HomeMy WebLinkAbout0140 HOLLY POINT ROAD - Health 140 Molly Point Road
Centerville
A_232 038 059
SMEA
No. H163OR
UPC 10259
smead.com • Made in USA
2 J��CYC(�c�G
m
'�`aTLtl
TOWN OF BARNSTABLE v
110CATION 4--70 jmil — SEWAGE#
VILLAGE ASSESSOR'S MAP&PARCEL 3
INSTALLERS NAME&PHONE NO. / ,/ c,Zfi
SEPTIC TANK CAPACITY / O O �/�c J
LEACHING FACILITY.(type) gc/ . 1he size)
NO.OF BEDROOMS
OWNER U
PERMIT DATE: R COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
FURNISHED BY
O D :—
C- D Z
3
I
TOWN OF BARNSTABLE
CATION SEWAGE# (2-
ILLAGE (feJ2 7'er K(JJ ASSESSOR'S MAP&PARCEL 3�?Irk
INSTALLERS NAME&PHONE NO. �,�.�/�r. C��e ham, CY
SEPTIC TANK CAPACITY - /S O O P44,3 �C�yl� C 0LO)
LEACHING FACILITY:(type) 2. 00 ��jsize) /.� X 2
NO.OF BEDROOMS
OWNER
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
F,''URNISHED BY
3 k-
1
' A Q
nC__ 3
10 -
r
TOWN OF BARNSTABLE
IjZ)CATION va 1=1ol—/e, it✓DI -f— SEWAGE#
VILLAGE Ce ��r y'/ ASSESSOR'S MAP&PARCEL
INSTALLERS NAME&PHONE NO.
SEPTIC TANK CAPACITY p O P��C -rfi1dK(&&o .
LEACHING FACILITY:(type) 2d_1;77vO gj�,dh e size) x
NO.OF BEDROOMS I I
OWNEREP
V
PERMIT DATE: / COMPLIANCE DATE:
Separation Distance Between the:_
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist
on site or within 200 feet of leaching facility) Feet
4 Edge of Wetland and Leaching Facility(If any wetlands exist
'1 within 300 feet of leaching facility) Feet
VURNISHED BY
D Z mil°s
r�y A2 t-
No. . Z0 05 _ Z(Z e ee d
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye
ZippYicatiou. for �hgpo.5ar Abpgtem Congtruction Permit
Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑ Complete System El individual Components
Location Address or Lot No. 1(4 0 � a yy f �� P�t �"f Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel C n�!'vf V] /M'I r—M C4 10(f F A 1 C4 Lt 3 )Ve14 IT-,A'\(, Vf
O
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 3 f
Oh's dnOT)-e�i Cokvk a3 J-3ng�er yH
ra9 3 5 W`0
Type of Building: W-ekiew"
Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder (. )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3AI IN s 30 gpd esig flow pr vided 3 _ gpd
Plan Date 07 Number of sheetFFprl evision Date
Title 41
Size of Septic Tank t$O d Type of S.A.S. A " SOU
Description of Soil c,
0
Nature of Repairs or Alterations(Answer when applicable) e io Se, iV C 0 ,�r
Date last inspected:
Agreement: -
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place t e system in operation until a Certificate of
Compliance has been issued by this,Bo rd of Health.
Signed .� Date l
Application Approved by . Date Co — 7, Zd C?j I
Application Disapproved by: Date
for the following reasonsIli
Permit No. �i DO$'' Z(Z. Date Issued 6'1 7^ Zb05
1
.�/� .CLi.fy/y�'_ l , �- �n 'r�l � •az lI 11
g o d[/ 4 a �,dl` I ll /�
No. �- Fee
^f
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
Z1PPrirac_tioi�'for �Bigonl �&p!5tem Construction Permit
Application for a Permit to Construct O Repair( (.)'�Upgrade O Abandon O ❑ Complete System ❑Individual Components
Location Address or Lot No. !1-40 {4-0 11 �i' 100'� �2q Owner's
JName,Address,and Tel.No. (q 0 � G��! �-7 7 0G
Assessor's Map/Parcel (e'1 �rVJt� ✓"1-7 / f Gr ►✓(f LCF L,t 3 Sh 51 r r'r 63)v,d I ,P, (� 0/ I ,f
Installer's Name,Address,and Tel.No. 3 b) 3 Designer's Name,Address and Tel.No. 3 6,�' .44 J�
7 S en.T1,,5 CG,SJ/ r?3 )711J-fr fI.H/��`t;f
937 qJ-0
Type of Building:
Dwelling No.of Bedrooms .3 Lot Size sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) hd - 330 gpd Design flow providedl 3 �'( ' gpd
{� Plan Date 3 I t GI d7 Number of sheets. A,��',/,Q', Q> evision Date "
Title
Size of Septic Tank k I So 1° f ✓i f �t Type of S.A.S. r� �U Ga,/ i_4- G1.� CL./3,,,
Description of Soil '' <j� c, : C ( Y N S 1e
U
d
Nature of Repairs or Alterations(Answer when applicable) f 1p qj C /),.5
r V
Date last inspected:
Agreement.; x
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in t
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
�r Compliance has been issued by thiard of Health.
..� �.
