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0185 GREAT MARSH ROAD - Health
85 Great Marsh Road Centerville tier" 1 A = 210 131 i SIIII �aECYClEpC� �J y„ UPC 10259 No. H163OR HASTIN0S.4N r � F No. - Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes IK PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, IVIASSACHUSETTS Z�PYiration for disposal 6pstem Construction permit pplication for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components aA oca ion Address or Lot No. 19 f , law r� Owner's Name,Address, Tel.No. 0-08 Assessor's Map/Parcel ((� �3 3,-b , &�7 AC� A ZO I oiler's Name,Address,and Tel.No.5D? 9,5-y-qS S` Designer's Name,Address,and Tel.No. I /it am /"1 X2e>'s e 'n f,, 'i j Al,rwc L( L7®KJv)(jee Shy S&P q / Type of Building: nn (t�vjf t(uJ J. f'► je« -d Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building ��� e No.of Persons Showers( ) Cafeteria( ) s Other Fixtures I Design Flow(min.required) a gpd Design flow provided 3.30 gpd Plan Date -(3 Number of sheets f Revision Date Title Size of Septic Tank OO Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �c /p1�n-c c�•�]� ` Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o H lth. n S' d `e Date Application Approved by Date �f7 Application Disapproved by Date for the following reasons T Permit No. Date Issued Z� l ---------------- ——_--- - — - -- — - --- - — No. U l J/ 1 9' Fee ! U� THE-COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes / PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS application for Misposai 6pstem Construction permit `Application for.a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Mai `ocation Address or Lot No. Vs— " � V&. Owner's Name,Address,and Tel.No. D$ cj S L/ 9na", 0)A z� j,"I C CI e rn � ) Assessor's Map/Parcel y, , ®, 'U ' 3s PCl r5)- r S �� /Vo✓sue�1 /�A ZO Inst ller's Name,Address,and Tel.No.Sp? 95-f-qr�s� Designer's �Name, LAddress,and Tel.No. (�3 - F) 4 ,f2/"� // A, ,,v I t I�Owh LZ G ItS� � ,S � �G N'i91^ C Type of Building: (H",tf CW-4 Dwelling No.of Bedrooms 9 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building ���, ,(_P,n C-C No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 33 0 gpd Plan Date Sr-f Number of sheets / Revision Date Title Size of Septic Tank /5 by Type of S.A.S. Description of SgiI t Nature of Repairs or Alterations(Answer when applicable) SAP t c�+-z Re✓iPCp r+c c9n"� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He,411h. •� Simemd -`��C -++ Date Application Approved by A Date ` �0 J Application Disapproved by Date - for the following reasons Permit No. d ( Date Issued 0 r ---------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(.A Repaired( ) Upgraded( ) Abandoned( )by �,,j 1 ( ova �� l�a..r ✓\ at /Se C CraZ� r-4? has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated k 2 0 - ? Installer LA)I �Zk-1 rl r- ('&Z+r"l Designer #bedrooms Approved design fl I pw— Z d gpd The issuance of this perm �-(, 1 �it shall not be construed as a guarantee that the systern will function a designed. �Date 3 Inspector --------------------------------------------------------------------------------------------------------------------------------------- No. 2 G J (Cl Fee d y THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ]Disposal 6pstem Construction permit Permission is hereby granted to Construct(/) Repair( ) 1Upgrade( ) Abandon( ) System located at /�f S C-r e z M 2►'� kc� re',f c e✓, and'as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction 7 ust be completed within three years of the date of this permit. !,� Q ! ,, G "ll tl� /e, Date �/ U/ 1 Approved by TOWN OF BARNSTABLE ~.LOCATION 5 - mwr �'x� SEWAGE# �5�� l� Cre all)- 'VILLAGE nr,14cy-V ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY d LEACHING FACILITY.(type) G�z'"'1 e� (size) ov NO.OF BEDROOMS a OWNER 0X)Zv`il PERMIT DATE: -Z D -1-3 COMPLIANCE DATE: 9 / -/3 Separation Distance Between the: l ' 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) / 2 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY IAA,4zvA D �3 r, )T7 SO 7 14 J-- - L. L aul-tory Services n' Ibrt/Ze la, F. n, �c:UeT' 3—r�t1`icvLor TD 2GO MQL n St-eetr,11-1yannjis, U 02601 0Lice: 508-862-4644 Fax: 508-700-6304 L esigner cCerf1'icratio n Form Date, �7 6� Sew,ne lr'ermit-o'�bl'3 '3l —Assessor's lM2pTarcell �d /3/ W' � �IA l�esn�ere �Ov)rj � �- - iIL2e 11mstaIlIlera � n.{ DD , Address: 9�� cti Address- �✓ff yG�rttov.� Oda„ On 5elq I 06>1 3 wM, /l (WeQ-✓'% was issued a permit to install a (date) n , (installer) septic system.at (/�- lT'ej HN'f4- a based on a design drawn by // (address) dated I&V• P 14 13- . V (design r) I certify that the septic system. referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocatioof the distribution box and/or septic tank. dlo'�: yv C'Xi I certify that the septic system referenced above was installed with major changes (Lo. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Flair revision or certified as-built by designer to _follow. H OF 414Ssgc (Installer's Signature)— o OJALA m� CIVILCA No.46502 o � ONAL ENG\a� Mesigll (Affix Designer's Stauip Mere) 'LEASE RETIGRs-i 1O BAMNMiBLE FIMIC HEALTH CERMCA E OF �e�ie :a'a id�� `—L NOT BE 6SKMETJ ui TIL 30TH '��S FORM AND A -BUILT C, r�R3; RECEIVE D BY THE BA NSTABLE PUBLIC FIT-HALgH DWISION. THAP1IK YOU. Q:talth/Septic/Desigaer Certification Form 3-26-04.Zoc Tow n of Barnstable p 4 /0 a s 7' Department of Regulatory Services Public Health Division DateMAM 200 Main Street,Hyannis MA 02601 Date Scheduled r ) Time Fee Pd. Soil Suitability .Assessment for Sewage Disposal Performed By: Witnessed By: LOCATION& GENnnERAL INFORMATION Location Addregs ��s 6k-e-oc'f- �lZ,�,f _ /'�eC. Owner's Name M C C!C a,,, ,\ Aa,�-dfg, gd. Address Cer4t� V I 1 LR- Assessor's Map/Parcel: a`O!/3 Engineer's Name Q P W h are NEW CONSTRUCTION REPAIR Telephone# , i7 3&A— 'J Y 1 . Land Use: I A ! Slopes(%) C 'G —S Surface Stones / � Distances from: Open Water Body�1 EGG ff Possible Wet Area Drinking Water Well /Wft Drainage Way lw ft Property Une ft Other ft SIME'TCH:(Street name,dimensions of lot,exact locations of test holes&pare tests,locate wetlands In proximity to holes) 411 �0o L-P �� �Z 00- N- VV Parent material(geologic)OG,4IA Q S ! Depth to 60drOelt Depth to Groundwater Standing Water in Hole: ' " //� Weeping from Plt Foca_ /y/A Estimated Seasonal High(Groundwater DETERMINATION FOR SEASONAL HIGH'WATER TABLE Method Used: Depth Observed standing in obs.hole: In. Depth to soil mottles: jtt, Depth to weeping from side of obs.hole: In, Groundwater Adjustment ft. Index Well# Reading Date: Index Well]oval _ Adj,f'actor— Add.(Groundwater Level PERCOLATION TEST Dide l7 d TW1,______ [Depth rvation # Time at 9" _ of Pero Time at G" Start Pre-soak Time @Time(9"-6") End Pre-soak Rate Min./loch Site Suitability Assessment: Site Passed '" Sitq Failed: Additional Testing Needed(X/N) /' Original: Public Health Division Observation Hole Data To Be Completed on Back--------- ***I£percolation test is to be conducted within 100' of wetland,you must first notify the. ! Barnstable Conservation Division at Ieast one(1) week prior to beginning. Q:\S EPTICVERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Sdil Color Soil• Qfhtr Surface(in.) (USDA) (Munsell) Mottling (Structure, Stones;Boulders, i ten'Y.%Uravel) �-Z O y-3 L S 00ip /k DEEP OBSERVATION HOLE LOG Hole# .�- Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (structure;Stones,Boulders. . —Q-0nplstrncv,%Or e J -72 3 -150 C A1/6 DEEP OBSERVATION HOLE LOG Hole#. Depth$om Soil Horizon Sall Texture Soil Color Soil Other Sur face(m.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o i to c Crawl) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Moll Other Surface(in.) (USDA) (Munsell) Mottling (structure,Sloncs',Boulders. Consistency, y Flood Insurance Rate Map: Above 500 year flood boundary No— Within 500 year boundary No V/,/ Yes Within 100 year flood boundary No.e Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas obstrved throughout the area proposed for the soil absorption system? Y F' If not, what is the depth of naturally occurring pervious material? Certification A/0 `' I,-)I certify that on V (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in�10 CMR 15.017. Signature Date (� 3 Q AS.EPTIaPERCPORM.DO C !� Date Physical Street Address-Check database to ensure it exists �- Working Phone Number _Actual Amounts -( ie. gas being used to fuel machines, thinner to clean brushes all count as hazardous materials-no blanks) Storage Information -location of storage, how long is storage for? If none, note that. Disposal Information -where and who? If none, note that. Applicant Signature - understand what is listed and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -give a vehicle washing policy and explain it !i Attach the Business Certificate with your sign off and comments **The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the.Town Clerk's Office, 1st Fl., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. DATE Fill in please: _ APPLICANT'S YOUR NAME/CORPORATE NAME 1V1 S BUSINESS YOUR HOME ADDRESS: I/ 6 r C -✓ 1--✓ p TELEPHONE # Home Telephone Number o der NAME OF NEW BUSINESS -7 EIN: 4/5-- 2 D Have you been given approval from j!je b ildin division YES NO ADDRESS OF BUSINESS l� MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. , 1. BUILDING COIF ISSIO ER'S OFFFo MUST COMPLY WITH HOME OCCUPATION This individ al h s n y p rmit req irements that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO Aut on d Signat COMPLY MAY RESULT IN FINES. MMENT r Q 2. BOARD OF ALTH This individual