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HomeMy WebLinkAbout0026 DEEPWOOD CIRCLE - Health 26 Deepwood Circle Centervil A = 169-013-005 x i No. 42101/3 ORA ESSELTE 10% C O 0 0 No. 00 392, Fee /0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 21ppliCotion for �Bigozat *pgtem Cow5truction Permit Application for a Permit to Construct( ) Repair(Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location"AAddress or Lot No./� / �C,✓rtQt A.,,r le Owner's Name,Address,and Tel.No. Assessor's Map/Parcel t!6 3�� Installer's Name,Address,and el.No. Designer's Name,Address and Tel.No. � Av, ?_Jos�' Ag e (L Ji' It/ A 15i ee_ Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3 ( 'e �JJ gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank C T , > d Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when app�ie) G 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 of alth. Sign Date 3 e Application Approved bM- 11IRA Date Application Disapproved by: Date for the'following reasons Permit No. Date Issued No. 00 792— Fee f V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION•- TOWN OF BARNSTABLE, MASSACHUSETTS Yes �•.w__ Zipplita ion for aigonl �§pgtem CoHgtructioH Permit s Application for a Permit to Construct O Repair(-Ir Upgrade O Abandon O ❑ Complete System ❑Individual Components Location Address or Lot No <7�n/TE62 Ael ale Owner's Name,Address,and Tel.No.. Assessor's Map/Parcel �/ 3� �I C/05 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No of Bedrooms �' Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided , %•�� gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 6 Type of S.A.S. Description of Soil ---> Nature of Repairs or Alterations(Answer when ap�ab'e') Date last inspected: Agreement: ` 4. The undersigned agrees to ensure the`constrtiction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this.Board of Health. Signed .> 1 /! T :t Date �/3,4 Application Approved by 1 } ;k\ %�J\ Date Application Disapproved by: _ Date" for the following reasons /l Permit No:'07 Date Issued J U 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 ��-- c '`f _ at � `' U O Cr ( j 2 c has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.2'rya — dated C1 Installer �� Designer l/i �7 G �✓ / J, -�' #bedrooms .S Approved des'gn, ow A _ gpd' A / ', 1 �, / 0 -� The issuance of this pe tttsh 11 n t,b�e�confstrued as a guarantee that the system will func7­111tionn as deesig ed. Date (J �c,� �/ Inspector A7 ———No. ��t/ 4Fee / 6 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS X06t$poot 44pgtem Con6truction Permit Permission is hereby granted to Construct ( ) Repair (/)-' Upgrade ( ) Abandon ( ) System located at tS /� �=/3 a-p O� l , a.G jA Q J f a(, ',--j 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 this;/prerrinitCY A,/ Date "! ��II(��" Approved by I ( ; . I// Town of Barnstable °AWE' Regulatory Services Thomas F. Geiler, Director RARMABEZ KAS& ° Public Health Division ' Thomas NIcKean, Director 200 Main Street,Hyannis, MA 02601 Office: 5087862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: '7 Sewage Permit# .too Assessor's Map\Parcel Designer: ' re �fc installer: S/GL L/7 �r✓ S j Address: R Qy q� Address: 02537 On of'o-„.1 -<,— was issued a permit to install a (da e) (installer) septic system at �� � py�yy 0 C!��L,C— based on a design drawn. by 'A � (address) (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 abode was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or anv vertical relocation of any component of the septic system) but in accordance with _Mate & Local Regulations. Plan revision or certified as-built by deli er to follow. OF �AsV DARR ME R (In ler's Signatur No. 1140 S1ER�� '] SOIT00 . I 'L • O I lD (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF � CONIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS F0101 AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION THANK YOU Q:Health/Septic/Designer Certification Form 3-M-0 !doc TOWN OF BARNSTABLE LOCATION A4'6�' Ac L �lwx�r� �/Le i� SEWAGE#' po-) � VILLAGE ;'/h ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO.4&cN ro.-.s T 37 OR 7`, ei SEPTIC TANK CAPACITY eX o s' i /ta a b LEACHING FACILITY:(type)_3 3 t O Tvr'"-i f raeS (size)2 X' 1.2- X J, NO.OF BEDROOMS OWNER 44cL144.4 eWF A,. PERMIT DATE: 421S/O^7) COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist , on site or within 200 feet of leaching facility) Feet "Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility). Feet FURNISHED BY f4 0 = 3,2,9 o 33 Town of Barnstable o Regulatory Services , AB . ' Thomas F. Geiler,Director 1639. •0� Public Health Division rF0 MP'�A Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 June 18, 2007 Deepwood Realty Trust c/o Nancy Galioto 22 Deepwood Circle Centerville, MA 02632 Re: 26 Deepwood Circle ORDER TO COMPLY WITH STATE ENVIROMENTAL CODE, TITLE 5 The septic system located at 26 Deepwood Circle, Centerville,MA was last inspected on May 23rd,2007 by Joseph M. Martins a certified inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: System is in hydraulic failure You have 60 days from the date of the system failure to bring the system into compliance. If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. B STABLE HEALTH DEPARTMENT Thomas A. McKean, R.S., C.H.O. Agent of the Board`of Health � 0�� / 17 i Town of Barnstable P# �TIM - � Department of Regulatory Services • Health Division Date r,►�t$, - ' -Public I , — tb3y ems$ 200 Main Street;,Hyannis MA 02601 �lFD RM'(�' ?. �• . . 471J;Oe Date Scheduled 0- 'Time Fee Pd. ,foil Suitability Assessment for Sewage Disposal Performed Witnessed By: �Q6� N ►� LOCATION & GENOAL INFORMATION Location Address Owner's Name g 8 f O(AJ&14 S C .�&4 V i le " p C� Address 1 Assessor's Map/Pntcel: i VL f () 1�j (�0 Engineer's Name {I re !"► t t'YP`1Q NEW CON(SMU(�!"ION,i REPAIR elephone# Land Use 1`—�'I�PN I�lu I Slopes Surface Stones �� Distances from: Open Water Body 100+ ft Possible Wet Area Vl p+ ft Drinking Water Well �� + ft C, l F ft Drainage Way JD � ft property Line ft Other SKETCH:($treet name,dimensions of lot,exact locations of i;ct holes&perc tests,locate wetlands in proximity to holes) , a pW W6 1 J= o 1 \ F ` \ Imo.- : • Parent material(geologic) �9G a O Vf Wg5h Depth to Bedfock ' Y F( �" 1: Mile Depth to Groundwater. Standing Water in Hole: O.h e_ - : 'i Weeping from Pit Face Estimated Seasonal i Ogh Groundwater 12 F DtTFRMINATION FOR SEASONAL HIGH WATER TADLE Method Used: (i ri�' I: VtOne i_ 14+ Depth observed standing in obs.hole: _In. Depth td 5011 mottles: In. h s�Depth toiweeping from side of obs.hole: 1 ' in, Groundwater Adjustment__-- f11 t- index Well# Reading Date Index Well Level �.4..