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0100 HERRING RUN DRIVE - Health
100 HERRING RUN,DR. CENTERVILLE A = 229 045 Rr t i AIl'I__A foul IlII UPC 12534 ��' IVO. 2�...1.53.3LOR $�ST•CONS°� HASTINGS, MN if Town of Barnstable i RECEIPT MA��`� ' 200 Main Street, Hyannis MA 02601 508-862-4038 39, 6. Application for Building Permit Application No: TB-16-2185 Date Recieved: 8/1/2016 Job Location: 100 HERRING RUN DRIVE,CENTERVILLE Permit For: Building-Demolition-Accessory Contractor's Name: KENNETH G EISNER State Lic. No: CS-006163 Address: ORLEANS, MA 02653 Applicant Phone: (781) 718-6835 (Home)Owner's Name: FEINBERG, MICHAEL A& ENA Phone: (781)789-0919 (Home)Owner's Address: 185 WESTON ROAD, LINCOLN,MA 01773 Work Description: Remove existing one bedroom cottage but retain existing foundation. Total Value Of Work To Be Performed: $5,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Kenneth Eisner 8/1/2016 (781)718-6835 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $5,000.00 Date Paid Amount Paid Check tt or CC# Pay Type Total Permit Fee: $50.00 8/1/201- $50.00 XXXX-XXXX-)CM- Credit Card _ - -0021 Total Permit Fee Paid: $50.00 .___o_. . THIS IS NOT A PERMIT Town of Barnstable Building Post This"Cird So That it is Visible From fhe Street-Approved'Plans Must be Retained on Job and this Card Must be Kept Posted aA `� Until Final Inspection Has Been Made. Permit0r�,r9cs" Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made Permit No. B-16-2491 Applicant Name: COUNTRYSIDE BUILDING&DEV Approvals Date Issued: 09/29/2016 Current Use: Structure Permit Type: Building-New Construction-Rebuild After Expiration Date: 03/29/2017 Foundation: Teardown Map/Lot: 229-045 Zoning District: RD-1 Sheathing: Location: 100 HERRING RUN DRIVE,CENTERVILLE Contractor Name: COUNTRYSIDE BUILDING& Framing: 1 Owner on Record: FEINBERG,MICHAEL A&ENA DEV 2 Address: 185 WESTON ROAD i ---- Contractor License: .'157034 # Chimney: LINCOLN,MA 01773 , Est. Project Cost: $ 200,000.00 Description: rebuild of 1 bedroom cottage Permit Fee:I $ 1,145.00 Insulation: I I F Project Review Req: rebuild of 1 bedroom cottage `ry Fee Paid: $ 1,145.00 Final: Date:� 9/29/2016 Plumbing/Gas Rough Plumbing: q '.. "." �,._--�"�"�.A," --• � � Final Plumbing: t Building Official I s � This permit shall be deemed abandoned and invalid unless the work',yauthorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which'this permit has been granted. final Gas: All construction,alterations and changes of use of any building and Structures shall be in compliance with the local'zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained n"for public inspection for the entire duration of the work until the completion of the same. — --- `"` r` Electrical Service. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided o this permit. Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing d � _ 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) l 6.Insulation \VI Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT i F tF1E fn_ i, DATE: Of FEE. 9� BARNS'PABLE + c mass. 1639. � REC. BY Town of Barnstable flfl SCHED. DATE:/9 Board of Health 200 Main Street,Hyannls.MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION r Property Address: 100 Herring Run Drive Fur Assessor's Map and Parcel Number: Map 229,Parcel 45 Size of Lot: 25,900 s.f. Wetlands Within 300 Ft. Yes X Business Name: N/A No Subdivision Name: N/A APPLICANT'S NAME: Countryside Building&Development Corp. Phone (781)718-6835 - Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON 32�A� y2/Z�.q�'/ � 6,sc �S�9 Malk�- Name: Michael A.Feinberg Name: Ken Eisner c/o Countryside Building&Development 14,� In(1/a..-tFn- Address: 100 Herring Run Drive,Centerville,MA 02632 Address:50 Tonset Road,Orleans,MA 02653 6:)-673 Phone: (781)718-6835 Phone: (781)718-6835 5-.)g-77,?-r?l VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) Section 360-1 Cannot locate septic tank to comply with the regulation. Section 360-1 Cannot locate pump chamber to com I i,i there ula' n. NATURE OF WORK: House Addition ® House Renovation ❑ Repair of Faile ;eptic Syst ❑ Checklist (to be completed by office staff-person receiving variance request application) tir t Please submit copies in 4 separate completed sets. _ Four(4)copies of the completed variance request Form 0 Four(4)copies of engineered plan submitted(e.g.septic system plans) t.J Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered s4iriiarian _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) _ Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC T. BSC GROUP Thoughtfully transforming our environments 349 Main Street (Route 28), Unit D West Yarmouth September 23,2013 MA o2673 Tel: 5o8-778-89i9 RE: Variance Application, 100 Herring Run Drive,Centerville,MA 800-288-8123 Dear Abutter: Fax: 508-778-8966 Notice is hereby given of a request for variances from the Town of Barnstable Board of www.bsgroup.com Health Regulations. The following variances are requested: 1. To allow aseptic tank to be located less than 100 feet from a wetland resource area; 2. To allow a pump chamber to be located less than 100 feet from a wetland resource area. The application and plans are available for review at the Barnstable Health Division office, located at 200 Main Street,Hyannis,Massachusetts,between the hours of 8:30 a.m. and 4:30 p.m., Monday through Friday. A public hearing on the above will be held at the Barnstable Town Offices. Please check with the Barnstable Health Division office(508) 862-4644 to confirm the date and time of the public hearing. Very truly yours, BSC GROUP,INC. Brian G.Yergatian,P.E.,LEED AP Project Manager/Associate cc: Barnstable Health Division File Engineers Environmental Scientists GIS Consultants Landscape Architects P:\prj\4973000\ Project Control\Correspondence\Outgoing\2013-09-23 bgy LT abutter notification.docx Planners Surveyors SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X D ❑Agent ■ Print your name and address on the reverse ❑PAdressee so that we can return the card to you. B. Received by(Printed Name) C at of D ivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item Ye /1-.—Article Addressed to: _-- If YES,enter delivery address bel ❑No + -- Prop ID:229050 \ HURLEY, ELV.I I4 107 HERRING RUN DR i 0z V CENTERVILLE,MA 02632 f 3. Service Type W Certified Mail ❑Express Mail --•— - - — ❑Registered O Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. T—T,30-46 — QQJl 4. _Restricted Delivery?-(Extra Fee) ❑Yes 2. Article Trans rfromNumb 7012 2210 0000 3818 7837 (transfer from service label) , PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1549' i I UNITED STATES POSTAL SEikVICE First-Class Mail Postage&Fees Paid LISPS Permit No.G-V/" • Sender: Please print your name, address, and ZIP+4 in this box • - - - --- I BSC Group, Inc. I 349 Route 28, Unit D 1 West Yarmouth, MA 02673 i I �6iN�z COMPLETE •N COMPLETE THIS SECTIONON DELIVERY '91111 Complete items 1,2,and 3.Also complete A. sign' -re item 4 If Restricted Delivery Is desired. Agent ■ Print your name and address on the reverse ❑ ddressee so that we can return the card to you. B. Received by(Printed Name) C. Dat of Deli ry ■ Attach this card to the back of the mailpiece, or on the front If space permits. fq 2065 i'e 5,43 D. Is delivery address different from item 1 ❑Yes 1. Article Addressed to: If YES,enter delivery address below: 13 No Prop ID:229046 ROBERTS,THOMAS D&M ARLEN.E 110 HERRING RUN DR CENTERVILLE,MA 02632 3. Service Type Cq Certified Mail ❑Express Mail ----J ❑Registered ❑Return Receipt-for Merchandise ❑Insured Mail ❑C.O.D. L=AN, -7'30 a Cho 4. Restricted Delivery?(Extra Fee) ❑Yes mber7012 2210 0000 3818 7844from servke IabeQ811,February 2004 Domestic Return Receipt 102595-02-M-1540, r UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • i BSC Group, Inc. j 349 Route 28, Unit D West Yarmouth, MA 02673 I I SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY I ■.Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. Agent ■ Print your name and address on the reverse ddressee so that we can return the card to you. B Re eived y(Prini Name)y , Date 6f�Delivery ■ Attach this card to the back of the mailpiece, ! ��P\ or on the front if space permits. D. Is delivery address different fro nt 1q ❑Yes 1. Article Addressed to: I I 'Yo K If YES,enter delivery address below- No--- Prop ID:229044 HULL,DONALD L&JANET C TRS S44 i HERRING RUN DRIVE TRUST 147 LAGUNA LOS ILAMOS,NM 87544 3. Service Type 0 Certified Mail ❑Express Mail L------ r -- —-----�-- ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4—9-73®a Qo — 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7 0 (Transfer from service laben 12` 2 210 q MJ 0 0 ;3 81'8 78 2 0 t PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1640 h I UNITED STATES POSTAL SERVICE First-Class Mail Postage&.Fees Paid USPS I Permit No,. k I • Sender: Please print your name, address, and ZIP+4 in this box • I I BSC Group, Inc. 349 Route 28, Unit D ` I West Yarmouth, MA 02673 I � I I I _ I I I C� COMPLETESENDER: COMPLETE THIS SECTION • ON DELIVERY ■Zomplete items 1,,2,and 3.Also complete Sig lure item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. kkce y P( ted Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, / /) ;y 0& or on the front if space permits. 