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0041 BABBLING BROOK ROAD - Health
41 BABBLING BROOD CENTERVILLE Now A = 188151 -- ---- -- - ----------------- - - -- - - ------ - — I S_III_��Jf® ECYC(FOCort, /I7 a Ts UPC 12534 No.2� 1� 53 pR NASTING8. YN e FIR c r G 5 lz - s r ^ C '1 NZ) Aj Bk 18295 Ps219 0-16692 03-49-2004 & 08= 42sx DEED RESTRICTION WHEREAS, STEVEN W. PORTER and JANICE M.PORTER,TRUSTEES OF THE PORTER REALTY TRUST,u/d/t dated February 4,2000,recorded in the Barnstable County Land Registry as Document No.794428,41 Babbling Brook Road,Centerville,MA,02632,are the owners of 41 Babbling Brook Road,Centerville,MA,02632,hereinafter after referred to as LOT A on a plan entitled"Plan of Land in Centerville,Barnstable,Mass.made for Valand,Inc."dated December 23, 1983 by Eldredge Engineering Co.,Inc.,recorded at the Barnstable Registry of Deeds in Plan Book 379,Page 65; WHEREAS,STEVEN W.PORTER and JANICE M.PORTER,TRUSTEES OF THE PORTER REALTY TRUST as the owners of said property have agreed with the Town of Barnstable Board of Health to a restriction as to the number of rooms contained in the house built on said lot that may be used as bedrooms; WHEREAS,the Town of Barnstable Board of Health,as a pre-condition to issuing a certificate certifying that the septic system located on said property is in compliance with 310 CMR 15.200, State Environmental Code,Title V,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage,is requiring that the agreement for the restriction as to number of rooms contained in the house built on said lot that may be used as bedrooms be put on record with the Barnstable County Registry of Deeds by recording this document.; NOW,THEREFORE, STEVEN W.PORTER and JANICE M.PORTER,TRUSTEES OF THE PORTER REALTY TRUST do hereby place the following restriction on the above-referenced land in accordance with their agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding upon all successors in title: The number of rooms that shall be permitted to be used as bedrooms in the dwelling located on the property at 41 Babbling Brook Road,Barnstable County,Centerville,Massachusetts,shown as LOT A on a plan entitled"Plan of Land in Centerville,Barnstable,Mass.made for Valand, Inc."dated December 23, 1983 by Eldredge Engineering Co.,Inc.,recorded stable Registry of Deeds in Plan Book 379,Page 65,shall not be increased beyon ee rooms, EXCEPT that,as the Town of Barnstable has agreed,a fourth room may be us oom if,and only if,the septic system located on said lot is upgraded,as required by 310 CMR 15.200, State Environmental Code,Title V,Minimum Requirements for the Subsurface Disposal of Sanitary Sewage. E Property address:41 Babbling Brook Road,Centerville,MA,02632 For title of STEVEN W. PORTER and JANICE M.PORTER,TRUSTEES OF THE PORTER REALTY TRUST see deed recorded at Barnstable Registry of Deeds in Book 13725,Page 322. Bk 18295 Pg 220 #16692 Executed as a sealed instrument this of �j' March 2004. 19'�Y , STEVEN W.PORTER,TRUSTEE r n- '7'? ICE M.PORTER,TRUSTEE COMMONWEALTH OF MASSACHUSETTS Barnstable,ss. March 2004 Then personally appeared the above named STEVEN W.PORTER,TRUSTEE and JANICE M. PORTER,TRUSTEE acknowledged the foregoing instrument to be their free acts and deeds, before me Brian D. WidegreAj Notary Public My commission expires:June 23,2006 q T Gl TRB�SCpU ROE CQt�F o �1SZ� AST 44EAO RE��BT�H BARNSTABLE REGISTRY OF DEEDS MAR. 10. 2004 11 : 23AM N0. 2110 P. 1 5 Kt _ t1le,No.41 Babbling brook Page#7 W �r 9vmCH / 01 File No.41 Babbling Br Address 41 l3abblina Bk Road City aroo fiery I I I e, _ County samsrabtp_�.. . State MA Zip Code Q2632__ sty Mcden staks o beael l S 112 bah 1 car Atoned game Orce Both 1st Floor afte Be?oom 2 Fm*room tai S to L09elrs 0 kn � vJth mor �t��chev► BO t3a armt 2rd Floor r � �• 31�0/ y it Health Complaints 09-Feb-04 1. Time: 10:00:00 AM Date: 2/9/2004 Complaint Number: 17262 Referred To: DAVID STANTON Taken By: DAVID STANTON Type: Complaint T e: p i Article X Detail: Business Name: Number: 41 Street: Babbling Brook Village: CENTERVILLE Assessors Map_Parcel: 188-151 Complaint Description: Septic Permit in 2000 said 4 beds on permit, but only a 3 bed septic was installed. In process of selling house, inspection came back as further evaluation by board of health required (because underdesigned and garbage grinder present) Actions Taken/Results: DS WENT TO SAID LOCATION. ROUGH FLOOR PLAN ON FILE. 5"POTENTIAL BEDROOMS"OBSERVED. ONE COULD BE REMOVED AS A"POTENTIAL BEDROOM" BY REMOVING THE GLASS DOORS SO IT HAS THE 5' C.O. GARBAGE GRINDER MUST BE REMOVED. EITHER A ROOM NEEDS TO BE REMOVED, OR A DEED RESTRICTION PLACED ON THE HOUSE FOR 3 BEDROOMS IF SEPTIC IS NOT UPGRADED. Investigation Date: 2/9/2004 Investigation Time: 10:00:00 AM 1 Er�� q d d �L U 3 s — s I's S COMMONWEALTH OF MASSACHUSETTS A EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION a � TITLE 5 1'DFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 41 Babbling Brook Road Centerville MA 02632 D Owner's Name: Steven Porter Owner's.Address: Same Date of inspection: January 21,2004 7,�L� ��U I Name of Inspector: PATRICK M.O'CONNELL Company Name: SEPTIC INSPECTION SERVICES CO. ��1 bona S o✓1 t' / Mailing,Address: 184 CAMMETT ROAD U G/ MARSTONS MILLS MA 02648 C� 3- Telephune Number: 508-428-1779 �F gnkr� ���/ q V CERTIFICATION STATEMENT J I certify that I have personally inspected the sewage disposal system at this address and that the information reported below i s .rue,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 D1 111111111111 approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: OF�tijq. Passes �y _X_ Conditionally Passes TRf ,N Needs Further Evaluation by the Local Approving Authority , ;,-"q.t Fails ' l L. . co Inspector's Signature: c� Date:_1/21/04 ����i� S INSP������`� Revised: 3/10/04 ������if1+It1►a��`` The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)wit iin 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. Notes and Comments: System designed for three bedrooms,deed restriction limiting house to three bedrooms unless:y-;tem upgraded.System not designed for use with grinder, recommend removing grinder. ****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 condition s of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 :►f l 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection:January 