HomeMy WebLinkAbout0024 EVSUN DRIVE - Health 24 Evsun Dr.
L
Centerville
a=� s�ns
No. 4210 1 l3 ORA
10' l
a o
Commonwealth of Massachusetts
. � - ; --_, Title 5 Official Inspection Form
C, a
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
24 EVS_U_N DR
----------- -- -----------
Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CENTERVILLE MA 02632—_ 9/9/07 ——
required for -----— -- ---- State Zip Code Date of Inspection
every page. City/Town
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way.
Important: A. General Information
When filling out
forms on the t ,S
�l
computer, use 1. Inspector.
only the tab key
to move your Michael DeDeck_o ------__--.--
cursor-do not Name of Inspector
use the return
key. Compass Realty Development Cor aratio_n____
Company Name
raD P.O. Box 2384
- ---------- ---- -------- -----——--------—
Company Address
Mashpee Ma C 102649
zrwo City/Town State )Zip Code
y3 rr.
508 - 221- 5003
Telephone Number License Number
V:t 4 CT.i
B. Certification ' X
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 ins'�ection`The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant tot Section 15.340 of
Title 5 (310 CMR 15.000). The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
Inspector's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
33WEQUAOUET•08106 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 1 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
�m -- — Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
%y 24 EVSUN DR --------
Property Address
C/O DAVID HOL_T, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CENTER_VI_LLE MA 02632 9/9/07
required for -_-- _ --------�---_---
-- --
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass" section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not
determined," please explain.
❑ The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent.
System will pass inspection if the existing tank is replaced with a complying septic tank as
approved by the Board of Health.
* A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate
of Compliance indicating that the tank is less than 20 years old is available.
ND Explain:
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced
❑ obstruction is removed
33WEQUAQUET•08r06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15
I�
Commonwealth of Massachusetts
- Title 5 Official Inspection Form
-- Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
24 EVSUN DR ---
Property Address
C/O DA_VID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CENTERVILLE MA 02632 9/9/07
required for —__.-.--_
State Zip Code Date of Inspection
every page. Cityfrown
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ 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:
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
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.
33WEQUAQUET•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15
i
Commonwealth of Massachusetts
Title 5 Official Inspection Form
y' Subsurface Sewage Disposal System Form Not for Voluntary Assessments
24 EVSUN DR ----- ---
Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CENTERVILLE MA 02632 9/9/07
required for -- State Zip Code Date of Inspection
every page. City/Town
B. Certification (cont.)
C) Further Evaluation is Required by the Board of Health (cont.):
❑ 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 coliform
bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be
attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® 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 '/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.
El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
33WEQUAQUET•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15
i
Commonwealth of Massachusetts
-- __ . Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
a, 24 EVSUN DR ---------
Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CEN_TERVILLE MA 02632 9/9/07
required for — State Zip Code Date of Inspection
every page. City/Town
B. Certification (cont.)
D) System Failure Criteria Applicable to All Systems (cont.):
Yes No
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ El Area
system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area— IWPA) or a mapped Zone II of a public water supply well
If you have answered "yes" to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
33WEQUAQUET•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15
Commonwealth of Massachusetts .
_- -- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
24 EVSU_N_DR --- ---
Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CENTERVILLE MA 02632 9/9/07
required for State Zip Code Date of Inspection
every page. City/Town
C. Checklist
Check if the following have been done. You must indicate"yes" or"no" as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?
❑ ® Has the system received normal flows in the previous two week period?
Have large volumes of water been introduced to the system recently or as part of
❑ ® this inspection? /
® Were as built plans of the system obtained and examined? (If they were not
El
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)]
I
33WEQUAQUET•08106 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 6 of 15
i
Commonwealth of Massachusetts
� ---- Title 5 Official Inspection Form
— Subsurface Sewage Disposal System Form Not for Voluntary Assessments
=4 24 EVSUN DR - —
Property Address
C/O D_AVID_HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CE_NTERVILLE MA 02632 9/9/07
required for State Zip Code Date of Inspection
every page. City/Town
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual):
3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
-
0
Number of current residents:
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ® No
Seasonaluse? ❑ Yes ® No
Water meter readings, if available (last 2 years usage (gpd)): N/A— -----
Sump pump? ❑ Yes ® No
N/A
Last date of occupancy: Date
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow (based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.): — --- -
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available: ---- — ---"" ----" - - -
Last date of occupancy/use: Date
Other (describe): --------- -- ----------------
33WEQUAQUET•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
a'jr 24 EVSUN DR -------------
Property Address
C_/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632 __-
Owner Owner's Name
information is CENTERVILLE MA 02632 9/9/07
required for State Zip Code Date of Inspection
every page. City/Town
D. System Information (cont.)
General Information
Pumping Records:
N/A _-- —
Source of information:
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: galions
How was quantity pumped determined? — ----
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
El maintenance
technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed (if known) and source of information:
N/A ------
Were sewage odors detected when arriving at the site? ❑ Yes ❑ No
33WEQUAQUET•08/06 Title 5 Official Inspection Form,Subsurface Sewage Disposal System•Page 8 of 15
Commonwealth of Massachusetts
P_ Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
�^ 24 EVSUN DR
Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is required for CENTERVILLE MA 02632 9/9/07
—
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Building Sewer(locate on site plan):
2'
Depth below grade: feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain): ---
Distance from private water supply well or suction line: feet
Comments (on condition of joints, venting, evidence of leakage, etc.):
JOINTS TIGHT,YES VENTED,NO LEAKAGE.