1. Article Addressed to: D. Is delivery addr�6VIfere ntit 1? ❑Yes If YES,ente d@I' ery ress b ❑ No FEINBERG. M:IC.HAEL A&ENA ° � 100 HERRING RUN DRIVE >) CENTERVILLE,MA-�2 32 3. Service Type W Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 1'1 30, to 1A 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number I 7 012 2 210 0000 3 818 7 813 (Transfer from service label) PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 r UNITED STATES POSTAL SERVICE First-Class Mail I Postage&Fees Paid USPS Permit No.G-10 I • Sender: Please print your name, address, and ZIP+4 in this box • I I BSC Group, Inc. 349 Route 28, Unit D I West Yannouth, MA 02673 I i i - r I � t Ji,rir ,: I III�� Ili I ,iI'Ii•, Message Page 1 of 1 , T Crocker, Sharon From: McKean, Thomas on behalf of Health Sent: Tuesday, October 15, 2013 8:17 AM ( j To: Crocker, Sharon; 'Wayne Miller' Subject: FW: 100 Herring Run Drive, Centerville 1 -----Original Message----- �r J From: Yergatian, Brian [mailto:byergatian@bscgroup.com] • W1 Sent: Monday, October 14, 2013 2:48 PM To: Health Subject: 100 Herring Run Drive, Centerville Tom, The applicant would like to withdraw the application, without prejudice, in regards to the Variance application for the property located at 100 Herring Run Drive, Centerville, MA. If you need anything further, please contact me. Thank you. Brian G. Yergatian, P.E., LEED AP I Project Manager&Associate BSC Group 349 Main Street, Route 28 West Yarmouth MA 02673 direct 617-896-4590 main 508-778-8919 10/15/2013 UV � � � � sd8- � Sa 3 — ��`r`�' BSC GRoup houghtYuily transior!mirig our environmentE 349 Main Street (Route 28), Unit D September 23, 2013 West YarmouthMA 02673 Tel: 508-778-8919 RE: Variance Application, 100 Herring Run Drive, Centerville,MA 800-288-8123 Dear Abutter: Fax: 508-778-8966 , Notice is hereby given of a request for variances from the Town of Barnstable Board of www.bscgroup.com Health Regulations. The following variances are requested: 1. To allow aseptic tank to be located less than 100 feet from a wetland resource area; 2. To allow a pump chamber to be located less than 100 feet from a wetland resource area. The application and plans are available for review at the Barnstable Health Division office, located at 200 Main Street,Hyannis, Massachusetts, between the hours of 8:30 a.m. and 4:30 p.m.,Monday through Friday. A public hearing on the above will be held at the Barnstable Town Offices. Please check with the Barnstable Health Division office(508) 862-4644 to confirm the date and time of the public hearing. Very truly yours, BSC GROUP,INC. &Sb-� Brian G. Yergatian,P.E., LEED AP Project Manager/Associate cc: Barnstable Health Division File Engineers Environmental Scientists GIS Considtants Landscape Architects Planners P:\prj\4973000\_Pr0ject Control\Correspondence\Outgoing\2013-09-23 bgy LT abutter notification.docx Surveyors r t 1 r TRANS. NO.: CITY/TOWN: Town of Barnstable,MA APPLICANT: Countryside Building&Development Corp. ADDRESS: 100 Herring Run Drive,Centerville,MA DESIGN FLOW: 660 gpd REVIEWED BY: DATE: N/A OK NO Legal boundaries denoted [310 CMR 15.220(4)(a)] X Street, Lot, tax parcel number and lot number noted on plan [310 X CMR 15.220(4)(u)] Locus Provided [310 CMR 15.2204(t)] X Plan proper scale?(1"=40' for plot plans, 1"=20' or fewer for X components) [310 CMR 15.220(4)] Easements shown [310 CMR 15.220(4)(b)] X System located totally on lot served [310 CMR 15.405(1)(a) for X upgrades]- if not, a variance is required [310 CMR 15.412(4) Location of impervious surfaces(driveways, parking areas etc.) X [310 CMR 15,220(4)(d)] Location all buildings existing and proposed 310 CMR X 15.220(4)(c)] Location and dimensions of system components and reserve areas. [310 CMR 15.220(4)(e)] X System Calculations [310 CMR 15.220(4)(0] X daily flow X septic tank capacity(required andprovided) X soil absorption system (required andprovided) X whether system designed for garbage grinder X North arrow [310 CMR 15.220(4)(g) X Existing and ro osed contours [310 CMR 15.220(4)(g)] X Location and log of deep observation holes (existing grade el. on X each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR X 15.220(4)(h) and(i)] Location and date of percolation tests(performed at proper X elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? 310 CMR 15.242 X Certification statement by Soil Evaluator [310 CMR 15.220(4)0)] X Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR X 15.220(4)(n)] Address 100 Herring Run Drive,Centerville,MA Sheet 1 of 7 N/A OK NO Location of every water supply, public and private, [310 CMR X l 5.220(4)(k)] within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply X within 250 feet of the proposed system location in the case X within 150 feet of the proposed system location in the case X of private water supply wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and any catch basins X located within 50 ft. [310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located [310 CMR X 15.220(4)(m)] (if water line cross see 310 CMR 15.211(1)[1]) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR 15.220(4)(o)] X Stamp of designer [310 CMR 15.220(1) and 310 CMR 15.220(2) X Stamp of Registered Land Surveyor(required if construction X activities within 5 ft. of lot line) [310 CMR 15.220(3)] Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as X approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] Test hole adequate to demonstrate four feet of suitable material? X [310 CMR 15.103(4)] Test Holes adequate to confirm adequate groundwater separation? X [310 CMR 15.103(3)] Benchmark within 50-75' of system [310 CMR 15.220(4)(q)] X Materials specifications noted? [various sections of 310 CMR 15.000] X System components not> 36" deep(unless Local Upgrade X Approval or LUA requested) [310 CMR 15.405 l(b)] Address 100 Herring Run Drive,Centerville,MA Sheet 2 of 7 N/A OK NO SEP Size OK? [310 CMR 15.223(1)] X Inlet tee located ten inches below flow line [310 CMR 15.227(6)] X Outlet tee 14" or 14"+ 5" per foot for increase ft depth [310 CMR X 15.227(6)] Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] X Note regarding installation on stable compacted base [310 CMR X 15.228(1)] Separation between inlet and outlet tees(no less than liquid X depth) [310 CMR. 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for X upgrades under LUA [310 CMR 15.405(1)(k)] Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 X CMR 15.232(3)(f)] Three access covers (inlet and outlet must be 20" or greater) - X middle access at least 8" (by 7/07) [310 CMR 15.228(2)] Access to within 6 " of grade -one port for systems<I 000gpd, X two for systems>1000 g d [310 CMR 15.228(2) All at-grade covers secured to unauthorized access? [310 CMR X 15.228(2)] El > 10 ft from building foundation [310 CMR 15.211(1)] X Buoyancy calculation Required/Done [310 CMR 15.221(8)] X H-20 Where appropriate? [310 CMR 15.226(3)] X Setbacks from resources [310 CMR 15.211] X 1VIUIti�� �,�- �.��. � � � � �, .� �• �x Required when other than single-family dwelling or flow>1000 g d [310 CMR 15.223(1)(b)] X First compartment 200%daily flow; Second compartment 100% daily flow [310 CMR 15.224(2) and(3)] X "U" pipe through or over baffle, outlet of each compartment with gas baffle or approved filter [310 CMR 15.224(4)] X Address 100 Herring Run Drive,Centerville,MA Sheet 3 of 7 N/A OK NO 1<TILDINC SEVER AND C�'TIT2 PIPING ` Located at least ten feet from any water line? [310 CMR X 15.222(2)] Disposal piping at least 18" below water line(when water and X sewer cross, see 310 CMR 15.211(1)[1]) Cleanouts required/provided ? [31.0 CMR 15.222(8)] X Thrust blocks specified in force mains?310 CMR 15.221(6)(c)] X Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable X [310 CMR 15.22M(6)] Proper pitch on all runs?(.005 within gravity-distributed trenches X and beds) [310 CMR 15.25](9) and 310 CMR 15.252(2)(c)] Siphon problem/(leachfield below pump chamber) X Endca s or vent manifoldspecified? X Size and orientation of discharge holes specified?(not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 X CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe X types allowed) HI RIB 1.11 SOXMIIII Stable compacted base [310 CMR 15.221(2)and 310 CMR X 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided?(when pressure sewer to d-box or steep pitch of gravity sewer) [310 X CMR 15.323(3)(a) Riser if deeper than 9" [310 CMR 15.232(3)(0] X Inside minimum dimension 12" [310 CMR 15.232(2)(b)] X Minimum sum 6" [310 CMR15.232(3)(e)] X Watertight cover if<2000gpd);waterproof manhole if>2000gpd X [310 CMR 15.232(3)(d)] Capacity(emergency storage above working=design flow)? [310 X CMR 231(2)] Proper setbacks [310 CMR 15.211 (same as septic tanks)] X Watertight 20-in minium access manhole at least 20" MUST BE X TO GRADE [310 CMR 15.231(5)] Service components accessible(not too deep with piping, X disconnects accessible) Alarm floats -alarm on circuit separate from pumps specified? X Exceeds two units must have two pumps operating in lead-lag mode. [310 CMR 15.231(6) and (8)] X Stable Compacted Base [310 CMR 15.221(2)] X Buoyancy calculations needed?Provided? [310 CMR 15.221(8)] X Address 100 Herring Run Drive,Centerville,MA Sheet 4 of 7 N/A OK NO Calculations correct? X 4 feet of naturally occurring material demonstrated? [310 CMR X 15.240(1)] Required separation to groundwater? [310 CMR 15.212)] X Aggregatespecified as double washed 310 CMR 15.247(2)] X System Venting required/provided?(system under driveway or X >36" deep) [310 CMR 15.241] Inspection ports specified and within 3"final grade? [310 CMR 15.240(13)] X Breakout requirements met?(No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and X Guidance Document GALLERIkES,PITSCHI�MBERS310 C1VIR 15`253 n .� . Chambers and Gal. in trench configuration supplied with inlet X every 20 ft. [310 CMR 15.253(6)] Each structure with one inspection manhole(if>2000 gpd must X be to grade) [310 CMR 15.253(2)] Aggregate I' minimum-4' maximum. [310 CMR 15.253(1)(b)] X 2' sidewall credit maximum [310 CMR 15.253(1)(a)] X In bed configuration, inlet every 40 s . ft. [310 CMR 15.253(6)] X TRENCI ES 3!,O Cae, Width T minimum 3' maximum [310 CMR 15.251(1)(b)] X 100 feet- maximum length [310 CMR 15.251(1)(a)] X Minimum separation 2x effective depth or width whichever X greater(3x if reserve between trenches) [310 CMR 251(1)(d)] Situated along contours [310 CMR 15.251(2)] X Breakout OK? [310 CMR 15.211(1)[4] and Guidance Document] X "Ow.(Maximum Yze of ed or field 5000� pa) i., x minimum 2 distribution 2 �- ........ . lines [310 CMR 15.252(2)(a)] X Maximum separation between lines 6' [310 CM R I 5.252(2)(d)] X Maximum separation between lines and outside of bed 4' [310 X CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6" minimum, 12" maximum. [310 CMR 15.252(2)(g)] X Separation between beds 10' minimum. [310 CMR 15.252(2)(0] X Bottom area used in calculations only [310 CMR 15.252(2)(i) X Address 100 Herring Run Drive,Centerville,MA Sheet 5 of 7 I J ' N/A OK NO bIDTHFPIAN�INyOJ��VE# x Pressure Dosed System ? Provided pump and piping X calculations as required [310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A X Remedial Use Approvals] If used in gravelless system -make sure jet is directed as not to X scour soil interface [Guidance Document Inspections once per year(systems<2000 gpd) or quarterly X (>2000g d) good to note on plan [310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet X the specification of 310 CMR 15.255(3)? Impervious barrier and/or retaining wall ? [Guidance Document] X Impervious barrier installation must be supervised by X designer [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional X Engineer [310 CMR 15.255(2)(a Side slope not exceed 3:1 ? 310 CMR 15.255(2)] X Breakout requirements met? [310 CMR 15.252(2)and X Guidance Document] At least 5 ft. from impervious barrier to edge of SAS (10 ft. X recommended) [310 CMR 15.255 (2)(e) Gruvellesssyste_m[I/AA Check DEP Approval letters for credits and design conditions X If used with pressure dosing do not allow pressure discharge X to scour soil interface Arternative Shp t%System[7/AA, rovaC��Lettersj ��� ,�,��� � � ` �`f � Was DEP Approval Letter provided and/or have you X reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? X Is there a note on the plan regarding the requirement for X perpetual maintenance agreement? Any alarms involved on separate circuits X Did the applicant submit an operation and maintenance X manual? )) Has applicant submitted a co y of a maintenance X "MAN" < Are the variances listed on the plan ? [310 CMR 15.220 X (4)(q)] RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] X New construction or increased flow proposed- [Refer to 310 X CMR 15.414] Address 100 Herring Run Drive,Centerville,MA Sheet 6 of 7 N/A OK NO ztiNo en_S40As#ve�ireas fi g' Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and X 310 CMR 15.216 - also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? X [310 CMR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] X x 1Vlasceltaneous ?� �.• z >, _F r Pumping to septic tank ? [ 310 CMR 15.229] X Shared System [310 CMR 15.290] X OF MAS �Q BRIl1N' YtOdATIAN � CML 9N 060 FSS AL Address 100 Herring Run Drive,Centerville,MA Sheet 7 of 7 Health Master Detail Page 1 of 1 1�44,,-,+Hea Logged Tn As: TOWN\mckenzim Health Master Detail Wednesday, October 2 2013 Application Center Parcel Lookup Selection Items Parcel Septic Perc Well Fuel Tank Parcel: 229-045 Location: 100 HERRING RUN DRIVE, CENTERVILLE Owner: FEINBERG, MICHAEL A&ENA Business name: Business phone: Rental property: r Deed restricted: ❑ Number of bedrooms : 0' Contaminant released: r Fuel storage tank permit: r i ave Parcel Changes I Return to Lookup Parcel Info Parcel ID: 229-045 Developer lot:LOTS 16 & 17 Location: 100 HERRING RUN DRIVE Primary frontage:69 Secondary road: Secondary frontage: Village:CENTERVILLE Fire district:C-O-MM Town sewer exists at this address:No Road index:0694 Asbuilt Septic Scan: 229045_1 Interactive map: Town zone of contribution:SPLIT(parcel is split between districts and State zone of contribution:SPLIT should be looked up on the map) Owner Info Owner: FEINBERG, MICHAEL A & ENA Co-Owner: Streetl: 100 HERRING RUN DRIVE Street2: City:CENTERVILLE State:MA zip: 02632 Country: Deed date:9/5/2012 Deed reference:C198089 Land Info Acres: 0.63 Use: Multi Hses MDL-01 Zoning:RD-1 Neighborhood: 0110 Topography:Level Road:Paved Utilities:Public Water,Gas,Septic Location:Lake/Pond Front Construction Info Building No ear Built Gross Area Living Area Bedrooms Bathrooms 1 1940 3796 3142 Bedroom 3 Full 2 1920 788 �570 1 Bedroom 1 Full Buildings value:$394,700.00 Extra features: $17,500.00 Land value: $316,100.00 http://issgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=229045 10/2/2013 Town of Barnstable Geographic Information System September 20,2013 249004 #103 249003 #89 229028 229053 #0 229041 229042 #74 #68 229043 #84 229044 #94 229029 #131 .:'.2291 W:. ::':::::' 229052 229051 #258 #85 O o . 229030 229049 229050.':::: #141 #137 O #110::i.,ir::.r::<:.�: '.:"ii.'•.:::;::•:.'..<:is: : z pR 229093 #2 24 229031 wgRRlN�*RUN #34 # 22 #147 229047 Op n9048 #1 z0t-U" 228142001 =0. Feet #35 q—Is 2zeo3500s #24 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:229 Parcel:045 Board of Health boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map Abutter List Type-Direct abutters(no set distance)and the properties located E are only graphic representations of Assessor's tax parcels. They are not true property across the street. Abutters boundaries and do not represent accurate relationships to physical features on the map 1",�/ such as building locations. Buffer {YAll AbutterReport Page 1 of 1 Board of Health Abutter List for Map & Parcel(s): '229045' Direct abutters(no set distance) and the properties located across the street. Total Count: 5 ® Close Map&Parcel Owners Owner2 Addressl Address 2 Mailing Country Deed CityStateZip 229044 HULL, DONALD L& HERRING RUN DRIVE 147 LAGUNA LOS ALAMOS, C149026 JANET C TRS TRUST NM 87544 229045 FEINBERG, 100 HERRING RUN CENTERVILLE, C198089 MICHAEL A&ENA DRIVE MA 02632 229046 ROBERTS,THOMAS 110 HERRING RUN CENTERVILLE, C76478 D&M ARLENE DR MA 02632 229050 HURLEY, ELVI 107 HERRING RUN CENTERVILLE, C19517 DR MA 02632 229130 BARNSTABLE, CONSERVATION 200 MAIN ST HYANNIS, MA 5317/146 TOWN OF(CON) COMMISSION 02601 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessors database as of 9/20/2013. http://66.203.95.236/arcims/appgeoapp/AbutterReport.aspx?type=BOH 9/20/2013 J ' September 23, 2013 f Barnstable Board of Health To whom it may concern I own the property at 100 Herring Run Drive in Centerville. Please be advised that BSC Group of 349 Main Street West Yarmouth and any of their employees has permission to represent me in all matters to do with the septic modifications and related work at 100 Herring Run Drive Centerville,Ma. Michael Feinberg 185 Weston Road Lincoln,Ma. 01773 THE Town of Barnstable Op Tp� Board of Health ► BMMSrABLE, f 200 Main Street - Hyannis MA 02601 9 MASS. g 1639. plfD MA't s C OJI Agreement to Extend Time Limit �\� �� for Acting Upon a \ ik Variance Request In the Matter of a variance request form received on & 3 the Petitioner(s), a" C 6—r�� /y � regarding the property at D-0 b-- 11z.�St the petitioner(s) and the Board of Health agree that the Board of Health has until THY 13 (insert date)to act upon the Petitioners' completed application for a variance. In executing this Agreement,the Petitioner(s) hereto specifically waive any claim for a constructive grant of relief based upon time limits applicable prior to the execution of this Agreement. Petitioner(s): Board of Health: Signature: Signature: Petitioner(s) rs epresentative Chairman f Print: 6-4-�A tJ NT I A,J Print: Wayne Miller, M.D. Date: ko j 8zl a Date: Address of Petitioner(s)or Petitioner's Representative Town of Barnstable Board of Health Public Health Division 200 Main Street Hyannis, MA 02601 . Phone: (508) 862-4644 Fax: (508) 790-6304 file q:extend.doc TOWN OF BARNSTABLE LOCATION I(�r� I�e.