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HomeMy WebLinkAbout0094 GREELY AVENUE - Health 94 GREELY AVE. Centerville A=245 - 145 UPC 12534 No.2153L w►ataos.ur No........7j........ J!................. THE COMMONWEALTH.OF MASSACHUSETTS BOAeRD .. LTH ---------- ........OF....... ... .............................. Apphration for UhipmFal Works Tonstrurtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal_ _��.i��il,....141v-.C-- t� ..ys .... ............... 1nQ-.A7_.d.d retssLoctio f_ =" ................•= 7.. e -3 L-oe.. -•-•---•---•--••--•. - a .... ................•-••--••-•• ..._..••---- ---.t..N ........... Owner Addr sf.5 ............... .......... = ..................................... Installer Address Type of Building Size Lot---�a}dsl_0.....Sq. feet U Dwelling-�No. of Bedrooms........... ............................Expansion Attic ( ) Garbage Grinder 4/9 '04 4 Other—T e of Building No. of persons............................ Showers — Cafeteria C� Other fixtures -----•..................•-•--- -- --- ----- ---- - -------•- W Design Flow......��.................. gallons per person per day. Total daily flow............. � ...............gallons. Septic Tank-�Liquid capacity. ....gallons Length................ Width................ Diameter................ Depth................ W x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area____....__._._._.___sq.-ft. �: Seepage Pit No.�°Q_Q___----- iameter.149(k..... Depth below inlet.................... Total leaching area..02.6.A-_...sq. ft. Z Other Distribution box ( Dosing tank ( ) Percolation Test Results Performed by............. ............................................................ Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit------------_....... Depth to ground water........................ G4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-..-•-_____.-__---______ Ri t..... •... �----- --a•-N�f •••..... O Descri o of Soil.... ......... . V 3 = . - -- / P - --- al y W - `�............................. Nature of Repairs or A tI erations—AnsV when a ica U P PP --------------- -- ----------------------------------------------•-..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITi U 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' ed b the b d of health. Signe .-•. ...... .... ........ ....................................... .................................. ate Application Approved By.. Date.............. Application Disapproved for t7elffollowing reasons:..................................... ...----•-•-•...............•-•••••-•----......•-•••••-----•-•...........---•-----•-•••-•-----•--.....•••.-----••-•---------•--------------------...----•-•••---•-•--•••••-----•--------••••-------•-•••- _-..Date Permit No......................................................... Issued. ...... ._ ..•..... D b " No....... ............ ;Kss.... _............._ THE COMMONWEALTH OF MASSACHUSETTS BOARD 9F HE TH .............Y--- .............. ........: ... '...... Appliration,. CiipniFai Works Tomitrurtion rrmit Application-is hereby made form Permit o n pp ,. y t t Construct ( ) or Repair. ( ) an Individual Sewage Disposal System at: 07 ... 0 Locn-Address q} Lot N A� �} Owner /► Addr s Installer= Address UType of Building/ Size Lot...40�4#.O._...Sq. feet Dwelling�KNo. of Bedrooms.......... ...........................Expansion Attic ( ) Garbage Grinder 401P a`k Other=Type of Building No. of ersons............................ Showers YP g ---------------•---•-------- ---P---------•- - ( ) — Cafeteria ( ) Otherfixtures ------------------------•-----•-•-•--------• • •-••----------•----------------------...........•---•-----......_------•-----_.... W Design Flow....: _____________ ________gallons per person per day. Total daily flow..............!�rl'--'-�� ................gallons. WSeptic Tank. Liquid'capacity.--_.gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length............____.