Septic Tank (locate on site plan):
Depth below grade: feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
----------------------------------------------------------------------------------------
1500 GAL. _
Dimensions:
3"
Sludge depth: ----------------_._.
31
Distance from top of sludge to bottom of outlet tee or baffle ------
1 ,
Scum thickness
Distance from top of scum to top of outlet tee or baffle ------- --- --"-- ""—
14"
Distance from bottom of scum to bottom of outlet tee or baffle -- --- --- ---- — - - -
MEASURED
How were dimensions determined? ---- --_----- --
33WEQUAQUET•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15
ICI
Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
\,a 24 EVSUN DR ____-- -_-__--
Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CENTERVILLE _MA 02632 9/9/07
required for - - --
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
NO NEED TO PUMP, TEE'S INTACT,STRUCTALLY SOUND, LIQUID LEVEL EQUAL WITH
OUTLET INVERT, NO LEAKAGE,
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.):
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):
33WEQUAQUET•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
�R Subsurface Sewage Disposal System Form Not for Voluntary Assessments
\a 24 EVSUN DR --
�� Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632 —
Owner Owner's Name
information is _CENTERVILLE MA 02632 9/9/07 ___
required for State Zip Code Date of Inspection
every page. City/Town
D. System Information (cont.)
Tight or Holding Tank (cont.)
Dimensions:
Capacity: gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
*Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
Distribution Box (if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert EQUAL WITH OUTLET INVERT—
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.):
D- BOX IS LEVEL AND DISTRIBUTION EQUAL, NO SOLID CARRYOVER, NO LEAKAGE.
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
A ET•08/06
Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15
33WEQU QU
Commonwealth of Massachusetts
Title 5 Official Inspection Form
— - ' Subsurface Sewage Disposal System Form Not for Voluntary Assessments
24 EVSUN DR — -----
- Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CEN_TERVILLE MA _02632 9/9/07
required for
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
Type:
❑ leaching pits number: -------
9
® leaching chambers number: ---
❑ leaching galleries number:
❑ leaching trenches number, length: --
❑ leaching fields number, dimensions:
❑ overflow cesspool number: — -
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
SOIL- GRAVEL/SAND, NO SIGNS OF HYDRAULIC FAILURE, PONDING DRY,NO DAMP SOIL,
VEGETATION - NORMAL.
33WEQUAQUET•08i06
Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
<\ 24 EVSUN DR ---- — --
Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632 _ _
Owner Owner's Name
information is CENTERVILLE MA 02632 9/9/07
required for - - --- State Zip Code Date of Inspection
every page. city/Town
D. System Information (cont.)
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.):
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.):
33WEQUAOUET•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15
Commonwealth of Massachusetts
---- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
4 24 EVSUN DR ------ -
Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is CENTERVILLE MA 02632 9/9/07
required for
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
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.
i-TA =771
5�
5S
33WEQUAOUET•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15
Commonwealth of Massachusetts
u�--- Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
24 EVSUN DR
Property Address
C/O DAVID HOLT, TODAY REAL ESTATE,1533 FALMOUTH RD, MA, 02632
Owner Owner's Name
information is required for C_ENTERVILLE MA 02632 _ 9/9/07
----
every page. city/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
❑ Shallow wells
22.91' _
Estimated depth to ground water: feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers- (attach documentation)
® Accessed USGS database -explain:
BARNSTABLE GIS -----
You must describe how you established the high ground water elevation:
BARNSTABLE GIS -- -------
33WEQUAQUET•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15
Town of Barnstable
pp 1HE 1p�
Regulatory Services
anxivsrnsre Thomas F. Geiler, Director
1639. `0� Public Health Division
TFD MA'S A
Thomas McKean,Director
200 Main Street, Hyannis, MA 02601
Office: 508-8624644 Fax: 508-790-6304
This septic system inspection report was completed by a private inspector who is certified
by the State of Massachusetts, Department of Environmental Protection.
Although the Town of Barnstable Health Division received the original/copy of this
report; this Division does not warranty the functionality of the septic system in the future
nor does this Division agree with any technical observation s and interpretations
contained within this report.
In addition,by receiving this report the Town of Barnstable Health Division does not
automatically approve the number of bedrooms listed within this report. The actual
number of bedrooms approved at a particular property would-be listed on the "Disposal
Work Construction Permit".
If you should have any questions regarding this report,please contact the certified Septic
System Inspector who conducted the inspection.
_......,,T,•. .. +..�..r •w��'.,w �. ...ti1...CY...� .. - ..a.�^'s-n n' ...f4......f�•rti'M.'1.r\..r..r..M.�,af.
h
TOWN OF BARNSTABLE -y1 ;
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager
Address of Offender '2-41 FV5tw_.^ � ��p_. MV/MB Reg.#
Village/State/Zip ce'l4ryilh 1,10-
r
Business Name aai/pm; on ✓t� '7 201 ,E
T
Business Address
Si-gnatii"re of Enforcing Officer
Village/State/Zip
Location of Offense 2� F-VISA.#►�. T)f1 J k.-Q-
� A 14-erv' 1[ Put�✓}�a /3t" /I �-h
[ d Enforcing Dept/Division
Offense 6,4-V 4 .P S1' 4 '" 11(t:<t i �(.c.•a�� �x� t�1* 'r..�lt *r �A 7c..3e-.r`f�
Facts a'`61. 61 .
` r
This will serve only as a warning. At this time no legal action has been taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the Town.
Health Complaints
18-Oct-02
Time: 3:05:00 PM Date: 10/15/02 Complaint Number: 3771
Referred To: SAM WHITE Taken By: PEGGY ROTHMAN
Complaint Type: CHAPTER II HOUSING
Article X Detail: UNSANITARY CONDITIONS
Business Name:
Number: 24 Street: EVSUN DR.