haa b, n inf m d of the it rr qu ements that pertain to this type of business. Authorized nature"' COMMENTS: MUST COMPLY WITH ALL, RAZARDOUS MATERIALS REGULATIONS 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: TOWN OF BARNSTABLE Date:07/ m/ TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: T t f �/ BUSINESS LOCATION: I& a tNVENTORY MAILING ADDRESS: Vj, IL y7 // 0?63ZTOTAL AMOUNT- TELEPHONE NUMBER: n 8 - 9"17 - p2 2r CONTACT PERSON: _60wolee'l I /V1 c EMERGENCY CONTACT T�ELjPHONE NUMBER: Sb f f_/7 —o Z --t MSDS ON SITE? TYPE OF BUSINESS: Wp /yAleb1/ INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes 1 GA l/.N _10 r W h 2C Laundry soil &stain removers ' �aUcOncluding bleach) /G4& Au/ry ©' DPKi+, Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials 11TAO�WN bF BARNSTABLE LOCATION 1 �;/`P,Zt 1"(I�r r h �, SEWAGE # �.�� 7 VII.;LAGE C�a✓1 I er v, I ) _ASSESSOR'S MAP & LOT 2/D /91 INSTALLER'S NAME&PHONE NO.L YA I .'E2"I IL©Sf SEPTIC TANK CAPACITY I62) a LEACHING FACILITY: (type) (size) 1. J,W NO. OF BEDROOMS J BUILDER OR OWNER Om J ea r rt_ PERMITDATE: i COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �or, Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) N/A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by N No. S �. 'ar 4 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Rppfication for Migoar *pttem Construction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. r�is C-t e Z I, JM z rs 4 Act Owner's,�fj ame,Address and Tel.No. C2✓tjer,� lie fate. IllZwl r'vl Cfl��e-,A Assessor's Map/Parcel *Dvo _ �� / JL /-r� (� r� S�'t �Ll Nbvwu�l 1 02. Installer's Name,Address,and Tel.No. r Q ��s 1 Designer's 1Name,A/d�drress and Tel.No. SZ)�_ 3 6 a_ J J ��1l►2+� ✓►'1 LCiez�'� 35ri s ra 1� ��„Iezre. �H�y'✓�eer6 orw>✓1f pZo�f .5-08- 95-L!' 95 J G C13.3 2,j-1 S7L Y2rk'70-_ h Type of Building: Dwelling No.of Bedrooms 3 — Lot Size Z9. 0,3 L> sq.ft. Garbage Grinder(/✓o) Other Type of Building F-rP w.c Qes. No.of Persons Showers( f ) Cafeteria( ) Other Fixtures _1 i J6 �( S►V7 _C k% Design Flow 33 gallons per day. Calculated daily flow gallons. Plan Date ef a -o f Number of sheets Revision Date Title Size of Septic Tank I.S 0 Type of S.A.S. l?e cl Description of Soil j4e_,�/C JS 0 a,—5� Nature of Repairs or Alterations(Answer when applicable) P Date last inspected: r)C / 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 this Board of Health. Sig Date — r Application Approved b Date 1 S s Application Disapproved for the following reasons Permit No. o'�a0 y 5 7 Date Issued 00 No: 7 . . , "a~Y_ Feed M Entered in computer: \••,.tY '1 � THE MONWEALTH�.OF MASSACHUSETTS Yes * PUBLIC HEALTH-DIVISION -TOWN OF BARNSTABLE} MASSACHUSETTS ` Rpprication for D gpont *pgtem Congtruction Permit [Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System ❑Individual Components Location Address or Lot No./?J Cr e Z M a v-S 4 AC_1 Owner's ame,Address and Tel.No. 9s-4 Assessor's Map/Parcel O j© — 13 / a�- /;r 3� (0Z r i s" / 8 /v©e-X/' 0Z1)&1 Installer's Name,Address,and Tel.No. Fi�5 p r.s 1 � Designer's Name,Address and Tel.No. 01Ih?,— �► LC/e.Ze-' , 3? I� Gt i�Loneare- t,1-,-;/ce,t /Uorwel[ 02_06l —5-(� �1S'-f �.� J �0 939 2►rt Sf 1�r'v'7o.���r x Type of Building: �' r Dwelling No.of Bedrooms Lot Size 000 sq.ft. Garbage Grinder(,Vo) Other Type of Building F_r2 rw c Pcc. No. of Persons Showers( 1 ) Cafetepiki— ). i Other Fixtures �o�)e��� 1� 51�+✓ - ��c�w2St�- 0--5 e l De'sign Flow ! 4646S� 933 gallons per day. Calculated daily flow gallons. Plan Date ef - x o—01 Number of sheets Revision Date Title Size"of Septic Tank J,S-u0 Type of S.A.S. 8e J Description of Soil,. Mc /C_CDs 0 "s- 7�5� Nature of Repairs or Alterations(Answer when applicable) .,/7 L-e.-.e.✓� t , Date last inspected: d 6:0 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 this Board of Health. , Sig `Date Application Approved b Date ,?) ) Application Disapproved for the following reasons !t Permit No. S-co S (4 a 7 Date Issued M �.�c � SQd` —10�1'�..� �-----------,--------- —--- =.-- E COMMONWEALTH OF MASSACHUSETTS ,,. aib BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( Upgraded( ) Abandoned( )by lJ.3 at N r r, yw S h CQ N�Q + a 1\�e_ has been constructed 'n acc rdance P with the provisions of Ti le 5 and the for Disposal System Construction Permit No. ��dated io , b Installer Il� cn Designer Cam, The issuance of t 's perrAit shall not be construed'as a"guarantee that the'sy to 'wi will .unction s,desiig ed.,,•,,,," a _bate /d C� �.� Inspector 3. - ,.-, � —————————————————————————— l � � . _ No. ��9 Fee ... THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE},_,MASSACHUSETTS Fe M gpogal *pgtem Con$truition permit Permission is hereby granted to Cof truct( )Repair(V U ra ( )Abandon(rr ) 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:Constructio must be completed within three years of the dat oft is Date:_ P 1,� 10-5 _ _ Approved`by Town of Barnstable Regulatory Services Thomas F. Geiler,Director fARNSTAS[E. MAss Public Health Division En 39. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form. Date: Sewage Permit# -rPM a 75 A-ssessor's Map\Parcel c 110 ,3 f Designer: U w n (!� C /h Q&3 1k� Installer: Address: !3 M i c/ Address: On was issued a permit to install a (date) (installer) / I r septic system at I 6�-et Ma,,-.rk- based on a design drawn by J (address) r� ay- Q dated / °Z`3 (de 'gner) Z'I'ce ify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. of 14g810 ARNE H.OJA y�N (Installer's Signature) 0 CIVIL No. 30792 �FG/STE��o��� ASS/ONAI E.N�'\ esi er's tgna (Affix De t er's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc a N_ 3 N Ty N t" O rn oFT"E rOiyti Town of Barnstable Regulatory Services * * * BMWSTABLE, * Thomas F. Geiler, Director 9 MASS. �p 1639. a Public Health Division rFD MA'S Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 William H. McClearn Date: March 1, 2005 35 First Parish Road. Norwell, Ma. 02061 NON-COMPLIANCE WITH STATE ENVIRONMENTAL CODE TITLE V. The septic system owned by you located at 185 Great Marsh Road , Centerville was inspected on, 4/1/2001 by John Graci 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: Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. Our records show that the system has been in a failed state for more than two years. You are ordered to hire a professional engineer or registered sanitarian to prepare a plan of proposed replacement septic system component(s). This plan is to be submitted to the.Town of Barnstable Public Health Division Office (Regulatory Services, 200 Main Street,.Hyannis),within (90) days receipt of this letter. The plan will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title V. You are a lso o rdered t o u ade o r r e l pgr p ace t he s eptic s ystem w rtlun s ix months (180) days o f y our receipt of this letter. Any person aggrieved by any order issued by the local approval authority may appeal to any court o f competent jurisdiction as provided for by the laws of the Commonwealth. You have the option of requesting an adjudicatory hearing pursuant to 310 CMR 15.422 Failure to comply with this order will automatically result in a public hearing scheduled before the Board of Health. PER O T BOARD OF HEALTH r omas A. McKean,R.S., C.H.O. Agent of the Board of Health CC: Board of Health JAmled_septic_letters COMMONWEALTH OF MASSACHUSETTST EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS s DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED ,F �' APR 6 2001 , r TOWN OF BARNSTABLE x'•; HEALTH DEPT. TITLE 5 ` ri r; OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS 4 RF F SUBSUACE SEWAGE DISPOSAL SYSTEM FORM `'`- PART A t' t � ; w; CERTIFICATION Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 Owner's Name: ROBERT THOMPSON C.O MARY MCDONOUGH Owner's Address: 97 EMERALD LANE MARSTONS MILLS MA.02649 FAILED INSPECTION ' Date of Inspection: 4/2/01 Name of Inspector: (please print) JOHN GRACI k ` Company Name: SEPTIC INSPECTIONS °z,'„ � Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 j st Telephone Number: 508-564-6813 FAX 508-564-7270 t CERTIFICATION STATEMENT ! 3 " I certify that I have personally inspected the sewage disposal system at this address and that the information reported below isj true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system ' inspector pursuant to Section 15:34,0 of Title 5(310 CMR 15.000). The system: _ Passes ! _ Conditionally Passes _ Needs�..Furtlier valuation by the Local Approving Authority X Fails Inspector's Signature: Date: 4/2/01 I , The system inspector shall submi a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 'wl ' 30 days of completing this inspection. If the system is a shared system or has a design now 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 ty. sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments THE SYSTEM FAILS TITLE V INSPECTION. THE LEACH TRENCH IS PAST THE EFFECTIVE DEPTH OF LEACHING.THE STAIN LINES IN THE MAIN CESSPOOL HAVE BEEN OVER THE PIPE.THE TRENCH HAS BEEN SATURATED. r f ' s tPA ****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 I 1 f"=1- ., t OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) ' Property Address: 185 GREAT,MARSH RD HOUSE CENTERVILLE,MA 02632 Owner: ROBERT THOMPSON C.O MARY MCDONOUGH Date of Inspection: 4/2/01 ' { Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D i 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 s` 1.� ` CMR 15.304 exist.Any failure criteria not evaluated are indicated below. six r- Comments: THE SYSTEM FAILS TITLE V INSPECTION. THE LEACH TRENCH IS PAST THE EFFECTIVE DEPTH OF LEACHING.THE STAIN LINES IN THE MAIN CESSPOOL HAVE BEEN OVER THE PIPE.THE TRENCH HAS BEEN SATURATED. 