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0045 HORNBEAM LANE - Health
45 Hornbeam Lane Centerville P A = 206 066008 S//// 2J�AEcrc�o�ay,. UPC 10259 No. H_163OR NA871N04 UN 0 TO OF BARNSTA'BLE LOCATION 45 HORNBEAM LANE. SEWAGE /EO'05-213 'TILLAGE -MRNS—AB1--E' ASSESSOR'S MAP Cr LOT206/66 INSTALLER'S NAME & PHONE NO.ELLIS BROTHERS CONST. 362-6237 SEPTIC TANK CAPACITY' 1 <,`" ;. 5TA-ti b 4ic—4 I LEACHING FACILITY:(type) /fir FIe- To—S, (size) X(g X 30)c 7��06lb NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER_ BUILDER O OWNER (�'���G� � 11�► A� J�C.� lc. ) DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No A_1 ��8 A--,7 - A,3 - of,, S 35 S 19 6 3 L 3&( No. 1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZIpprication for niopogal *pgtem Construction Permit Application for a Permit to Construct( . )Repair(V<pgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �L /�+-r� 'jpQyr,l, Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No,cS Gi 3(,,;t —(o;2 3 7 Designer's Name,Address and Tel.No. C,A--l-C, 6o.v3 Type of Building: Dwelling No.of Bedrooms l� Lot Size V_53_12sq.ft. Garbage Grinder(Aj0 Other Type of Building /&_f No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date 7_4el i 2-, Number of sheets Revision Date Titlef✓ Size of Septic Tank 45�fz/. a , Type of S.A.S. Description of Soil /� Q�✓ - 7� Nature of Repairs or Alterations(Answer when applicable) - ZW f r,4 Date last inspected: Agreement:The undersigned agrees to ensure the struction and maintenance of the afore described on-site sewage disposal system in accordance with,the provisions of T' of the Environ al Code and not to place the system in operation untiNi Certifi- cate of Compliance has bee ssue this Board of Heal Sign Date Application Approved by Date-) ' Application Disapproved fo . f owing re s ns drl N t 7 Pe7Wt No Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (fAmp lance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed ( ) Repaired ( Xpgraded( ) Abandoned( )by s �� at Odd _-1 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer L:'�� Z-c�J- Designer 6�,e, j� The issuance of this permit shall not be construed as a guarantee that the system will function as desig ed. Date Inspector No. Fee /0 THE COMMONWEALTH OF MASSACHUSETTS j g PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS igogarpgtent ongtrtiotterri�it Permission is hereby granted to Cunstr(ict( )Repaix.( ),s�;,.gar bar,cn( ) System located at 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`Yoc"al provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date:_ Approved by A " No. 1 / c Fee IN'rF-. r THExCOMMONWEALTKOF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION- TOWN OF BARNSTABLES MASSACHUSETTS ZIP'Yication for loi000l *p4tem'Construction Permit Application for a Permit to Construct( . )Repair(Upgrade( )Abandon( ) ElComplete System ❑Individual Components Location Address or Lot No. ��rj /�,.� Q Owner's Name,Address and Tel.No. •.�;. Assessor's Map/Pazcel m R� v pAc . G6 -�s ,4 �� Lam„ ;Aa,t44 Installer's Name,Address,and Tel.No.sc 3 6 t - a 3 7 Designer's Name,Address and Tel.No. 2 3 z�Atptrse" /rd Type of Building: Dwelling No.of Bedrooms � Lot Size 9�5_3_12 sq.ft. Garbage Grinder( jC7 Other 'Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow G GD gallons per day. Calculated daily flow G 6 gallons. Plan Date 2r 0 J 3 Number of sheets Revision Date Zt�3, Z o 0 3 Title 14ze _ f ' Size of Septic Tank f/SUv awZ. a Type of S.A.S. gel Z 30k3a X,tJ ft 4 Description of Soil _75e Dom/ i � Nature of'Repairs or Alterations(Answer when applicable) 017- X e 2 A 42 .S / �'� SS"8 Z—o 0 14 ;ram, Date last inspected: Agreement: 4 The undersigned agrees to ensure the struction and maintenance of the afore described on-site sewage disposal system in accordance with.the provisions