21,2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: 1 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: _XX_ 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. Answei 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 existin€,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 exr lain: 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 ex f la:n: The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass imp pection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND exf lai is Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 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(l)(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.pP Y rY pPIY• The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for 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: Page 4 :if 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 D. System Failure Criteria applicable to all systems: You much indicate"yes"or"no"to each of the following for all inspections: Yes No -X- 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 _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 ''/2 day flow -X- Required pumping more than 4 times in the last year NOT due to clogged.or obstructed pipe(s). Number of times pumped 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. _X_ Any portion of a cesspool or privy is within a Zone I of a public well. _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 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 forma _No_ (Ves/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 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"if 1 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. Th z system owner should contact the appropriate regional office of the Department. Page 5 -J 11 11FFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date ot'.Inspection: January 21,2004 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 Were any of the system components pumped out in the previous two weeks? _X_ __ 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? X_ ___ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _X_ __ Was the facility or dwelling inspected for signs of sewage back up? _X_ __ Was the site inspected for signs of break out? _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 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 maintenar.ce of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _X_ __ Existing information. For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of distance:is unacceptable)[310 CMR 15.302(3)(b)) I Page 6 :)f I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 FLOW CONDITIONS RESIDENTIAL Numbe.-of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIG N flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):330 Numbe•of current residents:2 Does residence have a garbage grinder(yes or no):Yes Is laundry on a separate sewage system(yes or no):No [if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no):No Water muter readings,if available(last 2 years usage(gpd)): 2002—64,000 gal.2003—76,000 gal.=191 gpd. Sump pump(yes or no): No Last da.e of occupancy: Currently Occupied COMMERCIALANDUSTRIAL Type oi'c stablishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-saiiii:ary waste discharged to the Title 5 system(yes or no):— Water meter readings,if available: Last dare of occupancy/use: OTHE g(describe): GENERAL INFORMATION Pumping Records: None Source of information: - Was sy:;tem 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 _X_Septic tank,distribution box, soil absorption system _Single cesspool Ovarf low cesspool _Pri vy —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 obtainei fi•om system owner) _Ti€;ht tank _Attach a copy of the DEP approval —Otl ier(describe): Approximate age of all components,date installed(if known)and source of information: Compliance date:2/4/00 for new leaching hm area. g Were sewage odors detected when arriving at the site(yes or no): No Page 7 .�f 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner; Steven Porter Date of [nspection: January 21,2004 BUILDING SEWER: X (locate on site plan) Depth be low grade: 8" Material:;of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: 25' Commcnts(on condition of joints,venting,evidence of leakage, etc.): Pine in good condition no evidence of leaks SEPTIC TANK: X (locate on site plan) Depth he low grade: 6" Material of construction:—X—concrete_metal_fiberglass_polyethylene othur(explain) If tank s metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificuta) Dimew ions:8' long x 5.2'wide—1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 29" Scum thickness: 1" Distance 'rom top of scum to top of outlet tee or baffle: 8" Distance Tom bottom of scum to bottom of outlet tee or baffle: 13" How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as relatod to outlet invert,evidence of leakage,etc.): Precast tee intact and clear.Tank not in need of pumping. GREA:3F TRAP: No (locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass__polyethylene_other (explain):_ Dimens ions: Scum thic cness: Distance from top of scum to top of outlet tee or baffle: Distance f-om bottom of scum to bottom of outlet tee or baffle: Date of la,.t pumping: Comm(nt, (on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as relatod io outlet invert,evidence of leakage,etc.): Page 8 :f I I IJFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of;Inspection: January 21,2004 TIGHT or HOLDING TANK: No (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass g ass polyethylene__other(explam): Dimew ions: Capacity gallons Design Flow: gallons/day Alarm pr-.sent(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: X (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 it to or out of box,etc.): Observed solids in box. Believed to be original box(not replaced when new leaching system installe4).No evidence of backup from leaching system. PUMP CHAMBER: No (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comment:;(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of I 1 C'►FFICIAL INSPECTION FORM-NOT,FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: 4 Infiltrators leac hing galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comme rns(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): No access to interior of infiltrators Probed stone area around infiltrators