� Signed // � Date
Application Approved by u,/r--- C Date �o - 1-7- 0 06 v"
Application Disapproved by: Ll Date
for the following reasons
"Permit No. 2OC7 ` Z Z Date Issued 6,' 7- 2U0s
. --
Z o o&- "/Z- THE COMMONWEALTH OF MASSACHUSETTS
a BARNSTABLE, MASSACHUSETTS
Cie tificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (1/) Upgraded ( )
Abandoned( )by l � 1 S Qfc��c S Ct•,S� �ilYt/� lit-►h C
at I t 10 1C)11 Pc'h r- +?`14 (1` 1"''ey (r% 'AasAeen qstructed in accordance
w' v' ' n f Ti 1 for Di sal S st m Construction Permit No.nth the pro Oslo s o ,,ti�e"" 5 and the spo y e t�(,/ (J( dated
Installer klf.' 34-,-4-e"3 Ccn(J Designer Oc)(-"'1
#bedrooms w Approved design flow � gpd
' 6 !
The issua
nce of{his permit shall 9-o1 be onsstrued�(a' a a a tie t at the system jllf function desi�ed. f / /t-7
Date rI! � ��� � !�t`'tfe (dSl.,` 1� Inspector �r04
V J1
=---- ----=4— ------- ---- -----------------
No. zoos - 2.6 ,z Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
Di!g pont *pgtem on ,truction Permit
Permission is hereby granted to Construct ( ) Repair (✓ ) Upgrade ( ) Abandon ( )
System located at 14 U 14, a 2C-a (4,1 /3,,1^sj-0),31 p
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
Provided: Construction must be completed within three years of the date of this p it.
Date (� ` 7— 2 0 0 5 Approved by
FROM :d.oun cape engineering inc FAX NO. :15083629880 Jul. 07 2008 02:16PM P1
> ;
U/ Town ®f Barnstable
loa Regulatory Services
I Thom is F. G eiler, Director
MARMA
a6�S Public -Flealth Division
Thomas McKean, Director
20010'D.ain Strcct,Hyannis,MA 02601
()H.:Fv:e: 508-862-4644 Fax: 508-790-6104
Installer & Designer Certification Form
11:!i ti E: Sewage Permit# ._J��OA,sscssor s:l a \Pareel
.4ii•.:biigner: �Oin1 �_ D �.._.... installer:
Address:
was issued a permit to install a
(installer) —
6;,a'71i::i(� system a.t. �l (C i based on a design drawn by
dress)
dated
(designer)
_ T certify that the septic Sy Stein referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic ta.tik.
......... _ I certify that the septic system referenced above was installed with major changes (i.e..
greater than 1 U' lateral relocation,of the SAS or any vertical relocation of any component.
of the septic system) but in accordance with State a5'L Local Regulations. Plan revision or
certified as-built by designer to follow.
���P�ZN OF Rggs�cy
�o DANIELA.
(1. .1., ... . d
OJALA
.lrsataller'S fit:.. n..atui.e) N�
CIVIL
No.46502
J N AL
J
... --:....... :. .....:.... l
esigner's Signature) (Affix Designer's Stamp Here)
�9i;E404R R TT1TIl� TO BARNSTAB T 1'1LB1T�' lli+ r.TH DIVISION C'ERTTFTCATE OF
(111toI.PI.UNCE 'WILL NOT BE ISSUED UNTIL BOTH TTTTS FORM AND A9.111I fl'J CAt,(k]) Altls
EIVED BY THE BA NSTAi1LE PUBLIC IIEALTH DIVISION. 'THANK YOU.
":'I:I„alth/ScFeie/Designcr Certification Form 3.26-04.doc
Jul 07 108 0.4:2-6p Ellis Brothers 508-362-6266 p.2
Ff.CM :r.Z:WI-t ca-,:,e eng i neer i n9 ;inc . FAX NO. :1508362988o Jul. 07 2009 03:26Pm Pi
Cow® of Bar®stab)e
Z i1i111Regulatory Services
nif Thomas F.Geiller, Director
Pubbe Health Division
Thomas McKean, Director
2001MRin Street,Hyannis,MA 02601
0,ftiux:: SOR-862-4644 Fax: 508-790-6104
Installer do Designer Certfication Ford
IODa ll:t;; _7 Sewage Permifi'o �`cc� Assessor's A+l;a$pWarcel
,i,aiil.gdlk a 4.e `-i 1 <1 L _ Address: t-2-
�.� 4WO, Yale
►"'i //`�
was issued a permit to install a
(insiauer)
...- (L„'► based on a design drawn by
ddiess)
i cerli ly that the septic system referenced above wss installed substantially according to
the design, which i a -include minor approved changes sticki as lateral.relocation of the
distribution box a nd/ot septic tank.
__.-..._.. 1 cry that the -4 lie system rePerencod above was insWled with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any companent
of the septic syst, a) but in accordance with. State &Local R.egatatiorts. Ilan revision or
rtif.W as-built by designer to follow.
DANIELA. ,
OJALA
-._..i._(j. itd1ir s.9 Snatuve) No.46502 H
NAL
-1; . i.��iier9 Sign, turf (Affix Designer's Stamp!'iere)
1[;1,]E !a,;ll Ufa°rll&&id T� BARNS"i'ABLF PUBLIC HFALTH DI41 slDIet C°ERB"IMCATC c 1F
i;GIVI7';B_IANCE WILL NQrI BE WSURD U NTTL BOTH TMS FARM AND AS-BUILT CCU ARE
'4P �_ YU ,➢iATtNQlPAi3LF PAJBLIC HE GTH DIVISION. THAIVIK Y()U.
t.�: I'e::9i:hl se i�lpcsi � r(a rtifi• im]Funn 3-26-04.(W
P
TOWN OF BARNSTABLE
LOCATION NQ Pp ( v►'^ h � J,(�,
VPe.LAGE ��. - ASSESSOR'S MAP & LOT 2,, -39`-yr9
.