of Titl of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has bee 'sued this Board of Heald Signed —1C4r Date" Application Approved by Date"° Application Disapproved fbLthe following reasns r—� OIT Or ru�,;4 T rd - y t Permit Nola V d i! Date Issued t THE COMMONWEALTH OF MASSACHUSETTS ' BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( Xpgraded( ) Abandoned( )by at c> has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer 1—" Designer .i The issuance of this permit shall not be construed as a guarantee that the system will function as desig ed. Date Inspector — --- ———————————————————————————————— No. Fee � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS ]DtgoosW *pztetn ott tr ctcon e mtt �� { Permission 1s here'ui,a, W",'�'-c �;,+e t) <enatr /r t' �, n� r. "��•� w System''cateu 5 .Ji1 .W ?a� � � $ a: _ J 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. *�y Provided: Construction must be completed within three years of the date.of this permit. Date:__• Approved bye No. LJI�� ✓ I�/ Fee 7<70 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Yes R pplication for Df Spool *p5tem Con!gtruction Perron Application for a Pennit to Construct( . )Repair( )Upgrade( )Abandon( ) 0 Complete System O Individual Components Location Address or Lot No. jfs-I*r,,7 a-e+M ' h Owner's Name,Address and Tel.No. Assessor's Map/Parcel 0����v/C v j �� r yi��h pCO/c/�, c20G W,6 7 S 6 /-X?C')ACC/ �e Installer's Name,Address,and Tel.No. Designer's Name,Ass and Tel.No. S- 9 t�,� �d�vi^•�' can S� 5j _,e"e ram- li nfC ^4 �- 973 )h a ry 3S Gam►'' '�-�"�-v► 3 Type of Building: Dwelling No.of Bedrooms �'� Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow q d A y 4 4v gallons per day. Calculated daily flow gallons. Plan Date 1 acle/ rlf sheets Revision Date a i o'Z�GZr Title Size of Septic Tank ISad Type of S.A.S. /d Description of Soil,Sg^P Soi Low 3o X oX Nature of Repairs or Alterations(Answer when applicable) 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 Environ tal Code and not to place the system in operation until a Certifi- cate of Compliance has been issued bv this Board of He th. Signed e Date Application Approved by Date Application Disapproved for the following reasons Permit No. CIO S —1 Date Issued G ' ' d Fee Entered in �uteri � CO computer:THE COMMONWEALTH OF MASSACHUSETTS _'•::•:'i, p Yes -< PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS : - 2pprication for Zizoogar *pg;tem Construction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) El Complete System .O Individual Components Location Address or Lot No. qX I*/r,Q Q�m �„� ] Owner's Name,Address and Tel.No. Assessor's Map/Parcel �� l�ti i/2vi P�4 r- a 7'�1/ ' '20f, / ,4 3 AR,h jr str . /-7,ch Ar e, Installer's Name,Address,and Tel.No. Designer's Name,Ad ress and Tel.No. F 1I�,S / x/G- r-I Cc�, S�- 2 3 ) ern-l�� /Za u/.,��'�'► r�3S 6,--Z" s Type of Building: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( i) Other Fixtures Design Flow 6 o J u G ttf) gallons per day. Calculated daily flow gallons.- Plan Date UT sheets f-Revision Date e3 rl�, , 1 5Zocz,f`, Title J Size of Septic Tank lSd6 Type of S.A.S. /a 5'. ch��l�vdl ,`J, Jel}�G1pr.l Description of Soil Rcj J LC 3v X 7 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: t i The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system 'in accordance with the provisions of Title'5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Heal l�i. Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. (��) �ir� 1 Z, Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( )by 1^11,5 r c.l3v 1-i /��°d�� 'T s,r.., at W S ��osn /� nil L.� min 5J� !