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HomeMy WebLinkAbout0251 BAY LANE - Health (2) 251 Bay Lane Centerville P A = 16 0057, a 0))(for N0. 152 1 5 /3 ORA v 0 S BAXTER NYE ENGINEERING& SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,3`d Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622 March 30, 2010 Mr. Thomas McKean Health Department 200 Main Street Hyannis, MA 02601 RE: 251 Bay Lane, Centerville Variance Request; 2/9/2010 Proposed Water Service Dear Mr. McKean : As per our phone conversation,we are proposing to sleeve the existing water service to the main house for the following reasons: 1) The existing service to the main house was installed in 2004, when the septic upgrade for the cottage was done, and is only six years old. 2) The south end of the house had been a garage that was converted to living space in 1986. Attempting to run water service into this part of the building would require cutting the concrete slab inside the house to access the crawl space. If you have any questions or comments, please do not hesitate to contact me. y..-a jjj ^• Very truly yours, — Baxter Nye Engineering& Surveying -: �l M. Stephen A. Wilson, PE SAW:kb 0:\2004\2004-003-B\ADMIN\LETTERS\2004-003 Health Dept.251 Bay Lane,Centerville 3-29-10.doe Land Surveys • ,Site Design • Subdivisions 9 Septic Design • Wetland Filings • Planning a Y ` ABUTTOR NOTIFICATION LETTER Date: January 25th, 2010 Re: Variance Request , As an abutter please be advised that a Variance Request has been filed with the -; Barnstable Board of Health. Additional details are below: _71 >pplaea:nz: William.&Jc:nne Rugg a Address: 251 Bay Lane ° .J Centerville, Massachusetts 02632 Project Location: 251 Bay Lane, Centerville Assessor's Map & Parcel- Map 166; Parcel 057 Project Description: Construct new soil absorption system as part of retaining wall reconstruction. Variances Requested: BOH Regulation; Ch. 360-1. To allow a proposed soil absorption system and existing septic tank to be 50'-75' from bordering vegetated wetland in lieu of 100'. Title V; 15.211(1) To allow a SAS to be 5' off a foundation (crawl space) in lieu of 10'. To allow a SAS to be 5' off a lot line in lieu of 10'. Title V; 15.203(2) To allow for the design of a two bedroom system in lieu of a three bedroom system. Applicant's Agent: Stephen A. Wilson, P.E. Baxter Nye Engineering & Surveying 78 North Street Hyannis, Massachusetts 02601 O Public Dearing: Town Council Hearing Room O Town Hall—2nd Floor 367 Main Street Hyannis, Massachusetts 02601 February 9th, 2010 at 3:00 pm #2004-003 RuggVarianceAbuttor.doc Baxter Nye Engineering & ' -- Surveying '$0.44 0 78 North St. 3`d Floor ? 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I7pes'at,least:four feet ofllrafUl'ully,occtirritig pervious,niaterlal.exlst in al[:oreas observed llirdugh:out tlie' .. ;area proposed for tlio-soll absorptloil'system? l` • . `. .,.:.,..._, ;...... . ,�-. -;If I-jijt;;what is'tlie deptli of nntgraliy 0ceurring.pervious utlite�ial7:`„:'�. . . ,; ' �.crtifi a I(ilt'. . t'- : ~:i ' :I certif`th,it'on'' >, "I w�) �.... i1�te :L liay. 'ass.. the stil,I%evaluator::exAinil,1. i. ..appr..oved by lice `,:..;.•, '. . ,. • bepprt:iieni,of.CgYiroiiiiientul;I'rotei t(Ott.atid that the aboye.>ii'alysI wris'ner'fontied.Uy,iiid eonslstent Willi,i.:.`;' ., • ';the required Lr'aitilitg,e4pertlse hiid`.e�lperleitco dascrili-ait'�!0 C R 15,017• . . I. i,.; :, °`.;.: c r r. d ;' ! : S nlifure" N- �.? .:� �Y Dlite r t . !� c .. . � . . o g- COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION RECEIVED Property Address: 251 Bay Lane J U L 2 9 2003 Centerville, MA 02632 Owner's Name: Betty Hambly TOWN OF BAR.NSTABLE Owner's Address: Same HEALTH DEPT. Date of Inspection: July 3, 2003 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O. Box 49 Map: 166 Osterville,MA 02655-0049 Parcel: 057 Telephone Number: (5011 162-9400 Lots: 3&4 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 N ds Further Evaluation by the Local Approving Authority F it Inspector's Signature: Date: July 6, 2003 The system inspector shall sub i a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. 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 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 251 Bay Lane Centerville. AM Owner: Betty Hambly Date of Inspection: July 3 2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair, as approved by the Board of Health,will pass. Answer yes, no or not determined(Y,N,ND) in the for the following statements. If"not determined", please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed 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: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 251 Bay Lane Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303 (1)(b) that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier, if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 251 Bay Lane Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No _ ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ ✓ Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ 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.] 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 System: 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" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 251 Bay Lane Centerville, MA Owner: Betty Hambly Date of Inspection: July 3 2003 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner, occupant, or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in.the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection ? ✓ _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS, located on site? ✓ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions, depth of liquid, depth of sludge and depth of scum ? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No ✓ Existing information. For example, a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 251 Bay Lane Centerville, MA Owner: Betty Hambly Date of Inspection: July 3 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x# of bedrooms): 220 Number of current residents: I Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system (yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump (yes or no): No Last date of occupancy: Currently occupied COMMERCIALIMUSTRIAL Type of establishment: 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-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: Pumped in 1996-per owner 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 a copy of the DEP approval Other(describe): Approximate age of all components, date installed(if known)and source of information: _Jun 29188-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of i l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 251 Bay Lane Centerville MA Owner: Betty Hambly Date of Inspection: July 3 2003 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting, evidence of leakage, etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 2 Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: /" Distance from top of scum to top of outlet tee or baffle: 9" Distance from bottom of scum to bottom of outlet tee or baffle: 12" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present The liquid level was even with the outlet invert There were no signs of leakage. GREASE TRAP: None (locate on site plan) 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 recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I 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: 251 Bay Lane Centerville, MA Owner: Betty Hambly Date of Inspection: July 3 2003 TIGHT or HOLDING TANK: None (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): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX: None (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: None (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.): 8 o. d Page 9 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 251 Bay Lane Centerville, MA Owner: Betty Hambly Date of Inspection: July 3 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits, number: leaching chambers, number: leaching galleries, number: ✓ leaching trenches, number, length: 1'x 4'x 30'-per as built card T 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.): _I dug down in the stone in the trench and the stone was clean There were no signs of failure or backup. The bottom to grade was 26" The septic is approximately 2'higher in elevation than the surrounding lot. CESSPOOLS: None (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: None (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.): 9 Page 10 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 251 Bay Lane Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 Map: 166 Parcel: 057 SKETCH OF SEWAGE DISPOSAL SYSTEM Lots: 3&4 Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. �ro••�- �w r' I Q s a a9.� lsb Page 1 1 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 251 Bay Lane Centerville, MA Owner: Betty Hambly Date of Inspection: July 3, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 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) 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: Ground water is approximately 6'below grade per wet lands in the front yard and a tidal river in the back yard. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 I�' BAXTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,3`d Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622 March 30, 2010 Mr. Thomas McKean Health Department 200 Main Street Hyannis, MA 02601 RE: 251 Bay Lane, Centerville Variance Request; 2/9/2010 Proposed Water Service Dear Mr. McKean : As per our phone conversation, we are proposing to sleeve the existing water service to the main house for the following reasons: 1) The existing service to the main house was installed in 2004, when the septic upgrade for the cottage was done, and is only six years old. 2) The south end of the house had been a garage that was converted to living space in 1986. Attempting to run water service into this part of the building would require cutting the concrete slab inside the house to access the crawl space. ,: If you have any questions or comments, please do not hesitate to contact me. I,< Very truly yours, Baxter Nye Engineering& Surveying LID CO M Stephen A. Wilson, PE SAW:kb 0:\2004\2004-003-B\ADMIN\LETTERS\2004-003 Health Dept.251 Bay Lane,Centerville 3-29-10.doc Land Surveys • Site Design • Subdivisions • Septic Design • Wetland Filings • Planning Transmittal Letter To. Board of Health , 200 Main Street Hyannis, MA 02601 Attn: From: Stephen A. Wilson, P.E. Subject: �,)w. /2,t5 /2rl Date: z We are sending you ®Attached ❑Under Separate Cover The following documents: Prints❑ Order of Conditions❑Variance Approval❑Recording Slip ❑Septic System Permit ❑Notice of Intent❑ Other DATE QUANTITY DESCRIPTION yA These items are transmitted as checked below: ® For Your Use ❑ As Requested ❑ For Your Files ❑ For Review and Comment ❑ For Recording As Required Other: [nt cal ,c t r-ce ZE v I Additional Distribution File No. 200'f--o 0-3 - - Baxter Nye Engineering&Surveying Phone: 508-771-7502,ext.13 78 North Street,3rd Floor Fax: 508-771-7622 Hyannis,Massachusetts 02601 E-Mail:swilson@baiter-nye.com Transrnittali etter5.doc Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form_- Not for Voluntary Assessments 'c, 251 Bay Ln Main house G v A Property Address Jean Rugg Owner Owner's Name information is required for every Centerville _ Ma 02632 1 /12/16 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General _Information s/# I/ on the computer, use only the tab. 1. Inspector: key to move your cursor-do not Michael DiBuono use the return Name of Inspector key. DiBuono Sewer and Drain ,eb Company Name 8 Johns path Company Address etwn S Yarmouth Ma 02664 _ Cityrrown State Zip Code 508-364-9587 S103522 Telephone Number License Number B. Certification 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 ❑ Fails ❑ Needs Further'Evaluation by the Local Approving Authority _ 8/12/16 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ***"This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 �e� . r N Commonwea8th of Massachusetts - Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house 711 Property Address Jean Rugg Owner Owner's Name infofmation is required for every Centerville Ma 02632 8/12/16 page. City/TownState Zip Code Date of Inspection B. Certification (cost.) 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: System contain a 1,000 GI septic tank as well as a leach field pipe in stone 26 5'x14'x6" B) .System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section-need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632- 8/12/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due u- --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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 'Y2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions-in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ 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 has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town . State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ❑ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced❑ ® 9 to the system recently or as part of this inspection? ❑ ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related.to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information Description: System contain a 1,000 GI septic tank as well as a leach field pipe in stone 26 5'x14'x6" Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection' Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: 219 Gpd Sump pump? ❑ Yes ® No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: — Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17_ Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cost.) Last date of occupancy/use: Date Other (describe below): General Information Pumping Records: Source of information: 2016 Was system pumped as part of the inspection? ❑ Yes ® 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) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 11/11/11 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1 Depth below grade: feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): 6" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1000 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 24" Scum thickness 3 Distance from top of scum to top of outlet tee or baffle 42 Distance from bottom of scum to bottom of outlet tee or baffle 1" Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): No evidence of leakin ,Tees and or baffles in place at time of inspection Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or.baffle Distance from bottom of scum to bottom of outlet tee or.baffle Date of last pumping: Date t51ns•3/13 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owners Name information is required for every Centerville Ma 02632 8/12/16 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tees are in place and levels are normal. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass 9 El polyethylene El other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): " Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection- D. System,Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Level and at normal level Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3113 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 26.5'x14'x6" ❑ 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.): Field is dry Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of inspection- D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): No ponding no break out Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owner's Name information is required for every Centerville Ma 02632 8/12/16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a � 251 Bay Ln Main house Property Address Jean Rugg Owner Owners Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 6 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 11/11/11/ Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: _ ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: System is raised. GWE at 72" Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 TOWN OF BARNSTABLE LOCATION = o�u. SEWAGE r ?:�s a ':a `� VMLAGE C ':� -ems f ASSESSOR'S MAP&PARCEL INSTALLER'S NANM&PHONE N0. SEPTIC TANK CAPACITY LEACHING _ LEACHING FACILITY. (type) (size) NO. OF BEDROOMS OWNER PERMIT DATE: e - COMPLIANCE DATE:. Separation Distance Between the: _ Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching.Facility(If any wells exist on site or within 200 feet of leaching facility) J`bY,=;-. Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) _Feet FURMSHED BY �3 �7r � I f Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 251 Bay Ln Main house Property Address Jean Rugg Owner Owners Name information is required for every Centerville Ma 02632 8/12/16 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑ System Information— Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 e�b t4- K p�)"4\a-A' j I No. Qa I I:37 7 :.N. 0) Fee APO THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 21ppYication for disposal *pstem Construction Vermit Application for a Permit to Construct( ) Repair(k-�Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.d,57/ <ane. Owner's Name Address,and Tel No. Assessor's Map/Parcel 16 efV.3a„ Installer's Name,Address,'and Tel.No.6�09' Designer's Name,Address,and Tel.No. f.' ,ro c;f .C?ot- arc sfry a�Q• * ei, lrr!o � �g�,br . Type of Building: Dwelling No.of Bedrooms�. Lot Size �'60_VW_Jsq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required gpd Design flow provided gpd Plan Date „"!U ® Number of sheets Revision Date Z J/U/fU �- Title Size of Septic Tank & t 1 , Type of S.A.S. y r�/ �M S1611 Description of Soil 4 Nature of Repairs or Alterations -(Answer when applicable) 413C r- So f rew w asir Ly en I i i n a )X{ 'Ct3 X. �(n 5 L 2 o ��GL. 