found no evidence of saturation or laree amounts of standin¢water. CESSPOOLS: No (cesspool must be pumped as part of inspection) (locate on site plan) Numbe-and configuration: Depth--top of liquid to inlet invert: Depth of,olids layer: Depth of;cum layer: Dimen:ioiis of cesspool: Materials )f construction: Indication of groundwater inflow(yes or no): Comment:;(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: No (locate on site plan) Materia is of construction: Dimen;ion s: Depth of solids: Comme-nts(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Page l{I(if l l WFICIAL INSPECTION FORM—NOT FOR.VOIaUNTA.RV A.SSRSSM.ENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SVSTEM INFORMATION(aoiatin ued) PrOPOI l,: Address:41 Nabbling Brook Rood,Cantorville, Owner: !:teen Porter ')ate oi'1"pec7;10n: ,lattWy SKR'N-"'l'0F SMA,+GE DISPOSAL SXST>E M Provide c,sketch Of the sewage disposal system including ties to at least two permanent reference landm,arics or benchtr:r k;1, l.oaato all waim within 100 foot,Loco,whore public water supply enters the building. Bobbling Brook Road 1,4 f ,r,f Page l I )f 11 OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of]nspection: January 21,2004 SITE EXAM Slope None Surface viater None Check ce Ilar Dry Shallow wells None Estimated depth to ground water: More than 20 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: Observed site(abutting property/observation hole within 150 feet of SAS) _X_C hrcked with local Board of Health-explain: Cheeked installation information in file C iecked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You mnsi:describe how you established the high ground water elevation: Information on file based on NGVD shows 22.0 feet to adjusted groundwater.Bottom of SAS 4-5 feet below grade. �T 16 2-7 -\ COMMONWEALTH OF MASSACHUSETTS' a I EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS d DEPARTMENT OF ENVIRONMENTAL 12ROTECTION m ® o a p W cV W U 0 a Uj CX 0 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION p Property Address: 41 Babbling Brook Road MAP o ., Centerville MA 02632 PARC�4 i Owner's Name: Steven Porter Owner's Address: Same LOT A Date of Inspection: January 21,2004 Name oil Inspector: PATRICK M. O'CONNELL Company Name: SEPTIC INSPECTION SERVICES CO. Mailing Address: 189 CAMMETT ROAD �(!o_ MARSTONS MILLS MA 02648 Teleph)ne Number: 508-428-1779 ° CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below i i true, accurate and complete as of the time of the inspection.The inspection was performed based on my training .ind experience in the proper function and maintenance of on site sewage disposal systems. I am a P `e�ttttuiirrpr,,� approved system inspector pursuant to Section 15.340r of Title 5(310 CMR 15.000). The system: OF M'gS�����i _— Passes Conditionally Passes CK _X_ Needs Further Evaluation by the Local Approving Authority = — Fails 0' L Inspector's Signature. o"IDate: _1/21/04_ ��'� Tl �• G��Q��`` The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)mil hin 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or gi eater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.Th:;original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority_. Notes an.]Comments: System designed for three bedrooms,four bedroom house. System not designed for use with gthider,recommend removing grinder. report only describes conditions at the time of inspection and under the conditions of use at that time.Th is inspection does not address how the system will perform in the future under the same or different conditi)us of use. Title 5 'n spection Form 6/15/2000 page l Page 2 Il 11 41FFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Properly Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection:January 21,2004 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. Comm�:nts: B. Sys;tem 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. Answe► yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain he 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 existin€,tank is replaced with a complying septic tank as approved by the Board of Health. *A met i I 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 exr I a in: 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 exr Ltin: T he system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass in:pection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND exr 1,[in: Page 3 :if 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Properiy Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 C. Further Evaluation is Required by the Board of Health: _XX 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: A 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. 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: Four bedroom house and three bedroom system Board of Health to assess bedroom count a ad determine course of action. f - Page 4 --f I l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 D. Sy;i:em Failure Criteria applicable to all systems: You mu it indicate"yes"or"no"to each of the following for all inspections: Yes l\o 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 _X— Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. _};_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _}; Any portion of a cesspool or privy is within a Zone 1 of a public well. }: Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] ,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 flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The fo I I swing 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 I1 of a public water supply well If you ha to answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"hi 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. 