�. Adj.fAetor,,,,, Adj.0roundwater Level.— � I. PIERCOLATION.TESL' Date e�?1 IP7 TIMr l LLD Observation TWO lit 9" L(.7,_. .....__-.— Nole# i Depth of Perc Time at b" .....�.--- Start Pre-soak Time. i V^ 7 _ I• Time(91'41 L:L� ---------- End Pre-soak Rate MinJinch Additional Testing Needed,Y/N) yv Site Suitability Asscssment: Site Passed Site Failed- f t _ Original:.Public Halth Division Observation Hole Data To Be Completed on Back-------- I`..' ***If percolaOn testis to be conducted within 100' of wetland,-you must first notify the Barnstable Noservation Division at least one(1)week prior to beginning. t y DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soit•Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ^ �L Consistenc %Gravel LCC-40 Q toots .SWO icy 'i2 S/e dne FV A-BL; DEEP OBSERVATION HOLE;LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Cons;sten^ a Gravel) �v : "�`( SgWD 10 YZ 3/2 ►� V gLC -3 0 FPl R-Bc Z DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsistenc %Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. nsist n I .t Flood Insurance Rate Man: Above 500 year flood boundary No— Yes v_— Within 500 year boundary No Yes �J Within 100 year flood boundary No Yes Death of Naturally Occurring Pervious Material ` 1 Does at least four feet of naturally occurring pervious material exist.in all areas observed throughout the _..J area proposed for the soil absorption system? 'V If not,what is the depth of naturally occurring pervious material? Certification 1 certify that on «� (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consist . the required training,expertise and experience described in a10 CMR 15.017. ��0 M�Ssq �o DAVID cyG� Signature �J�'" G �—� E 4461 Date �Vj 2'2, I gicj� U D. COUGHANOWR cn �O 410ENSE� Q_ •Q:4SEPT1CIPERCFORM.DOCPSG Town of Barnstable CF tNE 1p� , tio* Regulatory Services BAMSfABLE. Thomas F. Geiler,Director 9�A MASS. •�� Public Health Division rFD MA'S A Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 June 18, 2007 Deepwood Realty Trust c/o Nancy Galioto 22 Deepwood Circle Centerville,MA 02632 Re: 26 Deepwood Circle ORDER TO COMPLY WITH STATE ENVIROMENTAL CODE, TITLE 5 The septic system located at 26 Deepwood Circle, Centerville,MA was last inspected on May 23'd, 2007 by Joseph M. Martins a certified inspector for the State of Massachusetts. The inspection of the septic system showed that the system"Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: System is in hydraulic failure You have 60 days from the date of the system failure to bring the system into compliance. 0 If there are any questions about this reminder,please feel free to contact the Barnstable Health Department. BAF,NSTABLE HEALTH DEPARTMENT Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health r COMMONWEALTH OF MASSACHUSETTS G- EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: Dee W aa-4 lie (� Owner's Name: pZ beopa')d,)a kar 7/ vjI7 � Owners Address: C V /va# It O 7'D 2 2- Date of Inspection: � � 1�(� 02-&.3.Z .old,3/0®O 7 Name of Inspector:(please print) Joseph M.Martins Company Name: Accu Sepcheck Mailing Address: 17 Northside Dr., S.Dennis,MA 02660 Telephone Number: 508-385-5891 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper fimetion and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15340 of Title 5(310 CMR 15.000� The system: Passes Conditionally Passes Needs F Evaluation by the Local Approving) uthorit`y Fails - Inspector's Signature: Date: - �`" tIt _J s The system inspector shall submit a copy of this inspection report to the Approving Author +(Board o Iealt-or DEP)within 30 days of completing this inspection.If the system is a shared system or has d'd ign floAf 1000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate r 'on al ofte ofige DEP.The original should be sent to the system owner and copies sent to the buyer,if applicab e,and d"ppr(Mng authority. Notes and Comments: 41,A, 9 le / /^ A:w4 a l 7— L � " W //Igo Z-7, v) ****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. Page 2 of 11 OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 26 Deepwood Circle,Centerville,MA Owner: 26 Deepwood Realty Trust Date of Inspection: 5/23/2007 Inspection Summary: Check A,%C,D or E/ALWAYS complete an of Section D A. System Passes: I have not found any information wh' indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. ilure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the_^'for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally d,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is av e. ND explain: Observation of sewage or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a en,settled or uneven distribution box. System will pass inspection if(with approval of Board of Hea broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: Page 3 of I 1 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 26 Deepwood Circle,Centerville,MA 26 Deepwood Realty Trust Owner: 5/23/2007 Date of Inspection• 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 de mes in accordance with 310 CMR 15.303(l)(b)that the system is not functioning in a manner ch will protect public health,safety and the environment: Cesspool or privy is with feet of a surface water — Cesspool or privy is in 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has 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 1 100 feet but 50 feet or more from a private water supply well".Method used to determ- istance "This system passes if the well water is,performed at a DEP certified laboratory,for coliform bacteria and volatile organic comp indicates that the well is free from pollution from that facility and the presence of ammonia nitr and nitrate nitrogen is equal to or less than S ppm,provided that no other failure criteria are tri A copy of the analysis must be attached to this form. 3. Other. Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY FORM ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM PART A CERTIFICATION(continued) Address: 26 Deepwood Circle,Centerville,MA Property26 Deepwood Realty Trust Owner: 5/23/2007 Date of Inspection• D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ _L"' 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'/z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _ ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia- nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria ( are triggered.A copy of the analysis must be attached to this form.] S (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what wiU 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 You must indicate either"yes"or"no;"to each of the following: (The following criteria apply to large systems in addition to the criteria a ve) yes no — _ the system is within 400 feet of a surfs g water supply the system is within 200 f a tributary to a surface drinking water supply _ the system is I in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone H of lic water supply well Ifyou have Bred"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in S 'on 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. Page 5 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 26 Deepwood Circle,Centerville, MA 26 Deepwood Realty Trust Owner:Date of Inspection: 5/23/2007 Check if the following have been done.You mast 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 /nG fi_ ✓ Were all system components,a tg 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 Systems(SAS)on the site has been determined based on: Yes no Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)J Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 26 Deepwood Circle,Centerville, MA 26 Deepwood Realty Trust Owner:Date of Inspection: FLOW CONDITIONS 5/23/2007 RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no) Is laundry on a separate sewage system(yes or no):0 0 [if yes separate inspection required] Laundry system inspected(yes or no):_LV �,�� ( � 2 600 Seasonal use: (yes or no): A)v ��SP f 1(5,00 Water meter readings,if available past 2 years usage(gpd)): Sump pump(yes or no):LV0 ,J 3 6 Last date of occupancy:�T COMMERCIAIJINDUSTRIAL Type of establishment: Design flow(based on 310 CUR 15.203): �pd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no ._ Non-sanitary waste discharged to the system(yes or no): Water meter readings,if ava' Last date of occu OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): IV v 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 —ivy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach a copy of the DEP approval —Other(describe): Approximate a of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): o Page 7 of i l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT'S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 26 Deepwood Circle,Centerville, MA Owner: 26 Deepwood Realty Trust Date of Inspection: 5/23/2007 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron _40 PVC__other(explain): Distance from private water supply well or suction line: _ Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:V (local on site plan) Depth below grade: 2 Material of construction: ✓concrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: `111 D X Y12 Sludge depth: off / Distance from top of sludgef to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle:_ 0 Distance from bottom of scum to bottom of outlet tee baffle- How � How were dimensions determined: ra G1�` Comments(on pumping recommendations,inlet and outlet tee or baffle coridition,structural. tegrity, liquid levels as related to outlet invert,evidence of 1-1—age,etc.): GREASE TRAP: (locate on site plan) ' I Depth below grade:— Material of construction:_concrete_metal_fiberglass polyethylene other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or e: Distance from bottom of scum to bottom utlet tee or baffle: Date of last pumping: Comments(on pumping r endations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet m' evidence of leakage,etc.): "1 i Page 8 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAIL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 26 Deepwood Circle,Centerville,MA Owner: 26.Deepwood Realty Trust Date of Inspection: 5/23/2007 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: lions Design Flow: allonsiday Alarm present Nwor no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:eln 11p2 J 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 or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumjps-an p urtenances,etc.): i Page 9ofII OFFICIAL INSPECTION FORD-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL, SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: 26 Deep-wood Circle,Centerville, MA Date of Inspection: 26 Deepwood Realty Trust 5/23/2007 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type ( � !�(o ati1 2 � �� �leaching pits,number:_ leaching chambers,number: leaching galleries;number: leaching trenches,number,length: /��® leaching fields,number,dimensions: f 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.): / /zvrl-) leq(- p,7' '12 .s" "o✓/vim &7/' Pj Vi f,SIt �. 4,4-0 Z,�%,OjY A� eve/ sepa 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 s or no): T Comments(note condition oil,signs of hydraulic£2ilure, level.of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition i , signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 4 x Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 26 Deepwood Circle,Centerville, MA Owner: 26 Deepwood Realty Trust Date of Inspection: 5/23/2007 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Ir✓ z ' 3 S2- z- A3 ::-3 �f ® ��� 4 `4 Page 11 of 11 • OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: 26 Deepwood Circle, Centerville, MA Date of Inspection: 26 Deepwood Realty Trust 5/23/2007 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water J Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain:__ Checked with local excavators,installers-(attach documentation I/ Accessed USGS database-explain: 4r.-A G1 You must describe how you established the high ground water elevation: . brad, &-,cs4r4w, at�.'- j)ZA"d � w (A cevle,�ho,- ` 341 t 1 CERTIFIED SEPTIC SYSTEM REPORT q -7 30 LOCATION 26 DEEPWOOD CIRCLE CENTERVILLE, MA MAP 169 PARCEL 013 . 005 LOT 5 PREPARED FOR SELLER 9 d0 MR. & MRS . DAVID O 'KELLY n rJ 26 DEEPWOOD CIRCLE RECIEIVE CENTERVILLE, MA 02632 7 N to AUG 1997 TOWN OF BARNSTABLE HEALTH DEPT. ,` BUYER s ti MR . JAMES S . OWENS E 3 MONITOR RD . POUGHKEEPSIE , NY 12603 gq PREPARED BY HILLIARD HILLER P .O . BOX 250 CENTERVILLE, MA 02632 508-778-1472 COMMONWEALTH OF MASSACHUSETTS rd REcEovF' EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAI AUG 7 1997 'yf � b DEPARTMENT OF ENVIRONMENTAL PROTEC N TOWN OFBARNSTABI-I ` ONE 'AINTER STREET. BOSTON''. NiA 02108 61 ]9?