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACEL-=: S42001 S (size)
NO.OF BEDROOMS 3
BUILDER OR OWNER
PER MTTDATE: COMPLIANCE DATE: l`7 3 4»,euW_
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �` (`� i 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 sb r wo �. Feet
within 300 feet of leaching facility)
Furnished bye w.li;
I _ ^
o
V7•4� }
h
4 � .
Town of Barnstable
Ft „ o Regulatory Services
sexnsrnste Thomas F. Geder,Director
�w •• Public Health Division
'°rEc Mai A
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
November 15, 2006
Mr Fred Duncan
437 Shaker Boulevard
Enfield,NH 03748
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, Title 5
The septic system owned by you located at 140 Holly Point Road, Centerville, MA
was last inspected October 27th 2006 by, Troy M. Williams, a certified septic inspector
for the State of Massachusetts.
The inspection of your septic system showed that your system"Failed"under the
guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following:
A Septic System automatically fails in the Town of Barnstable when less than 50 feet
from the high water mark.
You have 2 years from the date of the system failure to bring the system into compliance.
If there are any questions about this reminder,please feel free to contact the Barnstable
Health Department.
BARNSTABLE HEAL H DEPARTMENT
Thomas A. McKean, R.S., C.H.O.
Agent of the Board of Health
'TROY WILLIAMS
-SEPTIC INSPECTIONS
Certified by MA Department of Environmental Protection (508) 385-1500
19 Hummel Drive
South Dennis, MA 02660
COMMONWEALTH OF MASSACHUSE'I"I'S
EXECUTIVE OFI'ICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT' OF ENVIRONMENTAL PROTECTION
TITLE 5 z3, - 65
OFFICIAL, INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SVSTEM FORM
PART A
CERTIFICATION �� g
Property Address: 140 Holly Point Road
Centerville,MA
Owner's Name: Fred Duncan
Owner's Address: 437 Shaker Boulevard
Enfield,NH 03748
Date of Inspection: October 27,2006 O v
Name of Inspector: Troy M. Williams
Company Name: Troy Williams Septic Inspections
Mailing Address: 19 Hummel Drive
South Dennis,MA 02660
Telephone Number: (508)385-1300
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 tirne of the inspection. The inspection was perfonned.based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP
appros cd sss,tem inspector Pursuant to Section 15.340 of Title 5(310 CMR 15.000). The sssicri C=3 �-
Passes I Cj
Conditionally- Passes
Needs further Evaluation by the Local Approving AuV Tit)
Fails
U'j
Inspector's Signature. Ste, , ; Date: to /z.-)
ram—
The system inspector shall submit a copy of this inspection report to the Approving Authority(B0 rd of I I(;hth or-
DEP)within 30 days of completing this inspection. If the system is a shared systern 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
Although system meets the minimum requirements set forth by the Massachusetts Department of
Environmental Protection,certification Is not to be construed as a guarantee of future working condition .
of system,piping or components. This Inspection represents the conditions of the system on the Date of
Inspection noted above.
""This report only describes conditions at the time of inspection and tinder 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. 6/1920001 pare I of 11
1'uge 2 of I I
01TWIA1, INSPE'C'I'ION let)JIM — NOT FOR VOI UN`I'ARY ASSESSMENTS
SUBS>!_JR ACC SCVYAGEe DIISPOSAV SYS'1'ttalyl 1INSPECI'ION MR*M
PA WJ' A
MZ'11V1CAT10N (continued)
Property Address: 140 Holly Point Road
Centerville,MA
Owner: Fred Duncan
Dale of Inspection: October 27,2006
Inspecliou Sunrruary: Check A,B,(',I)or Le /ALWAYS complele all of Section 1)
A. Syslem Passes:
1 have not iound any information which il)dicales Thal it , of Ille failure criteria described in 310 CMR
15.303 or in 310 CMR 15.304 exist. Ally failure criteriaa no valuated are indicated below.
Cormmtertls:
B. Sysicru Condiliollally Passes: t
_ One or more system components as desclibed o the"Comdilional Pass"seclion Deed to be replaced or
repaired. 'I'be system, upon completion of lbe replacet)lertl or repair, as approved by Ibe Board of I It- It, will pass.
Answer yes, no or not deleimined(Y,N,NI-)) ill the_ _ for the lollowing slatemenls. If"t delerrnined"please
explain.
The septic tank is it and over 20 years ollJ* at- Ibe stplic lack(whellre nit(al or nol) is structurally
unsound, exhibits subst;tntial inliltntlion or extiltralion or lank failure is imrp' till. System will pass inspection if the
existing lank is replaced with a complying septic tank- as approved by like oard of I lealth.
*A metal septic lank will pass inspection if it is stntGurally sound, no taking and if a Cerlificale of Compliance
irtdicaling liked the lank is less than 20 years old is available.
ND explain:
t
Observation of sewage backup or break out c iiglk stalic water level in Ill distribution box due to broken or
obslrucled pipe(s)or Hite to a broken, sculecl or r even distribution box. System will pass inspection if(with
approval of Board of Ijeallb):
Urok pipe(s)Ole replaced
o Intclii�n IS retnovtd
distribution box is leveled or replaced
NO explain:
file sys(erli quircd puutping more (ban LI limes tt year due to broken or obsuticled pipe(s).Tile system will
Bass inspection (will)approval of Ibe.Boar(i of lleallb):
--biokeu pipe(s) are replaced
obs(ructiou is removed
ND explain:
2 l
Page 3 of I 1
01"FICIAL INSI'ECCION leORM - NOT heOR VOLUNTARY ASSI?SSMI?NTS
SUBSUR11ACIs SI:+,'WAGE 01SPOSAV S'YS`I'EM INSPECTION RORM
I'ART A
CER'll 111CA`I'ION (continued)
t'roperly Address: 140 Holly Point Road
Centerville, MA
O11er: Fred Duncan
l)alc of Inspcctio,,; October 27,2006
C. hurther E'vaInalion is Required by (he Iloal-d of Ilealth:
Coutdilions exist which[-equine lu[-Iher evaluation by the Board of I leallh in order to determine if the system
is failing to protect public beallh,safely or the envilonineuf.