3 B. System Conditionally Passes:. :.,-ads;• ,.,; ;;. _ 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;TJD)in the for the following statements. If"not determined"please explain. U> n/a 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 ass inspection if the existing tank is replaced " Y P P g P ,�.-,� with a complying septic tank as approved by the Board of Health. ` *A metal septic tank will ass inspection if it is structural) sound,not leaking and if a Certificate of Compliance indicating # 'r P P P Y g P that the tank is less than 20 years old is available. ND explain: n/a n/a Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced i ND explain: n/a a. N p. n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass ¢c, inspection if(with approval of the Board of Health): -'i _broken,pipes)are replaced _obstruction is removed E F ND explain: n/a Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS x f. 3,ii'1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ` w CERTIFICATION(continued) k4 `i s�7gF�. Li.Sj��e' 7 Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 Owner: ROBERT THOMPSON C.O MARY MCDONOUGH Date of Inspection: 4/2/01 p ki. C. Further Evaluation is Required by the Board of Health: ;`g Conditions exist which require ftMher evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the''enviromnent. 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 s3, a 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the 47" 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. 'Fist j _ 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 t`ik and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used e6t determine distance n/a "This system passes if the well'water analysis,performed at a DEP certified laboratory,for coliform bacteria and y �- 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 at ached'`,ta this form. ` .7 3. Other: `*' n/a ti. {+r9i II 4, Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' , f PART A CERTIFICATION(continued) Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 Y Owner: ROBERT THOMPSON C.OiMARY MCDONOUGH Date of Inspection: 4/2/01 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for alLinspections: Yes No X _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ondin of effluent to the surface of the round or surface waters due to an overloaded or clogged - g P g g gg SAS or cesspool - X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool , �'.. X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/z day flow _ X Required pumping more than 4 times in the last year NnT due to clogged or obstructed pipe(s).Number of times pumped nLa. - X Any portion of the SAS,cesspool or privy is below high ground water elevation. - X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. R ., ! }' - X Any portion of a cesspool or privy is within a Zone 1 of a public well. ` r i s i4 - X Any portion of a cesspool or privy is within 50 feet of a private water supply well. > > � - X 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 :.� lfiii,• 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 o- -z , '"a less than 5 ppm,provided,that no other failure criteria are triggered.A copy of the analysis must be3, attached to this form.) X _ (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. ;< ; E. Large Systems: ? To be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 gpd. yt��t You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no $' - X the system is within 400 feet of a surface drinking water supply ''L 4it X the system is within 200"feet of a tributary to a surface drinking water supply X the system is located in a`nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped w} Zone I1 of a public water.supply well 4' t If you have answered"yes 1p any question in Section E the system is considered a significant threat,or answered l a "yes"in Section D above the lame 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. s {164. A. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 ` r Owner: ROBERT THOMPSON C.O MARY MCDONOUGH ' s: Date of Inspection: 4/2/01 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health _ X Were any of the system components pumped out in the previous two weeks? i _ X Has the system received normal flows in the previous two week period? 1, _ X Have large volumes of water been introduced to the system recently or as part of this inspection? X Were as built plans of the system obtained and examined?