•5�00 HEALTH nrP- � ti WILLIANI F WELD Y CO)I Gov c rno: S c c rc tarp ARGEO PAUL CELLUCCI DAVID B STRU}6 Lt.Govcrnor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioncr PART A CERTIFICATION �lv �LL'ipLc�GY�A u2GG.r' Property Address: G k�Iit""/lv�GL/` Address of Owner: Date of Inspection: ��Js � �� (If different) Name of Inspector: 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: _ Mailing Address: AU /��X' �S G G47,41/22!s/G6C Telephone Number: 5-eP - 7Z& CERTIFICATION STATEMENT I ceriify that I have personally inspected the sewage disposal system at this address and (hat 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: _ Passes _Ag!f-Condrtionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fraud s Inspector's Signature: f� Date: 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, 8, C, or D: A) SYSTEM PASSES: I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303 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. indicate 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 nspeason. a the septic tank, whether of not metal, is cracked, structurally unsound, shows substantial infiltration or ex(iliration, 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. (rwis•d 04/25/97) Day• 1 of 10 DEP on true Wono Woe Weo nttp rrwww magnet state ma usvoeo 0 Pnnteo on Recycied Pacer SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: �� DC�P(�.-�p� G//dGGC G ,'�' /l41rLG�r Owner: !>r� O/>'!/iQ O�`�LGy Date of Inspection: s77�92 BJ 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 L` distribution box is levelled or eplaced ZA";r4ivG The system required p mping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with ap royal of the Board of Health): br ken pipe(s) are replaced o struction is removed C) FURTHER EVALUATION IS REQ RED BY THE BOARD OF HEALTH: Conditions exist which requ re further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and th environment. 1) SYSTEM WILL PASS UNL ' S BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT HE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or pri is within 50 feet of a surface water Cesspool or pri is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UN ESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUN IONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system as a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to surface water supply. The system as a septic tank and soil absorption system and the SAS is within a Zone I of a public water supo'v 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 syste has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private wa er supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates thx the well i free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than ppm. Method used to determine distance (approximation not valid). 3) OTHER (revised 04/25/97) Pag• 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 26 OE'�rJC..iWp G//ZGG.E' GL,�J� /GG Owner: /"/-, Date of Inspection: �/as>E a7/9 D) SYSTEM FAILS: You must indicate either "Yes" or "No" as to each,of the following: I have determined that the system violas s one or more of the following failure criteria as defined in 310 CMR 15.303. The bans for this determination is identified belo . The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facili or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of effl ent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Static liquid level in the di ribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool i less than 6" below invert or available volume is less than 1/2 day floes Required pumping more t an 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumpe Any ponion of the Soil sorption System, cesspool or privy is below the high groundwater elevation. Any ponion of a cesspo I or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any ponion of a cessp I or privy is within a Zone I of a public well. Any portion of a cessp of or privy is within 50 feet of a private water supply well. Any portion of a cess of or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water qual ry analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, vol the organic compounds, ammonia nitrogen and nitrate nitrogen. Ej LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply t large systems in addition to the criteria above: The system serves a facility ith 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 wit n 400 feet of a surface drinking water supply the system is wit in 200 feet of a tributary to a surface drinking water supply the system is I ted in a nitrogen sensitive area (Interim Wellhead Protection Area - IWPA) or a mapped Zone II of a public water su ply well) The owner or operator of any suc system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 a 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: oP(; ���P'01�-r.��/] G//IG G Grp G�,vj�j��s/GL�" Owner: /+�/fy DAv//, O'`�GG Y Date of Inspection: 612 5- Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No _ 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. i� _ 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 Pan C is at issue, approximation of distance is unacceptable) (15.302(3)(b)) (revised 04/25/97) Page 4 of 10 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:Owner: Date of Inspection: FLOW CONDITIONS RESIDENTIAL: Design flow: 330 R.p.d./bedroom for S.A.S. Number of bedrooms:-_ Number of current residents: Garbage gander (yes or no):_�c�;' Laundry connected to system (yes or no):y�S Seasonal use (yes or no): Nd Water meter readings, if available (last two (2) year usage (gpd): Sump Pump (yes or no):,,w Last date of occupancy COMMERCIAUI DUSTRIAL: Type of establisF ment: Design flow: allons/day Grease trap pre ent: (yes or no)_ Industrial Wast Holding Tank present: (yes or no)_ Non-sanitary aste discharged to the Title 5 system: (yes or no)_ Water meter r adings, if available: Last date of ccupancy: OTHER: (D scribe) Last date of occupancy. GENERAL INFORMATION PUMPING RECORDS and source of information: System pumped as part of inspection: (yes or no)_ If yes, volume pumped: Qallons Reason for pumping TYPE OF SYSTEM t/ 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) VA Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: aG '0'e4 2e"4VO Owner: 47/h 11/�v/p O�/��G�Y ��'�rCl/L!✓/GGFz Date of Inspection: BUILDINGS JE R: (Locate on site Ian) Depth below de: Material of co struction: _cast iron _40 PVC _ other (explain) Distance from private water supply well or suction lir•t Diameter Comments: ( ndition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: (locate on site plan) Depth below grader Material of construction: _L concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance —(Yes/No) Dimensions: �/�1lz �d' ���� �3/I Sludge depth:_ Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: %1i Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bosom of outlet tee or banle:—./L How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) ;'AfS r,17. r'//yb G✓.9 S /=/LG�./� �✓/T/.