___ Total leaching area....................sq. ft. Seepage Pit No.10.0-0...... iameter../OXA..... Depth below inlet.................... Total leaching area a AP. t..sq. ft. Z Other Distribution box ( Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ O f___. ..........._.____ ................�._____.._..A.....---- --._..... .......... .. Descrip�+•,off. off So•1.•----_�"'_. J_ ..........................` � sir... r = y -- -- w t 111 VNature of Repairs or A aerations—Ansvber when applica� ..•-•-• -•------------------•--••---•-•----••----------•••-•••-------------------------••................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITY-E 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' ed b the b d of health. lgne ..... . ................................... ................................ Date Application Approved BY ._.... --------- � `-- ............ Date Application Disapproved for t e following reasons-------------------------------•----•-------•-•-------------•------------------------------------------....---•- ---------••-•-•..................•-•----...---••---------•--•-------•-----••--•---------•... -------••••------------------....--•-•------••----------•--------•--•--••-•------•-------•--------•------. Date PermitNo......................................................... Issued_........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH ......OF.......... E� ................................................ C rr#if iratr of T,aanpliFaurr THIS AT R71FY, at the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.. 4�'�i .._. - j ........... .......-- A. staller has been installed in accordance ith the provisions of TIU__ 5 The State Sanitary Code as des" cri din the application for Disposal Works Construction Permit No.._ ____ a...____ dated....._7!- "_- ? *.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE' SYSTEM WILL FUNC�N SATISFA TORY. C. DATE............................... Inspector. ------ THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTH ......... ......OF....... .. ,/!l!j.................................................... FEE.... i la tt1 v ,niirnrt it rrmii Permission i reby granted ' t d'l ( aG Gi1-------------------------------------------------------------------- to Constru ( or Rep ( an I ividual ewage posal S stem w-��j at No. t 4... �' �f ......-•-• ........ ... ........ Street as shown on the application for Disposal Works Construction Per 0_____________ ed.... .................... -.•----. Board of ealth DATE------------------•------•------••--•-----------............•-•--------- I FORM 1255 HOBBS & WARREN, INC., PUBLISHERS i 3 3 M .20� Z. O _-DRa v *y p r ® ' I I N10, � s h � � o o I f3ox �„Z �•' zo' N /c/`9. D. T,Pu S T 0. Agle 3117 /JoT�T-��*yiq+JZv.urS J3ASC� oN L�5 SVMGrD D.47-vy ` CERTIFIED PLOT PLAN LOCATIONr?Q,4FDW SCALE . ��: .'. . . DATE mASS. 0207 PLAN REFERENCE . . . . . . .S/-/olA/n/ /9.S C.�9•D, T7?.�..sT nrV� y '�l r I CERTIFY THAT THE ! ' .'sT / SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SEUACK REQUIREMENTS OF THE TOWN OF A?Z!�! . . . . . . WHEN CONSTRUCTED. Ci/9 D. TIZit/,,S 7- DATE PETITIONER: REGISTERED LAND SURV OR S �'T Z o oc Z .-Ayo�t d7`3 L. . .04/o. . ... . TOP OF FOUNDATION ' CONCRETE COVER ;;' CONCRETE COVERS •e o 4' CAST IRON 12"MAX. r" 3/4 PIPE (OR 12"MAEQUIV.)- MIN. 4 ORANGEBURG(OR EOUIV.) J PITCH 1/4"PER.FT. PIPE - MIN. LEACH PITCH 1/4"PER.FT PITCASTCHINGINVERT ° aEL.�B.Go.._ INVERT INVERT P . w ORSEPTIC TANK DIST. OUIV.ERT EL. ' ' BOX EL _/G•76 • .. GAL. INVERT F- 'EL.......... INVERT v` w w : TO 11/2EL./4.. �: SHEDONE• /Z --►tom-6�DIA. o• 11- �-- /o, DIA. PROF1 LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE P EL III Y SOIL LOG WITNESSED BY : DATE ; lY< TIME. �7�3o.A �A?!L. .M�!� � . BOARD OF HEALTH TEST HOLE I TEST HOLE 2 Rtt ENGINEER ELEV. . 30. . . . ELEV. .�� .IQ. . . i ' S 8 S � DESIGN DATA 34 NUMBER OF BEDROOMS TOTAL ESTIMATED FLOW . .33v. . GALLONS/DAY SstivD n ¢e -- Co'' BOTTOM LEACHING AREA 7�"Sv „ SQ.FT. /PIT .SAA/D/ SIDE LEACHING AREA i8e�sv Clr�•y�+�X.rv� �•f/Xrvi� . . t SQ.FT./ PIT GARBAGE DISPOSAL . e�IOAI' (50 % AREA INCREASE) CC TOTAL LEACHING AREA . ?