Village: CENTERVILLE Assessors Map Parcel: ANONYMOUS
Complainant's Name:
Address:
Telephone Number:
Complaint Description: COMPLAINANT SAYS THERE IS A MOBIL
HOME ON THE ABOVE PROPERTY AND
SOMEONE IS LIVING IN IT, SMELLS BAD IN
NEIGHBORHOOD FROM WASTE EMITTING
FROM MOBIL HOME (HUMAN WASTE).
ALSO SEEMS TO BE SOMEONE RENTING
THE BASEMENT OF SAID PROPERTY,
QUESTION WHETHER SEPTIC IS CAPABLE
OF HANDLING A RENTER THERE.
Actions Taken/Results: SW noticed sewer hose running from the mobil
home to just underneath the mobil home.
Spoke with person living in mobil home who
stated the sewer hose runs into a wheelbarrel
which is then dumped into the woods when full.
Issued cease and desist order on illegal
dumping of sewage. Notified Building Dept.
(Ralph Jones) about mobil home on property.
Owner's name: Scott Colantonio.
Investigation Date: 10/17/02 Investigation Time: 11:00:00 AM
1
No.141n;lw�el, Fee---
BOARD OF HEALTH
TOWN OF BARNSTABLE ASSESSORS MAP NO:
Applicat ion ffor VrIt CootructionAkrtO*El.
Application is he by made for a permit to Construct Alter or Repair )an individual Well at:
dion — Address A"'Ma d Parcel
l,
Owner ^ Address
Installer Driller Address
Type of Building
Dwelling
Other - Type of Building No. of Persons--------------
Type of Well Capacity_
Purpose of Well
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation icate of Co iance has issued by the Board of Health.
Sign
date
Application Approved By
date
Application Disapproved for the following reasons:
date
Permit No.
l��Z-_�: !�Zz_ issued ------------
date
—————— —————— ———————--——————————————————————————————————--
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certifiratr Of Compliancr
THIS IS TOCXRTIFY, That Individual Well Constructed VC), Altered or Repaired
o4e.
b'0C �' Installer
VjV el '001'�
a, —------
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Pem#<—o Dated
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE Inspector
BOARD OF HEALTH
TOWN OF BARNSTABLE
- �ertifitatP ®f �Gom�[iat�tP
THIS IS TO RTIFY, That Individual Well Constructed), Altered ( .), or Repaired ( ')
r
Installer —
�/ v
., k
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Pe No. -------------Dated----------z� ---
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE------ — Inspector------- -------- ----------
BOARD OF HEALTH
TOWN OF BARNSTABLE
Ivell Constructionpermit
No. d ��`� Fee
Permission is hereby granted
to Construct (, ), Alter S. ), epair ( ) Individual t:/}�J
oc�Y V S U/1 /J R. ;V-LU
/f�No. - - - - - -
street
as sho��plication for 3 �Construction Permit
No.-
G� r ____ --------------------
Dated-- ---` � --
—77"_"
Board of Health
DATE
No.'!: - 7�' Fee--
BOARD OF HEALTHd
TOWN OF BARNSTABLE f�
Appricat ion-*rVeir Congtructioni3ermit 087
A plication is he by made for a permit to Construct ;(' ), Alter ( ), or Repair ( )an individual Well at:
oc ion — Address — — Assessors Ma and Parcel
Owner Address
-- Installer — Driller Address r
r
Type of Building
--' Dwelling Y
— Other - Type of Building - No. of Persons--------
______—__—__—____
Type of Well
YP � t -------- Capacity-------------------__--
Purpose of Well-- ---- —
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulatio — The undersigned further agrees not to
place the well in operation eert•' icate .of Co iance has issued by the Board of Health.
Sign ------
date
Application Approved B %
date
+ Application Disapproved for the following reasons: --------------------------
4 �
r-,
date
Permit No. `� �____— Issued_------`--- '-'—'� Q
_ _ __---
- date
�-
.�t���
� ��
�� ��
� ��
o
� � ��s
S � �
a
��
S � �
� �
- 1 � �
� �
F&T-try
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS
,,RpapYication for �Digogal 6pgtem Congtruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or.Lot No. l Own s Name,Address and Tel.No. 66F9�to 9167
Assessor's Map/Parcel SvawQ /r
0 !X�a'l EVSvw !„C
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
2 6/, .s E K CA 0�-4 /,,� _®/ 7 7 9
r. u4-(. 4- 7 7 trne
Type of Building:
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers(Z-) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow 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)
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 Certifi-
cate of Compliance has been issued by th' VdWHh.
Signed,. V 0 Date
i
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued
3! r,;
glop
4 8
No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01pplication for Mizpoal *potem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) []Complete System El Individual Components
Location Address or Lot No. 0 s Name,Address and Tel.No.
5_09 9
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.
C/4 ()14-4 -2 _o/ 7?
VL,-,2j V 7
Type of Building:
Dwelling No.,df Bedrooms Lot Size sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers Z.) Cafeteria(
Other Fixtures
Design Flow gallons per day. Calculated daily flow 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 Alteration]i(Answer when applicable)
Date last inspected:
t
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 Cerifi-
cate of Compliance has been issued by thi oard oEHe
Signed Date
_V 0
Application Approved by -A Date
Application Disapproved for-the following reasons
Permit No. Date Issued It 1*9!Z
L- — ————————————————1---—————
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 qon
at i r>-r- r_I Z�S L)A I J W-1 1AS , (1E A as e constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. as
Installer Designer
The issuance of this permit/shall not Pe c%strued as a guarantee that the system wi functi.n as designed.