+� l��rlit Avg /QL c/�.rG��'� � .Ca�9YS L�9�, ?bV W.AeC 5 44rs ,V 494 ,A,0 RiSLr�rs GREASE TRA (locate on sit plan) Depth belo grade: Material of onstruction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimension . Scum thick ess Distance f m top of scum to top of outlet tee or baffle: Distance f om bottom of scum to bottom of outlet tee or baffle: Date of I t pumping: Commen (recomm ndation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity 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: Owner: /s/� Date of Inspection: TIGHT OR HOLDING ANK: (Tank must be pumped prior to, or at time, of inspection) (locate on site plan) Depth below grade: Material of construc n _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimensions: Capacity: gallons Design flow: gallons/da� Alarm level. Alarm in working order _ Yes; _ No Date of previou pumping Comments: (condition of i let tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: y (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) ,liter SoG�oS S' '!Fz-9 Tidy/ /-�l�i /L �h/d ';(� ' /'aX Gr�9S L� /,��-i�� i NL O ` /5 o� /=/G L— 5 7/cif lleyl-/.r/, PUMP CH BER:_ (locate on si a plan) Pumps in orking order: (Yes or No) Alarms in orking order (Yes or No) Comment : (note co ition 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: VC 174C�7ldCYJO Owner: /'lA" 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 failure, level of ponding, condition of vegetation, etc.) tdiy c CESSPOOLS: (locate on site pl n) Number and co figuration: Depth-top of liq id to inlet invert: Depth of solids yer: Depth of scum I yer: Dimensions of sspool: Materials of con truction:. Indication of gr undwater: inflow (cesspool must be pumped as part of inspection) 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 soli s: Comments: (note concliticii of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (—iced 04 1 25/97) Page B of 10 Il SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION„(continued) PropeOwner: Add l9/9v� �'�Lvc-XJ.O G//1L G,C G,!' j'�/jC.✓GG/� Date of Inspection: 7 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) t , o t I (revised 04/25/97) Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: aG q�p�wpo p CiiZGG/ Owner: ""A', Or9liiQ p"K�GG y Date of Inspection: Depth to Groundwater J, Feel Please indicate all the methods used to determine High Groundwater Elevation: --*'—Obtained from Design Plans on record 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 Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. Must be completed) ,r3 gR vsr /L GAS si ,,z.�s Tk� S 1 r& THa O 1� --'!IT.4Z,,V (revised 04/25/97) Page 10 of 10 1 No. r tl� / v Fee 50.00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for Mi.5pogar *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 26 Deepwood Circle Owner's Name,Address and Tel.No. e y Center�ri le Mass. 02632 26 Deepwood Circle Assessors ap arcel Centerville,Mass. 02632 Installer's Name,Address,and Tel.No. 508-775-3338 Designer's Name,Address and Tel.No.508-775-3338 J.P.Macottlber & Son Inc. J.P.Macomber & Son Inc. Lox 66 Centerville Mass. 02632 Box 66 CEnterville,Mass. 02632 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow 3x110 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Cprnentp 1 weep hale in the septic- tank 12" scniare cnncrpte 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 d not to place the system in operation until a Certifi- cate of Compliance has been issup by this Yo of lth. 8/19/97 Signed Date Application Approved by a Date Application Disapprove or the following reasona__��____ Permit No. Date Issued .i ./ 50.00 NO. i r� .. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1 ,a Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS 0(pprication for ;Digogar *pgtem Con!5truction Permit i Application for a Permit to Construct( )Repair P)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components , Location Address or Lot No. 26 Deepwood Circle Owner's Name,Address and Tel.No. Centerville Mass. 02632 26 Deepwood Circle Assessor's Map/Parcef Centerville,Mass. 02632 Installer's Name,Address,and Tel.No. 508-775-3338 Designer's Name,Address and Tel.No.508-775-3338 J.P.Macdmber & Son Inc. J.P.Maoomber & Son Inc. Boc 66 CEnterville,Mass. 02632 Box 66 Centerville,Mass. 02632 , Type of Building: ` Dwellings No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( ) ' Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Desin Flow 330 gallons per day. Calculated daily flow 3x110 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank t Type of S.A.S. Description of Soil •e - Nature of Repairs or Alterations(Answer when applicable) Cemented weep hole in the septic tank. 12" square concrete 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 d not to place the system in operation until a Certifi- cate of Compliance has been issu d by this o}lo lth. 8/19/97 „w Signe A Date Application Approved by Date Application Disapproved or the following reason Permit No. � 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 J.P J comber & Son Inc. at 26 Deepwood Circle Centerville,Mass, been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. `r ated Installer Designer The issuance of this pe al b nstrued as a guarantee that the systetw il ti as esi a. Date Inspector .. 2­0—————————————————————————————— No. Fee THE'COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 1wigw6al *p.5tem Con.5truction Permit Permission is hereby granted to Construct( )Repairer Upgrade( )Abandon( ) System located at 26 DEF,P MD CIRCLE CE=VILLE,MASS. and as described in the above Application for Disposal System Construction Permit.The applicant rec gnizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Con c o u pleted within three years of the date o Date: Approved by �. Z 203 498 826 us Postal Service '-Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail See reverse Sent to � Street&Num r Po ce, P Postage Certified Fee Special Delivery Fee Restricted Delivery Fee LO Return Receipt Showing to Whom&Date Delivered a Return Receipt Showing to Whom, Q Date,&Addressee's Address 0 TOTAL Postage&Fees rh Postmark or Date U_ rn n. I Stick postage stamps to article to cover First-Class postage,certified mail fee,and charges for any selected optional services(See front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached, and present the article at a post office service y window or hand it to your rural carrier(no extra charge). 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the a�i return address of the article,date,detach,and retain the receipt,and mail the article. LO 3. If you want a return receipt,write the certified mail number and your name and address rn on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends it space permits. Otherwise,affix to back of article. Endorse front of article a RETURN RECEIPT REQUESTED adjacent to the number. Q 4. If you want delivery restricted to the addressee, or to an authorized agent of the addressee,endorse RESTRICTED DELIVERY on the front of the article. Goo M 5. Enter fees for the services requested in the appropriate spaces on the front of this E receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. o LL 6. Save this receipt and present it if you make an inquiry. 