�7: v. SQ.FT SA��p 5.4-►/D /44 PERCOLATION RATE MIN/INCH /.N!-?.WATER ENCOUNTERED E LEACHING AREA PER PERCOLATION RAT . . SQ.FT. NUMBER OF LEACHING PITS APPROVED . . . . . . BOARD OF HEALTH Sro v8' PZ-'Yz PrT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DATE . . . . . THOMAS E.KELLEY CO. n AGENT OR INSPECTOR ENGINEERS—SURVEYORS Ulu& C 346 LONG POND DRIVE ., � S,OUTH YARMOUTH,MASSjA OF, MAss9 02664THOMAS C ` i •• //////+� �, s � v TO O N G/STEQ���1►�i. SS�ONALtia PETITIONER TOWN OF BARNSTABL-E— LOCATION �� �£'L y .i . SEWAGE # VII-LAGS R' ASSESSORS MAP & LOT /NsPfe ar �J J% ,/ s©e NAME&PHONE NO. �? d`lJ �!9`/U�O �S' -0 SEPTIC TANK CAPACITY �fT� /NSF cic� LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMI IT COMPLIANCE DATE: 44:= -Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility. (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by � Q o 13' r COMMONWEALTH OF MASSACHUSETTS z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL PROTECTION F ie,M SyO� /\ 350 MAIN STREET WEST YARMOUTH,MA Ciff UM 508-775-2800 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSME TS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM 3 PART A r``` CERTIFICATION MAP 245 PAR 145 Property Address: 94 GREELY AVENUE Owner's Name: THIBEAULT,GEORGE Owner's Address: 181 CATERINA HEIGHTS CONCORD,MA 01742 t Date of Inspection DECEMBER 12,2002 Name of Inspector:(please print) JAMES D.SEARS ,• Company Name: A&B Canco yrki7F�Litpr''��E Mailing Address: 350 Main Street West Yarmouth,MA 02673 Telephone Number: 508-775-2800 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ./ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: /� -fib• C, 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 tot he buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 1 � Y Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 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: N/A 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 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 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: Title 5 Inspection Form 6/15/2000 2 i Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 C. Further Evaluation is Required by the Board of Health: N/A 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 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 public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility,- and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Title 5 Inspection Form 6/15/2000 3 J Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(CONTINUED) Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 D. System Failure Criteria applicable to all systems: N/A 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 pit 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 N/A Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply N/A Any portion of a cesspool or privy is within a Zone 1 of a public well N/A Any portion of a cesspool or privy is within 50 feet of a private water supply well N/A Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.) NO (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:-N/A To be considered a large system the system must service a facility with a design flow of 10,000 gpd to 15,000 gpd. 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 the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well. If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system is 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. Title 5 Inspection Form 6/15/2000 4 Page 5 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 Check if the following have been done. You must indicate"yes"or"no"as to each of the following Yes No J Pumping information was provided by the owner,occupant,or Board of Health J Were any of the system components pumped out in the previous two weeks? J Has the system received normal flows in the previous two week period? J Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) J Was the facility or dwelling inspected for signs of