(If they were riot available note as N/A) i„, X _ Was the facility or dwelling,inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? : a X _ Were all system components,excluding the SAS,located on site? X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the R baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? X _ 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: , t Yes no s ' X Existing information. For`example,a plan at the Board of Health. *` } 3 ':1 X _ 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)] F 4. 41y�1. r j : Page 6 of 11 E � i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Viz. PART C SYSTEM INFORMATION u` Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 .J Owner: ROBERT THOMPSON,C;O MARY MCDONOUGH •�5 Date of Inspection: 4/2/01 t FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):3r, Nu'mber of bedrooms(actual): 3 DESIGN flow based on 310 CM11"115.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no):NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no):YES Water meter readings,if available(last 2 years usage(gpd)): n/a Sump pump(yes or no): NO .5 k:r4'Q Last date of occupancy: n/a F COMMERCIALANDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): n/agpd Basis of design flow(seats/persons/sqft,etc.): n/a f, Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO •„,. Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings,if available:,n/a , Last date of occupancy/use: n/a OTHER(describe): n/a t. 'GENERAL INFORMATION Pumping Records Source of information: n/a } Was system pumped as part of the inspection(yes or no): NO T If yes,volume pumped: n/agallons--'How was quantity pumped determined? n/a Reason for pumping: n/a ; TYPE OF SYSTEM •"'* X Septic tank,distribution box,soil absorption system cesspool Single cess r _ g P ` •?t��s' _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) r ' _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from j �. system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a ' Approximate age of all components,:date installed(if known)and source of information: 1950 k t,•. 't Were sewage odors detected when arriving at the site(yes or no): NO E { S" (1• r '^f Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ;j". PART C SYSTEM INFORMATION(continued) Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 Owner: ROBERT THOMPSON C.O MARY MCDONOUGH tf 'U{•: Date of Inspection: 4/2/01 +t BUILDING SEWER(locate on site plan) Depth below grade: 18" N:w.. Materials of construction:_cast iron _40 PVC Xother(explain): ORANGEBURG "`"" + Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 12" ".s Material of construction:Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 5' X 5' BLOCK CESSPOOL" Sludge depth: n/a " t Distance from top of sludge to bottom of outlet tee or baffle: n/a �.` <`.... Scum thickness: n/a x� Distance from top of scum to top of outlet tee or baffle: n/a s� Distance from bottom of scum to bottom of outlet tee or baffle: n/a f How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): �e THE SYSTEM FAILS,THE STAIN LINES INDICATE THE LIQUID LEVEL HAS BEEN OVER PIPE. # { t GREASE TRAP:_(locate on site plan) i 4 re 55 Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a �;n.i Scum thickness: n/a Distance from top of scum to top of_outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a k Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related ;r to outlet invert,evidence of leakage,etc.): n/a 114, fill . .r IT S JT fy f Sri J 7 Page 8 of 11 r ' 9.4t. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ` SYSTEM INFORMATION(continued) ; Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 Owner: ROBERT THOMPSON-C.O MARY MCDONOUGH Date of Inspection: 4/2/01 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) c . Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level:N/A Alarm in working order(yes or no): NO Date of last pumping: n/a ` Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:_(if present must be opened)(locate on site plan) 't G l r t a� Depth of liquid level above outlet invert: n/a Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): n/a PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a s .i 9/ F R Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 Owner: ROBERT THOMPSON C.O MARY MCDONOUGH Date of Inspection: 4/2/01 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) Y If SAS not located explain why: n/a ' �.. Type n/a leaching pits, number: n/a n/a leaching chambers, number: n/a n/a leaching galleries, number: nla 1 leaching trenches, number, length: 20 n/a leaching fields, number: n/a n/a overflow cesspool, number: n/a n/a " ' innovative/alternative system a1 f Type/name of technology: n/a r Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): THE LEACH TRENCH IS PAST THE EFFECTIVE DEPTH OF LEACHING,THE TRENCH HAS BEEN SATURATED.THE STAIN LINES IN CESSPOOL INDICATE THE SYSTEM HAS BEEN IN HYDRAULIC F' tj` { . . ` . FAILURE. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a s Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a .