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 Enviromme ode a not to place the system in operation until a Certificate of Compliance has been issued by this Board of Healt F Si Date / `A Application Approved by - Date 1 Application Disapproved by Date for the following reasons Permit No. `3 2 7 Date Issued t l �� No. CS '2 = Fee /DD THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: -PUBLIC HEALTH DIVISION -TAN-60'`BARNSTABLE, MASSACHUSETTS Yes application for Disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( 'Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.0?,5— �Ct t7C Owner's Name,Address,and Tel.No. .3�£-779 .�a Assessor's Map/Parcel �(A Ce��, ���/�17 wil��CLen A 1 9 s f f Installer's Name,Address,and Tel.No.569•4/3Rf'FS9,?Go Designer's Name,Address,and Tel.No. 1Z '�40pp / Ua Type of Building: Dwelling No.of Bedrooms Lot Size f : Ct,e c�..+sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets'' / Revision Date 2 �l� i Title Size of Septic Tank ,0 1, cx ,r _ G Type of S.A.S. u - C" r Description of Soil f Nature of Repairs/or Alterations(Answer when applicable) n Jai; 51 t'`��r Date last inspected: / f Agreement: The undersigned agrees to ensure the construction and maintenance of the afore.described on-sitesewage.disposal system in accordance with the provisions of Title 5 of the Environment al-C6de — not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health,,- F / S'igna Date Application Approved b( t Date Application Disapproved by Date for the following reasons Permit No.�� I r— 3 7 Date Issued I r ) l --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS' BARNSTABLE, MASSACHUSETTS ' Certificate of Compliance i THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(. ) Upgraded( ) Y Abandoned( )by at t . ,,JCa jNj Q 7)P fi r , has been constructed in accordance with the prrovisions oTTitle 5/and the for Disposal System Construction Permit Nam.G'' — 7 dated 11 1 Installer\ � �r 'A 014_1�. r X Designer R11 "A el 1 oA i #bedrooms _� Approved design flow � gpd i The issuance of this permit shall not be construed as a guarantee that the systern W l Ibncf n esigned. Date � 9A Inspect --------------------------------------------------------------------------------------------------------------------------------------- No. DD ) 1 `3 / / Fee /00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS j Disposal 6pstem Construction J)ermit Permission is hereby granted to Construct( ) Repair(k1r Upgrade( ) Abandon( ) System located at, r r 4 v-,L r, 1, 1 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this Qb Date l� r , Approved i i EXCERPT FROM BOH MEETING MINUTES 2/9/10: I. Variance— Septic (New Item): Stephen Wilson, Baxter Nye Engineering, representing William Rugg, owner— 251 Bay Lane, Centerville, Map/Parcel 166-057, 1.5 acre parcel, three septic variances. Stephen Wilson presented the plans. He said the owners do not have a failed system. However, they are undertaking work on the property by the SAS and decided it will be cost efficient to do all the work at the same time. Mr. McKean asked for a floor plan. Mr. McKean stated the staff has no issues with the plan. There is not an additional percolation test required before the permit. Mr. Wilson explained that if a percolation test was to be done ahead of time, it would hurt the SAS currently being used. Mr. Wilson also said he'd be happy to retest the soil at the time of construction and confirm the soils have not changed. Dr. Miller asked to check whether he needs an additional variance setback from wetland. He said it is unlikely that sewer will be coming to this area and suggests considering using an I/A system for future possible requirements by the State. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to approve of the variances and an additional variance of setback to the Coastal Waters, with the following conditions: 1) will do a 2 bedroom Deed Restriction on the house (there is already a 1 bedroom Deed Restriction on the Cottage), 2) the engineer will confirm at the time of installation that the soils are the same as tested at the time of original perc. (Unanimously voted in favor.) Excerpt BOH Feb 2010 251 Bay Ln Cent.doc Page 1 of 1 Stephen 'WilsOh From: Crocker, Sharon [sharon.crocker@town.barnstable.ma.us] Sent: Monday, October 31, 2011. 