('f Le) VILLAGE ASSESSOR'S ASSESSOR'S MAP&PARCEL RN1F?MTrR'S NAME&PHONE 1,40" rtt k-&,oAmO Gl. I'Y19 SEPTIC TANK CAPACITY 000 LEACHING FACILITY:(type) t f`r-1Uv°=- (size) NO.OF BEDROOIv'S OWNER PERMIT DATE: '+ ! ATE: aZ I Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY a J\ \,tt \ \ 15 / ffl ? 29 27 f { ! { J J f f f J ♦{ f\ fONO \ \ \ \ \ 4 \ \ J J J ll{�`wR f J•! \ 4 \ 4 4 \ \ \ 4 \ \ \ 4 J i f f f { i i ,• f f f f f 4 \ \ \ 4 \ 4 4 4 \ 4 \ 4 \ ` %26 w Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsu ewage Disposal System Form - Not for Voluntary Assessments w 100 Herring Run Road . Property Address Mar el Owner Owner's Name information is required for Centerville MA 02632 July 31, 2012 every 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: A. General Information When filling out forms on the � •y11I" computer,use 1 Inspector: only the tab key p to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co._ _ ----- Company Name r� 189 Cammett Road Company Address Marstons Mills MA 02648 Cityrrown State Zip Code 508-428-1779 SI 12855 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 _ July 31, 2012 Job# 12-118 In pector'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 shags:omit 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. l5ins•11110 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts • Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is required for Centerville MA 02632 July 31 2012 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Tank was not in need of pumping at time of inspection, pump and alarm were functioning and leaching system was dry. 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts • Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is required for Centerville MA 02632 July 31, 2012 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): I ❑ 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•11/10 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 100 Herring Run Road _ Property Address Mark Feinstein Owner Owner's Name information is Centerville MA 02632 July 31 2012 required for every page. Cityrrown 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 day flow t5ins•11/10 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 M 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is Centerville MA 02632 July 31 2012 required for State Zip Code Date of Inspection every page. Citylrown 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 CM 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•11/10 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 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is Centerville MA 02632 July 31, 2012 required for every page. Citylrown 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 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): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CM 15.203 (for example: 110 gpd x#of bedrooms): 550 15ins•11/10 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 w 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is Centerville MA 02632 July 31, 2012 required for every page. City/Town State Zip Code Date of Inspection D. System Information Description: 0 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ❑ No Unknown 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-11/10 Title 5 Official Inspection Form:Subsurface sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts .y w Title 5 Official Inspection Form Subsurface'Sewage Disposal System Form - Not for Voluntary Assessments 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is Centerville MA 02632 July 31 2012 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date describe below Other( ): General Information Pumping Records: Source of information: Tank was pumped 8/31/10 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is required for Centerville MA 02632 July 31, 2012 every 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: Unknown 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) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No 2000 gal. Dimensions: 0" Sludge depth: t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection i n Form s p Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is required for Centerville MA 02632 July 31, 2012 every 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 Scum thickness 0" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank had liquid only, no solids. Tees were intact and clear and liquid level was at bottom of outlet invert. 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �,. 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is required for Centerville MA 02632 July 31, 2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene • ❑ other(explain): 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form J Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is Centerville MA 02632 Jul 31, 2012 required for Y every 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 0 Comments (note if box is.level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is required for Centerville MA 02632 July 31, 2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 8 Infiltrators ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions.- El 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.): Interior of infiltrators were video inspected with no standing water or evidence of surcharge found 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 l5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal Syslerrt-Page 13 of 17 •e Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is Centerville required for __. __. MA 02632 _ July31, 2012 every page. Citylrown 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 ❑ drawinq attached separately 15 27 15 r %26 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is Centerville MA 02632 Jul 31, 2012 required for Y every page. Cityfrown 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: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database -explain.- You must describe how you established the high ground water elevation: Bottom of mounded leaching system is higher in elevation than pond at rear of property. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 100 Herring Run Road Property Address Mark Feinstein Owner Owner's Name information is Centerville MA 02632 Jul 31, 2012 required for Y every page. Citylrown 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 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 o1 17 F COMMONWEALTH OF Ii SSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMEN F �� J i gLE DEPARTMENT OF ENVIRONMENTAL ROTECTIR 29r5 JUN 17 AM 9: 54 SION y� TITLE 5 OFFICIAL INSPECTION FORM[—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 100 Here, kz%)I& 'Dr+V C/ h 9ro Owner's Name: fit~ t Owner's Address: lee A r+`+ +__ e+ `) —0,1J032 Date of Inspection: Name of Inspector (please print) 140 L � L Company Name: + IrteAU, Mailing Address: 90 09-uq( Telephone Number: — 8 CERTIFICATION STATEMENT I certify that i have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 4 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. 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 IHSPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: e d @- Owner: c5 G i Date of inspection: Inspection Summary: Check AAC,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 CNiR 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"s i n need to be replaced or repaired.The system,upon completion of the replacement or repair,asaPPre y the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the f owing statements.if-not determined"please explain. The septic tank is metal and over 20 years old*or a septic tank(whether metal or not)P structural if the unsound,exhibits substantial infiltration or exfihratio or tank failure is imminent System will ass inspection existing tank is replaced with a complying septiwc as approved by the Board of Health. A metal septic tic tank will pass inspection if it is y sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years o is available. ND explain: Observation of sewage bac or break out or bigh static water level in the distribution box due to broken or obstructed pipe(s)or due to a bro settled or uneven distribution box.System will pass inspection if(with approval of Board of Health): broken p4ie(s)are zqgaced obsuvctimislemoved distribution iution boot is kwled or replaced ND explain: The syste required pumping more than 4 times a year due to broken or obstructed pipe(s).The s3ahm will pass inspectio (with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 A Page 3 of i i OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: rr; jest PH ve Owner:_ b Date of Inspection: 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 . 