1. System will pass unless Board of 1Icalll►detcru►incs ill accordanee will, 310 CIVIR IS.303(t)(b) that the
systel►►is nol fuuclioutl,g in a uuuu►er which will protect public heallb,safety and the envirournenl:
Cesspool or privy is within 50 Iec l ofa surlace Water ^I So ro.1-✓(1
_ Cesspool or privy is within 50 lecl ofa border ing vegetated wellailtl or a sal(Marsh
2. Syslei❑will Fail w►Icss the Itoard of Ile;dlb (and I'ublic Water Supplier, If any) tit!lel'intlies II►al file
system►is I'll[lei ioning ill a n,auner Ilia( proteels ll►e public licalilt,safety and enviroumeul:
The system bas a septic oink and soil absorption system(SAS) and Ibe SAS is within 100 feel of a
su[-lilce water supply or tributary to a surface wait[-supply.
The system bas a septic tank and SAS and the SAS is within it Zone I ofa public water supply.
Hit system has aseptic lank and SAS and Ibe SAS is within 56 leer ofa private water supply well.
system bas a septic lank and SAS and Ibe SAS is less loan 100 legit bill 50 feet or more firorn a
private water supply well". Method used to determine distance
41 Phis sysivill passes it'lire well water analysis,perlorlued at a MIT certified laboralory, lo[-collfornl
bacteria atltl volatile olgai►ic col
tl,ouuds indicates Ilia(the well is lice fionl pollution Irom that facility and
tlit presence ofamnlonia pilrogeu and nitrate nitrogen is equal to or less Ilia,, 5 ppnl, provided that mo other
failure criteria are higgered. A copy of the analysis must be atlacliecl to Ibis form.
3. Olber:
i
3
i
Page 11 of I I
OIi'I�'ICIAi� iNSI'I+'C'I'I! )ly rOX2N1f — NOT Mit VOLUNTARY ASSI'SSMI?N"CS
SUBSIA ACC Sll,'WAGtie, MSPOSAI. S'YSTEl N/I IINSIkLCI'IUN F' ORIVI
pA RT A
CCR'i IVICA`I'iON (continued)
140 Holly Point Road
Property Address: Centerville,MA
Fred Duncan
Owner; October 27,2006
Date of Inspection.
D. Systc►u h;►ilure Criteria applicable to all systems:
You must iotlicalc"yes"or"no" to each(if the following till.;ill inspections:
Yes No
__ _✓ Bilcklip of sewage into facility or sysltml conlpoilent clue to overloaded or clogged SAS or cesspool
Discharge or poudirlg o1'e111uen1 Io the sill Bice of the ground or surface waters clue to an overloaded or
clogged SAS or cesspool
Stalic liquid level in the disiribulion box above outlet invert tlue to an overloaded or clogged SAS or
cesspool
l.ltlllid deplll in cesspool is less than 6"below.invert or available vohlme is less Ihan %clay flow
- Requilett pun►ping more Ihan 9 linles in lbe last year NOT due to clogged or obstructed pipe(s). Number
of linles ponlpctl
_✓ Any portion of the SAS, cesspool or privy is below high ground water elevation.
Any portion of cesspool or privy is within 100 feel elf a surface water supply or Iribulary Ina surface
/ water supply.
I! Any pinion of a cesspool or privy is willlio a Zone I ofa public well.
Any portion ol'a cesspool or privy is wilhitl 50 f et Oki private water supply well.
Any portion of a cesspool or privy is less Ihan 100 Icel bill greater Ihan 50 feel from it private water
supply well with uo acceptable water quality analysis. l'f'his syslell►passes if the well water analysis,
perforo►cd al a I)N I'ccr((ficd labaralory, for coliforrl► bacleria and volatile organic compounds
Indicates (1►at the well is free(i oln pollluton from► that facility anti the presenct:of'11111nouia
llilrogen and nilrale nilfobell is ellual Ip or less than 5 ppn►, provided ll►a( po other failure criteria
11re triggered. A copy of(l►c ;ll►alysis rliusl be all;lcl►ed to this fol-rr►.l
_AL—(Yes/No)fhe system fails. I (lave dclerrlliued Ih;ll one or more of the above l;lllore crilelt;l exist as
described in 310 CMIt 1.5.303, Illerefore the system hails. Tht;syslell)owner shokkld conlacl like board at
Health to deterriline whal will be necessary to correct the luilure.
L. Large Systems;
I'o be considered a i;frgo syslenl(lie system► l7.uusl serve a facility rvilh .1 esign flow of 10,000 gpd l0 15,000
6 ld.
l
You must indicate either"yes"or"no" to each of the (allowing:
(flit following criteria apply to large systems in atldilion to Ibc '-it is above)
Yes no
like system is wilhim 900 feel of a surface drinkii water supply
_ file system is willkin 200 feet of a hibutary a surlikce drinking water supply
the systeml is located in a r►jtrogell se ttive area(lnterirn Wellhtad Protection Area—IWPA)or a mapped
Zone M1 of i public wale,-supply i
If You have 40sweretl"yes" to any gilt loll ju Section I> the system)is considered a sjgnilical�t lltrwit, or answered
"yes"in Sec(io11 Pallove►Ile large stem 1►44 failed.The owoer or operator of ally large system car sidel-ed a
sjbnjlicant tl►feat 1tne e(SeelioA I r failed ltnciei Seclioll 1)shall tlpgrado like syslent in accordance wjllf 310 CMIt
153M.Tile syste1110mller slit" cl conlacl the appfop!into regional office of file Department.