1`he system owner should contact the appropriate regional office of the Department. A Page 5 A 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Properry Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 Check ifthe following have been done.You must indicate"yes"or"no"as to,each of the following: Yes N 3 _X_ _ _ 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? _X_ _ _ 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? _X_ _ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) _X_ _ Was the facility or dwelling inspected for signs of sewage back up? _X_ _ _ Was the site inspected for signs of break out? _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 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 Iocation of the Soil Absorption System(SAS)on the site has been determined based on: Yes no _X_ __ Existing information.For example,a plan at the Board of Health. _X_ __ Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of distance ii unacceptable)[310 CMR 15.302(3)(b)] Page 7 J 11 ()FFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date oi'Inspection: January 21,2004 BUILM NG SEWER: X (locate on site plan) Depth tclow grade: 8" Material i of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: 25' Comm(tits(on condition of joints,venting,evidence of leakage, etc.): Pipe in aood condition,no evidence of leaks. SEPTIC: TANK: X (locate on site plan) Depth below grade: 6" Material of construction:—X—concrete_metal_fiberglass_polyethylene _other(explain) If tank s metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimem ions:8' long x 5.2'wide—1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 29" Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 13" How were dimensions determined: STICK WITH HINGE FLAP. Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as relato(I to outlet invert,evidence of leakage,etc.): Precast tee intact and clear.Tank not in need of pumping GREM) TRAP: No (locate on site plan) Depth be low grade: Materia 13f construction:_concrete metal fiberglass_polyethylene—other (explain) Dimens is,ns: Scum thickness: Distance from top of scum to top of outlet tee of baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of h st pumping: Comm(rr s(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as relatod to outlet invert,evidence of leakage,etc.): Page 8 Jf 11 t:)FFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 TIGHT or HOLDING TANK: No (tank must be pumped at time of inspection) (locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass__polyethylene___other(explain): Dim—en si,3ns: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of I ast pumping: Comments(condition of alarm and float switches,etc.): . DISTRIBUTION BOX: X (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: 0" Comments note if box is level-and-distributio to outlets equal,_any evidence-of-solids-car-yover,any evidence of leakage i nto or out of box,etc.): Observed solids in box.Believed to be original box(not replaced when new leaching system tailed).No evidence of backup from leaching system PUMP CHAMBER: No (locate on site plan) Pumps in working order(yes or no): Alarms it working order(yes or no): Comme n:s(note condition of pump chamber,condition of pumps and appurtenances,etc.): I Page 9 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 SOIL A BSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type lea.:hing pits,number: _X_1(:a.ching chambers,number:4 Infiltrators lea,:hing galleries,number: leao.hing trenches,number,length: lea,;hing fields,number,dimensions: ove rflow cesspool,number: in n)vative/alternative system Type/name of technology: Commc nts(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): No access to interior of infiltrators,probed stone area around infiltrators found no evidence of saturation or large amounts of standing water. CESSPCIOLS:No (cesspool must be pumped as part of inspection) (locate on site plan) Numbe•,end configuration: Depth- top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indicati ou of groundwater inflow(yes or no): Commc nis(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: No (locate on site plan) Materials of construction: Dimen,io ns: Depth of solids: Comm(nts(note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation, etc.): Page 10 of 11 o"IFFICIAL INSPECTION FORM—NOT iFOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:41 Babbling Brook Road,Centerville' Owner: Steven Porter Date of I nspection: .fanuary 21,2004 SKETC11 OF SEWAGE DISPOSAL SYSTEM Provide E.sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchrr a Mks. Locate all wells within 100 feet.Locate where public water supply enters the building. Babbling Brook Road I I H to 5 �3 34 to Page l i of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 41 Babbling Brook Road,Centerville Owner: Steven Porter Date of Inspection: January 21,2004 SITE I XAM - Slope None Surface water None Check ccllar ' Dry Shallow wells None Estimate l depth to ground water: More than 20 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: Ob::erved site(abutting property/observation hole within 150 feet of SAS) _X_C h.-cked with local Board of Health-explain: Checked installation information in file C iecked with local excavators,installers-(attach documentation) A zcessed USGS database-explain: You miss t describe how you established the high ground water elevation: Information on file based on NGVD shows 22.0 feet to adjusted groundwater. Bottom of SAS 4-5 feet below grade. No��W (�� Fee J�• 7 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: 1111////// Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[ppYication for Migpool *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade(J)Abandon( ) O Complete System )(Individual Components Location Address or Lot No. .,pb Owner's Name,Address and Tel.No. Assessor'sMap/Parcel ; Installer's Name,Address,and Tel.No. 1 Designer's Name,Address and Tel.No. S w\ S 5-t. Type of Building: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 'b � gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank e Type of S.A.S. i L• Description of Soil Ft AdLlz Nature o Repairs or Alterations(Answer when applicable) O g Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has bee hh. Signed Date — Application Approved by Date 3 2e" Application Disapproved for the following reasons Permit No. 7- Date Issued ----- s..No Fee .: ' -THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes { '•.