102595-e7-8-0145 a I ' I r.l 1HE Town of Barnstable t � a�►xtasreat.E, Department of Health,Safety, and Environmental Services , ' Public Health Division P.O. Box 534, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health April 6, 1998 David and Laura O'Kelly 26 Deepwood Circle Centerville,MA 02632 ORDER TO COMPLY WITH 310 CMR 15.00,THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at 26 Deepwood Circle, Centerville was inspected on August 1, 1997 by Hilliard Hiller,a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00)due to the following: • The distribution box was leaking wastewater effluent. You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office(Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code,Title 5 within thirty(30)days of receipt of this notice. You are also directed to bring the septic system into compliance within sixty(60)days of receipt of this order letter. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground,or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF T E BOARD OF HEALTH T McKean,R.S., C.H.O. Agent of the Board of Health q\health\dbfiles\title5 i.doc , .�"E' ►,� Town of Barnstable Department of Health, Safety, and Environmental Services r BARNBTABM s Public Health Division 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health TO: �� �-cc Ua � rc DATE: ✓�1'�/ 3/ l4 ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at'Z60 was inspected on by , a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines f 1995 TITLE 5 (310 CMR 15.00) due to the following: I CQ,sue 6A )41 1-zx K)E,-s You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within ( days of receipt of this notice. 4V-�Sqv You are also directed to bring the septic system into compliance within days of receipt of this order letter. S� Pf You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health g16ta1th\6H1aVide5L&c PAR Real Estate System - General Property Inquiry Help Parcel Id: 169 013-005- Account No: 352282 Parent: 94800 Locationt 26 DEEPWOOD CIRCLE CENT Neighborhood: 37AC Fire Dist: CO Devel Lot: 5 Lot Size: . 35 Acres Current Own: OKELLY, DAVID rl & LAURA R State Class: 101 26 DEEPWOOD CIRCLE No. Bldgs: I Area: 1872 Year Added: 86 CENTERVILLE MA 2632 Deed Date: 120195 Reference: 9977/168 January 1st: OKELLY, DAVID M & LAURA R Deed MMDD: 1295 Deed Ref: 9977/168 Comments: Values: Land: 27200 Buildings: 94300 Extra Features: Road System: 26 Index: 1976 ( DEEPWOOD CIRCLE ) Frntg: Index: ) Frntg: Control Infai Last Auto Upd: 052596 Status: C Last TACS Update: 051696 Land Reviewed By: Date: 0000 Bldgs Reviewed By: ME Date: 0593 Tax Title: Account: Taken' Account Status: Hold Status: Cancel Press XMT for more data Next screen PAR Action Owners Name Road Index Road Name Parcel Number 169 013 006 001!� Ae� - -t � I — 01S 4 L� —.,, � 7 THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ................ ----- --.�OL0.4.......OF.... fN1'T�..1+5;Z. .��----------------------------------- Appliration for Bi4pooFai Workii Tons#rnrtion ramit Application is hereby made for a Permit to Construct (✓) or Repair ( ) an Individual Sewage Disposal System at • ......... - ?'!°-. © C12 1,E=.fJT ___�.....................................•-- ------- L at', n-Add,E_& � or Lot No. ... .............................................. ............................. ----•---.....-•---••---..............................--- w ner Address a -------------- Installer Address Type of Building Size Lot.....1.._.t................Sq. feet Dwelling—No. of Bedrooms---..........��..............................Expansion Attic ( ) Garbage Grinder WO) p., Other—Type of Building No. of persons............................ Showers ( ) — Cafeteria ( ) 9' Other fixtures ---------------------------------- W Design Flow........................J am................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...------�----..-eiameter......-8-..------- Depth below inlet............... Total leaching area....:Z®e..sq. ft. Z Other Distribution box ( Dosing tank ( ) ,I ~' Percolation Test Results Performed by---�!a?_ .N!(6.................................. Date..........--............................ aTest Pit No. 1................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...---...............--. P4 ------------------------------------------------------------------------------------•-----.........-------..........----•-•-------•----....................-- 0 Description of Soil----------- --- -------•--------•--------------------- .................................... ..................................... �, ---•-------------------------------------- �'2. tax -i.� t :-1 1 = n�c�� W --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•----•-•---. VNature of Repairs or Alterations—Answer when applicable............................................................................................... -•------------------------------•--...-•--------•-----------------------------------•---•-•-........----------------------------------------•----...-------------------------------------------••.------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Cert' icate of Comp • ncejjas been iss by the board of health. Signed ...../ -� AW �� Application Approved By ... ... .. ......... ............... I �- Application Disapproved for the following reason • .......... ......... ............................. .................................... ..... ............................. -------------------- ------------------------------------ ------ . ...................../al, ........ Permit No. --"..I..'.. .... .. ... .................... ......... Issued .... .............. ... t------ ' S / No.....................�.! Fss.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --•----....-- c�tt..i�.......OF.... ?,t,,E .:3LZ................................... Appliration for Uhiposal Works Tonstrnrfion Frruat Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: f _ ..... _......�-.�-... . ... . .. .z'... ---- it?___ ----•---- - -•---- orLotNo."--•----•-------•---•---•---•------------ .Addt s-- f . Owner t� -^} b� [ Address ... ---------------------------------I-------------•-___•_---•---------•-•----•------•--- ------------------- Address d Type of Building Size Lot.... .. " ...Sq. feet Dwelling—No. of Bedrooms___________ ___________________________Expansion Attic ( ) Garbage Grinder (iljo �._.. p.l Other--Type of Building .