11:36 AM To: Stephen Wilson Subject: Excerpt BOH Feb 2010 251 Bay Ln Cent.doc Attachments: Excerpt BOH Feb 2010 251 Bay Ln Cent.doc <<Excerpt BOH Feb 2010 251 Bay Ln Cent.doc>> Nice to hear from you. Here you are. Have a good day. 10/31/2011 February 5, 2011 Dear Mr. McKean, Please review this deed restriction. We have made the necessary changes to meet with your approval and have had it recorded at the Barnstable Registry of Deeds. If all is in order, please place in my file and send me a notice in order that I might put it out for bid. Thank you, W. C. Rugg DEED RESTRICTION WHEREAS,William C.Rugg and Jeanne B.Rugg(the "Owners") are the owners of 251 Bay Lane, Centerville,Massachusetts (the"Premises"); WHEREAS,the Premises is more particularly described in a deed recorded with the Barnstable County Registry of Deeds at Book 17923 Page 98 (the"Deed")- WHEREAS,the Premises has two structures located thereon, a primary dwelling(the "Primary Dwelling") and a guest cottage(the"Guest Cottage"),which Guest Cottage, as of the date hereof,is subject to the deed restriction recorded with the Barnstable County Registry of Deeds at Book 17769,'Page..203; WHEREAS,the-Owners-have agreed with the Town of Bamstable Board of Health to a restriction as to the number of bedrooms in the Primary Dwelling on the Premises as a pre-condition to obtaining a disposal works construction permit in compliance with 301 CMR 15.000 State Environmental Code,Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; and WHEREAS,the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310.CMR p - 15.000, State Environmental Cpde;:Title_:V;IVlinimum Requirements,for the Subsurface Disposal of Sanitary Sewage, is requiring that*4greement for the restriction of the U number of bedrooms in any house on the Premises be put on record with the Barnstable CountyF Registry of Deeds b e, ording this document. NOW,THEREFORE, the Owners do hereby'place the following restriction on the Premises in accordance with their agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding up' n,all successors in N title: . 1. The Primary Dwelling on the Premises may contain no more than two bedrooms. The Owners agree that this shall be a permanent deed restriction affecting the Premises,.unless otherwise released. c 2. This restriction shall be released upon the Premises' connection to any municipal w sewer,public sewer, or Massachusetts Department of Environmental Protection approved innovative/alternative nitrogen reduction and the abandonment of the subsurface sewage disposal system at the Premises serving the Primary Dwelling, as evidenced by a release signed by the then-owner of the Premises certifying as to the same. Said release shall be effective upon its recording with the Barnstable County Registry of Deeds i 3rn uAvh ee, ; tr asy r msment executed on behalf of the Town of Barnstable Board of Health or its successor specifically. i releasing the same. Said release shall be effective upon its recording with the Barnstable County Registry of Deeds. For title of the Owners to the Premises, see the Deed. Executed as an instrument under seal as of the 10`h day of December, 2010. WILLIAM C. RUGG J A B. RU G THE COMMONWEALTH OF MASSACHUSETTS Barnstable, ss. On this 10'h day of December, 2010 before me, the undersigned notary public, personally appeared William C. Rugg and Jeanne B. Rugg, proved to me through satisfactory evidence of identification, which were , '� *+ T',; ,Cloe the persons whose names are signed on the attached document, and acknowledged to me ftAA that they signed it voluntarily for its stated purpose. 9 No Pub fic s _ u L- t tp. ST Town of Barnstable Regulatory Services Thomas F. Geiler,Director �MAM AABE. ' Public Health Division ► � Thomas McKean,Director FD MA'S 200 Main Street, Hyannis,MA 02601 Office: 568-862-4644 Fax: 508-790-6304 Date: IZ- III-za1 I Sewage Permit# Z01--37 7 Assessor's Map/Parcel /(o!0 037 Installer& Designer Certification Form Designer: Sbtnjm,, A Vl%lsc K_ P5 Installer: 130, 4m 1,0-Wi CCA15J. Address: Address: P, p, 13,x 7o4 '7% Ojor4,1S+ . Hpywo.« ozoxo1 VAOrsdwns MCUS CZ�ysr On / `3o r4-al eJW CArv►d, was issued a permit to install a (date) (installer) septic system at ; ,,S/ Peul "mc , Cc"lsryi!/c based on a design drawn by (address) lL-).teem P.t. dated 2/7- //o (designer) I certify that the septic system.referenced above 'Wasinstalled substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box ao&@r. wpsi@ 4aak. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes.(i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &.Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if required) nspected and the soils were f s 'sfactory. "OF ss90 p� STEPHEN yG ALLYN (Installer's Signature). C) WILSON No.30216 STER����`��� '(Designer's Signature) (Affix DaW, Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT. BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice forms\designercertification form.doc (' 2WL/-0031 oZ v ,t lP = v i / \ .�'.� FN" O L ( ,35 �s -.._......_..__.. V, n ` J / ` `a4,,S a ✓ \� �xTEi-roEJ �Ecr- iIcU p ©II{ \\,,'// Pt;lZclv'ILFNGr� i, W � z tl J o r � ^W \� +, Zoning and Flood Zone Information Per Site Survey by Sullivan Engineering&Consulting,Inc. '----- !( \ �N�T610� ' q dated October 3,2019 revisions .i. 4 C� ILr�F=1�, IJ_vJ 1--r=4.Ylouls y/ hl�' ( I`iI,GI� f Lot coverage and square footage /�." U� •fi �' (n.uYt' ' GiUrG1'!*cf± Gl�/It-�)-IGT•/ B q B RD-1 Zone IZ_ Zo 1 n1 . _ I _ f - - ---- - \ See Sullivan Engineering drawing for all related lot coverage and set back >/ F vv'�" �:,.., i .- A� u I INEYFAo15 _- �VNy Q r.. .;;T - information. ell .' .. `.: •�\1��Lv6 ?_FV `� 4• y°zmv�,toiNCr I 17R r-!,�• flood Zone S 5HT 171' v.. ; Zones AE(Elev.13)and AE(Elev.12) / Substantial Improvement GrARr-erE j /- v a/ �`n - - - _ - - �, Threshold `y+ tea. / �\� - -...r 'v. .- _ - I ,k I� � � ti \ �(� i 51•I�w/Ei� t `.7 � -- Proposed construction to fall beneath the substantial improvement� �`----� per,y�ls3 : r —- 1 threshold.Contractor shall provide all relevant cost/value information. See also,notes on the structural drawings. At Proposed Garage flood vents are not required,rather they are proposed .vhE�riiVlL rI:Lr -X;� IO �/) liz -q/ ' w�� i�/ v KITGL '[4'�-Q �- '�UIJ_�"". r as prescriptive to mitigate minor flooding that may occuratgarageonly. /.p,'rLZ\ / '2ex Cn=` Vic.`; �, - _-- ' V11IV�W/x( / u I I v[ la� N i otr.IGN / 2 sh�cvE a !iI Isr.PPlrnR --- - u' n' /•�v� M11..F!-L71zINLf l �. _1 � ;��y� - ._ o �MASo.IUKY,GNM1iGY I __ Q N 2gz ,$•a'='.. � �,srsro-i� pr' IG HI�./Sui�UEp;.