``4''`$,. Depth of scum layer: n/a ";` '° Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): =l n/a PRIVY: (locate on site plan) I S M. Materials of construction: n/a Dimensions: n/a �, ? Depth of solids: n/ai}y' Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a "f g is ;. E .F . Page 10 of 11 i OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM , PART C Y SYSTEM INFORMATION(continued) Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 Owner: ROBERT THOMPSON C.O MARY MCDONOUGH Date of Inspection: 4/2/01 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. c each �- H. 4` ti i w� i Page 11 of 11 .t OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ' i SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 185 GREAT MARSH RD HOUSE CENTERVILLE,MA 02632 Owner: ROBERT THOMPSON C.O MARY MCDONOUGH Date of Inspection: 4/2/01 SITE EXAM ` _Slope Ya,, Surface water ) _Check cellar , Shallow wells Estimated depth to ground water 10 feet ' Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a ={ti �;''�;, YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators,installers-(attach documentation) NO Accessed USGS databasetgxplain: n/a 5 You must describe how you established the high ground water elevation: GROUNDATER IS AT 10' I; # sra r t r i Ni; tail ' I I SYSTEM PROFILE TEST HOLE LOGS TOP FNDN. AT EL.48.04' ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) ACCESS COVER (WATERTIGHT) TO ENGINEER D.A. OJALA, SE /46.0' MINIMUM ,75' OF COVER OVER PRECAST /� WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM 46.0' WITNESS. GLENN HARRINGTON, RS _ 2" DOUBLE WASHED-PEASTONE f+ DATE: 7/17/01 , RUN PIPE LEVEL 45.37 "-�"�-` FOR FIRST 2' PERC. RATE < 2 MIN/INCH LOCUS ( PROPOSED 1500 Y INVERTS Ll 1 ' 44.0 GALLON SEPTIC 43.75 43.0 CLASS I SOILS P# c�AT MARSH TANK (H-._) GAS 43.0' BAFFLE '43.17' corn r' x ( 3 % SLOPE) �6" CRUSHED STONE OR MECHANICAL 42.5 co Q c� 1 ELEV. 3. �. 4' COMPACTION. (15.221 (2)) 0.5 �� 0 41.85' Q. ALA: $� J� DEPTH OF FLOW s ( 11 X SLOPE) TEE SIZES: lee 3/4" TO 1 1/2" DOUCILE WASHED STONE FILL .. INLET DEPTH m 10" 15„ OUTLET DEPTH 14" LAY PIPE AT 0 5'/' SLOPE A LOCATION MAP Vr • LE�1CHIhJG 8.95' SL FOUNDATION--- 10 SEPTIC TANK 5 D' BOX 8' FACILITY 20.r 10YR 3/2 ASSESSORS MAP t10 PARCEL 131 `+ B I i LS i 32.9' 50" 10YR 6/6 41.23' ^ o N +D.00 _ wr -I`5,21 MED/COS , Y 7 4 UTILITY' LE C�,g,� G T as,91 GUY a6 �, f�s, 150 32,9' WIRE X/ +47.78 _ NO WATER ENCOUNTERED NOTES: /,/ >4,6 38 O�D r _ �6.67 SEPTIC DESIGN; (GARBAGE DISPOSER IS NOT ALLOWED 1. DATUM IS ASSUMED FROM BARNSTABLE GIS MAP E�IS LNG r o . s �3�.,, .,f t. . . . : t DESIGN LONi. _. 8EDt2C3t0M5� GPt7\),. .� __sGPD,.._ M. P L WAS � •� , ,l. , rxm�sr�.+r��i�S�.":»:€ .,�".'r„ ,�?nR� ,d;^,F,,,�' �..: •,.,,..r,a,,,,.., .i ,5.-�..,,,,.k, � `e`P�._ G'.&�1w ;! n �47.32 USL A 3.... GPD DESIGN -FLOV _ 3 MI'�IINIUM PIPE .'IT i 1� F 1 P=R r+ r'F - 8, f, a / /46,7 14( 711. 1 _ - / / STONE WATER ,po, ��, jr SEPTIC TANK: 330 GPD ( 2 �, 660 4. DESIGN LOADIN` FOR ALL PRECAST UNI�IS U SE AASHO H- DRIVE /' SHUTOFF5• PIPE JOINTS TO &F MADE WATERTIGHT, 1500 USE A __-_ GALLON SEPTIC TANK '6. CONSTRUCTION DETAILS TO BE IN 'ACCO,RDANCE WITH MASS. LEACHIN ENVIRONMENTAL CODE TITLE V, i 47.22•� « �a6.24 W 47.27 i N/A 47.` 4 / GU -' 7. TH S PLAN 15 FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT SIDES: A� E '.6�, t - �_TO BE USED FOR ANY OT''AER ,PURPOSE. �46.5a �I-46,14 fr 30 x 15 (.74) 333 CO UTY f. BOTTOM: 5 PIPE,:POR SEPTIC SYSTEM TO SCH. 40-4 PVC...._ POLE � 333 9, COMPONENTS NOT TO BE BACKFILLED OR .CONCEALEV�VITHOUT ' TOTAL:.. 450 S.F. GPD HOUSE ,�185 �` ,IVSPECTION BY BOARD -OF-HEALTH AND 'PERMISSION OBTAINED 49 26 USE LEACH FIELD, 30 x 15 WITH (4) 4 PERF, PVC FROM BOARD OF MEAL TH: .68 PIPES SPACED 3' APART, WITH 0.5' STONE BENEATH 10.- PUMP & REMOVE OR FILL;.W CLEAN SAND EXISTING f :Io 47.'j8 DECK EXISTING 46,52 i \ / ) SYSTEM j .\ DWELLING TFw48.04• V LUO BLOCK �� 1 CHE RY SAPL PATIO tvQ' 6.94 N TI TL E . SI TE PLAN 46' 46 PROPOSED SPOT ELEVATION OF_ _ PROVIDE .92 ���� 185 'GREAT MARSH ROAD ClEANOUT --•�,.