�I
1''�►ge s of'I l
014"ICIAL INSM,CTION DORM — NOT I�OI2 VOLUNTARY ASSESSMENTS
SUI3SUIthACI SE
WAGE DISPOSAL SYS' J-eI M INSpLC`ION DORM
1'A I2'i' I3
CIII?CItC�IS`I'
l'l-operly Address: 140 Holly Point Road
Centerville,MA
Ow11Lr; Fred Duncan
Dale of Inspection; October 27,2006
check if the li,llowiug have been done. You nmtst indicate"yes"or"no"as to each of file following
Yes No
i'oolping iulol limlion was provided by lilt owner, -kccupaul, or Board of I leallh
Wei e any of the system components pun►ped oul in the previous Iwo weeks?
__ ✓ I las like system received normal flows in lilt pievio us Iwo week period '?
I lave large volumes of water been introduced to the system recently or as pail of this inspection ?
Atl', WCic as boill plans of,likesystem obtain"ao(l exaurincd7 01"they were not available mole as N/A)
_✓ ___ Was the I"cilily or rlwelliog inspected fur signs of sewagt back op '?
Wits lilt:site inspected inl signs of'bieak ool Y
Were all syslcu,Components, excluding the SAS, iocaletl till silt '?
,1///4 Were the septic lank manholes uncovered, opened, and the interior tit'filetank inspected for lilt condilion
of tht; bal'iles of lees, mlalerial ofconslruclion, din,ensic,us, depth of liiµlitl, depth of sludge and depth of scorn?
_ Was the facility owner(an(i occupants if diflcrenl lioru owocr)provided with infi,rnation oil the proper
maintenamct of subsorlace sewage disposal sysleills ?
The size ant)l0catiou of the Soil Absorption Sysleu►(SAS) on file site has been deltrmitled based on:
Yes no
Exisling illfoimlation. Foi example, a piall at file Board ofIleallh.
Deter mined in the field(if any of the failure criteria rela(er! to 1 a,f C is of issue appilixinlalion of distance
is unacceptable)[310 CMR 15.302(3)(b))
S i
Page 6Of II
OLDFWIAI, INSITCTION DORM — NOT FOR Y01,1-INTARY ASSESSIVi NTS
SullsulwACV± SEWAGls IajSpUSA1-, SyS'11I?M INSPECTION #011 !
PART O
SYSTIM JNI10I1IYlA'I'I0N
I'l-oper(y Aildress. 140 Holly Point Road
Centerville,MA
Owner: Fred Duncan
hate of Lnspection: October 27,2006
VLuvy CONDITIONS
ItI?SIl)I�N'I'IAI.
Number of bedmoins(dcsigu): Number of betlroo11is(actual): _
DI!'SIGN flow based till 310 CMR 15.203 (for example.- 110 gpd x 11 of lieilrooms): 3 3 0
Number of current resideuls: o t,
: Does residence have a garbage gritidei(yes or no): `YF S
Is laundry o11 a separate sewage system(yes or no):,vu [if yes separate inspection reyuiredl
L-amulry systeu: inspected (yes or no): Aj_1.•9
Seasonal use: (yes Or 110): -3.r-jr
Water meter readings, if available(last 2 years usage(gptl)): p S= / Y1 Je
Sunup pump .y(yes ur nib): �� -- — y`lh= t
Last dale iJf occupalicy: i)4i_s2h�. 't vS< t S '/t�. !J Y — �� 030
� / l
C6MMEItCIAL/INI)t1ST11IAI.
Type ol,csfablishment:
Design flow(based on 310 CMR 15.203): — ----- gt�d
llasis of design flow(seals/persous/sglt,elc.) _
Grease trap present(yes or no): — — ----- - — ----- -------
luduslrial waste holding lank preseul(ye or no): _
Non-sanitary waste discharged 10 the Title 5 system es or nM): _
Water:nctcr readings, ifavailabic, _
Last date of occupancy/use: ----- — ----
OTHER It (describe):
GLSNlAtAI., IN1,01tIVIe1TI0N
I'unlping Ltccords
Source of infon kill loll: - , _1-�
Was system puntperl as part of file inspection(yes or no):—
If yes, volunle pumpet(: _ gallons -- I low was rluantity puuyled determined?
Reason for pumping: --- --_----- --.---
'rl!I'I?nil SYS'l'I?M
Septic tank,dish ibmion box,soil absorption System
Single cesspool
Overflow cesspool
—pl-ivy
Shared system(yes tin no)(if yes, attach previous inspection records, if any)
_ Innovalive/Allenlalive technology. Attach a copy Of file current operation and maintenance contract(to be
obtained from system owner)
— fight lank —Attach it copy of the I)lf'approval
Other(describe):— _ -- -- ----
Approxinime age of all components, date inslallei)(if l nown)and source of information:
Were sewage odors dejected wllep ar4iving at the site(yes or no):�o
6
i
Page 7 of I I
OF ICIAI, INSPE,Cl'ION FORM — NOT +OR VOLUNTARY ASSI�SSMI.N I S
SUBSURFACE SEWAGLe MSPOSAI SYS'I'EIVI INSPECTION 1�012M
1'A Wli' C
SYSTC'IY1 INFORIVIA"1'ION (continued)
Property Address: 140 Holly Point Road
Centerville,MA.