�>TI��EN I MWt2 °_ zu "�cH'2i?N I5L_Hp I;: i —Ma N. v'^ - I. I•-JlIp1I� ___ __' • _...•._ r yp� !•'I �I _Y:�,. 41 . �---t --U. ��' I7�' ..I I I le,�— - I cv UP �I� Wr Ur- New I7oof..y�/=,.,;>ta.:=;>sGy �-��:9..�i3 _ )!. 7— I. —' , �Qr > w i I'LUs•ft L u c-t�h or .---------' '':!' i � W U II (,/A3 11 i I Q w N -77 ! w co �iI t — %rs's�/�c���o�c:7r�cr':FTC u•E='-I-�s i I ;� Nwow viviTlo-Ihd- V'A"T f l IM�rB z i Rt. ?. -- T f— r WMLI. mil` L.0, "Yr--V-Ac.� I ------------- -- -'-- SHEET NO. p i V4° II �I `I j/ P-' of Al ) evm•ateert mu r + ' 1 10 o / N r•� � o� Cm p > _ I rn _ N + \ VWr.OF / X / to14 / r 00 V •� ` � 1 I I I // � > i v c,� � am �z' .� ._�1�.1>_-. m_ On 14 -' L TAT40 • �i�� �CCB N c�olv - -- -�� 1 F IR /' • ] - 1 _ G 14 • r 4b ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH .• r / 7 r r m TITLE V OF THE STATE SANITARY CODE DATED MARCH 31,1995 J� # ■ ANY LOCAL RULES APPLICABLE. :. r k O Jj S 89'44000" W yf AM' r CB DH ,2 8 ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING �p h WF SM-3 / ! W5 / O: 1 I \ z 5� BY DESIGNING ENGINEER C10.� 4 �`L o, y� �• a � � , r °C WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, p• a NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT o`'r `•; M.., ;. a,, '' a " 9.61. FOR INSPECTION. �k�-., a' � ^�.,p,�. -••�- � �.�� :. •�' .� t�r•s911�0 _. �, "ID77 ' el Y , 4!y p A' o THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN -� _ °.� ,.. ••� p `� ,r. 8.4 6,p� APPROVAL BY DESIGNING ENGINEER j� - � � r _. Cmigvil ,al f EXISTING SEPTIC TANK b .' ,.''��x 'Oq - ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" PVC., SCH 40 n : Lending / r I AND PUMP CHAMBER N • WF SM-4 n� i 1 r r i TP 1 J m r ' ) 4.9 a. PROJECT BENCHMARK : DATUM = NGVD M28 QS A-9 7 TBM = MAGNAIL SET IN PAVEMENT ® ELEV.= 8.95' � ' wc•` �'` ine \a FocR* ' CE' ER Il I LLE `�\ .. A 1 T3 a- I ! COASTAL BANK - ' ' 6 `j 1 � \ 50.0. i i i � WF A-10 ZONING DISTRICT: RD-1 STATE DEFINITION 1 I `�, 3.5 _ // Ei.1 MINIMUM LOT AREA: 2 ACRES x 7.8 }x ! j� MINIMUM FRONTAGE: 20' LOCUS MAP SCALE: 1" = 2000' TBM: MAG ,5 / ` MINIMUM WIDTH: 125 • , _ TP# 2 NAIL SET / J J / FRONT SETBACK = 30' SIDE & REAR SETBACK = 10' 1 r / OVERLAY DISTRICTS: \ WF sM-5 l 3. 1 i� 8.5 RPOD - RESOURCE PROTECTION OVERLAY DISTRICT SOIL LOGS DATE:AUGUST 26, 2003 15 ,' �1 WF A-8 \ AP - AQUIFER PROTECTION P#=P 10,554 7,1 ' �I is- .'='" r' , LOCUS PROPERTY IS SHOWN AS: ENGINEER: BOARD OF HEALTH AGENT: > x CONSTRUCT NEW RETAINING WALL - / 7.8 ASSESSORS MAP 166 PARCEL 057 Stephen A. Wilson,P.E. Sam White LOCUS DEED: E T2 `- j' Y:?.0 / �/ X 7 3 7.9 7 ,� REMOVE EXISTING PAVED DRIVEWAY DEED BOOK 17,923 PAGE 098 TES T 1 TEST I_ TEST TP AND REPLACE WITH PERVIOUS MATERIAL G.S.E. = 9.6E G.S.E. = 8.0t 9.o x I PLAN E. 7.a' I PLAN BOOK 9C PAGE 89 0 0 / I BRICK- AP SANDY LOAM AP SANDY LOAM r.� , ` \LAWN '® 9.0� WALL 7 , I 1 COMMUNITY PANEL NUMBER 250001 0016 D 7-2-92 6" 10 YR 5/4 12" 10 YR 5/4 >` \ WF sM-s I i y \ RETAINING THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONES 7., I WF A-7 off' 1 1 WALL ; , B, A 10 (EL•11). B B FQ�� IEL 9.4 I i I SANDY LOAM SANDY LOAM �c`' � / r` ' I REPLANT EXISTING TREE ON SITE; IF NEEDED " r . ° of , ' CON T'RDC�'ION NOTES: 14 10 YR 6 4 18 10 YR 614 7.6 7 i C PAVED ,'/ I I �\' NEW EDGE OF DRIVEWAY - FIELD ADJUST 1. THE CONTRACTOR IS TO SECURE ALL APPROPRIATE PERMITS. MEDIUM SAND MEDIUM-COARSE SAND rr i 1 Ir 8.0 -� ` 5 4, DRIVE 3 - i�" i ,� 48" 10 YR 5/6 / r I y ��' , i , �� 2• THIS PARCEL IS LOCATED IN THE FLOOD PLAIN. EXISTING , Is i 10 YR 5 6 ONSTRUCT NEW RETAINING WALL SAND ALTI SEPTIC .\ WITH IMPERMEABLE BARRIER 3. EXISTING LEACHING TRENCH IS (IN SAME LOCATION OF PROPOSED LEACHING FIELD) C2 MEDIUM SAND WARACE OF SHELLS � . TANK .. WF SM-7 i` i , i \ \ a WF A 6 TO REMOVED. 96" 10 YR 2/1 84" 10 YR 2/1 4. REMOVE UNSUITABLE SOILS BENEATH AND AROUND PROPOSED SYSTEM, BACKFILL REMOVE EXISTING RETAINING WALL WITH CLEAN GRANULAR MATERIAL FILL THAT MEETS THE REQUIREMENTS OF 310 CMR WATER ENCOUNTERED PERC o �$' / M _ r p � • AT 72" RATE = 8 MtN/Mt 4.7 , � , , , u n_ '�•�' ' � "� � 1 A-5 \ 15.255(3). �wN� 5. LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN AT LEAST 72 HOURS PRIOR TO DW / _ .� 'o+ �, SLEEVE FIRST 20' OF ;ATER SERVICE (IF NEEDED) ANY EXCAVATION FOR THIS PROJECT CONTRACTOR SHALL MAKE THE REQUIRED 2 A N NOTIFICATION TO DIG SAFE 1 888-344-7233 AND APPROPRIATE WATER , a o ' c �� ( - ) I CERTIFY THAT IN APRIL OF 1995 I PASSED THE SOIL / I WF SM-8 ``t \ \\ ' ��� ' 1'� `\\ DISTRICT TO DETERMINE UTILITY LOCATIONS. EVALUATOR EXAMINATION APPROVED BY THE DEPARTMENT OF • 1 `\ ` - 7 P �� ENVIRONMENTAL PROTECTION AND THAT THE ABOVE ANALYSIS I x <-.4.,1 7.e:. �' P R � � WF� -4 \ 6. ALL STRUCTURES BURIED DEEPER THAN 4 OR SUBJECT TO VEHICLE TRAFFIC SHALL WAS PERFORMED BY ME CONSISTENT WITH THE REQUIRED 3 8� BE H-20 LOADING. TRAINING, EXPERTISE AND EXPERIENCE DESCRIBED IN 310 CMR 7.a EXISTING \ 4.8 1.5.017 - WATER A-3 ( �� 17 I ' 7.5 SERVICE 8.5 ` • A-2 7. THE EXISTING WATER SERVICE LOCATION TO MAIN HOUSE IS APPROXIMATE P W00 _DECK 4 i \ � / 6ii ai K ` yt �z BASED ON TIE CARD FOR C-O-MM WATER DEPARTMENT. IF' WITHIN 10 OF PROPOSED SIGNATURE DATE l - s � ', ', << ` ��� w �, � � � '� `� � �' SAS, R SHALT. BE SLEEVED. 1"' � � � •� 8. ALL EXCESS SOIL TO BE REMOVED FROM THE PROJECT SITE. 17.0 �\ r 5 WF A-1 • \ , s 6.6 a, o z 9. IMPERMEABLE BARRIER MUST BE INSPECTED BY DESIGNING ENGINEER PRIOR TO UP #227-16 BACKFIWNG. WF SM-9 � `� � Existing Septic System for Cottage: 10. DESIGNING ENGINEER TO CONFIRM SUITABILITY OF SOILS IN AREA OF PROPOSED , LEACHING SYSTEM. 1.) File I DA-03067 r'- I �'' \ of �a �► °' �` `' 2. Variances ranted b BOH on 10 15 2003. ram' n \ ti `� �� �� o �P , T s 11. EXISTING SEPTIC SYSTEM - PERMIT 186-683. ) 9 Y / / ;;�P�1H OF Ai"�� ('Q N,\�` �\ o o� 4� 5 N� ,' s.3 i 3.) Septic Permit 12004-040 ��N b qs ��� rEPHEfv n , F. v TBM: MAG r \ ,o� G •e �F, !