^� --�"" No. of persons............................ Showers ( ) — Cafeteria ( ) PaOther fixtures ---------------------------••••. .................................•--------•---•••----•------- Design Flow...................... ... ...............gallons per person per day. Total daily flow.............................. �.......gallons. WSeptic Tank—Liquid capacity_.A gallons Length................ Width..1.....I....... Diameter.--__-__•-___- Depth................ x Disposal Trench—No..................... Width_••.•______--_____-- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.........t------__.. iameter....... 4......... Depth below inlet.......e_.._... Total leaching area...�! ..sq. ft. Z Other Distribution box ( Dosing tank ( ) '­' Percolation Test Results Performed by.................................�.'t�t' _:...':.... __................................. Date......_--............................... aTest Pit No. I................minutes per inch Depth of Test Pit.........-.......... Depth to ground water..._" ' ........... Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water--._•___-__-____.__-___. a ----------------------------••----•--•--•-----•--••__..._.___---r-•-•----•----..._---•-_•.............................................................. 0 Description of Soil............ ------ . •-•--•••--- ....................... U W UNature of Repairs or Alterations—Answer when applicable---------------------------------............................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operatiori until a Certificate of Comp ' Yn�cePhjs be i s�V by the board of health. M a� tt�t/ Signed �ay_ r Application Approved B ..,...r1�I7//UT t- ........ ......../. e/r l�Zi1�/t �i'!_��-----------.... ---- � 1... .C•"'" PP PP Y ...... w ---.... ..- - Application Disapproved for the following reasons:,,............................................................................... ........................ ---- --------------- Permit No. -.....f i:.......................... .. Issued ............-------I.i- .._ ate...... /lla[e THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --- -P�- -... O �. s ---- -- ........: . . A . ............................................ Cer#tf rate of Tomplinure IIS,IS �,0 C' 9TIF,,Yjhat the Individual Sewage Disposal System constructed or Repaired ( ) by ------- r - ----- --- ------ ------ -- ....-- ----...........--.... .... ......------.... ... .......................... ---- 1 at ....... .... .... ........ ... ....... ..... ----------- has been installed in accordance with the provisions of TITLES"f�f,,-The St to Environmental Co e cribed in the application for Disposal Works Construction Permit No. .-..�...i, ' .........!J.............. dated --_- ..... ........ ----.-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARA THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE ...... ....................... ....... ........ ...................... .. .. .. Inspector .................................................................................................. THE COMMONWEALTH OF MASSACHUSETTS -- BOARD OF HEALTH .�„ ..........OF........ ,!! : ............................................... No No...1.9�••_-•----... FEE.......---•--.......... dispo sa orkv Tnn strudinn rrmitlf ` `Permission fs hereby granted_...\ J j-5C41 __ __._. ? . . -------•••-• ........................................... to Construct (V_) or Repair ( ) an Individual Sewage Disposal System ' 7" t � , y �� � two s L /.✓� / V /L Street �" r-! as shown on the application for Disposal Works Construction Permit No._ _ _. :___._ Dated..../...._ ... ism_ [- i � .............. ................................ ! ........................................................... ,!� •_ rr DATE--------------—7---------•----- �•--•---•---._._.......----•-- Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS c� IL G,ArtacG� G�LI�ro�z _ 148 G� ' r►c T41-"tC _ 330,�'ISO % • S G F' 1 ) I USA' 1000 GAL..-- I TAB SPOSAL PIT - uSE ISoC AS SF 34 S * ` 3 7S G•.P.�. ; 2- / :gaT-ro�K Area= �A sT=•. � 12 _ � B � ToTAL:. 'c>ESIG�.1 4 5•pn• i -r-oTa tr mat L�f F'L.Ow = 33D 6.P.p• . . .;. m oo rye' ' 7E2GDLDT10�.1 CZI�TE `��I� �-�4(I IJ•OIZ o , \ p o I Lp P TFR � �< i rZ 4 A i no 29733 ii4Y n 4 OF �'•� .rG � 4, Tor Fub _ _M ST o: 33 SJBSAL 4rpP�.' 1ST :IW -:GA•t. T'a�tK - lo00 33 wv 6at.: 33 :A t-cA�1 p MED WtT - ��fa%4lli _ SA hl.D WAI"Fl> CEQTt.F_LGD - -p Lc:), " pt- A, -LbChT10 A L Llo P¢oPasi�) _ pttat�c, RLFtcza VQCa :GUizSIF-`1 ;7t=lAT . TI 4��uSG ,1-lFaZL.t�ta GC�LPL�IS .:W�t'C{••� ,Tl.�i::: �j1DC..L.t►-1�., -_ _' _ : _ I �-�-- � : . _�-- .. A.IJt� 5C'T'1..�tiGIG �CQ •ro�,v�.? or= 1gt��z,�Jtirr ..': :atiJn iS. Nvr 1-041Tl:o (�!. ►�►[_. 3g1 I�L -19 �w :�.,-..., .'. .. � :; .;.• ,_ - .REGtS�[t=tZ�D 'i�AF-1C� �U��iG`(vt�4 T► t is n c_aN I 0,STSlZVtt_Lr. l_?A. ,. .... .... � ... .. � _ r - —.TO WN OF ARNSTABLE ---L&"ATION PU1/Gb =�C�(�. SEWAGE # C VILLAGE ���11'��Vl�l ASSESSOR'S MAP & LOT t 'S NAME&PHONE`NO.O. ��ll P Y a-*.,fS SEPTIC TANK CAPACITY �(�V LEACHING FACILITY: (type) r Ir (size) x(a NO.OF BEDROOMS e r .• . w} BUILDER OR O R PERMITDATE: f COMPLIANCE DATE: Separation Distance Between the: f Maximum�Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If pff wetlands exist within 300 feet of le facility Feet Furnished by ' fir LJ �rS7ucES o I � z 42 =3y . 82 3 37f , R3r2 3- #q ` 37 • QV= 3q o 3 , i TOWN OF BARNSTABLE LOCATION aG ,diZ ioao G//'Cei' SEWAGE # 92-/1 VILLAGE 4,Cx-f. ASSESSOR'S MAP & LOT t-r 6 INST 'S NAME&PHONE NO. A Of/GG4L SoB-77 -/y7� SEPTIC TANK CAPACITY /ate G/f G LEACHING FACILITY: (type) (size) g6dZ NO.OF BEDROOMS 3 B ROWNER 65,YW,0 o�, '` LG7' PERMITDATE:�f7/9 y COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility d 3 Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachir fa ili Feet Furnished by / �— ! �at �/7l i9(s/i /u�l-ifGf: C . O I _ I y S OWN OF BARNSTABLE op 0/lI/9r� A . ' 11" La 9 �Ad C.�f G LOCATION �( SEWAGE # 9-Z'(� VILLAGE &vtlf fV l� ASSESSOR'S MAP & LOT &59 6(3— DVJ` INSTALLER'S NAME & PHONE NO. 11, Dq:ltd l �71-ldq 6 - SEPTIC TANK CAPACITY I, 4010 y,,d 0m S LEACHING FACILITY:(type) LeAll„ V�+ (size) NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER tt BUILDER OR OWNER 9 DATE PERMIT ISSUED: `DATE COMPLIANCE COMPLIANCE ISSUED: I y l �-- VARIANCE GRANTED: Yes No \� - 5 ° zqy MOH TGA C-0 -T TSP-'C TI01V PLAN APPLICANT: MELLO TOWN: CENTERVILLE DEEPWOOD CIRCLE �45,17' DRIVEWAY LOT 9 LOT 7 —_ DECK y 7�C�-1G 5E � b�n1 LOT 8 SHED 1g1 Z9 6'O MAP & PARCEL pp� .� 189/007 d� a4<y�OF I'Lq MAP & PARCEL yg� aF�3''T�3FJ'cy�. 