Date.- Inspector
U
----- -------------------------------
No. I I Fee forg
I THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
�m -
=i0poal p5tett Con.5trurtton Permit
I
Construct
J( (
Permission is hereby granted Atp6consl R U grad Aban n79
System located at
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 iust be/ompleted within three years of the date of t t*t.
Date: Approved by
V
t";r // e v!!UU j WN OF BARNSTABLE
-7
.-�' SEWAGE # �!
LOCATION 3 c"�.� 6 "
VILLAGE ASSESSOR'S ASSESSOR'S MAP &LOT
INSTALLER'S NAME&PHONE NO. a+n
SEPTIC TANK CAPACITY LYE
LEACHING FACILITY: (type) h4g � (size)
NO.OF BEDROOMS
BUILDER OR OWNER Srtsv��
PERMIT DATE i — COMPLIANCE DATE: / L
Separation Distance Between the: .
Maximum Adjusted Groundwater Table and 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
r � ,
��� L
TOWN OF BARNSTABLE
LOGATiON SEWAGE #
V14LAGE (•92 aa
ASSESSORS MAP &LOT
INSTALLER'S NAME&PHONE NO.
f S&-nit TANK CAPACITY X.`r 9'62
LEACK NG FACILITY: (type) •` (size)
NOI OF BEDROOMS_ .—
l BUff:DER OR OWNER
..;; ITDAT•E:�I_,l �l >�T COMPLIANCE DATE 1 S�
PERM.
p 'atop Distance Between the: `
l S,e s
Feet
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility
Private>Water Supply Well and Leaching Facility (If any wells exist Peet
i.1oq site or within 200 feet of leaching facility)
Edge::of:Wetland and Leaching Facility(If any wetlands exist Feet
: :wittia 300 feet of leaching facility)
Futrushed by
<:
L4 1
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate of (gontlatianre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed >CY or Repaired
by ..................... W.r."
-------------------------------------------------------------.........................................................................
... ...................................
Insrallcr
at .............. ------ .......... -—-------- ..........................................................---------------------.-----
has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. -,5-. 7......... dated .......... -.......................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE------..........................................................-.................................... Inspector ................................................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Permissionis hereby granted...........allrkla,- ---------........................................................................................
to Construct (Y) or Repair an Individual Sewage Disposal System
Street P
as shown on the application for Disposal Works Construction Permit --- Dated...........................................
........................................................................................................
Board aHealth
^ DATE--------------------------------------------------------------------------------
FORM
� i
-� �
oC3 '2> .
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
App iratilan for Uiiipmi ii Work.5 Cnnnitrnrt"inn Itermit
Application is hereby made for a Permit to Construct (K) or Repair ( ) an Individual Sewage Disposal
System at:
................ - .....S -� 5 ` 2. ti�� .. Location. \--d•d-•-rc-s•s------------------------------------ •----- T ? J---o-T...L-o-t---N-
o....
...........................
..•----•----
eA
(� ......-•-•-- 1/�U ' 6 .••-•------..................•• d ......---••-..................••..........-. .. ----•------- ------•--
' ess
�5
F Installer Address
dType of Building Size Lot....... ...Sq. feet
UDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons-------------..-....._------ Showers ( ) — Cafeteria ( )
a' Other fixtures ------------------------------- - -
W Design Flow................... ..... ..-.gallons per person per day. Total daily flow.............521.95 -............_....gallons.
WSeptic Tank—Liquid capacitv..I--gallons Length....�". Width...`f..8.... Diameter............�Depth...s:
x Disposal Trench—No. .................... Width...... Total Length------ Total leachingarea..... --9.1q7ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing t k ( )
Percolation Test Results Performed by--------- .................. Date....... .........
1.4
Test Pit No. l....2:Z....minutes per inch Depth of Test Pit.... Depth to ground water......83.`.............
Test Pit No. 2.._...'�.._._minutes per inch Depth of Test Pit..... . Depth to ground water.....-$:.�5........
R. ---------------- ----------------------------------------- ----------........ -------...._....... -------
0 Description of Soil :�� = t s -t �$- i-?---L.. ,aQ.S. ......^^e....................................................r�
U ............................... t 5 - g' - •t-7--n..--•. .....................••..`..............-----•-- •-------•-•-........
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 Enviro ental Cod —The undersigned further agrees not to place the
system in operation until a Certificate of Co n e hasl3e n issue b t. board of health.
Y P ' I -� t
L E /d
Sign ........................... .................. ............................................ .... ..../..:......
Application Approved By .................... . ... ... . .. ............... . ................................. ..R-.l_ .-....I.4
Date
Application Disapproved for the following reasons: .......................... . .................... ................................. .............................. . .
....... ............ .............................. ................. .................. ----....--- -------...................-----------*................. .....--.........-------------- ---
...------- .-----.....-----.._......
Dare
PermitNo. ......... �-...�.�........................ Issued ............................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
'
BOARD OF HEALTH `
/� � � �� OF ��������ST�����~��
I�n'--'�-.7�'^2-'/ FnEor Tanotrudion
._''L����---.
^="^""""'^ is hereby"= e^~~ e~'--'- -'-'----'---'—'-'----'-------'----''-------
to Construct Repair ( ) an /uuiv/"uu o,wugc Disposal System
at zmo.---�-�=.���--' '-'__ -_-.-_-----.--..-'______
Street
[ as shown on the application for Disposal Works Construction Permit .- Dated.......... ................................