-PUI§LI 4-`HEALTH DIVISION -TOWN OF BARNSTABLE. MASSACHUSETTS application for �N,5pogar *pgtem Construction Permit Application_=jor a Permit to Construct( )Repair( )Upgrade(✓)Abandon( ) ❑Complete System )Vndividualt omponents Location Address or Lot No. Owner's Name,Address and Tel.No. c Assessor's Map/Parcel ti?VvCef T_ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. S o,)1 S 5"1, Type of Building: Dwelling. No.of Bedrooms�_ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 41A0 _ gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 9 Type of S.A.S. . O Description of SoilO S Y�rA. Nature of Repairs or Alterations(Answer when applicable) r N & 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 Certifi- cate of Compliance has b�tl issu€d-b f--H alff:y' Signed i Date Application Approved by :' Date 3 Application Disapproved for,the following reasons ' Permit No.Zd&U VS Date Issued 413 -------------------------�—_ ------------- THE COMMONWEALTH OF MASSACHUSETTS r :t 4ARNSTABLE, MASSACHUSETTPC " Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )1ep iced'"( )Upgraded Abandoned( )by ft n- G A 7^ F C_ at L.l CC- has been constructed in accordance with the provisions of Title 5 and the for Disposal-System Construction Permit No.?.aya dated M i79'_o Installer Designer The issuance f this p t shall not be construed as a guarantee that the s ill function a rde is g Date ` 4/ Inspe r� No. �`�U � -----^-------------------Fee �C) .�'••� THE COMMONWEALTH OF MASSACHUSETTS 68�- PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS 'Wi9pool 6potem ConMr tion Permit Permission is hereby granted to Construct( )Repair( )U rade( bandon( ) System located atLj and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this e 't. Date: S�3/2�l/� Approved by ..1� 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS.CONSTRUCTION PERMIT (WITHOUT.DESIGNED PLANS) hereby certify that,the application for disposal works construction permit signed by me dated —�: , concerning the ti l property located at L tb ► �� meets all of the following criteria: IL4 This failed system is connected to a residential dwelling g only. There are no commercial or business f uses associated with the dwelling. `/ The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. There are no wetlands within 100 feet of the proposed septic system ,/ There are no private wells within 150 feet of the proposed septic system here is no increase in flow and/or change in use proposed y There are no variances requested or needed. ,The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when ap.licable] If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted ,groundwater table elevation, Please complete the following: Q A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation - o +the MAX.High G.W. Adjustment. f°� _ 6197 DIFFERENCE BETWEEN A and B SIGNED : DATE: [Please Sketch propo d plan of sy back]. NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert f . . � 0 a �� rw�5 r b�� : , . ��,��. �i o TOWN OF BA.RNSTABLE LOCATI01V/6z AA IZ-4- r 6'd4 Air� SEWAGE # �- VILLAGE SGV-eg- !/// ASSESSOR'S MAP & LOT/?? - I INSTALLER'S NAME&PHONE NO. 4nS' SEPTIC TANK CAPACITY -f U r� y j LEACHING.FACILITY:_..(tYPe) La,, Z217dV Td/23 (size) NO.OF BEDROOMS - B»MOR OWNER PERMIT DATE: 6" COMPLIANCE DATE: -n Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Pnvate Water Supply Well and Leaching Facility wells exist ._ , � PP.Y S ty (��Y on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist wifliin 300 feet off le hing facifi Feet i Furnished by z z it d - 1 1- .1 1,2 / a - 67-83- + _ l 13 J Board of Health Town of Barnstable _ -" ! P.O. Box 534 t �Sv No.. .....••--......... ��t� VS�tt��c ���aC��.h �p}�� '�—ni Fps............._....._......_ TFTE a�NI�9WWEial'ACAJIV 1t9%QW*.1 TS BOAR® OF HEALTH ............ .................----....OF......_......--..................... ...-......_... Appliratinn for Disposal Workii Tnntrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Babbling Brook Road, Centerville Lot # 19a ................-........--...................................................................... ............---•--•......-----•-•------•-•-.....-----•-•-•----.....---•----•--.......------....--- Location-Address or Lot No. .....................1Qbil..lux]aP_x.................._..................... .................30 West Main Street, Hyannis -•-•-------•---------•........................................•............-- Owner Address aArch Construction Hyannis PQ Installer Address Q Type of Building Size Lot.........3Q,LtQD.....Sq. feet Dwelling—No. of Bedrooms.Three______________________________Expansion Attic ( ) Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria Otherfixtures ------------------------------------•--------•------------•-••-••-•--••---•-------••--•--•-••-•---••----------•---•---------•-•------•--.......••---- W Design Flow______________________110•-._ _gallons per person per day. Total daily flow----.--------_.__.•......._330 gallons. WSeptic Tank—Liquid capacity-`6Q...gallons Length................ Width................ Diameter................ Depth...._........... x Disposal Trench—No..................... Width ....... Total Length......__ ..__ Total leaching area. _)�/_�_�. sq. ft. Seepage Pit No. �.. ..... Diameter.._...��"__-_-_- Depth below inlet_...c j..._..... Total leaching area._'-`.`t 0_—_.sq. ft. Z Other Distribution box� Dosing tank ( ) �" Percolation Test Result Performed bY.......................................................................... Date...................................... Test Pit No. 1.1Qss-..2_minutes per inch Depth of Test Pit.................... Depth to ground water--------_................ f>~ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ••---------••-----------•--•---•--••---•-•..........................................•••••••-----........---..................-----•-•----•---............---- 0 Description of Soil_.....Q-1.5'.Loam_&-Subsoil, 1:5'-8:S' Medium Sand x w x --••-•••--•------------------------•••••-•----•-•------•-•----------•-----•-......•-----••------•-•----•---•--•-••------------•-----•----••----•---•---•--•-•-•-•----•---•------•--••••--•----------••-- U Nature 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 Sanitary Code—The undersigned fuher flees not to place the system in operation until a Certificate of Compliance has b- "issued by the b arofe�� . /� Signed. .......................... G � -----•--••----•---------•--•••---- ------------••--------..-- •---• ---------.........._..._ Date ApplicatiogoApproved BY tfing ---•--- - -- - - --------------•-.-----.---------------------•- 1_ ----- . .... Date Application Disapproved for the reasons:.........................................e o ' 4pa'"I_1'\'1 (NE" ER MUST SUPEr v.'S.. :...-, . --•----------- Ad. _ �;r^vWAS INSTALL INRITI'22Q II �s�fE < NG Permit No.----- .