160/019 sTEPH J. v m q DOYLE D ,V 4 v FLOOD PANEL: 250001 0015 C FLOOD ZOIJE: "C" DATE MAP REVISED: 8/19/19$5 1 MEREBY CERTIFY THAT THIS 16DRTGAGE MLSFECTION PLAN HAS BEEN PREPARED FOR; DATE: 6/23/14 SCALE: 1'" = 40' STEVEN J PIizu-n DEED REF: 13743-207 PLAN REF: 357-69 THE LOCATION OF THE DNWNG WOW DOES NOT FALL waTHIN.A SPECIAL FLOOD MAZARD ZOM PFR TAP90 INBP;=C'n01J YHL DWELLINO APPEARS TO CON"M TD THE LOCAL ZONING BMAWS IN EFFECT THE 5Tp =REM SHOVLV ON THIS MONMAC£INSPECTION PLAN ARE LOCATED BY 71i'E 9URVd1 AT 7HE TILJE OF CONSTRUCTION VATM RESPECT TO HORRONTAL D1MENMONAL SMACk REWIRWOM ONLY.NO Dd MMENT SURVEY WAS PERFORMw ANU LOCATIONS SHOWN RRE AY TAPE AX OR t5 El(ENPT FROM VIOLArW ENFDRaD4 MT ACMON tkOM NA MWERAL LAWS CHAPTER 40A AN INS11T 4INT SURVEY15 NECE+mW FOR PRECISE DETERAUNA710N OF BUILDING LOCATIONS. SECTION 7.REPFRENCE DEED SUBJECT TO AND VATH THE EMHEFI7 OF ALL MWT9,MCHIS OF WAY AND 190W lCHMENT3,IF Aqy R:XIST,EnBa WAY ACROSS PROPERTY LAlM YANKM LAND EAMRESMVATM G LEGAL D RE TARIC ONS O RECO A IF ANY THERE SHALL BE.AND INSOFAR SMV@Y CWPANY INC.SHALL NOT BE HELD LIABLE FDR DAMAGES RESULTING FROM ANY WK VM OF TI'U8 PLAN FOR PURIV655 DINER VAN MORT4A(Z INSPECTION. TELEPHONE: 508-428-0055 YANKEE .SAND SURVEY COMPANY, INC FAX: 508-420-5553 119 ROUTE 149. .Morstons Mills, MA 02648 yonkeesurvey®com cost.net Iwww.yankeesurvey.net 83278 JM LEGEND S ju'S --_ - - PROPOSED CONTOUR CIR o� - 88,90 ft 98 PROPOSED SPOT GRADE ---_------ —— 9B —— EXISTING CONTOUR ac •� O `\ + 96.52 EXISTING SPOT GRADE p o Op I_ O I \ W— EXISTING WATER SERVICE CIR AREA = 15213 sf TEST PIT - ` SIT t S n�® ` 38.95 WA LOCUS MAP N.T.S. I j �Gj �6'. 38.8 39 \• GENERAL NOTES: BENCH MARK\: I. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL co38.73 a T� 2 —__ CZRmE-R`LANDSCAPE TIE BOARD OF HEALTH AND THE DESIGN ENGINEER. rn j x 33' —'� a ELEVATIOI`) 39.99 ` 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS 7�� \ OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE BARNSTABLE nl� DATUM \.O LOCAL RULES AND REGULATIONS. fi ! i TH-1 \o \� F M 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR ! 39 `• _ ��� s0101, TO INSPE TION NEER.D APPROVAL BY THE BOARD OF HEALTH AND THE DESGND RREN M. 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING MEYER FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN �„ ENGINEER BEFORE CONSTRUCTION CONTINUES. No. 1140 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. / \ 6. THE DESIGN ENGINEER 1S NOT RESPONSIBLE FOR THE FAILURE OF / \ �fC/STtn`" THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF �� J4#1TA?\PN _/�(� HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. I \/ I \ 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED 38 \/ \ (, TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY. 39 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING \\ \ CONSTRUCTION. 10. EXISTING LEACH PIT TO BE PUMPED, CRUSHED AND REMOVED. (location unknown) \\ \\ 0� 71 L `•\ _ 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 12, THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY �0Q 40 , `\ T AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING 14. ALL PIPING TO BE 4" SCH 40 0 1/8"/FT (UNLESS SPECIFIED OTHERWISE) 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A GARBAGE GRINDER 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING j \\ WATER \ GATE i -------------------- ----GAS GATE 38 s � PROPOSED SEPTIC SYSTEM UPGRADE PLAN 26 DEEPWOOD CIRCLE, CENTERVILLE, MA Prepared for: Arch Construction SURVEY REFERENCE: MAP: 169 Engineering by: Surveying by: SCALE DRAWN JOB. NO. LOT.•013/005 DARRENM.MEYER,R.S. Boo—Tech Environmental PLAN "-20' DMM PLAN OF LAND BY BAXTER & NYE, INC., SURVEYORS DEED BOOK. DATE:12036 Poeoxse� (508) 364-0894 ]-DATED: ,TUNE 16; °1984 DEED PAGE. 317 EAST SANDWICH MA 02537 CHECKED SHEET N0. 508-362-2922 08/28/07 DMM 1 of 2 t ELEV. TOP FOUNDATION (Existing) I =40.39 F.GEL 39.50 F.G.EL: 39.25 ' F.G. EL: 3880 FINISH GRADE= 38.80 a f MAINTAIN 2% MIN SLOPE OVER LEACHING AREA COVERS TO WITHIN 6 OF GRADE :0 6" INSPECTION PORT L = 27 W/IN 6" OF FINISH GRADE A 6„ • 4" SCH 40 PVC :; , L _ 5' 10"I ° ° ° ° ° ° ° ° ° ° ° ° ° ® S= 1 7 MIN. s (MIN.) TEE'S ARE TO BE 14 ( ® S= 1 - (MIN.) o...A ' 4" SCH 40 PVC j INV.36.10 INV.36.0 INV.35.80 ° ° ° ° ° ° ° ° ° EXISTING GAS : OUTLET BAFFLE PROPOSED DB 3 ° ° ° ° ° ° 101,101 ° ° ° °• •: H-10 DISTRIBUTION BOX I 25' INV. 36.35 EXISTING 1000 GALLON SEPTIC TANK NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INVERTS PRIOR TO CONSTRUCTION mnFFaem � 9" MIN. 2) D-BOX SHALL BE SET LEVEL AND TRUE TO PER T1 TLE 5 OF GRADE ON A MECHANICALL COMPACTED SIX Mgsfgc INCH CRUSHED STONE BASE, AS SPECIFIED IN BREAKOUT EL. = 36.25 3� y 310 CMR 15.221(2) INV. ELEV.=35.60 ( o D�f�R emu+R 3) REPLACE EXISTING 1,000 GALLON SEPTIC 5 TANK WITH. 1500 GALLON SEPTIC TANK J/4•- 1_1�. 24" " o. 1140 IF FAILED, DAMAGED, OR UNDERSIZED. DWRE WA&IEV SMW INVERT SEPTIC SYSTEM PROFILE 4) INSTALL INLET & OUTLET TEES AS REQUIRED BOTTOM EL.= 33.60 /STEM �(.g�0') --,48" 50" 8" S4NI TARP I 146$0 I SEPARATION 6.10 FT. INFILTRATOR 3050 SPECIFICATIONS BOTTOM OF TH-1 EL: 27.50 SOIL ABSORPTION SYSTEM (SECTION) SOIL LOGS P # - 11877 DESIGN CRITERIA NUMBER OF BEDROOMS: 3 BEDROOOM I a DATE: AUGUST 22, 2007 SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) SOIL EVALUATOR: .DAVID COUGHANOWR, R.S., CSE DESIGN PERCOLATION RATE: <2 MIN/IN ° WITNESS: DONNA MIORANDI DAILY FLOW: 110 G.P.D. HEALTH AGENT DESIGN FLOW: 330 G.P.D. L Depth GARBAGE GRINDER: NO (not designed for garbage grinder)SEPTIC TANK: 330 INLET END Elev. TH-1 Depth Elev. TH-2 De (OPEN) _ � _� gpd x Z = 660 gpd USE EXIST. 1,000 GALLON SEPTIC TANK 39.5 0" 38.8 A 0" 330 = 445.94 S.F. FILL LOAMY 10Y R 3 A 74 D LEACHING AREA REQUIRED: ( ) 4.5"D14 ACCESS PORT FOR INSPEC7/0N. 38.34 14" 38.3 6" USE THREE A LOAMY SAND B (3) INFILTRATOR 3050 UNITS WITH 4 FT. STONE 38.0 B 10YR 3/2 18" ioYR SAAND ON THE SIDES & 1.3 FT. STONE ON ENDS: 25' L X 12.16' W x 2'D LOAMY SAND BOTTOM AREA: 25 x 12.16 = 304 SF 36.17 10YR 5 6 40„ .36.3 C1 30" SIDE AREA: (25 + 12.16) X 2 X 2 = 148.54 SF Ct TOTAL SQUARE FEET PROVIDED = 452.6 vs. 445.94 REQ'D DESIGN FLOW PROVIDED: 0.74(452.6 S.F.) = 334.95 G.P.D. vs. 330 G.P.D. req'd ° ° ° ° ° ° ° ° ° ° PERC 034.5 MEDIUM PROPOSED SEPTIC SYSTEM UPGRADE PLAN MEDIUM SAND SAND INFILTRATOR 3050 1oYR 6/4 10YR 6/4 26 DEEPWOOD CIRCLE, CENTERVILLE, MA NOMINAL CHAMBER SPECIFICATIONS Prepared for: Arch Construction Engineering by: Surveying by: SCALE DRAWN JOB. NO. SIZE (W x H x L) 51 x 30 x 85.4 27.5 144" 27.8 132" DARRENM.MEYER,R.S. Boo-Tech Environment&! N.T.S. DMM WEIGHT 80.0 LBS. PERC RATE <2 MIN/IN. ("C" HORIZON) PERC RATE <2 MIN/IN. (" )C" HORIZON (508) 364-0894 DATE CHECKED SHEET NO. EASTPoaoxsatSANDWICH,MA 02537 NO GROUNDWATER OBSERVED NO GROUNDWATER OBSERVED 506.362-2922 08/28/07 DMM 2 of 2