Owner: Fred Duncan
Dale of luspecllou: October 27,2006
BUILDING SEWER (locate bn site plan)
Deptb below grade.
Materials ofconslruetion: ./cast iron —401'VC Iodic (explain):
Distance from private wales supply well or suction line: —A1
Colnnlcnls(on condition of joints, venting, evidence of leakage, etc.):
' --�_��n��,__sue w•v� fir�,u-v _ ------—
SCPTIC"PANIC:—(locate on site plan)
Depth below grade: --
Material of constnlction: --coneicte_nlelal_11beiglass__polyethyle
_othei(explain)_ _ .
If bulk is metal list age: — is age confiinled by a Certificate of Col ianec(yes ur oo):—(atlacb a copy of
certificate)
Dimensions:
Sludge deplll:------ — --—_ _ --------
Distance from to)of slid e Ib bottom
I b I m ofoullcl lee or ba e:
Scum Ibickness:_ _ --.-.----
Dislance froiu lop of scum lb lop of oullet tee or t
Distance b-oil,boltorll oI sclltll to holloln of of et lee or baffle:
flow were dimensions detemlioed: —---
Conuncnts(oil pumping lecununeodali s, llllc( anal oullet tee or baffle condition, stniclurill integrity, liquid levels
as related to bullet invert, evidence eakagc, etc.):
GREASE'CRAP.—(locate oil site plan)
Depth below grade: —
Milt,elid of construction:---C1111cretC_niclill__liberglass—po etllylene--outer
Scum thickness:
Distance fionl lop of scuul to lull of outlet (cc or bafil _Distance born bottom of scum to bolloln of oullet e of baffle__
Date of last pumping:_ _--
Comments(on putllping reconuneo li dolls let and ollllcl tee or baffle condition,slnlclural integrity, liquid levels
as related to oullet invert,evidence of le. -age, etc.):
7
Page 8 of l l
011'11C1AL INSPECTION DORM — NOT ViOlt V01-.UNTARY ASSI:SSMI!?N`1'S
SUBSUIWACE SEWAGI-� MaISVOSAI.� SYS`I'rM INSPECTION FORM
l'A it'V C
SYSI'I!IYM INFORMATION(couliuuc(l)
Property Address: 140 Holly Point Road
Centerville,MA
Owner: Fred Duncan
Dale of Inspection; October 27,2006
TIGHT or II01..11)ING TANK; (tank must be punq)ed al lime of ii eclion)(locate ou site plan)
Depth below grails:_—
Material of construction: concrete metal fiberbla: ___polyethylene other(explaiu):
—
Capacity:
Design Clow: ---gallons/day
Alai in present(yes or no): _
Alarm level: _ Alann in working - er(yes or no):
Dale of last pumping: --
Conimeuls(condition of alarm and at switches, etc.):
DISTRIBUTION BOX: _(ifpresent must be 0pened)(lo• It on site plan)
Depth of liquid level above oullel iuverl:
CAmmculs(note if box is level and rlislribulion to lets e(Iual, any evidence of solids calryover, any evidence of
leakage into or out of liox, Cie.):
1'U1V1P CIIAIV111102; (locale on site plan)
I'ur»ps in waiting order(yes or uo): _
Alarms in working order(yes or no):
Comments(note condition oFpump cliambcr, con .ton ofpuntps and appurlenaoces, cfc.):
8
1111ge 9 of
OPTICIAL. INSIT CTION FORM — NOT FOR V01-UN'I'Al2'Y ASSESSIYIE N`CS
SUBSUMeACE SEWAGE 1)1S110SAI, SYSTEM INSPECTION I+ORM
VA III' C
SYS'ITNl INFORMATION (continued)
PI-operly Address: 14.0 Holly Point Road
Centerville, MA
Owner: Fred Duncan
Date Of Inspection: October 21,2006
SOIL. AIISORPTION SYSTIL ML (SAS): (Iocale oil site plan,excayalloil pot required)
II'SAS not located explain why:
I ylie
leaching pits, number. _
— leaching chambers, number:
--leaching galleries, nunibcr: ---
Icaching 11Ctil:lieS, nuruber, Ienglh:
_ leaching fields, 1iumbcr climensious: -- --
��Overflow cesspool, number:_t --
____ innovative/ullcrnative syslcui 'l'ype/Hanle of technology; ______-- _
COtIt111enIS(tune condition of soil, sighs ol'lrydraulic failure, level ol,pondiug, damp soil, condition Of Vegelat.on,
etc.): ( /�
_��_vJv. L_L�'1'ls�,-+ —S.L1Lt�C_.�la..J -w�3__�u✓N,�__y.�.��.__� �o .%�' L✓ol.�'-Gv- _.- - �..
CLSSI'OOL.S: (cesspool nutst be pumped as hall of inspeclioo)(locale on site plan)
Depth-- lop of licluitl to iolcl invert: —
Depth ofsolids layer:_ ---
Depllt of scull.layer:----L _
Dimensions of cesspool:—�
Materials o f coustrticli4..: -
Indication of'groundwatel.illllow(yes or no): A,p ,
Coll)rilents(1181c colldltioll of soil, signs ol.11ydi;ullic failtire level of ponding, condition of vegetation, etc.):
��r�^ S , h W(J� i, y'r h w v. I' Yn c. 1 r ✓t �✓1 (I� _-YJ n�h 15b✓►,y( , y�
_T1^a.. -�- u f c� ✓_�(.�� �- (�r-. � w �_�y�__ vt u �'c�.;- (�:�u., 1 t�4- �
Its✓h� ti Vt . c.� .; Soy+,. ✓cewOle .4 �t/o✓� �,,t}
ITIVY: (locale on site plat.)