� --_-.'-----_--_...''-_----.-__-__--'--'-_--
Board of a=uh
� DATE............................................................................
-
FORM owyoo*oamsm WARREN.INC..PUBLISHERS ^
i
THE COMMONWEALTH OF MASSACHUSETTS
I
BOARD OF HEALTH
n TOWN OF BARNSTABLE
Certificate of Comyliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ><� or Repaired ( )
by .......................... '__ .......................... ."all..... --------------------------------.....................................................
1.
i. at .............. •-
has been installed in accordance with the provisions of TITLE 5qo�f The State Environmental Code as described in
the application for Disposal Works Construction Permit No. .._.f... ....__,5--- 7---------- dated ......................................._.... -
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE..... ........._._... Inspector ----------------------._..._..------ ..............................................
No.---3. :._ / V""Finc..... ina........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 0:F HEALTH
TOWN OF BARNSTABLE
Applirativlt for Ui�5pwial Works Cnomitrurtion Permit
Application is hereby made for a Permit to construct (X) or Repair ( ) an Individual Sewage Disposal
System at:
............................................................. ................................. •........__________....._._.__........_._......._..._..........
Location-Address or Lot No.
._::..._.______ _____________ _ _ ______ ___ .......
/ l A --3, / j,//Address
u
Installer / r Address
Q Type of Building / Size Lot......................f._..Sq. feet
--.Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ---------------------------- No. of persons............................ Showers. ( ) — Cafeteria ( )
QOther fixtures --------------------------------------------------------------------------------------- ---------------------------•------------------•--•----------•
W Design Flow...................r: ......._..........gallons per person per day. Total daily flow............. .a.._...__._......_.gallons.
GG Septic Tank—Liquid capacity__-!----__gallons Length__`_:_�_'___ Width_._:1.. ...__ Diameter................. Depth..._..._ ......
Disposal Trench—No. .................... Width-- ?. ........ Total Length......A!� ....__. Total leaching area'. :. '..sq.
3 :Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft.
z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by........ ._._I".r� . _, ,.........r_• .................... Date....... .:__�_.`.__�__ ..........
Test Pit No. I-___I---_-._._--minutes per inch Depth of Test Pit---- Depth to ground water.....:.................
LTq Test Pit No. 2..'_,`...._._minutes per inch Depth of Test Pit...... . `._.... Depth to ground water...... :................
a
- ' .
0 Description of Soil---•-=• ••-•••-• ly < E
U ............. •-----.....•'.s........---••----1--......--------------.`-- --------.......---.--_-=='-----•---------------------•---- •----•---•--•----•--------.....---•-------•--
W •-•-•-•-•--••----------------•-------•-•-••••--•-••-----------......-•--•--•----.....•••••••••--••-•-----••••--•--------...--•--•-----•--•••----•--•-•-....-••••--•••••-•-••-•-•--......................
' U Nature of Repairs or Alterations—Answer when applicable............................_.........................._......................._................
l
...• --•----••--•. ....---••.................• ............................. ---••---•-•--•--•--•-••---•-••-•••--------.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
i the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has-been issued b)y the board of health.
Y l�� i I
Signed�.l..C -= � �G ( `.::.........._.......... --. ............... .. ....�.......................:......
Dare
Application Approved By ........... .. �>- .-1.. .--. -.V
................................................ Dace
Application Disapproved for the following reasons: ................ .... ............................--.......................--.......................... _---------.----
........................ ..................................................................... . .........................--... .............................. . . . . . ................................
Dare
Permit No. ......... - . -- ---------------------- Issued
Dare
PyoF,THE To�y TOWN OF BARNSTABLE
OFFICE OF
s,►a MASK BOARD OF HEALTH
MASK
019. �� 367 MAIN STREET
HYANNIS, MASS. 02601
November 20, 1987
Mr. Arne Ojala
Down Cape Engineering
926 Main Street
Route 6A
Yarmouthport, Ma 02675
Dear Mr. Ojala:
Your request for a variance from the Board of Health "Installation of On-Site
Sewage Disposal Systems on Marginal Lots" Regulation on behalf of your
clients, George Conduris and John Salerno, to install an onsite sewage disposal
system on Lot 6, Evson Drive, Centerville, is not approved.
The soil observation hole revealed only 1.1 feet of naturally occurring pervious
soil after utilizing the maximum groundwater elevation formula contained
in the United States Department of Interior Geological Survey publication,
"Estimating Highest Groundwater Levels For Construction and Land Use
Planning at Cape Cod, Massachusetts, Example," dated September 1983.
A tremendous amount of clean granular fill would have to be trucked to the
site and deposited 4.8 feet high in 'the area of the on-site sewage disposal
system and twenty-five feet in all directions from the system. Mounding
in order to install an on-site sewage disposal system has not been a common
practice on Cape Cod.
Dale Saad, the Coastal Health Resource Coordinator gave testimony that
the proposed installation of the on-site sewage disposal system would be located
44 feet from a wetland and would be located in close proximity to Bumps
River. The Town of Barnstable in its "Stormwater Priority Listing" dated
.August 1985, revised 1987, lists Bumps River as an area where shellfish
resources and wetlands must be protected. The installation of an on-site
sewage disposal system in this area could have a detrimental effect on the
wetlands and shellfish resource areas.
The United States Environmental Protection Agency recommends that each
on-site sewage disposal leaching facility be located at least 300 feet from
wetlands to reduce eutrophication from total phosphorous. The United States
Environmental Protection Agency's National Eutrophication survey states
that 0.25 lbs: per year of total phosphorous enters wetlands from every person
served by on-site systems within 300 feet of freshwater wetlands. (US EPA
1983)
In addition the sewage disposal system plan was reviewed by Thomas McKean,
Mr. Arne Ojala
Lot 6, Evson Drive
t �'�ii�►terville
November 20, 1987 .
