPAIR 0 18.0' I \ UP I _ - LOCAL UPGRADE PROVISIONS OWNER: ' \ £N82.31 2 E _ _ - JENNIFER CASSISTA / , _ _�-- REGULATION REQUIRED PROPOSED 576 CRAIGVILLE BEACH ROAD A/O Sandy 10YR 4/1m / ' �.� 98.92 • BARNSTABLE, MASSACHUSETTS / - NONE MASS. DEP VARIANCES OF PAVEMENT BEACH ROAD _ __- - --- 17.8' - 2' 1 UP EDGE gE REGULATION ----_ ---REQUIRED PROPOSED I - CRAIGVILLE - _ � =X --- - - Sandy Loam I - - - X` __ _. _ _ __ -_-- NONE SCALE 1 " = 20 ' B 1OYR 5/6 CATCH i X X-..� _ - BASIN �� -X X DATE: OCTOBER 6, 2005 24" 16.0' � _ _ -- _ - --� , � � REVISIONS o 10 20 40 so so PREPARED BY: Loamy Sand / - �I \ NO. DATE BY APPR. DESCRIPTION C-1 - Horsley Witten Group 10YR 5/6 36" 15.0' � Sustainable Environmental Solutions 44" 14.3' - - �,. 90 Route 6A �. Perc C_2 Loamy Sand 1 Sandwich, MA 02563 .� 10YR 7/4 phone: 508.833.6600 59" ""�` 13.1' SITE PLAN 120" 8.0' fax: 508.833.3150 SCALE: 1" = 20' Drawn By: JL Designed By: JL Checked By: FPL Date: OCT. 6, 2005 JOB No. 917