sewage back up? J 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)has been determined based on: Yes �--No -------------------_ - _ J Existing information. For example,a plan at the Board of Health. J 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)] Title 5 Inspection Form 6/15/2000 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 FLOW CONDITIONS RESIDENTIAL Number of Bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 11.0 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): YES Seasonal use(yes or no): YES Water meter readings,if available(last 2 years usage(gpd)): N/A Sump pump(yes or no) NO Last date of occupancy: UNKNOWN COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: N/A Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: gallons—How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM / Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: 1980 PERMIT#80-371 Were sewage odors detected when arriving at the site(yes or no): NO Title 5 Inspection Form 6/15/2000 6 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 BUILDING SEWER(locate on site plan): ✓ Depth below grade: 14" Materials of construction: Cast iron w-'40 PVC _ other(explain) Distance from private water supply well or suction line: Comments(on condition of joints,Venting,evidence of leakage,etc.):' SEPTIC TANK(locate onsite plan): ✓ Depth below grade: 16" Material of construction: ✓ concrete metal fiberglass polyethylene other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1,000 GALLON PRE CAST Sludge depth: 3" Distance from top of sludge to the bottom of outlet tee or baffle: 27" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 12" Distance from bottom of scum to bottom of outlet tee or baffle: 16" How were dimensions determined: ASBUILT AND TAPE Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): MAIN TANK AT WORKING LEVEL.INLET TEE,OUTLET BAFFLE.TANK AND COVERS 16"BELOW GRADE.NO SIGN OF OVERLOADING SEEN. GREASE TRAP(located on site plan) —-N/A -- Depth below grade: Material of construction: concrete metal fiberglass polyethylene other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recormnendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Title 5 Inspection Form 6/15/2000 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 TIGHT or HOLDING TANK: N/A (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no) Alann level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ./ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.,): DISTRIBUTION BOX IS 16"X16",2 1"BELOW GRADE.BOX IS LEVEL AND SOLID.ONE LINE IN,ONE LINE OUT.NO SIGN OF OVERLOADING OR SOLID CARRYOVER. PUMP CHAMBER: N/A (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Title 5 Inspection Form 6/15/2000 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type if leaching pits,number: 1 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.) LEACHING IS ONE 1,000 GALLON PRE CAST PIT.PIT AND COVER 24"BELOW GRADE.DRY,STAIN LINE AT 30".WALLS CLEAN,NO SIGN OF OVERLOADING OR SOLID CARRYOVER. CESSPOOLS: N/A (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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation etc.): PRIVY: N/A (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.) Title 5 Inspection Form 6/15/2000 9 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two pennanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. l�✓ 0 1 � Title 5 Inspection Form 6/15/2000 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 94 GREELY AVENUE WEST HYANNISPORT,MA 02672 Owner: THIBEAULT,GEORGE Date of Inspection: DECEMBER 12,2002 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to no groundwater 12 feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: J Observation site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation Accessed USGS database-explain: You must describe how you established the high ground water elevation: HAND DUG TEST HOLE 12'NO WATER. 