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public ealth,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 v -etated wetland or a salt marsh 2. System will fail unless the Board of H th(and Public Water Supplier,if any)determines that the system is functioning in a manner that p teas the public health,safety and environment: _ The system has a septic tank d soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tribu a surface water supply. The system has a septic and SAS and the SAS is within a Zone 1 of a public water supply. — The system has a se "c tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a eptic tank and SAS and the SAS is less than I QO feet but 50 feet or more from a private water supply ell"'.Method used to determine distance "This system p es if the well water analysis,performed at a DEP certified laboratory,for colifortn bacteria and vol ile organic compounds indicates that the well is free from pollution from that facility and the presence o onia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteri are triggered.A copy of the analysis must be attached to this form. 3. Othe 3 A- i Page 4 of l l OFFICIAL INSPECTION FORMP--NOT-FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DMOSAi. .SYSTEM INSPECTION FORM d -PARTA- CERTMCATION(continued) Property Address: 100 rri At Pdo �Je Owner: Sr- -.L e� Date of inspection: !//Age D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No PC Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ( Discharge or pondmg 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 disc bution 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 h day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _ C 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. rX Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. at Any portion of a cesspool or privy is less than i00 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.IThis system passes if the well water.analysis, performed at a DEP certified laboratory,for eohfirm bacteria and volatile organic.compenn ds 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 mast serve a facility a design flow of 10,000 gpd to 15,000 YYoou must indicate either"yes"or"no"to each of the foll (The following criteria apply to large systems in addition the criteria above) yes no the system is within 400 feet of a ce drinking water supply _ the system is within 200 feet a tributary to a surface drinking water supply the system is located in trogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone H of a public w r supply well If you have answered"y to any question in Section E the system is considered a significant threat,or answered "yes"in Section D abo the large system has failed.The owner or operator of any large system considered a . significant threat un Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The syste owner should contact the appropriate regional office of the Department. d Page 5ofII OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address Owner: 6 e D Date of Inspection: O Check if the following have been done You must indicate"yes or"no"as to each of the following: Yes No j r 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 �I 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 ofthe 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 minie—nance of subsurface sewage disposal systems? I 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 ptable)[310 CMR 15.302(3)(b)) 5 Page 6 of 1 I w OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENT'S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Mo. Pi eo Del C ` C� Owner: Date of Inspection: D FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 6- Number of bedrooms(actual): C� DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents:-3 Does residence have a garbage grinder(yes or no): O Is laundry on a separate sewage system(yes or no): [if yes separate inspection required] Laundry system inspected(yes or no): AO Seasonal use: (yes or no): AJO Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no):NO Last date of occupancy:Lm�- COMMERCIAIA NDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203)' �Pd Basis of design flow(seats/personsls etc.): Grease trap present(yes or no): Industrial waste holding tank esent(yes or no):_ Non sanitary waste disc W to the Title 5 system(yes or no):_ Water meter readings, available: Last date of occup yluse: OTHER(de ribe): GENERAL INFORMATION Pumping Records Source of information. Was system pumped as part of the inspection(yes or no):ll 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) a co of the DEP approval Attach PP _Tight tank _ PY Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): 6 • Page 7 of 1 I OFFICIAL. INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: /OV WCOP Arr'I16 "V�tU 1� J1tGe Owner sc.t b \� r Date of Inspection: BUILDING SEWER(locate on site plan) . Depth below grade: Materials of construction:—cast iron 0(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: 1K (locate on site plan) it Depth below grade: Material of construction:_r concrete metal fiberglass___polyethylene _other(explain) P (y attach a copy of If tank is metal list age:_ Is age confirmed by a Certificate of Compliance es or no):_ ( R' certificate) Dimensions: �O�iGt/ Sludge depth: a w 1/Distance from top of sludge to bottom of outlet tee or baffler Scum thickness: �S~ g " Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee baffle: /s How were dimensions determined: R Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of le Qe,etc.): + GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction: concrete_metal class`polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top o utlet tee or baffle: Distance from bottom of scum t ttom of outlet tee or baffle: Date of last pumping: Comments(on pumping ommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet inve evidence of leakage,etc.): 7 I Page 8 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner b l Date of Inspection• TIGHT or HOLDING TANK: (tank must be pumped at tim pection)(Iocate on site plan) Depth below grade: Material of construction: concrete metal .. fiberglass----Polyethylene other(explain): Dimensions: Capacity: gallo Design Flow: ons/day Alarm present(yes or no): Alarm level: Alarm' working order(yes or no): Date of last pumping: ,. Comments(condition o and float switches,etc.): I DISTRIBUTION BOX:_ff (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: a VO" Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage m o or out of box,etc.): /I n y--s='�6 PUMP CHAMBER: Pe (locate on site plan) Pumps in working order(yes or no):. Alarms in working order(yes or no):LCS Comments(note condition of pump chamo T,wndition of pumpsgnd appurtenance tc.): S � . 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: /00 e f-I �n tre Q J� Owner: C, le Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number. leaching chambers,number. __1( leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): ` S g a c9q LVLUr' Cl f CESSPOOLS: (cesspool must be pumpe part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet inve Depth of solids layer: Depth of scum layer: Dimensions of cesspool- Materi als of construct* n: Indication of groun ater inflow(yes or no): Comments(note ondition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site Materials of constructs Dimensions: Depth of solids: Comments(note ondition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of l 1 OFFICIAL INSPECTION FORD—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM 3. PART C SYSTEM INFORMATION(continued) Property Address: 1001lefro14 4 1tE Owner: S Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply eirters the building. f� �n '. Page 11 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner: . �5 Date of Inspection: SITE EXAM Slope A)O Surface water t{&' Check cellar 11 a e_ r Steal low wells 6 C7 Estimated depth to ground water I r feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plats on record-If checked,date of design plan reviewed: �X 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_ , r Il Permit Nianber; Date' Completed by- HIGH. GROUND-WATER LEVEL COMPUTATION, Site Location-, zoo 114-r6kr- Lot No. Owner: Address: Contractor: Address: Notes: S,r_CP I Measure dep--h to water table . to nearest 1110 ft- -------_--------------------- -------------------- ......... Da 7 onzh/dzvfymr I STEP 2 Using Water-Level Range Zone and Index Wall map locate sate and determine: OA Appropriate index well---------...................................... Weer-level range zone ..................................................... if f STEP 3 Wing morrbly report,"Current Water Resources Conditions" determine m,rrent death to venter level for index,rMll I ........................... M !year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A),current depth to water leve-1 for index wefl (STEP 3), and water-Ic-:rel zor4 (STEP 28) determine water-lseve,4 adjustment _--___-_--------------_-------_- ....................... ------ STEP 5 Estimate depth to high water by subtracting the water- level,adjustment (STEP 4) from.measured depth to water ievelat site;!'STEP 1) ................................................................................................ FVM 1&--FWPM*X"COMPUtWOn 1WM. No....,f• r i:..... FEB......1Q_0........