Health Inspector for the Town of Barnstable. Mr. McKean found that the
plan does not show the location of percolation tests as required by 310 CMR,
15.02'(5) of Title 5, and that you did not request a variance from Title 5.
You are reminded that Regulation 15.02 of Title 5, states that variances
may be granted only when in the opinion of the Board of Health that (1)
enforcement thereof, would do manifest injustice. (2) the applicant has proved
that the same degree of environmental protection required under this title
can be achieved without strict application of the particular provision. You
did not introduce evidence that denial of this variance was a manifest injustice
to the applicant, nor did you prove that the same degree of environmental
protection required under -Title 5 and Town of Barnstable Health Regulations
would be achieved.
It is our feeling that the granting of this variance at this time would violate
the spirit and intent of the Environmental Code and the Town of Barnstable
Health Regulation.
W
tr l/y you s,
Grover C. M. Famish, M.D.
Chairman
BOARD OF HEALTH
TOWN OF BARNSTABLE
JMK/bs
SECTION - SEWAGE bSSFss MtLF 1GS , Lot 83 zoNep__2,e
FLoo'0zON� $ S�TBbcICs.: FQ�NT = 2a'
1 + - SIDES i 1zEb�� 10'
26
lo' _SEPTIC TANK- 32., -"D"BOX - 14' -LEACHI�LD ' 2o�T� N N
TOP OF FDN v Q,
-25!}v(MSL)• "2"OFIftTOVi" LOGUj• J N J
a
W AS HE O STON E �.
m� Qo $eNcuMeekes•61ce
EL.24. 0
\
- .------ - --- ��--- ---- E `'
L 2.3..3 5 P
d" PCRF PIPE.PYG y 1" = 20pp' 21
i
•ff IN- OUT- IN• OUT• 2Z.3$I
1 IN•
22 OI?� L- SEPTIC _
1 Z2.-1� TANK Z2"43 21.I35 :"- 't3.1-(5:' •`, - /�
ELEV. ELEV. ELEV. ELEV. 22 7I
L!
5-EPT1C TLRK To µLVg INL.E.T TEES ZZ.t(�
._ih1L£T'fEE•70EXTEN0 10"BELOW INVEt'T ELEV. ELEV. y --- — — i \ �pf
GUZ LET TEE TOELTENO14°BELOtii IWVEZT
-10'r¢0'
- OF ik"-ith" s \ 23 (pO .P R O
WASHED STONE \
SEPTIC- •'t`4NKLOT CS
' t.
TEST HOLE LOG r ��; &q4 5 ±
!j' PRo '
TEST BY e•FdIBBA.NIGPE. 3,t7UPlrVtNCG�Ci3:o,�1-.�
WITNESS
TEST DATE 4 - 25- 88 DESIGN 3 BEDROOM HOUSE ;-
T.H. • 1 t T.H. 0 2 ( , �� 's �0
_Y ELEV. 22.t] ELEV.22.� NO r i . I �a.d TF4 2 \ T <\
L ot,M LO&YA ¢ <2 DISPOSER DISPOSER I / *�5� oG ��`�
5 t35o� ueso PE RC RATE MIN/IN. � S ,y e\ , 20
le° 2�•� let zo./o FLOW RATE 110=3 (GAL../DAV 1 330
SEPTIC TANK i'So (r.5)= 9 5
:s
LPb c�Eh REQ'D SEPTIC TANK SIZE
dL¢S EOd>?SE a.PP► ltaTtv�.. AekA ='�IS� �4^ r.r. : Fi .. 2 f ^.
LEACH FACILITY + �j �_� j' � �:?t'L,z
Mob MEt� SIDE WALL ( ... . ) o G/D. S Z.
AG i= Ilo.lS BOTTOM C1t4a�Llol 1�'4 S1S� I.b ) h�l G/D.
CO bea seKe TOTAL 451 U
tCo 14.6 Ui E2 ' _ 13.85 , \� �� f '/ 4Q% / Q
USE: qE LEACHING TIEI.D `\
ro�, i -/ v
(�"� i01 W I K C} ' LOnIC� � O.S I7� P +' ,' � '
1 4'—, WATER ENCOUNTERED D E `� 23 � / / /
NOTES' (UNLESS OTHERWISE NOTED) S?< sr rjr; rat Srlccr Q /
t ' G
Ko(r A4JU�T�dE'r� CAC.CS• ,'S�. / r
1.DATUM(MSU TAKEN FROM JLM ZS F•1.7-M•COKM• PaNE>`. 25 0001 n O 1 r7�
2.MUNICIPAL WATER 1S AVAILABLEOF
s.PIPE PITCH:4A"PER FOOT
1.DESIGN LOADING FOR ALL PRECAST UNITS:AASHO• -e4 AMIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(1)FT..PIPE JOINTS SHALL BE MADE WATER TIGHT M g7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF ASS.STATE ENVIRONMENTAL CO'DE TITLESR / SITE PLAN
b.T4A5 VLAol W,, mwo"P 'gp 019M okVr � 'O-U•C � tED . r
� l�Ro�P"'iv UI.J5 efAJU6;� E � •, �� - OF_ LOCUS: LOT 5 E V5 La N D2.1 VE
11.41e4c_:xLe_ 4o f e�-re s,-� Lk-f D jv,Kic z14-t-N• ot NAL ENGINEE P:.R o� ARNE yG
+G. Io'ptlwteLoFi.Jl-►Sur��trE So11, - fr�J1(Z(cp L�¢o.��+o � ►t Fac ic �T�. t H. �'. REF: PB. 281 PG. 22
t _
(lOWdl cape engineering . O 1 ~; PREPARED FOR:—C1 2E F r J&B R IE L 0"E<
} /
CIVIL ENGINEERS
LAND SURVEYORS ` CI t
BOARD OF HEALTH I
(EXISTING)'............ E z' on main GIL RE -Q�., R
�"= '
CONTOURS (PROPOSED)-0-O--O-�- APPROVED ATE BdeNS�l-C�Bi-�rMA SCALE 30 DATE
SECTION — SEWAGE bSsFss Ml>,P 1�8 , Lod 83 ZbNEp -cam
i FLoobZC1N SETBbctCs' F�ZONT 20,
i SIDES to'
SEPTIC TANK- 32, -"01,80X - -LEACH FIffLD
TOP OF FON tz 0 UT� h
-- "2"OF4eT01h" 1 LOGU5, 7 a Q�
WASHEDSTONE F
EL.24. a G
4 mJ r Q � $ENGIlM�K=1C ESl'd10E
� � � ELEY• = 21. B�
L
_ 5
1 rL" PERF.PvG PSi'E
A IN• OUT- IN- 2z.35 / y L-OCbT1oN M4P
OUT T. IN• ��{ f i" !