• ry0 0 100x0 EXISTING SPOT ELEVATION IN THE TOWN OF: \ TH �5 J 100 PROPOSED CONTOUR - CENTERVILLE BARNSTABL E � � 100 EXISTING CONTOUR s PREPARED FOR: W I_LIAM MCCLEARf� IQ� / 5,25 +44.44 20 0 20 40 60 Feet LOT 5 23 BENCHMARK �. �.. NAIL IN 25" OAK 35,413 SFt ELEV a 47.T BOARD OF HEALTH / 44 MA = JULY 23 2001 +44.34 SCALE: 1" 20• DATE: / UTILITY APPROVED DATE POLE ..._., ` 5' REMOVAL OF UNSUITABLE SOIL REQUIRED AROUND PERIMETER OF +44.38 + 5.05 43.96 off sos-3a2-a!ur LEACH FIELD, DOWN TO SUITABLE GUY Cox 908 362-9�0 SOIL LAYER. REPLACE WITH CLEAN WIRE i MED. SAND. down cane en�ylneerin,p�, inc. Q �G• 4 j l' C3 b Of Hqs' ��'� ^� . CIVIL ENGINEERS H, c MNt j } ' O o O.OU � o� PANE � �' o AR�"f H, o + LAND SURVEYORS °'"�'" +44,07 +44.46 939 main st. yarmoutr, ma 02675 , ! _f l SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE TEST�+m HOLE T L� LOGS TOP FNDN. AT EL. 45.88' MARKED WITH MAGNETIC TAPE OR 1 1 11 L E (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. ACCESS COVER TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE ENGINEER: D.A. OJALA, SE ACCESS COVER (WATERTIGHT) TO 2' PEASTONE OR GE❑TEXTILE GLENN HARRINGTON, RS 45.0 MINIMUM .75' OF COVER OVER PRECAST / WITH RED OVCR SYSTE IN 6" OF FIN. GRADE FILTER FABRIC OVER STONE 2% SLOPE REQUIM 44.8 WITNESS: �- RUN PIPE LEVEL BLOCKS OR DATE; 7/17/01 I 43.71' FOR FIRST 2' MORTAR ALL PRECAST RISERS < 2 MIN/INCH LOCUS (EXIST) P7ROPOSED 1 500 4 COMPONENTS PERC. RATE _ //`` <TYPJ INV'S EL, 4195' 4' GALLON SEPTIC , ENDS SIDES 42.65 42.40 ;0000000 ° : o`a00000a CLASS SOILS P# GREAT MARSH �� TANK (H- 10 ) GAS ° ®® ®®®® ®0®® �®M® 8g000°o° BAFFLE 0000`� 42.06 42.23 6" MIN SUMP 0 o°o°o°o° , ti 2 12" MIN. INT. DIM. > ° ° ° ° °°°°°°°° 39.95 �i J ELEV. Liz ELEV. 9� ( % SLOPE) �6" CRUSHED STONE OR MECHANICAL O„ , 0» COMPACTION. (15.221 [21) L 45.4 45.4 H-10 500 GAL. LEACHING CHAMBEf BY ACME PRECAST❑R EQUAL. l DEPTH OF FLOW = 4 ( 1 % SLOPE) ( 1-7 SLOPE) (2) UNITS REQUIRED 0 0` TEE SIZES: 3/4'- -1/2' DOUBLE WASHED STONE 4' MIN. 10„ ALL AROUND PRECAST STRUCTURES 2" 2" Q INLET DEPTH = OVERALL DIMENSI❑NS TO ❑UTSIDE OF STONE, 25.00' X 12.83' -» OUTLET DEPTH = 14 LS LS LOCATION MAP NTS LEACHING 4„ 1OYR 4/2 4„ 1OYR1 4/2 FOUNDATION- 53' SEPTIC TANK 17' D' BOX 13' FACILITY ASSESSORS MAP 210 PARCEL 131 32.9' BOTTOM TH *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL NO GROUNDWATER FOUND LS Ls UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM 1OYR 6/6 1OYR 6/6 v 36" 42.4' 36" 42.4' C c NOTES 0 perc ® perc 1. DATUM IS 7N �la NNC- 1 ® 0r1 G(U=1�ri M/ alb �L�, ASSUMED 7` -- MED/COS MED/COS 2. MUNICIPAL WATER IS EXISTING >O +44.38 `al�' IS �(1/•\N t7 �a�j1"}' J�,..11�\�� LOT 6 3C� �� ���� 2.5Y 7/4 2.5Y 7/4 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. �w J+-(\��S SON 4. DESIGN LOADING FOR ALL PROPOSED PRECAST i UNITS TO BE AASHO H-]Q 5. PIPE JOINTS TO BE MADE WATERTIGHT. 0.00 150" 32.9' 150" 32.9' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH 310 CMR 15.000 (TITLE 5.) NO WATER ENCOUNTERED ��� 2(� +44,07 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND +44,46 NOT TO BE USED FOR LOT LINE STAKING OR ANY +43.08 OTHER PURPOSE. II1' PROVIDE CLEANOUT 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. SEPTIC DESIGN: (GARBAGE DISPOSER Is NOT AI I OWED ) 1�_,C V-A XD50)`� G o 00 - - 9: COMPONENTS NOT TO BE BACKFILLED OR o ='LOT 5 S 2 -<BEDROOMS 110 GPD) ._ `20, _. CONCEALED WITHOUT INSPECTION BY BOARD OF rp 144,46 USE FLG�f. __ 8�31ROOMS ( GP�J) GPD HEALTH AND PERMISSION OBTAINED FROM BOARD 35,413 SFf DESIGN A 220 GPD` DESIGN FLOW OF HEALTH. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR { 44,1 1L ,z�4 SEPTIC TANK: 220 GPD ( 2 ) = 440 CALLING DIGSAFE (1-888-344-7233) AND -I-43.32 CID44.88 �55 CI(� /j; � �1 +4 6 4 USE A 1500 GALLON SEPTIC TANK VERIFYING THE LOCATION OF ALL UNDERGROUND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF PROP. EXISTING j WORK. CLEAN-OUTS DWELLING LEACHING: +42.78 TF = 45.88' t5 11. ANY UNSUITABLE MATERIAL ENCOUNTERED `� 2� 2 ►)®TIE: Tq\ �� 2(25 + 12.83) 2 (.74) = 112 44 8 le A ow N �a 116 (�1C k1°4Ct SIDES: SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. 25 x 12.83 (.74) = 237 BOTTOM; 12. EXISTING LEACHING FACILITY SHALL BE PUMPED 44 ' DECK " AND REMOVED OR PUMPED AND FILLED WITH CLEAN +44. T6TAL: 472 S.F. 349 GPD SAND. RNEP1 +43 1 - , 44,98 ob USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR CPw '� 58 � W 1 \�� -I-43.64 EgUAL) WITH 4' STONE ALL AROUND UTILITY �\ / 45.37-,, GRAV ��� +43.30 POLE �\ , +44,41 T .\ DRIV 2 ` SLEEVE SEWERLINE FOR 10' EITHER \ 43,46 ti� O \ � +44�1 ZZ I SIDE OF CROSSING WITH WATERLINE \ LEGEND I Fo 100.0 PROPOSED SPOT ELEVATION TITLE 5 SITE PLAN p \, \ + 100x0 EXISTING SPOT ELEVATION OF +4501. +44/g9 44,39 00 PROPOSED CONTOUR 185 GREAT MARSH ROAD IN THE TOWN OF: yo\` / +44 4 ` 0 �'S 0 EXISTING CONTOUR y 4 oG�P ( CENTERVILLE ) BARNSTABLE ` 44,18 �� ,/ PREPARED FOR: WILLIAM McCLEARN 0� ,21 20 0 20 40 60 Feet BOARD OF HEALTH BENCHMARK MA �44.37`� 44 / NAIL IN 18 OAK APPROVED DATE ' o / ELEV ' 0.00 44.81 SCALE: 1„ _ 20' DATE: JULY 23, 2001 i +44,08 off 508-362-4541 NOTE: SEPTIC SYSTEM IS NOT DESIGNED fax 508 362-9880 8/8/13 (SAS) o�� � � FOR VEHICLE LOADING l� 119/13 (ADDRESS) s'" G DA 'IEL down cape engineering, inc. �� OANIBLA. OJALA �. �\ o OJA a CIVIL e" Io " OJ(FLA �\ CIVIL No.46502 OJALA A'0.40a80 CIVIL ENGINEERS � - .� No. LAND SURVEYORS �Fs ��s e� G`� ss ` qN es °y �'°suRVI& -44.85 `SIONAI ESE mh�r�' 939 main st. yarmouth, ma 02675 V O 1 - > 79 DANIEL A. OJALA, .E., P.L.S. DATE