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliration for Disposal Works Tonstrurtinn 1hrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at .....!QQ....,1�........... . �..ax&w& .......... ------�� � 7 ._.. .......... ocatio - ss or Loo,o. ........ ... ............:�r.._..... _ ... ......._........................ .. - .. . .. . . wne ----- •-- L _�lr.�r��lG�fPc.Ad.. Insta9ler Address T of Building Size Lot.......:....................Sq. feet U� Dwelling—No. of Bedrooms_______ilov_________________________________Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ---------- - Des ign W Design Flow............................................gallons per person per day. Total daily flow........................._____._._____._____gallons. Septic Tank—Liquid capacity............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 area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by _---------•-------------------------- Date Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................ (4 ........ •-- -..._._.. _ ....................•-----•-•--.._...._.......................................................... ODescription of Soil-------------•-••- --•-----••------------------------------•...------•---...._..-•----------------------.........._.. x U -------- ------------------------- •--•--------- _____----------------------- •-------- ___-_____---------------------------------- ••---------------------- .................................. 0 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 Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complian has been issued by the board of health. Signed ..-- ----. %-'... --�� Date Application Approved BY ...... --- ....................................................... aZ-- -... - Date Application Disapproved for the following reasons: ---------------------- --------------- ----- ------------------------------------------- ---------------- ---- ------------ ------------------------------ . • Date Permit No- -------- .. �-�. ............ ... Issued ...................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE &r#tftra e of Compliance THIS IS 0 CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( � ) Installer ` at -----------------1..0-0....... --------------.... ...... .......�rj" = ����wc.. has been installed in accordan with h the provisions of TITLE 5 The State Environmental Code as described in the application for Disposal Works Construction Permit No. .......9�..aR....3.3...1?...... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...............................---- ------------------------------------------------------ -------- Inspector ...........-----------.......-----------------.------------......................---------------. No....L_2=33K... Fps.... ra.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Diipu�a.l• Workii Tonutrnrtuan Vrrmit '_,,Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System-at: 2�& ocatio -A �ss or Lot No. ........ !t ls!s.. ••'�Cma � � •.. . �•.... ....... ..................... W 47-Z.— wner O �7 ��ii _._.... Insta le Address Type of Building _ Size Lot................_...........Sq. feet Dwelling—No. of Bedrooms....... ................................Expansion Attic ( ) j' Garbage Grinder ( ) a Other—Type of Building ____________________________ No. of persons......................... 'Showers ( ) — Cafeteria ( ) .;. Other fixtures W Design Flow............................................gallons per person per day. Total daily flow.................................._.........gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area............_-------sq. ft. a Seepage Pit No________-_____________ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..................................................................... ---- Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 S Test Pit No. 2................minutes per inch Depth of.Test Pit..................... Depth to ground water........................ Description'of Soil.......... &..•. `„ !1�-=--•--••------------------- •--------------------------- = --- U 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 Environmental,Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliant has been issued by the board of health. r� Signed - . ----�-��% �^:-�---- ------- ------------------ ---1--� ------------------ Date ���� Application Approved EY ---------------- ------C ...... .............--...........................-- --..7--.. ,5..-.'� f- - Date Application Disapproved for the following reafon ----------..................-----------------------------------------------...............................--------------- t -----------------------------------------------------p----------------------------------------------------....-..--------------..............---------------------..........------------------------------- ----------------------------- PermitNo- --------1...0----"------�-3_3....................... Issued ................................ .................. Date THE COMMONWEALTH OF MASSACHUSETTS r ' BOARD OF HEALTH TOWN OF BARNSTABLE Cer#tftrate of Tontlaliance THIS IS KO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by ............................V ----------- ................................................. - Installer at ---------------�. v... a< �tr'---------- -------------------------------------------...................................------....--- has been installed in accordan with the provisions of TITLE 5 pt The,. tale Environmental Code as described in the application for Disposal Works Construction Permit No. ....... l...QZ...-.33....E-..... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-- ------------- ------------- ------------------- -- ---------------------------------------- Inspector ............................................................ ----- -----------. ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH q TOWN OF BARNSTABLE Woposal Works TINunstr ion rrutit Permission is hereby granted � >. �`�< to Construct ( ) or Repair (k) an Individual Sewage Disposal System at No..............I•() v 6�'. = -�=`=`---------••------•-•----------_. . Street (� as shown on the application for Disposal Works Construction Permit No._/_ �:_-`3�31f_ Dated................................:......... c?- .•--•-. --- -- - - DATE. —7 ` ao- 01 l/ Board of Health FORM 36508 HOBBS&WARREN,INC..PUBLISHERS {. 4 FEINBERG I RESIDENCE 3 2 t '= 3 2 100 HERRING RUN DRIVE °S1 a'+ '�' as+ y, .u.+ CENTERVILLE,MA a n'7ye 444' ' 4-0113/ 5 6'-3y 5 Ste • 1� . .C-� 9• rmrre�a�s min! 1; 1'-0' YY• i woad a,•oor '� ___________ GENERAL NOTES.�„°.,.am.e.�.F 611 � Y �_—+O6 � 11� ` I LWTY�lO aT•. `11 . ___ice_ i-T.bZb�1____-I' ______III�(__l _ F7 i i - aHaa wa O i�' BEDROOM I __� L _ 'L_ __ -{ tNvO ____ P ,._____ T__1 ..r„.w.se.=...w�..a,wm...u,w..n,o4n••:w•m u I i I t T-"/6 '2-3- �"Ay y-o 00 Ibl : '% i � ' •Q`I ` RIDGE c i I n - \ -----_'_____tL _� �r1�•�'•- ' -- - LJ - ro• �wnwoo ? 'a m , , i , ` "a i ' i 1 i d i \� •_emu r e/ 4'W4 Y 5/e 3 P 1}g• Sy s p SJ��fP 9 .'^B \5 :. FIRST FLOOR PLAN SCALE 1/4'=1•-7 1 ROOF PLAN SCALE:1/4—l- 3 NICHOLAEFF ARCHITECTURE+DESIGN ' 812 Mah Street Osw.ille.MA 02555 1 T 508 420 529E q 3 Z 4 F 5084202240 8tpp Ail A I31 - ICholaalf.c9T ,p �.FiU AI 15 if 1-� 317/• "1 P 9• o\ —________ _________- ,N,4 n1p PROJECT NUMBER: DRAWN BY:AH.ON.CO SCALE:AS NOTED DATE:SEPTEMBER 7,2010 -- ----_- r- I 3yp• 3a� i - L__J . 1.INTERIOR DOOR DIMENSIONS SHOWN ARE NOMINAL DOOR LEAF SIZES IN INCHES.G.C.TO CONFIRM ACTUAL ROUGH OPENING SIZES REQUIRED WITH THE INTERIOR ODOR FABRICATOR.INTERIOR AND EXTERIOR DOOR b �. WINDOW HEAD CASINGS TO AUGN UNLESS NOTED OTHERWISE 2.DIMENSIONS ARE TAKEN TO FACE OF ROUGH STUD FRAMING, d CENTER-LINE OF DOOR OR WINDOW,OR CONTROL POINT LINE,UNLESS INDICATED OTHERWISE. ------- OTHERWISE _�lnoaa�— -`_ 3.O ALL EXTERIOR WALLS SHALL BE 2X6 a 2x8 @ 16'O.C.,UNLESS NOTED i t___7___.r_ _y __ __� - OTHERWISE TITLE,2c �..'