2 2-�I 3SEPTIC /
ELEV. / ;--T3 TANK 21.85 - '2ct:.;3!ylso 1; Q
LEV. -I'
o
ELEV. ELEV. :40 -�- ` (7 22 i-
SEPTIC T6hlK To 4�t,v1` INLET TEES 7-z tL.' Zt q9 cam, 1 \ i\i ``,� / 6� zi2p
.iNLE.T'TEET0t_.KTE140 W' '.E'l.OW 1!(4EIZT ELEV. ELEV. i ` gyp,
�_OUZLET TEETO Ef.Tgi.10 14"gELbw IKvE¢ I[
T - {, 0�� ;
soJ.weTee o
(O r4•0 OFUW -Ilh.. i 23 Q, ti
WASHED STONE \�SEPTIGT
7�\,, LD S
` s
114
TEST HOLE LOG
i 1
TEST BY IP•FdiEB4N J.yu 9 r,41NC-7 I, (g,o.�{
4 3
WITNESS
TEST DATE DESIGN BEDROOM HOUSE ,
T.H. • 1 T.H. 0 2 �I��\0
ELEV. Z2.6 ELEV.22 1- NO t . I .r;k0�� 1�,2 F A�X�\
LOdM DISPOSER DISPOSER
<2 �:: 1 �; ` %:; E 0G 3 \
s PrSol �_ v$s� PERC RATE MIN/IN. {{ t - S ,y ,{, e \ 20
19° -'��•$- 18 20. FLOW RATE 116 3 (GALJDAY I
SEPTIC TANK -,S (I s1= 496. 5 -
LF.. C\_F ilk REO'D SEPTIC TANK SIZE
04¢S Eobese APPI.IG4T�v�.► APB z v/"9�= 44a 1. Q �� a ,-^'
LEACH FACILITY
SIDE WALL
BOTTOM (I+4o)) 104-1) =4515 t I.p 1 . 'F �I G/D. i
bt3 56ND TOTAL 4s1 !a c
/ 0
12f0 1IL , USE: auk LEACHING 0
14.1 6i01 W IDE CSC S r-1=P \
1 Lowe +� OA D1 /
WATER ENCOUNTERED ' �� 2?
NOTES: (UNLESS OTHERWISE NOTED) s = ''`_ � ; SHEET-.
M 25 F'.I:QM.COKM• PoeiEL, � 250001 OOIG G
1.DATUM(MSU•-TAKEN FROM.R �J
!.MUNICIPAL WATER 1S AVAILABLE
, S
!.PIPE PITCH:1r•'PER FOOT �N Of
�.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO- -I O -44
S.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES:(I)FT. G� \��/ /� !
i.PIPE JOINTS SHALL BE MADE WATER TIGHT ARNE H. �. , �(�
7.CONSTRUCTION DETAILS TO of ACCORDANCE WITH COMM.OF MASS. 1 OJALA
STATE ENVIRONMENTAL.CODE TITLE 5 CIVIL I f' SITE ' PLAN
�.'ft115 PIA►! PE:OP�Jg;> 0gr G.JLef j e0aj D dof W IJOW No.
9 I LOCUS: L 07 S E VS d IJ D 21 V E
OF
'Sri �5 d tz N 5 7 L_F_ , M is.
1•�Nc � f Yv�� Ir��✓ 'Ii�-i T V.GI �1� �7sf�I�, R NAL ENGINEEGI R o� ARN
i.0. 1o'p�Mvvtel_oFrJr►Su�'(sbl.E Seut f-ajta4= L�POJ. �p ��u► Fc-f_t ,ram. r H. �_1 REF: PB. 2S1 Pa. 22.
? d*WO cope en8ineeiiaf �.so °J LA NI PREPARED FOR: C=RE-EnI 61z I E R 1.O M E
` CIVIL ENGINEERS /
�r Tc .�%.