Malerials of coitstrucli4n:
Dimensions: ------------------- -- -- ---
Depth of solids:
Conuncnls(hole condition of sail, signs of hydras c failure, level of pooling, condition of vegetation,etc.):
1'a6e 1 I ul, I
OF ICIAI., INSIT CI'ION VORIyI — NOT FOR VOLUNTARY ASSESSMENTS
SUlls tilt 11'ACE UWAGL DISPOSAL SYS7TM 1NSP1±:C''I'ION hORIVI
PART C
SYSTEM 1Nle0RVIA'#'I0N (continued)
Properly Address: 140 Holly Point Road
Centerville, MA
Owner; Fred Duncan
Dale of luspeclioll; October 27,2006
SITE 1!X A M
Slope
S,Irlilce walcl
Check cellar
Shallow wells
Estimated depth lit ground water/Z' ) I�ct k Arliuslcrl high gruuncl walcr elevation
Please indicate(check) all u,clhuds used lit dclelmiue the high ground water elevaliun:
Oblained Iron,sySltul design plans un record - Ifcl,ecked, (title ol'desigu plan reviewed:
Obsclved silt(abulling properly/obscrvaliun hole wilhill ISO feel of SAS)
Checked will, local hoard ul'l leallil explain: -
Checked will, local excavalurs, inslallers- (allach docrluleolalioo)
Accessed IISGS database explain: -L e'
You rluisi describe how you eslablished the high groruul miler clevalioo:
.��cs
Kra,. vw� .Z.S ' ,,,.�,,,.(,�;r1 rj►,� �.tiJ,,ir�.�t �..5 d, .f( �..� _ /
S i ti c ✓rw � .� wi'h.ti 3o 0' �� L.v �co' _ (13u�1-. o/�LcS a�,.d 1 1 10,04
lu.o �j.6
V36s I I
lac�� . I
S r
l
l d-lc�. �1 6411
7 /
This report has been prepared and the system! lnspeclert as of the dale of hispeclion. This report is not a
warranty or guarantee that the system will function properly in the future. There have been no warrpnlies or
guarantees, eilhef expressed,written of Implied, felatirig to the system, the Inspection and/or this report.
• 1I
T'age Ill of'
f�
0I1"ICIAI. INSIT CTION VORM - NOT I�OIZ VOLUNTARV ASSESSMENTS
` SUBSURFACE SCWAGE DIISI'()SAr, SYS'I'I+M >lNSI'1?C'I'ION r012M
J'A R'l' C
SYSTEM INI+ORMIATION(continued)
140 Holly Point Road
Properly Address: Centerville,MA
Fred Duncan
Owucr: October 27,2006
Dale of luspeclioo:
SKIS TC11 Oh SEWAGE JASI'OSAL SYS'1'1?IY1
Provide a sketch of the sewage disposal system including lies Io at least Iwo permanent reference landmajks or
beocbmarks. Locale all wells witbiu 100 1cel. Locate wllere public wilier Supply entel'S the building.
P0rv'l
I �
3
I) � � s ill = y3t
D
3y
C +h oL
SO
I
{
10
SYSTEM PROFILE NOTES
TOP FNDN. AT EL. 51.1'
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE?
LEGEND AccEss COVER ro WITHIN 3" OF FIN. GRADE 1. DATUM IS WEQUAQUET LAKE DATUM SYSTEM
ACCESS COVER (WATERTIGHT) TO 'f'oGr
100.0 PROPOSED SPOT ELEVATION 48.0 MINIMUM .75' OF COVER OVER PRECAST j- WITHIN 6" OF FIN., GRADE r�
2% SLOPE REQUIRED OVER SYSTEM 2. MUNICIPAL WATER IS EXISTING
45.6
2" DOUBLE WASHED PFASTONE "
100x0 EXISTING SPOT ELEVATION *EXISTINGC RUN FOR PIPE 2LEVEL OR GEOTEXTILE FABRIC 3. MINIMUM PIPE PITCH TO BE 1/8 PER FOOT. N
PROPOSED 1500
100 PROPOSED CONTOUR GALLON SEPTIC
3' MAX. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO
45.5' Bsarat
45.75 t TANK (H- 10 ) �E 6" SUMP 42.6' H- 10 Pond
100 EXISTING CONTOUR ;. �� 41.87
42.04 Air
5. PIPE JOINTS TO BE MADE WATERTIGHT.41.8' E3DOO O mOCUSMIN. (_2X SLOPE) -4 6" CRUSHED STONE;2MECHANICAL E3 � � � � ED ED MASS.6. NSTRUCTION ENVIRONMENTAL (LS TO BE IN CODE TITLE VACCORDANCE WITHDEPTH OF FLOW COMPACTION. (15.22 [ ]) 2 C� 0 0 0 0 0 a a o 39.8
TEE SIZES: 3/4" TD 1 1/2" DOUBLE WASHED STONE 7. THIS PLAN IS FOR PROPOSED CONSERVATION PERMITTING
INLET DEPTH Q_ AND WORK ONLY AND NOT TO BE USED FOR LOT LINE
OUTLET DEPTH .14" STAKING OR ANY OTHER PURPOSE.
�- esuaquet o�
8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. fake
(2.3 x SLOPE) ( 1 X SLOPE) 5' o
9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED
WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION
FOUNDATION 10 SEPTIC TANK 134' D' BOX 90 FAA LHIINrG OBTAINED FROM BOARD OF HEALTH. LOCUS MAP
LAKE G.W. EL. 34.8' 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING SCALE: 1" = 2,000't
DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION
*THE INSTALLER SHALL VERIFY THE (OBS. G.W. EL. 33.2') OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO ASSESSORS MAP 232 -PARCEL 38
LOCATIONS OF ALL UTILITIES AND ALL COMMENCEMENT OF WORK.