� s 4.ALL INTERIOR PARTITIONS SHALL BE SCI 2X4/2x6 @ IS'O.C.FULLY PROPOSED FLOOR PLANS -= INSULATED W/M'UNFACED FIBERGLASS SOUND INSULATION ` GENERAL NOTES 14TION HARD-WIRED PHOTOELECTRIC COMBINA K an/C-O. MOKEICO2 DETECTOR WITH BATTERY BACKUP - •- 0 HARD-WIRED PHOTOELECTRIC SMOKE DETECTOR 9D. WITH BATTERY BACKUP Al J LOFT FLOOR PLAN SDALE:"4' 2 FIRE PROTECTION 5 i , SCHEDULE OF ELEVATIONS SILT FENCE DESIGN CALCULATIONS LOCUS INFORMATION NOT TO SCALE , .. sf HOUSE GARAGE DESIGN FLOW LOCUS CURRENT OWNER: MICHAEL A. FEINBERG OVERLAY DISTRICT: AP, ESTUARINE, RPOD ENA FEINBERG TOP OF FOUNDATION VARIES 30.00 OAK STAKE 6 BEDROOMS 0 110 GPD/BEDROOM = 660 GPD NITROGEN SENSITIVE 8' O.C. (MAX) TITLE REFERENCE: CTF 198089 s n t ZONE: NOT A ZONE II 4" INVERT AT BUILDING 8.0f 25.40 REQUIRED SEPTIC TANK I' FILTER FABRIC x PLAN REFERENCE: LCP 20973-E FEMA FLOOD 4" INVERT AT EX. SEPTIC TANK (IN) 26.4f `� 2-COMPARTMENT TANK REQUIRED ZONE DISTRICT: "C", DATED 8-19-1985 N 660 GPD X 200% = 1,320 GALLONS ASSESSORS MAP: 229 PANEL #250001 0005 C4" INVERT BACKFILL POLES USE EX. 2,000 GALLON SEPTIC TANK AS 1ST CHAMBER PARCEL: 045 �` ^r € _ 4 INVERT AT EX. SEPTIC TANK (OUT) 26.15 FLOW USE NEW 1,500 GALLON SEPTIC TANK AS 2ND CHAMBER MINIMUM LOT SIZE: 87,120f S.F. 4" INVERT AT SEPTIC TANK #2 (IN) 24.70 6 ZONING DISTRICT: RD-1 EXISTING LOT SIZE: 25,900f S.F. (UPLAND) V ` LEACHING FACILITY PROVIDED SETBACKS: FRONT 30 m 4" INVERT AT SEPTIC TANK #2 (OUT) 24.45 0 6 RE-USE EXISTING 6-BEDROOM LEACHING FIELD INSTALLED SIDE 10' EXISTING LOT COVERAGE: 2,977t S.F. (11.5%) " IN 1992, WITHOUT MODIFICATION REAR 10' LOCUS MAP 4" INVERT AT PUMP CHAMBER (IN) 24.40 NOT TO SCALE 2" INVERT AT PUMP CHAMBER (OUT) 24.15 EARTH UNDISTURBED 2" INVERT AT DIST. BOX (IN) 32.2f C , , tN,OFiygs �� BRIAN G. G 4" INVERT AT DIST. BOX (OUT) 32.0f EXISTING LEACHING FACILITY TO REMAIN IN SERVICE WITHOUT MODIFICATION ��� FLEXIBLE PIPE TO MANHOLE YERGAT A CONNECTION (NEOPRENE BOOT) '�'L �5 "�' GRASS AREA ,o ,9 N . 206 WF#4 F� NOT TO SCALE LONG POND CONCRETE 90��SG TE WF#3 WF#2 BOUND FOUND �0 WF#5� �', , '� DECK �� OFFLINE 1.5' 1 ,000 GALLON PUMP CHAMBER (H- 201 WF 1 INSIDE FACE OF NEOPRENE BOOT NOT TO SCALE COTTAGE MANHOLE 6dA -" •a STAINLESS STEEL CLAMP 515t S.F. PROPOSED � � •�( � SILT FENCE FORMED OPENING I NOTES PROPOSED MITIGAPLANTITION 27.2 X^ WF ,� FF=28.2 .3 4 BRIAN G. YERGATIAN DATE GS 9>_0" (436 S.F.) CONCRETE PROFESSIONAL ENGINEER 1. SEPTIC TANK SHALL BE STEEL REINFORCED CONCRETE. N WF#8 PAD "�- 28 2. SEPTIC TANK SHALL BE CAPABLE OF WITHSTANDING H-20 LOADING. WF#9 v - '.'. ` i i - i i i PIPE 3. ALL PIPE CONNECTIONS REQUIRE NEOPRENE BOOTS. '" W c ` ` `�•W`�`.�. .` - `.`. � COVERED EX. 2,000 GALLON 4. THE TANK SHALL BE MADE WATERPROOF AT THE FACTORY. Wp_rER. / ` SEPTIC TANK NON-SHRINK 5. TEES SHALL BE SCH. 40 PVC AND SHALL BE LOCATED EDGE OF -.-.•.- GRASS W• r , � � PORCH WF-T1-P1 � -� / (TO REMAIN IN SERVICE) WATERPROOF WITHIN 12" OF TANK WALL AND ACCESSIBLE FROM TANK &I WF#10 `��`�•+`+`+`� GROUT TYP.) SEPTIC SYSTEM 5'-3" ==O - - - COVER. CONCRETE WF#13 1,150t S.F. • / ` 6. FILL ALL UNUSED KNOCKOUTS WITH HYDRAULIC CEMENT. BOUND FOUND WETLAND \ ANODIZED 7. PUMP CHAMBER SHALL BE SHOREY PRECAST OR OFFLINE 0.6' X \ JJ PR POSED ALUMINUM OR EXPOSED METAL TO BE ��WF#12 WF DDmON EX. PUMP STEEL KORBAND .e' CORROSION NTHPROTECTED A REPAIR APPROVED EQUAL. �-- _ 8. PUMP CONTROLS SHALL BE SJE VERTICALMAST PUMP SWITCH BY SJE RHOMBUS OR APPROVED EQUAL. 28 FF=29.0 j CHAMBER BITUMINOUS COAT #100 i PUMP EX. CHAMBER A. = '�a A . . PLAN VIEW WF-T1-P2 EXISTING X I LING X CRUSH AND REMOVE s FROM SITE IN • f a THE LENGTH ENGH OF THE FIRST PIPE » 1,814± S.F. ' ACCORDANCE WITH SECTION SHALL NOT EXCEED 5 FT. RAISEI(2) O COVER, TYP. OF FINISHED g SECOND STORY THE REQUIREMENTS 100 HERRING RUN DRIVE GRADE USING PRECAST CONC. RISERS GRASS AREA / F.. OVERHANG OF TITLE V. 6" MAX 6" HICK REINFORCED FF-3E.1 5 � SO. / CO �. N ,t IN CON(. TANK SLAB F4cF pF'cFF,Q o PROPOSE . I500 GAL. v' o TO +o 28-- SEPTIC TANK AND o CENTERVILLE " � �` / REINFORCED GENERAL NOTES MAS SAC H U S ETTS 2 PVC CONDUIT TO CONTROLS S r. ' CONCRETE SLAB ,,� X 27.9 EL 26.15 0 0 Z '� 4" SCH. 40 PVC (BARNSTABLE COUNTY ° = NEOP. 1. THIS PLAN IN ONLY INTENDED FOR THE DESIGN AND CONSTRUCTION OF THE SEWAGE INLET BOOT f N / y N DISPOSAL FACILITIES. -� 2 SCH. 80 PVC M /� C N<UT NEOP..• TEE DISCHARGE PIPE a � / / 28.9 BOOT o X /1 2. ALL CONSTRUCTION METHODS AND MATERIALS SHALL CONFORM TO 310 CMR 15.000 EMERGENCY 1/4" WEEP HOLE z " 29 AND BARNSTABLE BOARD OF HEALTH REGULATIONS. STORAGE PROPOSED / 4 SCH. 40 C -0 ,o SITE PLAN 6'-0" SILT FENCE 4'-9" 5" PUMP ON a QUICK DISCONNECT 2g -� � 0 3. THERE ARE NO KNOWN OR PROPOSED PRIVATE WELLS LOCATED WITHIN 150 FT. OF " COUPLING 0 30 THE PROPOSED LEACHING FACILITY. 4" 7 PUMP OFF MYERS SRM4 SEWAGE PUMP 7°°, y . 0 ;., PROPOSED 1,000 GAL " I / ,� r 0 PUMP CHAMBER AND 4. IF AN OVERDIG IS SPECIFIED, REMOVE ALL TOPSOIL, SUBSOIL AND OTHER UNSUITABLE a 2.. F�cF \�� ``' REINFORCED • o,� .FR �-/ / 0 X29.11 ®31 MATERIALS. AUGUST 23, 2013 IJ,A -Tp f CONCRETE SLAB " 6" ��\ SECOND STORY �- ` I / 5. IF AN OVERDIG IS SPECIFIED, REPLACE ALL EXCAVATED MATERIALS "THIN THE LIMIT 5 TO ' GRASS AREA OVERHANG '`32 OF EXCAVATION WITH CLEAN GRANULAR SAND, FREE FROM ORGANIC MATERIAL AND CONCRETE BOUND / --" `' R f3 PROPOSED 6" MIN. 3/4" TO 1-1/2" 75.78' �• - ^�- ...--••�� - � / 2" SCH. 80 PVC DEETRIOUS SUBSTANCES. MIXTURES AND LAYERS OF DIFFERENT CLASSES OF SOIL CROSS-SECTION VIEW CRUSHED STONE N8436'40"W L�24.g4, � �.�'' PROPOSED � � � ( SEWER FORCEMAIN SHALL NOT BE USED. FILL SHALL NOT CONTAIN ANY MATERIAL LARGER THAN 2 R� -` GARAGE .WITH r�l INCHES. A SIEVE ANALYSIS USING A #4 SIEVE SHALL BE PERFORMED ON A 60.Os, f� f 3�4» WATER W 2ND=STORY -- EXISTING GARAGE REPRESENTATIVE SAMPLE'OF FILL. UP TO 45% BY WEIGHT MAY BE RETAINED ON THE PUMP CALCULATIONS 4' W SLAB=30.0 130 _ 501 BE RAZED #4 SIEVE. SUCH ANALYSES MUST DEMONSTRATE THAT THE MATERIAL MEETS EACH OF HE FOLLOWING SPECIFICATIONS: DESIGN FLOW TO CHAMBER = 660 GPD � ``"^4 �-� X 29.5 ..-...-.--- -• -` Epp ._-_ ,_..-- I � NO. DATE DES(. REQUIRED EMERGENCY STORAGE = 660 GALLONS \, r r DECK �, 100% MUST PASS #4 SIEVE = N PRO OSEP D --- 10% MUST PASS #50 SIEVE 1 9/20/13 VARIANCE REQUESTS EMERGENCY STORAGE PROVIDED 671 GALLONS NUMBER OF DAILY DOSING CYCLES = 5-6 PER DAY ` � / NC. STEPS ' / # ` V/ 0-20% MUST PASS 100 SIEVE �4p, % �� / /10' 0-5% MUST PASS #200 SIEVE 10,0 1 a DEPTH ASSOCIATED WITH CYCLE - 5 INCHES �.\� FJ /� � � ' � •� �+ �• ..� � 1 - . GRAVEL Ll :•- 6.- EXISTING UTILITIES WHERE SHOWN ON HE PLANS ARE APPROXIMATE. HE ENGINEER 37.125 SF X 0.417 FT X 7.48 GAL/CF = 116 GAL/CYCLE _ ' rOF /J AREA GRASS X 33.8 ;"A ���" DOES NOT GUARANTEE THEIR ACCURACY OR THAT ALL SUBSURFACE STRUCTURES ARE OVER SEPTIC AREA ,ram SHOWN. CONTRACTOR SHALL VERIFY THE SIZE, LOCATION AND ELEVATION OF INVERTS DESIGN TOTAL DYNAMIC HEAD ' = 15 FT � � �\ 0 ® 1(6 BEDROOM PER 1992 DESIGN FLOWRATE (GPM) = 27 GPM \ / ~`., PERMIT 92-238) CPAM w OF UTILITIES AND STRUCTURES, WITHIN THE LIMIT OF WORK, PRIOR TO THE START OF r I No 3 M CONSTRUCTION. IF ANY DISCREPANCIES ARE DISCOVERED OR FIELD CHANGES GUY 3Ce29.8 �� ` REQUIRED THE CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY. HE PUMP SHALL BE A MYERS SRM4 OR APPROVED EQUAL, � WIRE •-•� � > CAPABLE OF PASSING 2-INCH SOLIDS, AND DELIVERING 27 GPM } � AT 15 FT OF TOTAL DYNAMIC HEAD. I ®-- /34.0 X 7. THE CONTRACTOR SHALL BE RESPONSIBLE FOR PROPERLY COORDINATING THE S �� PROPOSED CONSTRUCTION ACTIVITIES NH DIG-SAFE AND THE APPLICABLE UTILITY /`\ VENTS - COMPANIES, AND SHALL COMPLETE THE PROPOSED WORK WITHOUT ANY INTERUPTIONS 1 29.6 z S6 .4�62• / co 3 IN SERVICE. 1 500 GALLON SEPTIC TANK H-20 m � '� g°6'30" . 32.2 ~� __ t 9�z©�z �,,, 8 CONTRACTOR IS REQUIRED TO NOTIFY DIG SAFE, PER MASS. STATUTE CHAPTER 82, NOT TO SCALE o V \ SECTION 40 BY CALLING (888) 344-7233, OR BY COMPLETING THE ONLINE BENCHMARK: NOTIFICATION PROCESS BY VISITING WWW.DIGSAFE.COM A MINIMUM OF 72 HOURS PRIORLU PREPARED FOR: w TOP OF BARNSTABLE X 30.7 s6 MOTES: -� o ROAD BOUND DISK 2� TO HE START OF CONSTRUCTION. 24 DIA. COVER, TYP. Q d I ELEVATION = 29.9� �03 TOWN OF BARNSTABLE REQUIRES COUNTRYSIDE BUILDING & 1. SEPTIC TANK SHALL BE STEEL REINFORCED CONCRETE. RAISE (2) TO WITHIN 6" OF FINISHED 2. SEPTIC TANK SHALL BE CAPABLE OF WITHSTANDING H-20 GRADE USING SEWER BRICK AND z 83. I / AS-BUILT CERTIFICATION 9. HIS SYSTEM IS NOT DESIGNED FOR HE USE OF A GARBAGE GRINDER. INSTALLATION DEVELOPMENT CORP. o Ij OR USE OF A GARBAGE GRINDER AT THIS PROPERTY IS NOT ALLOWED PER 310 CMR LOADING. MORTAR AS NECESSARY m z 50 TONSET ROAD 3. ALL PIPE CONNECTIONS REQUIRE NEOPRENE BOOTS. " " o �S 15.240(4). 4. HE SEPTIC TANK SHALL BE MADE WATERPROOF AT H 6 MAX. 6 HICK REINFORCED ►- ORLEANS, MA 02653 FACTORY. CONC. TANK SLAB 5. TEES SHALL BE SCH. 40 PVC AND SHALL BE LOCATED WITHIN 12" OF TANK WALL AND ACCESSIBLE FROM TANK COVER. 