>'► f VARIANCES BEING MUffi'! NAIL SET o ��' TEPHEN �G 3 EL 6.53 2 , ; 71 NT s TOWN OF BARNSTABLL- PART AI; SECTION 1.00, 100' SETBACK REGULATION. To allow a proposed so# absorption system and an existingseptic tank to be 47'-75' from a No,302 6 JFss"IST LEGEND •� , EXISTING PROPOSED \`,, �c,o �,r bordering vegetated wetland lieu of 100. �� G�srtEc�� a- /-�v(cs �'1P. � TITLE V; 15.211(1). To allow an S.A.S. to be -5' off a foundation (crawl space) in 2 O AL� x i a �\��� �` ` �' 6 2- o 2 d lieu of 20'. To allow an SAS to be 4' off a lot line in lieu of 10: To Blow an SAS y o !b /co A Stake & Tac Set/Found 251 Bay Lana O PK Nail Set/Found \` ` o � 2.3 w , , �, to be 47' from a bordering vegetative wetland in lieu of 50'. To Blow an SAS to be �� o1 ~ ' �y 44 from a coastal bank (state det�ed) lieu of 50. Centerville, Massachusetts Concrete Bound \ \ WF SM-10 �t O ■ O Gas Gate 1 ® Electric Meter \\ � •; 9 .lam . �� ❑ Catch Basin �- TITLE V`, 15.203(2). To allow for the design of a two bedroom system in lieu of a PREPARED FOR x 1.9 2.4 gtii _ Lt8 Water Gate _ 3 WF END 11 ��o D=K DATA »r�'''••-••..,� i T,1 three bedroom system. A deed restriction will be recorded limiting the house to two ■ ® TV/Cable Box ��`� SINGLE FAMILY - 2 BEDROOM +� rst1��° ' bedrooms. x,,9 5 NO GARBAGE GRINDER William Rugg ® Telephone Riser \ n Variances granted by Board of Health on 2/9/2010 -0- Utility Pole Fo•.`. DAILY FLOW = 110 X 2 = 220 G.P.D. moo, TITLE 200 Contours cF N LEACHING FIELD DESIGN DA•10010 Zooxoo Spot Grade ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED L440SC 0 TOM Septic stem Upgrade ^� Main House Test Pit \'`. RETAI" nwu p System Pg USE 3 - 4" DISTRIBUTION LINES IN AN REM a Ids '•,r 26.5' X 14' DOUBLE WASHED STONE FIELD AS SHOWN � �^\ GWX 220 G.P.D.10.60 = 367 S.F. OF BOTTOM AREA REQUIRED �x USE 26.5' X 14'= 370 S.F. AREA PROVIDED , � ��, BAXTER NYE ENGINEERING & SURVEYING 2 CLASS 1 SOIL; PERCOLATION RATE 1" IN 8 MIN. n n Surveyors 298 I� �-,,r„t Registered Professional Engineers and Land S eyors 78 North Street- 3rd Floor, Hyannis, Massachusetts 02601 ��INLET SYSTEM PROFILE Phone- (508) 771-7502 Fax - (508) 771-7622 „ TO TANK TO AT LEASE WITHIN 6` FINISH GRADE r NOT 'TO SCALE MISHED GRADE OVEI? T� - 10.0� FINISHED GRADE OVER 0. Box = 10.of _.�1 20 0 20 40 FINISHEDU1 o.wADE ovETt LEACHING TRENCH = 10.0t FIRST 2' (TO BE LEVEL) PROVIDE INSPECTION PORT TO DRn�wY 'i,�I GRADE 4 PERFORATED PVC BOTTOM OF SYSTEM SCALE IN FEET OL2 m` r then O 2.OX --2 SCH. 40 (1YP) 9' MIN. - 36' MAX. COVER GRADE INV OOUTT 7.9s 4` SCH. 40 PVC _ ,� ..� •�, t;t• ,: r:. /� /� /� /� /.� / /� /� /� /�� „. . SCALE: =20 W 7 s SUMP INv our= 7.7 ,i'..' DATE; 1/19/2010 INSTALL s' .,:� ,`.,' '.a•• '�.' i •i '�'• y'• f GAS BAFFLE EL 7.1 2` PEA$TOI1E s` cRusHm r F• _ r i I ~26.5' OR FLIER FABRIC 4-1 1 2• DAW wASHm -_�'` b REV. DATE. REMARKS STONE I 3. 4' . 1 2 2 10 REVISE DESIGN & NOTE �� •. � _• , .-.- •..::.� INN= LEACHING FIELD 14' 2 214110 DISTANCE TO SALT MARSH RErAMM � Tn DaM 3 2 10 10 REVISE CONST. NOTES i� • ► 8 MIL POLY avm BELOW GRADE TO THE SAME CROSS SECTION A-A � AS � � IS ate. DRAWING NUMBER ' EXISTING 1000 GALLON SEPTIC TANK DISTRIBUTION BOX GROUNDWATER6 r EL 2.1 NO SCALE TO BE INSTALLED ON A LEVEL STABLE BASE 1* AI�K�WALL N.T.S. 0: 04 04-003 surve worksht 04-003-HSE-SEPTIC OBSERVED GROUNDWATER EL 1.75 (8/26/03) C>a ra1-- 2004-003 ! �" ) ! t,�l s }`c� r �. - cos ot`, Q 5 ��• r l h U d 1 / - GBM= H0TSS` 4 • .'. �' /, < , C: I' i ' ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH - i \ - t i TITLE V OF THE STATE SANITARY CODE DATED MARCH 31,1995 ;W(is °s ' I �1' cB DH FND „ . ANY LOCAL RULES APPLICABLE. S 8744'00- W r N '• t a. e / ;:, •t' WF SM-3 / I , ` ` v ,,, a ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING i� 1\po.� � < �Y BY DESIGNING ENGINEER WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFIWNG, O• oSA ba a NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT oN 0 N ' I ' ! / 1 �.s � o � 4"6 W FOR INSPECTION. d• ."�` ,�� ... � Q d .t �. « �� •5 6 o o THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN �( APPROVAL BY DESIGNING ENGINEER ' EXISTING SEPTIC TANK. ' •'✓' "` ,, V QDI / '4 AND PUMP CHAMBER a Pudic - w WF SM-4 4 ;' �� o 4a �'a } ALL SANITARY DISPOSAL SYSTEM PIPING r0 BE 4 PVC., SCH 40 7 s L,,,d;,,g I TP 1 ^ < 8 4.9 m o x a.' t• �o A-s a PROJECT BENCHMARK : DATUM = NGVD M28 OS TBM = MAGNAIL SET IN PAVEMENT A ELEV.= 8.95' �`�" . yf I COASTAL BANK - r 6 f Sp / WF A-10 ZONING DISTRICT. RD-1 ; % CE. R V I E y`�. A R B U R I STATE DEFINITION .ON LOT AREA 2 ACRES f - �y�' I o t I I I ) 3.5 f - MINIMUM 5 " MINIMUM FRONTAGE. 20' NNN IBM: MAG 5 ' LOCUS MAP SCALE: 1 = 2a00' / MINIMUM WIDTH: 125 I \ I TPI NAIL SET ! / , EL 8.95' FRONT SETBACK = 30 SIDE & REAR SETBACK = 10' OVERLAY DISTRICTS: I \ WF SM-5 ' 3 II rn p•`} RPOD - RESOURCE PROTECTION OVERLAY DISTRICT SOIL LOGS DATE:AUGUST 26 2003 j N r WF A-8 1 AP - AQUIFER PROTECTION P#=P 10,554 - " ' i CONSTRUCT NEW RETAINING WALL LOCUS PROPERTY IS SHOWN AS: ENGINEER: BOARD OF HEALTH AGENT: • ASSESSORS MAP 166 - PARCEL 057 7.8 Stephen A. Wilson,P.E. Sam White I _ 7. LOCUS DEED: 7.9 r REMOVE EXISTING PAVED DRIVEWAY DEED BOOK 17,923 PAGE 098 TEST PIT 1 TEST PIT 2 AND REPLACE WITH PERVIOUS MATERIAL 9.0 = G.S.E. = 8.0t-�" G.S.E. 9.6t � � � � PLAN REFERENCE: 1 PLAN BOOK 19 PAGE 89 0 0 LAWN BRIG TBM: I AP SANDY LOAM AP SANDY LOAM ' 1 , ® �.o� WALL 7.'