�....J Gl............................. IssuC�DAt10E-T - _ - AL1.ED IN STRICT ,i ti t r t. No..� FEa. ........... �. 1 THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF HEALTH OF.......................................................................................... Apptiratilan for Dispusa1 Works Tnnit-nrtiun ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Babbling Brook Road, Centerville Lot # 19a ................__......_...................................................................... -•--•-------------.....------------......-••----------••-•---------•-••......----.......-----••--- Location-Address or Lot No. ....................."ktti-_T3dmmar-----••..........................•--• ................30 West fain Street, Hyannis -•-------•---••------ ---------------•....-----------........•---.... Owner Address a Arch Construction Hyannis ................... Installer Address UType of Building Size Lot_..._....3Q_,0QQ.....Sq. feet Dwelling—No. of Bedrooms.Three...............................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow......................110...............gallons per person per day. Total daily flow............._._....._____330 gallons. Septic Tank—Liquid capacity/ .a...gallons Length................ Width................ Diameter............_... Depth................ W Disposal Trench—No..................... Width✓.........._....._ Total Length......._._.•_• Total leaching area — __. ..__Sq. ft. Seepage Pit No._._ Diameter......-`:•""....... Depth below inlet.................... Total leaching areas-...........Sq. ft. Z Other Distribution box ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1 1ess.-2_minutes per inch Depth of Test Pit.................... Depth to ground water........................ fr, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.-._.___---------______- O Description of Soil...._0-1.-5!_Loam &.Subsoilt_..1._5'-8.5'- Medium__Sand........................................................... - - x W U Nature 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 Sanitary Code—The undersigned furtherp�grees not to place the system in operation until a Certificate of Compliance has, by the boat'd of heafh.,, Signed_ � �- f .�' .._ Date Application Approved BY „_. ;.� : E ---------'3 ......................................... / Disapproved for the f ing reasons______________________________ --------•-•---Date............_ -------------------------------------•--••------------------------•-•••-•-------••-------.....------...-•----------------------------------------------------------------------------------------------- •k Date PermitNo.._-_!1_!---- �---------------------------------------_ Issued_---------....---__ ------•-•---•--•------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..: ...J.................OF.......... .:t Y j.. .. Tn#ifiratr of Toutpliatta THIS IS TO CERTIFY, at the ndividual Sewage Disposal System constructed ( or Repaired ( ) has been installed in accordance with the provisions of TIT F j�o he State Sanitary �de as described in the application for Disposal Works Construction Permit No.__-���......................... dated__..._---__.:.___.....______ .............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............•-•------............•....-------•--•--------------••••---•--•--.. Inspector.................................................................................... 1 THE COMMONWEALTH OF MASSACHUSETTS ~ BOARD .OF HEALTH y "�� No.!} y...� ...., 3 OF.......-•.......................................................................... .............................. . ....... FEE........................ Disposal Works Tian jinn rrmit Permission is hereby granted......... !r.4._ ........... -.._._...._ to Constr ct orRepair ( ) an Individu wage Disp- Syst �_ at 'j Stree as shown on the application for Disposal Works Constrion Permit t u t No,�..l!S YJ,Dated. . .. .__65.1..E✓5 �:Sr..-' --tr:".iv- s'�Vn=:: --------•-------------••--------•---••--•---.----- �i ( 0 7 Board of Health DATE................. a. ..................................................... FORM 1255 A. M. SULKIN, INC.. BOSTON I % i Fermit Number: Date: rJ HIGH GROUND-WATER LEVEL COMPUTATION Site Loc tion: �� �C/tip- �2o-fl� Lot No. Owner:` �6AN� .� .v� Address: Contractor: Address: Notes: r y � x�f i 4 21y��4 STEP 1 Measure depth to water table zr $ ' to nearest 1/10 ft. �/ /p 6 •, ss . . . . . . . . . . . . . . . . . - ate, ;q, ` �� d & STEP 2 Using Water-Level Range Zone k `Er p{' ` and Index Well Map locate site and determine: A) Appropriate index wel 1 • , i *� '. �¢ . �, B) Water-]eve) range zone v � { STEP. 3 Using monthly report"Current ' Water Resources Condit-ions" determine current depth to /J� ��`.µ n r ye s 4, water level for index well . . . . . . �/�3 � D', r mo yrYk � STEP Using Table of Water-level � r � Adjustments for index well STEP 2A) , current depth to 4 :d water level for index we] ] +, (STEP 3) , and water-level zone (STEP 213) determine KE water-level adjustment . . . ,ft STEP 5 Est inate depth to high water by subtracting the water- �� - i. �.: . 1 evel 'adjustment (STEP 4) from measured depth to water level at site (STEP 1) . . . . . . . . . . . . . . . . . D �1Y d a.; LEVY, ELDREDGE & WAGNER ASSOCIATES, INC. ENGINEERS-LANDSCAPE ARCHITECTS-PLANKZRS LAND SURVEYORS 889 WEST MAIN STREET CENTERVILLE,MASSACHUSETTS 02632 (617)775-22" August 10, 1988 Conservation Commission Town of Barnstable 367 Main Street Hyannis, MA 02601 Attn: Mr. Robert Gatewood Dear Sir: We request a Conservation Commission final inspection and certification of compliance be issued for the property described in D.E.Q.E file number SE-3-1050 Order of Conditions as amended and dated May 29, 1987 , a copy of which is attached. The project (property) location is at Lot 19A Babbling Brook Road Barnstable, MA. This office has reviewed the requirements listed in the Special Conditions and finds the following: 1 . Foundation is located as indicated on L.E.W. Assoc. , Inc. Certified Plot Plan dated August 3 , 1987 , a copy of which is attached. 2 . Site conditions are as indicated on L.E.W. Assoc. , Inc. As-built Plan dated July 17 , 1988, a copy of which is attached. Should you require further information please be in contact with me. ' Sincerely, LEVY, ELDREDGE WAGNER ASSOCIATES Pau Levy, P.E. ,R.L.S. L'WP/mlw ✓Board of Health Attn: Mr. J. Dunning Valand Construction, Mr. Don Douquette Mr. John Turner, per request of Valand Const. 