BOARD OF HEALTH .�.�� LAND SURVEYORS ilE cl 15 R
(EXISTING)------------- V• 1��1 CONTOURS OL
(PROPOSED)�O-0"O-0- APPROVED GATE BdeNr7�ASL-��MA f rA SCALE 1'' = 3a 1 g
•�� GATE Z 2 S
a -
ALL
Ai
SEPTIC PROFILE - ,: TEST HOLE LOGS
T.O.F. AT EL. Z
ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE)
ACCESS COVER (WATERTIGHT') TO ,,. ._ .__. ENGINEER:
ZS�a MINIMUM .75' OF COVER OVER PRECAST WITHIN S' OF FIN. GRADE
.� — 2% SLOPE REQUIRED OVER SYSTEM WITNESS: --
2.� o k
' RUN PIPE LEVEL — DATE:------- -- _ �0 0 i I
FOR FIRST 2' Y DOUBLE WASHED PEA` ONE AT` — h
PROPOSED — 3' MAX PEFZ.. R
GALLON SEPTIC \ _ —y` -- r, CLASS — — SOILS P
"a 3
/yi 4 TANK (H— 10 ) GAS L— ) w+j
BAFFLE
oil
0 0 0 01 a 0 0 a
SLOPE) 6" CRUSHED STONE OR MECHANICAL '
`$o • • • • • • • • • • • •
COMPACTION. (15.2r. [2]) �1—_ --------------- ,��.� 4 ELEV. � ELEV.
DEPTH OF FLOW = _ r < `� �
s SLOPE) ( % SLOPE) L "-`
TEE SIZES: } A,E✓� : -t {x
INLET DEPTH
3/4 TO 1 1/2 DOUBLE WASH-ED STONE --- - - - - -"� f ' I LOCATION MAP SCALE 1- _
OUTLET DEPTH
FOUNDATION-- --- SEPTIC TANK --- ------ D' BO;x, ---- -- -- - _ LEACHING ASSESSORS MAP PARCEL
FACILITY
ZONING DISTRICT:
YARD SETBACKS: ' 4'
FRONT = Z�
SIDE = o
REAR
I 11 PLAN REF. —
I FLOOD ZONE:
r _
T'-- NOTES:
t90 41 t-•4 TV bA
ARBAGE DISPOSER I 1 . DATUM IS
,�,, �, • �-w;�,,•�,,..s- - . ; �•- *�-. ' 'ra.. SEPTIC DESIGN: (G s !�✓� � ��.�ww►% � I N(a� ; ,'"�.►•-1 'y
_ D-SIGN FLOW: _:� BEDROOMS (t i1,J.GPnI — lam GPD 7. MUNICIPAL- WATER IS
X , LSE A ' _ GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. i
�•. `, ``j��---b i
S PTIC TANK: GPD
- T 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H-
w. _ _ --
s � "Sc `'�"� 1 � � - "��:� • °� �''�,` `� �.."' •- (_� LSE A • :;. GALLON SEPTIC TANK PIPE JOINTS TO BE MADE WATERTIGHT.
��- ✓"� MCI, �, �. .� G;.� j ` ' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
a% �y �� LEACHING ENVIRONMENTAL_ CODE TITLE V.
7. TH'S PLANRO;IS FOR P 'OSEG WORK ONL', AND NOT TO BE
SIDES:
USED FOR LOT LINE STAKING.
/ E
1 f� f 4 �' h '\ J ` \ • \� ` lwJ? 7 S x toGi >?i �1 c "
EOTTOM: (� 8. PIPE FOR SEPTIC SYSTEM TO SCH. aC-4 PVC.,
�`�'�.� �+ �"'` ` , a ►� � �- T3TAL: �t� S.F. h"a GPp 9 COMPONENTS NOT 0 BE BACKFILLED OR CONCEALED WITHOUT
_.__ _- --- •-•' -- i INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED
.Cj�; i �` __- - -- ��'�T tic I:�? i.1T�,�•r a1G , TS FROM BOARD OF HEALTH.
--_ >
. _ .'
m �J / , - <', +� _ "' �( �- -`---- r--�--- �= tq' "�'�-` �0. CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE
as Y, y
r LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR
.., � '---•-..,,.�_..,.•� �'` ,�� `�� .��;..----' r �r��� '' �_ .- ,. . ..... %%'�i '"%--�''�.c�- v��ac-y - �.a' k -�t.y �'a _ � TO COMMENCEMENT OF W
, ORK.
GEND
S' TE AND SEWAGE PLAN
F 1 00.0 PROPOSED SPOT ELEVATION OF
100XIC EXISTING SPOT ELEVATION ---- -- ---
r v r 1 IN THE TOWN OF:
, ram 100l PROPOSED CONTOUR ,
s r —• J — — 1 OO — — EXISTING CONTOUR PREPARED FOR:
ri
E-12 Xr _u
BOARD OF HEALTH
�1 "" " / — - - ------- — ---- - --- MA SCALE: II- 2 DATE:
�� ��• / APPROVED DATE
14,
off 5W-362-4541
4 !.1'J�.'.. y.l(G.1',.,i-r.1 vJ D E.i►' raSe.ta-'S (�p..l ►�R-G c•�' E:.•G 1-i�...If:.-+l►j �)fr�y.•►-1 �A.";-L,'% t�¢Y i 'j�K.('
1101 1 fax 509 362-9W �/AsL nFA/71t�A- !�-, i�I�E)
t -t'� r.�� i-� 1.� - "' �C. Qf�srO�.C�Sc-;r ":Opk... �''SY✓ F':,a ZI
wk- �� 1� down cape engineering, Inc.
CIVIL ENGINEERS ri
LAND SURVEYORSOJMA
�- ,-- • •f939 main st. yarmouth, ma 02675 '� --DATJOB -r -� ` dZ- 52.�� JAL#4' DATE
�' s t tV