6. FILL ALL UNUSED KNOCKOUTS WITH HYDRAULIC CEMENT. „ NEOPRENE EL 26:40 y FEL 25.90 BUOYANCY CHECK FOR SEPTIC TANK BUOYANCY CHECK FOR PUMP CHAMBER VARIANCE REQUESTS �0_ up BOOT GROUNDWATER ELEV. = 28.00 GROUNDWATER ELEV. = 28.00 j BARNSTABLE BOARD OF HEALTH 349 Route 28, Unit D T TOP OF SEPTIC TANK = 25.90 TOP OF PUMP CHAMBER = 25.65 J •' 10" = FINISHED GRADE = 29.00 FINISHED GRADE = 29.00 W. Yarmouth Massachusetts 10-o " '- NEOP. 1. TO ALLOW A SEPTIC TANK TO BE LOCATED ' 3 �r BOOT WEIGHT OF SEPTIC TANK = 21,230 LBS WEIGHT OF PUMP CHAMBER = 14,500 LBS 85 FEET FROM A WETLAND RESOURCE 02673 _ 6,_0" WEIGHT OF CONCRETE SLAB = [(11)(6.17)(0.5) - (2)n[1)Z(0.5)] X 150 LBS/CF = 4,619 LBS WEIGHT OF CONCRETE SLAB = [(9)(5.25)(0.5) - (2)7T(i)�(0.5)] X 150 LBS/CF = 3,308 LBS AREA IN LIEU OF 100 FEET. 5087788919 " LIQUID WEIGHT OF OVERBURDEN = [(11)(6.17)(1.0)] X 85 LBS/CF = 5,769 LBS WEIGHT OF OVERBURDEN = [(9)(5.25)(1.0)] X 85 LBS/CF = 4,016 LBS 4-9 LOCATE DEPTH I - INLET TEE OUTLET TEE o SUM OF FORCES ACTING DOWN = 21,230 + 4,619 + 5,769 = 31,618 LBS SUM OF FORCES ACTING DOWN = 14,500 + 3,308 + 4,016 = 21,824 LBS 2. TO ALLOW A PUMP CHAMBER TO BE © 2013 BSC Group, Inc. 6'-2" - - UNDER COVER W/GAS BAFFLE 6" LOCATED 95 FEET FROM A WETLAND I _ _ _ 6" SEPTIC TANK & SLAB SEPTIC RISERS PUMP CHAMBER & SLAB PUMP RISERS RESOURCE AREA IN LIEU OF 100 FEET. SCALE: 1" = 20' VOLUME OF WATER DISPLACED BY STRUCTURES = (11)(6.17)(6.5) + (2)(7T)(1.42)2(1.6) + = 462 CF VOLUME OF WATER DISPLACED BY STRUCTURES = (9.0)(5.25)(6.5) + (2)(7r)(1.42)Z(1.85) + = 331 CF :.. p. •:' WEIGHT "OF WATER DISPLACED BY STRUCTURES = 462 CF X 62.4 LBS/CF = 28,829 LBS WEIGHT OF WATER DISPLACED BY STRUCTURES = 331 CF X 62.4 LBS/CF = 20,655 LBS 0 10 20 40 Fm RESULTANT FORCE = 2,789 LBS DOWNWARD RESULTANT FORCE = 1,169 LBS DOWNWARD 6" M►NIMUM - FILE:P:prj\4973000\Civil\_Drawings\4973000-SP.dwg PLAN VIEW 3/4" TO 1-1/2" CROSS-SECTION VIEW ** SEPTIC TANK WILL NOT FLOAT ** ** PUMP CHAMBER WILL NOT FLOAT ** CRUSHED STONE DWG. N0: 617 -02 JOB. NO: 4-9730.00 SHEET 1 OF 1 r SOIL TEST PIT DATA: ,, MANHOLE OOVER TO�I m «u �,o,, NO. OvrLETS:�1 �K"SLOTS �,'Ems: ��„�,o,, -�� MOM. _ r " 2 lND/CATLT lMDICATES OdStRVED t2•MIN. ;/' 1. DIMIBUTION BOX TO W17WSTAND M-10 'S' � 2��" 4" DIA. / _�_c�/ �gCx rTE� z GROUNDWATER • pOVER .' / r--•---, LOADING UNLESS UNDER HEREBY H-20 LOAD PG \ � Ir C� /✓111!�1 S �� DES 14,J A 1 S 1 OR TRAVELED WAYS P-7589 r s-�- - -- -- --- � r.�. �•:.•::- . .• • �. -: . . :. ..:- .. • t ��SHALL ArPLr. • � = - - - - - - -- - - - I s INLET M t I � ca o ( I i � o 0 111h" o TEE ( 2•PROV/DLFINLET Tit AS SHOWN WNERE C= FLOW TP No. I TP No. 9 1 SLOPE OF INLET PIPt EYCEEDS o.Ol fr/FT , .. Mtt Mo�rtt! GRDB4 3 I 0 GRD.EL. _ _ m�� Z �-----� OR /N A PUMPED STSIEM. 1-2Y." 3"-1 (- 1-4" LINE SECTION B-B .I PRECAST.STRL �- _G ' { J. FIRST TWO FEET Or PIPE OUT Of TXE SfCT10N A-A - /1'IAA GW.E1_ u,z /✓IA% GW.EL- zTz memFoleceb _ � �o PLAN VIEW DIMINUTION BOX rV BE LAID LEVEL 0 0 SE/TIC TANK (o'er WLET 4W MIN. cum"- 6% I.RECOMMENDED MANUFACTURER - -ToP SoI>L GR E[. 1 1 'y-� T� u0U10 DEl�T11 TEE 4, S-� ROIONDOOR APPROVED EQUAL. IL ' s•1°IN'I.3xTo I-IA'S 3` covo CLEANOUT & INSPECTION LID ,, 6.OlA.�TLETts) B Q�• ON LEVEL STABLE BASE � � µ• 4 - BOTTOM �- ; ..., � �VOC A 1 3 Co Az 6 3 �_�H 5 c W DIA.MANHOLE COVER •' �►TERTISHTLq 4 a"INLET • FONTS (T1M) I ( 1 A References: J A")D PLAN VIEW CROSS SECTION VIEW 4 OU?LtT 5 S NOTES: T ,► _ _ _ _ _ _ — - I« N I 4'-0" 1. SEPTIC TANK TO WITHSTAND H-10 LOADING !. INLET AND OUTLET TEES TO BE CAST IRON. ...•. ,•••. --'� WLET 6 6 UNLESS UNDER PAVEMENT. DRIVES OR TRAVELED SCHEDULE 10 PVC OR CAST-IN-PLACE CONCRETE. N�— ON r WAYS. WHERE BY H-20 LOADING SHALL APPLY. TEES TO BE CENTERED UNDER MANHOLE COVER. LEVEL.STAlLE I• I ' ' — 2.-ALL PIPE CONNECTIONS AND CONCRETE CON- I. RECOMMENDED MANUFACTURER - ROTbNDO OR � r • I � STRUCTION TO BE WATERTIGHT. APPROVED EQUAL CROSS SECTION VIEW Fv --- - -- - - - - - - -- - - 8 _ S 2 STONE g g SEPTIC TANK DETAIL NO. OF GALLONS: zdl,o DISTRIBUTION BOX DETAL B e• -0" LOCUS MAP •Q 10 10 NOT TO SCALE NOT TO SCALE SCALE: 1'-2063• IV PLAN VIEW 11 11 ,. „�, ,. 1,•, �: 11-1 pE DESIGN ANALYSIS 12 12 LEACHING tks 8ER DETAIL FD-Axe-j' NOT . TO $CALE DESIGN FLOW: DATE: ,y-i7- 9 DATE: Al- i7- 90 t 4 X8 FLOW DIFFUSORS R OR EQUAL A',l //sE =�,8EaZM,97 x /io Gr.D = �yo �•,--� TEST dr: C• Jo LL`/ TEST Sr.C Jo!.L`/ = Pro Title: o7Tft[�c / 3Ll�POp�q K //O �/�r� T•»�• • SSo G.PD IeC1 --- WITNESSED dr: WITNESSED NY: 24- 0PE06ING AROVE F011 Mr! s _ 4'�-RISER 9 _T PVC _*HEFTING _.O DMSOF 4 WL EL � L.-- ' —�� ll�' RET ;� 3c- I SEPTIC TANK REQUIREMENTS: FRAME a��0 COVER- - PERC. RATE: PERC. RATE: - - - - - -� FINISH GRADE 4" L014M AND SEE �� • SSo GPI x i5o = 8=.5" GAL LOTS ROTUNDO PUMP CHAMBER O < Z .I CONC. FOOTING 0 o$ 4 BARS SPACED AT 12" EACH WAY ��sc 0000 6;U . TA/t/K MIN,//NCH K/N,/INCH I I 4 5 it �� 12�'OIA. X 4'MIN. a G Q •. b INLET-4-PVC PIPE 0 d 16 & 17 TP No. TP No. APPROXIMATE WCATION OF HEAVY I 1 ;N A BLACK PIPE TO SUPPORT FLOATS O FLOW DIFFUSOR i•� -�J (FII-1- IQUflIED - , O ' GRD.EL. OR ;;�' 4 " PVC PIPE v +D GRD EL. PUMP POWER CABLE 6 FLOAT I WITH MEDIUM HERRING CONTROL CABLES TO L — — -- — — EOUAL ! COARK SWD 0 GW_EL. GW.EL. SUITABLE FOR DIRECT BURIAL OR 0 0 CONDUITPLACED IN SuuLOc a WI ES. tD ♦ a .D , VARIES 3�-0" MAX' O LEACHING FACILITY REQUIREMENTS: $,�v 6•? PLAN VIEW RUN 1 1 PRDPOSEO.FINM QUM TYPICAL VENT D E T A 1L 0 ' � 8 - h'�'S ' � �� l e . 0 rDIFryS�s w 4!'STon/E �c 16 I x•9�' l:gc�// Ae�A 2 2 EL• 28.0 ,MI COVER NO TO SCALE �. � p D FINISH GRADE 2 6 a f DRIVE 3 3 SECURE CHAIN TO WALL OR / J�) l / Q� MANHQ.E FRAME 21� ■ �/Z�•E�/ALAL �1RgA ' t 3Z�x •9L •_ lD V� 4-INLET-INV EL• --�TO DIST BOX 1OR�w >r.. o7To/!! AzeA = �/ x l®/ ' PUMP TO SECURED AT TOP " _ 6�° S� CENTERVILLE q q 2 FIvC DISCHARGE kFT SDR 21 a BOTTOM OF PUMP CHAMBER 'mV- 25.75 / G S 5 MERCURY FLOAT ILEVEt CONTftOLI O W �� I - RYP) HOT 01P WL1L 4/O M 1WREE ED PI O sCl�.eo .�� TNREAOED �M = aGAFMAIII 6 6 ALARM LEVEL 6 24.75 4- COAAW LAG PUMP ON•EL. O I� 7 7 2 - MYERS PUMPS p • � .'.EACHlNG FACILITY PROVIDED: S 8 PUMP ON EL- 23,75 V. W HR5 , I/2 .HP D �; , 21 49 GPM AT t9.5 a• « _ 8" MIN.COMPACTED. a- y�xe L Ft�..�o,Ff�.so,es ��y. STaI.1g PUMP OFF EL_ � � 6 / 9 g PUMP EL 20.50 _1 SCREENED GRAVEL SIDEuJgLc, 4ro!A: /o8 5.�x 2sG.�U/sr •Z7o 6�D 10 10 ••• ` 6'MRJ wnsr�o STONE r a: -� :• Ilia. YroM.1 aim Ig4TTcA ' 64D SF, A I.D C�r'D �sr = G4063V c --rdrAt = q/0 6r:D SECTION NOTES, . . Alw�f%- 4iy bP d = 617 SF 9/0 > sso 61- CLASS A CEMENT CONC"CrE TO W Usti. D � ptJMP QHAM13ER DETAIL 2. EaSANSION Jamm TO 9E Pucm 90' O.C- MAXIMUM wrrm 34v& 12 12 NOT TO SCALE ,iNTQtMEOIATE coNSTRt1mON ,1otNT3 PLACED AT 3d oz.MAxIMUM- NOTES 3. ALL-'CONCft-M DIMENSIONS 90" ARE MINIMUM. DATE: DATE: r I UNLESS OTHERWISE NOTED, ALL CONSTRUC- TION METHODS AND MATERIALS SHALL CON- TEST ST: TEST BY: FORM TO TITLE V OF THE STATE ENVIRON- PREPARED FOR j'�ETAIIrdN�'�i \/�fA� MENTAL CODE AND ANY APPLICABLE LOCAL WITNESSED BY: WITNESSED BY: ll 1I V WALL,NOT TO SCALE > RULES AND REGULATIONS. MARK SCIQVELLI r 2 GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL CONCRETE PERC. RATE PERC. RATE: STRUCTURES IN ORDER TO PROVIDE A WATER- mIN,/ImCH M/N,//NCH TIGHT SEAL. 3 ALL SH/PLAP JOINTS IN SEPTIC TANK SHALL BE SEALED WITH NEOPRENE GASKETS OR ASPHALT CEMENT TO PROVIDE A WATERTIGHT INVERT ELEVATIONS SEAL. lop PRECAST CONCRETE SEPTIC TANK, DISTRIBU- ors < +� TION BOX. AND LEACHING FACILITY TO WITH- �NOFAkq S 4' INVERT AT BUILDING �� c� ``" �' ,� STAND H-10 LOADING UNLESS UNDER PAVE- `�� w,e 1 , v 4 4 I ,r; ti MEN .' DRIVES OR TRAVELLED WAYS WHEREIN A.M. Wilson 4' INVERT AT SEPTIC TANK (in) Z( • 3 SYSTEM PROFILE LOADING SHALL APPLY. AssoCiates 4'/NVERT AT SEPTIC TANK (out) Z . ZI NTS S ALL PIPES IN THE SYSTEM SHALL BE SCHED- Inc 4" INVERT AT DST. BOX (in)mj ULE 40 OR EQUAL NN a a 0 Z FINISH GRADE • 6 WASHED CRUSHED STONE SHALL BE FREE OF I 4' INVERT AT DIST. BOX (out) 31.gz R 2 LAYER OF W DIA.PEASTONE ALL DIRT, DUST AND FINES. 911 Sfteed 1 0 COVE FIRST TWO FEET TO mob C - 2" PVC BE LAID LEVEL 4•PIVC „ l AT ALL POINTS OF INTERSECTION OF WATER O�etwv&/NA 02655 INVERTS AT LEACHING FACILITY: SDR 21 -4 PVC VENT LINES AND SEWER LINES. BOTH PIPES SHALL 508-428-1450 « • 3A4-1-1/2� DIA.WASHED STONE BE CONSTRUCTED OF CLASS ISO PRESSURE 4' INVERT AT BEGINNING OF $' 2000 GAL w , / ; 1• PIPE AND ARE TO BE PRESSURE TESTED TO LEACHING FACILITY 31 1(0 ,7� �— ASSURE WATERTIGHTNESS. Drawing Title H-20 DISTRIBUTION BOTTOM ELEV. = 30.2' - �..IS , 4• INVERT AT END OF SEPTIC TANK BOX f, 4 8 SEPTIC TANK DISTRIBUTION BOX. ETC. LEACHING FACILITY 3 ( Ito FLOW- SHALL BE MANUFACTURED BY ROTUNDO OR ELEVATION AT BOTTOM OF DIFFUSORS AN EQUIVALENT MANUFACTURER. 11 LEACHING FACILITY _ 30'20 MAX. GROUND WATER ELEVATION = 26.2' 9 EXCAVATE ALL UNSUITABLE MATERIAL IN SUBSURFACE PUMP LEACHING AREA AND BACKFILL WITH CLEAN OBSERVED GROUND WATER CHAMBER GRAVEL OR COARSE SAND. ELEVATION z 3,o SEWAGE TO BE INSTALLED ON A 10 HEAVY EQUIPMENT SHALL NOT BE ALLOWED LEVEL, STABLE BASE TO OPERATE OVER THE LIMITS OF THE • SEWAGE DISPOSAL SYSTEMS DURING THE DISPOSAL DESIGN COURSE OF CONSTRUCTION OF THE SYSTEMS. NOTE: SEPTIC TANK a PUMP CHAMBER TO BE WEIGHTED 11 NO FIELD MODIFICATIONS TO THE SEWAGE DISPOSAL SYSTEM SHALL BE MADE WITHOUT MAINTAIN 2'+COVER OVER 20PVC LINE TO D-QOX. PRIOR WRITTEN APPROVAL OF THE ENGINEER AND THE LOCAL BOARD OF HEALTH. 11 THIS SYSTEM SHALL BE INSPECTED AS RE- QUIRED BY SECTION 2.10 OF TITLE V. 13 A CERTIFICATE OF COMPLIANCE AS RE- 1 QUIRED BY SECTION 2.8 OF TITLE V MUST BE OBTAINED BY THE CONTRACTOR UPON COM- PLETION OF THE ABOVE WORK. IF AN 'AS BUILT" PLAN IS REQUIRED DUE TO CONTRAC- Scale: 1"=AS NOTED TOR DEVIATING FROM THESE PLANS, WORK FOR SUCH 'AS BUILT' PLANS SHALL BE COMPENSATED BY THE CONTRACTOR. o FEET 14 THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE bISPOSAL UNIT. Date: - - 1 Dw9 No: 15 ALL ELEVATIONS A)tf EASED ON N.GV.D. Design, C.P J. m DATUM. Check: N f Drawn: J-V.B. NEW fNGLANO REPROGRAPHICS&SUPPLY CO _ --- - -- - --- - -