_TOP of _ 2 , COMMUNITY PANEL NUMBER 250001 0016 D 7-2-92 6- 10 YR 5/4 12"' 10 YR 5/4 WF SM-6 % 1 \ (' RETAINING 7 ` i I WF A-7 \ THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONES t \ B, A 10 (EL 11). B B �'� , EL 9.4 , f �� i �� �1 ' i I REPLANT EXISTING TREE ON SITE; IF NEEDED SANDY LOAM SANDY LOAM tioq o� ( 1 7.6 % CbNS'fRlICT[ON NOTES 14"' 10 YR 6 4 18"' 10 YR 6 4 PAVED I I NEW EDGE OF DRIVEWAY - FIELD ADJUST 1. THE CONTRACTOR IS TO SECURE ALL APPROPRIATE PERMITS. C 1 C - � , + , MEDIUM SAND MEDIUM-COARSE SAND DRIVE 3 - / � f I � , � ,. I 1 2. THIS PARCEL IS LOCATED IN THE FLOOD PLAIN. 48 10 YR 5/6 10 YR 5/6 I, CONSTRUCT NEW RETAINING WALL T C C� i WITH IMPERMEABLE BARRIER 3. EXISTING LEACHING TRENCH IS IN SAME LOCATION OF PROPOSED LEACHING FIELD C2 SAND (ACTT) WF SM-7 •` .-• ( ) MEDIUM SAND W CE OF SHELLS WF,A-s � TO BE REMOVED. � 96"' 10 YR 2/1 84• 10 YR 2/1 I " a t 1 4. REMOVE UNSUITABLE SOILS BENEATH AND AROUND PROPOSED SYSTEM, BACKFTLL M , REMOVE EXISTING RETAINING WALL WITH CLEAN GRANULAR MATERIAL FILL THAT MEETS THE REQUIREMENTS OF 310 CMR WATER ENCOUNTERED PERC 0 48" A 15.255(3). AT 72 RATE - 8 MINIIN // I LAWN b h i o ' SLEEVE FIRST 20' OF\WATER SERVICE (IF NEEDED) 5. LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN, AT LEAST 72 HOURS PRIOR TO ' .� \ ANY EXCAVATION FOR THIS PROJECT CONTRACTOR SHALL MAKE THE REQUIRED NOTIFICATION TO DIG SAFE 1-888-344-7233 AND APPROPRIATE WATER WF sM-8 2.`�`, \\ �� �.�' 7 r ' `� ' � � ( ) I CERTIFY THAT IN APRIL OF 1995, I PASSED. THE SOIL \ 1 ' \ \ DISTRICT TO DETERMINE UTILITY LOCATIONS. EVALUATOR EXAMINATION APPROVED BY THE DEPARTMENT OF 7 ENVIRONMENTAL PROTECTION AND THAT THE ABOVE ANALYSIS 7.i OR �� WF\A-4 6. ALL STRUCTURES BURIED DEEPER THAN 4' OR SUBJECT TO VEHICLE TRAFFIC SHALL WAS `PERFORMED BY ME CONSISTENT WITH THE REQUIRED 7.0 EXISTING '` \ - + . ` �A-3BE H-20 LOADING. 15.017IINIG, EXPERTISE AND EXPERIENCE L1ES�'! l43 9N,,,310• CMR 1 ON DECK 7.5 , SERVICE 5 �, / r 11YF A-2 7. THE EXISTING WATER SERVICE LOCATION TO MAIN HOUSE IS APPROXIMATE I RICK Pre 6 BASED ON TIE CARD FOR C-O-MM WATER DEPARTMENT. IF WITHIN 10 OF PROPOSED SIGNATURE DATE 211 aelo �•,� I W SAS, IT SHALL BE SLEEVED. �••,j, CF 7.0 r\� ` WF A-1 8. ALL EXCESS SOIL TO BE REMOVED FROM THE PROJECT SITE, 9. IMPERMEABLE BARRIER MUST BE INSPECTED BY DESIGNING ENGINEER PRIOR TO ? WF SM-9 UP227-16 �i BACKFIWNG. Existing Septic System for Cottage: 10. DESIGNING ENGINEER TO CONFIRM SUITABILITY OF SOILS IN AREA of PROPOSED g P Y g LEACHING SYSTEM. 1.) File # DA-03067 \ `, ; ��� 11. EXISTING SEPTIC SYSTEM - PERMIT 186-683. TN of 2.) Variances granted by BOH on 10/15/2003. �'' ' •\ `` , o ��a d,►. �` m F. -� 3.) Septic Permit 12004- : .�P� �s��� \ \ Do•QGF' py � ' ,� vv IBM: MAG ` iP��H(1F ' �� TEPHEN Svc F- o G v� \ NAIL SET o VARIANCES BENGG RE�QUffiTBD "Y'�l 151 3 EL 6.53 2 , �c? TEPHEN G V g TOWN OF BARNSTABLE: PART 111; SECTION 1.00; 100' SETBACK REGULATION. To allow � • �� 9 '� 4� LEGEND •�`, o \ ', ` a proposed sal absorption system and an existing septic tank to be 47-75 from a So21ti EXISTING PROPOSED \`. o�� ��, •� bordering toted wetland in lieu of 100'. � `v� � \'`�ss1Gt � % IST TITLE V, 15.211(f). To allow an S.A.S. to be -5' off a foundation crow) in Stake & Tac Set/Found , ( fie) O PK Nail Set/Found \`.., lieu of 20. To allow an SAS to be 4 off a lot line in lieu of;10. To,allow an SAS 251 Baysane o Concrete Bound \ \ WF SM-10 2. w 0 2- a �Lo ► to be 47' from a bordering vegetative wetland in lieu of 50. To allow an SAS to be O Gas Gate Electric Meter 44' from o coastal bank (state defined) in lieu of 50'. Centei ille, Massachusetts 19 g r ❑ Catch Basin \ t 9 \', _ 2.4 ry',i , �I► - ���� ek � a„ TITLE V; 15.203(2). To allow for the design of a two bedroom system in lieu of a PREPARED FOR WF Water Gate -o.\ END 11 ,� •.�o DESIGN DATA � '"rt three bedroom system. A deed restriction will be recorded limiting the house to two � SINGLE FAMILY - 2 BEDROOM LLIS y Y bedrooms. I�►Ilham Rugg Im N/Cable Box •�' ' G ' ® Telephone Riser '� ;<t.sr 5 NO GARBAGE GRINDER `'o' a•23?4 '� • r/al'�a11C@S ranted b Board Of Health OI'i 2/9/201� -O- Utility Pole �;•`' DAILY FLOW = 110 X 2 = 220 G.P.D. °°, 'e^M GIS7E�``� - 20° Contours �cF ��. `� �• ` � 2ooxOo Spot Grade 01, N LEACHING FIELD DESIGN DA-1001 O Test Pit \ .p ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED Septic System Upgrade ^� Main House .p USE 3 - 4 DISTRIBUTION LINES IN AN REaw 4p '• 26.5' X 14' DOUBLE WASHED STONE FIELD AS SHOWN \'` 220 G.P.D./0.60 = 367 S.F. OF BOTTOM AREA REQUIRED NA ° 5 USE 26.5' x 14'= 370 S.F. AREA PROVIDED 11, W ��� BAXTER NYE ENGINEERING & SURVEYING CLASS 1 SOIL; PERCOLATION RATE 1 IN 8 MIN. 2"1 -; 3"„X Registered Professional Engineers and Land Surveyors 78 North Street-3rd Floor, Hyannis, Massachusetts 02601 T T SYSTEM PROFILE y wrrHlN s• FINISH GRADE o4 Phone - (508) 771-7502 Fax - (508) 771-7622 NOT ro SCALE FINISHED 10.0E GRADE' OVER TANK FINISHED GRADE OVER D. BOX = 10.0t FTr�nstlm GRADE OVER LEActM TRENCH i 10.ot 20 0 20 40 FIRST 2' (TO BE LEVEL) MOVIDE WSPE�cnoN Parr m Y then 0 2.0% 4 PERFOM IED PVC BOTTOM OF SYSTEM SCALE IN FEET OR1YE1w1Y • -� OL2 m SCH. 40 (TYP) 9" MIN. - 36' MAX. COVER r GRADE r, ' DWNG 4• scH. 40 PVC i ,: SCALE:1 =20 A rNv our= 7ss INv = �, s" SUMP ' .:' ..-• , . `�:,..: `' .• /,� /.� /,� /,� /.� /, /.� /,� /.� /.�i r DATE: 1 19 2010 INV OUT= 7.7 / / INSTALL _ .: GAS BAFFLE !•• r• _y r t r, EL 7.1 2' PEAST0IIE s• CRusHED r- 2s.5' ar FILTER FABRIC -1 1 2' D%W �-_�"` �, REV. DATE. REMARKS STONE BASU INV= 3' 4' 1 212110 REVISE DESIGN & NOTE LEACHING FIELD 0 14 2 2/4/10 DISTANCE TO SALT MARSH col I EMMMc OU To EX00 3 2 l 0 10 REVISE CONST. NOTES CROSS SECTION 'A-A' a M_ POLY BELLOW MN To THE SAME EXISTING 1000 GALLON SEPTIC TANK DISTRIBUTION BOX GROUNDWATER ADJUSTMENT EL 21 No SCALE DO" AS THE NW.L Is D PM. DRAWING NUMBER TO BE INSTALLED ON A LEVEL. STABLE BASE (� C- TM RUAM WALL N.T.S ;r OBSERVED GROUNDWATER V EL 1.75 0: 04 04-003 surve worksht 04-003-HSE' SEPTIC (8/26/03) -�� C�E'TIe►�1_ 2004-003