88 WAVERLY STREET FRAMINGHAM,MASSACHUSETTS 01701 TOE DEQE He No. SE 3-1050 �,� •� �'i o, (To be provided by DEQE) ! Commonwealth �, • of Massachusetts I aauSTMM % Cityfrown:Barnstable Yua co •639. `�® Applicant Larry L. Naviaux �0 YAY 6' AMENDED Order of Conditions MASSACHUSETPS WETLANDS PROTECTION ACT G.L. c. 131, §40 TOWN OF BARNSTABLE WETLANDS PROTECTION BY-LAW, Ch. 3, Article XXVII FROM: BARNSTABLE CONSERVATION COMMISSION To John T. Turner Sane (Name of Applicant) (Name of property owner) 30 West Main St. , #15 Address Hyannis, MA 02601 Address This Order is issued and delivered as follows: Zi by hr..nd delvery to applicant or representative on May 29, 1987 (date) ❑ by certified mail, return receipt requested on (data) This project is located at Lot #19 Babbling Brook Rd. , Centerville Barnstable Assessor's Map # 188 Lot 151 The property is recorded at the Registry of Deeds in Barnstable Book 291 Page 32 Certificate (if registered) Notice of Intent dated Sept. 28, 1983 Date of Hearing Final Hearing on Dec. 20, 1983 This Order is issued on May 29, 1987 Findings The Barnstable Conservation Commission has reviewed the above-referenced Notice of Intent and plans and has held a public hearing on the project. Based on the information available to the Barnstable Conservation Com- mission at this time,the Barnstable Conservation Commission has determined that the area on which the proposed work is to be done is significant to the following interests in accordance with the Presumptions of Significance set forth in the regulations for each Area Subject to Protection Under the Act (check as appropriate): ARTICLE 27 ONLY ❑ Public water supply J0 Storm damage prevention ) Erosion Control ❑ Private water supply K) Prevention of pollution ❑ Wildlife J Ground water supply ❑ Land containing shellfish ❑ Recreational. r. 0 Flood control 0 Fisheries 0 Aesthetic Therefore, the Barnstable Conservation Committee hereby finds that the following conditions are necessary, in accordance with the Performance Standards set forth in the regulations, to protect those interests checked above. The Barnstable Conservation Committee orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced above.To the extent that the following conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent. the conditions shall control. GENERAL CONDITIONS 1. Failure to comply with all conditions stated herein,and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. This Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state or local statutes, ordinances, by-laws or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: (a) the work.is a maintenance dredging project as provided for in the Act; or (b) the time for completion has been extended to a specified date more than three years, but less than five years,from the date of issuance and both that date and the special circumstances warranting the extended time period are set forth in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill, containing no trash,refuse,rubbish or debris, including but not limited to lumber,bricks,plaster,wire,lath,paper,cardboard,pipe,tires,ashes,refrigerators, motor vehicles or parts of any of the foregoing. 7. No work shall be undertaken until all administrative appeal periods from this Order have elapsed or, if such an appeal has been filed, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Final Order has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, the Final Order shall also be noted on the Lard Court Certificate of Title of the owner of the land upon which the proposed work is to be done. The recording information shall be submitted to the Rarn.c_tahla rnnservation Commissio on the form at the end of this Order prior to commencement of the work. 9. A sign shall be displayed at the site not less than two square feet or more than three square feet in size bear- ing the words, "Massachusetts Department of Environmental Quality Engineering. File Number SE 3-1050 10. Where the Department of Environmental Quality Engineering is requested to make a determination and to issue a Superseding Order,the Conservation ComiT11Qsion shall be a party to all agency proceedings and hear- ings before the Department. 11. Immediately following completion, the project shall be certified to be as per these conditions and plans, in writing, to the Barnstable Conservation Commission by the project engineer who shall be registered in the state of Mass. 12. Upon certification by the project engineer the applicant shall forthwith request, in writing, that a Certificate of Compliance be issued stating that the work has been satisfactorily completed. 13. Prior to any work being done at the site, all legal advertising bills incurred by the petitioner in relation to the Wetlands Hearing held on this project shall be paid. 14. This Order is issued under Article XXVII of the Town of Barnstable By-Laws as well as under Mass. G.L. Ch. 131, sec.40. The Barnstable Conservation Commission or Conservation Officer shall be notified no more than two weeks nor less than two days prior to the commencement of work, and have the authority to issue an Enforcement Order if the terms or intent of this Order are not complied with. 15. It is the applicant's responsibility to provide all contractors with a copy of this Order and to ensure that all workers are informed of the conditions of this Order before they begin work at the site. ]6. The work shall conform to the following plans and special conditions: PLANS: Title Dated Signed and Stamped by: On File with: ° Robert B. Eldredge, R.L.S. Commission Certified Plot Plan Dec. 19, 1983 Albert Morse, P.E. Barnstable Conservation George Low, Jr. , R.L.S. Site-Sewage Plan April 3, 1987 A. Paul Simard, P.E. Special Conditions (Use additional paper if necessary) 1. Approval shall be contingent upon receipt and approval of a.revised plan indicating date of revision for house footprint. 2. The pool and attendant recontouring shall be eliminated from the proposal. 3. The work limit for the project shall be the existing 18' contour elevation, as shown on the above-referenced plan. There shall be no disturbance of the site below this established work limit line. 4. Retaining walls may be used to contain the fill, as necessary. Staked hay bales are to be put in place and approved on site by the Commission or its agent prior to the start of construction. 