BUILDING SEWER OUTLETS AND ELEVATIONS
PRIOR TO INSTALLING ANY PORTION OF 11. EXISTING LEACHING FACILITY SHALL BE PUMPED AND LOCUS IS WITHIN FEMA FLOOD ZONE B & C AS
SEPTIC SYSTEM. ALL EXIT LINES MUST REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. SHOWN ON COMMUNITY PANEL #250001 0005 C
CONNECT TO PROPOSED SEPTIC TANK. DATED AUGUST 19, 1985
12. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE
REMOVED 5' BENEATH AND AROUND THE PROPOSED LOCUS PARCEL IN THE GP OVERLAY DISTRICT (ZONE 11)
LEACHING FACILITY.
TEST HOLE LOGS
ENGINEER: DAVID FLAHERTY, R.S.
SYSTEM DESIGN. WITNESS: DONNA MIORANDI, R.S.
DATE: MARCH 13, 2007
EXISTING GARBAGE DISPOSER IS NOT ALLOWED
PERC. RATE _ < 2 MIN/INCH
DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD CLASS I SOILS P# 11648
USE A 330 GPD DESIGN FLOW
SEPTIC TANK: 330 GPD (2) = 660
USE A 1500 GAL. P
BENCH MARK - TOP OF .i SEPTIC TANK on W 44.5' on � 44E7
CONC. BND. EL. 38.4 •/.,./ LEACHING: 1 0/A 0/A
•j• SIDES: 2 25 + 12.83) 2 (.74) = 112 GPD LS LS
* •/•• BOTTOM 25 x 12.83 (.74) = 237 GPD 10YR 3/3 10YR 3/3
r" 43.9' 14"
Bearse Pond 34 TOTAL: 472 S.F. 349 GPD 43.5
'� 44 .LSE 2 5 B B
38 �� /••• `�'
x 3g ( 00 GAL. LEACHING CHAtABERS (ACi�iE O^ ECtUAL) • LS . LS .
USE
4 a`O 212,E BENCH MARK - TOP OF WITH 4� STONE ALL AROUND / 2.5Y 5 4
40 2 " 2.5Y 5 4 /
j r CONC. i3ND. EL. = 48.3 24 42.5 36" 41.7'
LOT 59 44 /• p CO/NC• W C 1 C
24,250 SF f / / ASK /- MA
/ P s2 0 47 APPROVED DATE BOARD OF HEALTH FLS MS
(UPLAND) / •/-
0.6 AC. t 46 II g ( 45 38" 2.5Y 6/4 41 3' 2.5Y 6/3
DWELLING 3 BR DWENG 46 a�
CP
•• TOP OF FNDN - 51.1'
o ,/••/ vs �� I C2
� I � �E � Pr�c
�°j I
o / I O OR\ MS 138" 33.2'
p I OBS. G.W.
W 7g'3.
178, APP. EXIT POINT FLAG. I 120" 2.5Y 6/3 34.5' 150" 32.2
S '
WALK 3 / �� 48 NO GROUNDWATER ENCOUNTERED
i 49 47 VARIANCES"
46
45 o I �� IN-HOUSE VARIANCE AS PER AR�TM_Z BOARD OF HEALTH
POLICY LETTER DATED NOVEMBER 15, 2005:
TITLE 5 SITE PLAN
' �
•,� °K- 48 ;:i I (4) FAILED SYSTEMS ONLY-
51 :Y:.-, �6, � ��
r �- SEPTIC TANK OR PUMP CHAMBER PROPOSED TO
OF
O . ,_ = oI O BE LESS THAN 100' BUT MORE THAN 75' AWAY
WORK LIMIT LINE TO BE •••` 264 f. pt_..- �' FROM WETLANDS OR A WATER COURSE.
CONSTRUCTED USING SILTATION �. h° ° �`0 140 HOLLY POINT RD.
FENCE OR HAYBALES OR BOTH. 48 W 31.7' I
•-�• - " PAVED RIVE I (CENTERVILLE) BARNSTABLE, MA
�w
•` UTIU71ES AND WATER LINE IN AREAS ~t I PREPARED FOR
OF PROPOSED SYSTEM COMPONENTS. 4S W
CAUTION MUST BE EXERCISED! 44 \ I
WATER LINE MUST BE SLEEVED �� p�O
I RWTHIN 10' OFE-ROUTED. SYSTEM �^ �� FRED DUNCAN
1 0, ,
�o0 5 REMOVAL OF UNSUITABLE SOIL DATE: MARCH 16, 2007
REQUIRED AROUND PERIMETEI; OF
LEACHING FACILITY, DOWN TO
SUITABLE SOIL LAYER. REPLAJE Scale:1"= 20'
WITH CLEAN MEDIUM SAND.
0 10 20 30 40 50 FEET
,
• off 508-362-4541
1 fax 508 362-9880
N OFNSs9 FA\'Z k CFN
ARNE H. oyGN o�� ARNE q°yG
o OJALA �` �� H.
U CIVIL Cn 0 OJALA y do wry c ap e engineering, il"7 c.
•o No. 30792 No.26348
S�oNA a�. gNDESS\oo� Cl VIL ENGINEERS
SUR\41� LAND SUR VEYORS
DCE #07-0 > 7 DATE ARNE H. OJALA, P.E., P.L.S. 939 Main Street - YARMOU THPOR T, MASS.
07-017 DUNCAN.DWG (DDF)