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DUE TosNN COPYRIGHT DATE REVISIONS A"R�°—OssmmDMIL SECOND FLOOR PLAN NORTHSIDE NDRTHSIOE HEREBY EXPRESLY a DESIGN D 2 a 8 >s �R DESIGN RO ESPO RIIUW OR OG90E RESERVES ITSCOMMON LAW ON LO SEsOwOmun'at UAINUTY COPYRIGHT.THESES PLANS ARE � Rw�daN ASSOCIATES NOT TO BE REPRODUCEDSHEET N0. DATE: p01�a oD w T"E PROPOSED CONDITIONS OR COPIED IN ANY DRAWN JH OR �OC��Ix CHANGEDFO M OR MMA NER WHATSOEVER 1°""'ENE°`R 'Q� MAGUIRE RE51DENGE WITHOUT FIRST OBTAINING THE fIRE C[IIOENOaG Cab1RUCTlb�A 8/26/08va ES TAIRN TO TOUR 02AL DISTINCTIVE RESIDENTIAL do COMMERCIAL DESIGNIXPARTMENT 0CIAM REPUTOR 94 GREELY AVENUE EEXPRES I�NT�OF rPER I IS DENn��M5T WEST 1-IYANNISPORT '�5'a MAIN rARMourHPORT�IW36=z�Z CHECKED DESIGN. w7 i Ia 24.82 ----------- --- - x 2 g� / \ x 25.08 / \ �02 0 200 25.02 \� \ .29, ` PROPOSED G 4�� DRIVEWAY e+ � 94 24.95 PROP. GARAGE 25.65 ' ` / FIRE PIT AREA EXISTING 5.61 25.77 25.62 W / x GRAVEL DRIVE p = 26.01 25.79 LOT AREA o 25,032 SF t a 25.14 .08 �i.11 Q' SHED 36 •4' o 4 / m DECK c�AI 24.98 30,0, / 5 8 I r LP �� 30.8. EXISTING DWELLING TOP FNDN. = 26.76' 24,95 x 26 16 26 rt rn N 77CC qq cp� 125. O 5.90 26 Q 6.06 0% C VV 0 25.82 ---•�� ` `v 26.08 �ts 6.42 PUTTING REEN 25.88 6.16 !^ StpCKAO f �NCe �, 26.1 (6 S 2�0'22 43 � 2 i I kl� EF INE LINE r RmaE VEwi ARCHITECTURAL DESIGN . ALT SHMGL6 -- IV11 vmOP 5HFATHMR/ F , y (m n Tro•sTwlcnrRAL woeE ��x . anO RAFIEIiSo la•ou PS M296 ' -- - � _ Rse Fb.MS�i vrvx.FntieLpe'4-W�sq,ay� . 8WFSTBGYR3kD OSTER41E,NA02655 TO AVOID VO _ • I R1Gm WPIO WASH BARRH2 RC¢liRm - O � ___ AT F%18"Rt®fiE OP E%}ERIWt WALL. - ! FA=1>�AT ALL � rt,6THt,TOP F1ATE _. - rrB FAV.JA/lxd� MB�BH2 ' l.ONNNaYi VB"W6 SOFFR BSI - : I <I FJ"H2'02 WALL " - � Sib 9[f.STUDS P ta'OLl . .. 1 - f a•1i3�1 Fb.MJ1V . 4 mX41O VS TK�7➢SMCATHMb/ . BREAKFASTNOOK .. {.. TmzpnW5T U8 3' 8x46'GONLREIE WALL e . 10 MILYAP IREfNSBt I"v WATK1.AVi FOOTING PARTIAL REAR ELEVATION SCALE:114"=1.-0„ 5EGTION"A-A" o " , m s I aI I K!1 usTwvtAce I I 0 cc FO.MDATbH{VRIDOW I I NEW CRAWL SPACE - 1 I sCOWArEM LViTC I I. Ni ` rolma<a10 NEW BREAKFAST NOOKry1 --._—I � - II 10 m�vAFaR REIARp32 I CD - \ so 1/8[60 v9• 30 v9• - i F I . Lij ' ,� 8Yc06'WNCRETE WALL .1 1ox16•ccwnw�us FaomG '�:I .�i I ARCH i 1 IA . _ _ j I a I - wKHers vxsxva- I r.I . LR4/OJE FJOSTdIG�' ^•• CREATE ALfE6 , - ... A GASWOFBIIa16 - EXISTING BA5EMENT 94 GREELEY AVE - t EXISTING KITCHEN to EXISTING MASTER BEDROOM W.HYANNISPORT AMMON �10- FOUNDATION PLAN „ i • . SCALE:1/4"=1'-0" . a ' • ' Ell 6dE 1E 64 I EXISTING RESIDENCE WALL LEGEND EXISTING - - EXISTING BATH EXISTING - "�' PLANS/ELEVATIONS REMOVED -- t . f EXISTNG LIVING ROOM , FIRST FLOOR PLAN • Al I SCALE 1/4"=l'-0" DAB van r Q Ville L c s { a s Nantucket �24.8%2 . Sound X 25.08 LOCUS MAP SCALE 1"=2000'f �o N ASSESSORS MAP 245 PARCEL 145 25.02 \G f \�0 S , LOCUS IS WITHIN FEMA FLOOD ZONE C AS !� PROPOSED �G� SHOWN ON COMMUNITY PANEL #250001 D DRIVEWAY n E � DATED REV. JULY 2, 1992 94 24.95 ZONING SUMMARY \ PROP. GARAGE 25.65FIRE PIT AREA ZONING DISTRICT: RD-1 EXISTING GRAVEL DRIVE 25.27 25.62 MIN. FRONT MIN. SIDE SETBACK CK 30 10' / 2 / 26.01 25.79 MIN. REAR SETBACK 10' N LOT AREA MAX. BUILDING HEIGHT 30, 25,032 SF f 25.14 .08 aa 11 SITE IS LOCATED WITHIN AP DISTRICT I 36.4' oQU SHED EXIST. �� DECK �. 24.98 OWNER OF RECORD / MICHAEL & KAREN MAGUIRE 94 GRtE:LY AVENUE 25 8 _. .. LP WEST HYANNISPORT v� 30 8 EXISTING DWELLING 4 / TOP FNDN. = 26.76' y �I REFERENCES X 24.95 O �� J 25."26 16 z6 N 26.76 o DEED BOOK 16242 PAGE 96 p N cy PLAN BOOK 292 PAGE 72 26 5.90 O 6.06 N 25.82 NOTES 6.42 26.08 v PUTTING REEN 25.88 ® 1. DATUM: APPROX. NGVD (GIS SPOT ELEV.) 6.16 2. SEPTIC SYSTEM SHOWN PER AS—BUILT ON Sro�KgD f E�NeF FILE WITH THE HEALTH DEPT. 2 po 22 26.1 43 \k 2 SITE PLAN OF i i 94 GREELY AVENUE WEST HYANNISPORT I PREPARED FOR off 508-362-4541 fax 508 362-9880 OF MICHAEL & KAREN MAGUIRE spa DANIEL �yG down cope engineering, Inc. A. 01ALA N AUGUST 15, 2008 Cl 1/lL ENGINEERS o 4098, 4 LAND SURVEYORS �d ' Scole: 1"= 20' 939 Main Street — YARMOUTHPORT, MASS. DATE DANIEL A. ~, PLS A, PE, -- - 08-186 0 10 20 30 40 50 FEET