6. Slopes shall be planted with appropriate vegetation for erosion control. .All disturbed areas shall be replanted immediately following completion of construction. Areas stripped of vegetation may not be left unvegetated or unmulched for more than 60 days. 7. Dry wells shall be installed for roof runoff. 8. The driveway shall be of pervious surface such as gravel. 9. Two copies of the above-referenced plan, dated Dec. 19, 1983, shall be submitted to DEQE, Lakeville'. ..........................................................................'Leave Space Blank) �- �, J • L � y Issued By Barnstable Conservation Commission Signature(s) ZZ Z:6�— This Order must be signed by a majority of the Conservation Commission. y On this 29th day of May 87 19. before riie personally appeared Elisabeth E. Clark , to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. NnvPmhPr 28 1991 otary_ blic _ My commission expires The applicant,the owner,any person aggrieved by this Order,any owner of land abutting the land upon which the proposed work is to be done or any ten residents of the city or town in which such land is located are hereby notified of their right to request the Department of Environmental Quality Engineering to issue a Superseding Order, providing the request is made by certified mail or hand delivery to the Department within ten days from the date of issuance of this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and the applicant. Detach on Dotted Line and Submit to the Issuer of this Order Prior to Commencement of Work. To Barnstable Conservation Commission (Issuing Authority) PLEASE BE ADVISED THAT THE ORDER OF CONDITIONS FOR THE PROJECT AT FILE NUMBER , HAS BEEN RECORDED AT THE REGISTRY OF ON (DATE) If recorded land, the instrument number which identifies this transaction is If registered land, the document number which identifies this transaction is Signed Applicant MILL 0 ' .. � 18A �9 n lT �t 9` o" i CERTIFY THAT THE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND r PAUL A. \1 AS INDICATED LEVY � No. 10617 fly AT E STERE LAND SURVEYO LEVY & ELDREDGE ASSOCIATES,INC. CLIENT Korn�N C I E® (SLOT PLAN ENGINEERS - LANDSCAPE ARCHITECTS 408 NO..,,..LLZ? PLANNERS— LAND SURVEYORS DR. BY e / IN �p1 889 WEST MAIN STREET jCHKD.BY, F Iv-T_JZ'R V► L.--Z; M CENTER I LLE, AAA. 02,632 ISHE .OF SCALE, , „ 4p ' DATE 9 8 3 i 20 FT. MIN. �� Z 75 TOP OF FOUND. SOIL TEST EL. _ -��'` 10 FT MIN � :,': �-' ,� DATE OF 501E TEST 'WITNESSED BY � 14,'� � CONCRETE 4" SCH 40 P C PIPE CLEAN SAND PERCOLATION RATE -Z-- MIN. INCH COVERS MIN PITCH I/8 PER FT. OBSERVATION HOLE I OBSERVATION HOLE 2 , - 1 7, CONCRETE -�- COVERS 2" LAYER OF ELEV = -' o ° ELEV,= $ CAST N PIPE " " C (OR EQUAL; MIN, 1/8 - 1/2 WASHED G lel PITCH 1/4 PER FT. g STONE Z FLOW LINE J 10i, EL - z` Gj �6 4' / o MIN. f EL.= 2 7. 7 2'0�' i EL - ~ 7 LEVEL zz. _ , EL= 7 '3 2 a 1V Z { EL. = , w Y DIST EL = L7 � t 1r,. � X ,_ ' � WATER AT EL-1 � WATER AT EL.= BO � � 3/4of 4�- 11/2 v so° c o GALLON WASHED STONE o ° ' 1 000 �4 DESIGN CALCULATIONS SEPTIC TANK `� ° o EL.= 2 PRECAST LEACHING NUMBER, OF BEDROOMS l� BASIN OR EQUIV. j GARBAGt DISPOSAL UNIT 11*1 6 DIAM. TOTAL ESTIMATED FLOW SEWAGE DISPOSAL SYSTEM PROFILE , Y ' 5116/ 1 y,,.� c �r �� GAL./BR /DAY x � BR.) _ �'7 0 GAL. DAY REQUIRED SEPTIC TANK CAPACITY 75- GAL. NOT TO SCALE ACTUAL SIZE OF SEPTIC TANK 000 GAL. BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE EL= LEACHING AREA REQUIREMENTS OBSERVED WATER TABLE /i ' /r"'_r ) EL.= 16 5- SIDEWALL AREA I;AL./S.F. BOTTOM AREA fi GAl_./SF LEACHING CAPACITY ( BOTTOM+ SIDEWALL) GAL. > LEGEND RESERVE LEACHING CAPACITY � 7� ©AL. EXISTING SPOT ELEVATION 00XO :. EXISTING CONTOUR — -- -- -00-- ----_- 01�1 - '�..�''�JQl- ) FINAL SPOT ELEVATION NOTES: + FINAL CONTOUR ---- ----- Al I WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.O.E. j SOIL TEST LOCATION 7 _ T.1TlrE 5 AND THE TOWN OF � RULES AND . ..� -�--- .. .. UTILITY POLE --0-. ,.---_--- , -�, �-� - REG .ATPGNS FOR THE SUBSURF E DISPOSAL OF SEWAGE. TOWN WATER ____ W - 'r_._. w I «:.. •� �- : �« "" CATCH BATE ( � ALL "COVERS TO SANITARY UNITS SHALL BE BROUGHT TO ~ WITHIN 12" OF FINISHED GRADE . � f~ `' t 3. EXISTING AND FINAL GRADES SHALL REMAIN ESSENTIALLY THE SAME. � 1 1. 4. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H- 10 LOADING UNLESS THEY ARE UNDER OR .ri� 'r.-' / z WITHIN 10 FT OF DRIVES OR PARKING AREAS, H-20 LOADING (! MIN. FRONT SETBACK �� SHALL BE USED UNDER OR WITHIN 10 FT OF DRIVES OR PARKING. j-�Y R.iE' %. „n.y j✓ac� t4ls MIN REAR SETBACK _ l0 S. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE i MIN. SIDE SETBACK /D SHALL BE MORTARED IN PLACE. 6. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH 1 : J DEEDED OR ZONING REGULATIONS. OWNER /APPLICANT IS TO t (lur- o yr �� k �n OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 1�' 54 f � > �� rE °`' �'�' APPROVED BOARD OF HEALTH ; � X _ "`• DATE AGENT jj ` �� Ew ur _ ! / '�' { - i PROJECT LOCATION, p - �7 f, 1 w 3� E t1 1 - Q N /4' , 1l 'l ,� _ �:�- �� i4` /��Get�o K �U. �9, ,✓5 IIf{ I'n' 1 Q` tt APPLICANT In F R O L. A. , ~t fLFVY Y, F_L DREDGE, 8 lidiAGNER ASSOC /NC �� jx�` (� (�/O �` '� �rpy �,v� ENGINEERS - LANDSCAPE ARCHITECTS O ?7 ; r . \ �, i3 PLANNERS - LAND SURVEYORS 889 WFST MAIN STREET CFNTERVILLE, MA 02631 PAUL A. LFVY }I "} No. 10617 ,4 S j �, ��� '.?;� .Foe N0. R�, LOCATION MAP SHEET OF 7�1 `�LJ / #40ft TOWN OF BARNS TABLE LGt�f; IO � a�flL� SEWAGE # VII.LAGE �/I/ ASSESSOR'S MAP & LOTat .n. INSTALLER'S NAME&PHONE NO. S-.n SEPTIC TANK CAPACITY LEACHING.FACILITY: (type) ^Z41 J /1T� IWL3 (size) NO.OF BEDROOMS a R%0R OWNER ��-s�%'.�' AR-Y— PERMITDATE: '` 6e� COMPLIANCE DATE: ��� "� •� Separation Distance Between the: Mliximum 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 le Ching f 'Li Feet Furnished by ` f1'lid/ 1 dd , 1 , TOWN OF BARNSTABLE)Oe H I V LGC_. y �s�G G /.-t;�24264WAGE # VILLAGE C �7Gn y i � ASSESSOR'S MAP & LOT ,p -- INSTALLER'S NAME & PHONE NO.,? r SEPTIC TANK CAPACITY la©O LEACHING FACILITY:(type)f A'l/l P ' (size) NO:-OF BEDROOMS //PRIVATE WELL OR PUBLIC WATER to UILDER R OWNER DATE PERMIT ISSUED: 67 5- DATE .COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No Aga /f oZ, /.3 z�z � o� G�c� s