�I -P' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer 1=�� Il dc-.. rS CchS f Designer art,-1,C �i-t I -r. ,.,e . The issuance of this permit shall of be construed as a guarantee that the sy i�L tion as designed. Date �/l �t'D Inspecto. No. r -1 3 Fee . THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migooal *potem Conotruction Permit Permission is hereby granted to Construct( )Re air(. )Upgrade( )Abandon( ) System located at 4 S ho r) /j�g rrt �n r� /���,� S/q 63 1-7 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 mu t be completed within three years of thereof this 'ermit. "- Date: /1�. Appro d-by r 1 05/ . 15:41 15084309979 r PAGE 01/03 Af7CHAEL D. FORD,ESO ULU ATTORNEY AT LAW 72 1vLAN STREET,P.O.BOX 665 CGS WEST HARWICH.NIA 02671 ""PLEASE NOTE NEW FAX A�D E-IIAIL ADDRESS*** PHONE (508)430-1900 F.-LX(508)A30-9979 � kA_ 417 EMAJL: rndfesgl@verizon.net G'-Xti; U 1'-zk,— DATE: 5 j f O �J L.�f TELECO�YI.blU,VI ATIO,VI�vFORytAT1ONSHFET PLEASE DELIVER THE FOLLOWING PAGE(rS')TO: 4 rn R40 kilt oard Q,al-Wl Recipient's Name �— 1C- an)f1 Company Telephone dumber aQ— 30 Telefax Number TIES MATERIAL IS FROM: Michael D. Ford. Escuire Sender's Namc (508) 430-1900 Telephone Number � (508) 430-9979 Telefax Number TOTAL PAGES 2 (NOT INCLUDING COVER). IF YOU DO NOT RECEIVE ALL THE PAGES'S PLEASE CALL SENDER'S TELEPHONE NUMBER AS SOON AS POSSIBLE. REMARKS: >NDTxa Or cOr.Tmc.�w.rtt< TITS rLldKtrrAL MAY CONTARV WFORMATION THAT 5 PRNAEOED APO CONTTOENTUL AND 9 VrMED ONLY FOR rIR L2E OPTHE MXVMU"OIL=VI Y NAMED ASOY%7 TiR READER OF TUS 1%Ae3wC r..L M NOrTue 4frPM90 RR WYT Olt TB VAPLOVES OIL TIM HOST LLM-WS®LE FOR DELNGRaO TO TEE WrDIDE0 RZMIZNT,YOU AAE HEREBY NOT T=THAT MCf DMUMNATION. OQ19>LMON OR COPYMC OP TIOS CONML'�nCA'nON 6 MCIY PROHMRED,7 YOU RAVE RECrEMr-s COMM=CATION W ERA00.PL<,<.NOR'(VS c<r.emnsur ar TLlsrn0.+5 TO wA3..'GC eon LNYPUC:IONSANDAOV L 05/18/2005 15:41 15084309979 T T PAGE 02/03 Bk 19936 1 �sa335 033113 05-18-2005 a o i =34p DEED RESTRICTION. WHEREAS,Peter and Janine Dallow of P.O. Box 5886,Montecito, CA 93150 are the owners of 45 Hombeam Lane located at Centerville, MA and being shown on a plan entitled Plan of Land in Centerville, MA for A.H. Rand,duly recorded in Barnstable County Registry of Deeds in Plan Book 13, Page 73; WHEREAS, Peter and Janine Dallow as the owners of said lot have agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 C.M.R. 15.000 State Environmental Code,Title V; Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS,the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 C.M.R. 15.200, State Environmental Code,Title V Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the Issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document; NOW THEREFORE, Peter and Janine Dallow do hereby place the following restriction on their above referenced land in accordance with their agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding upon all successors in title: Any house constructed upon the lot shall not contain more than four(4)bedrooms and we, Peter and Janine Dallow, agree that this shall be permanent deed restriction affecting Lot 8 located on Hombeam Lane, Centerville, M.A., and being shown on the plan recorded in Plan Book 13, Page 73. For title reference, see the following deed: Book 15553, Page 286. ZIA E cuted as a ed instrument / a day of W o f aoc)-s Peter Dallow On an' Dallow-r I . _1_ 05/18/2005 15:41 15084309979 � y+ J J PAGE 03/03 STATE OF CALIFORNIA SANTA BARBARA, SS. "' 2005 On this the day ofbi,,j ,2005,before me,the undersigned notary public,personally appeared Peter and J ine Dallow, proved to me through satisfactory evidence of identification which was ri to be the persons whose name are signed on the preceding or attached docume t, and acknowledged to me that they signed it for its stated purpose. �4 E-e-GRIFM Notary P bl" come►ission*1319673 My commission expires: ©q)41 0700' Notary Public-California Santa Barbara County My Comm,Exvwes Sep 1,2005 Town- of Barnstable do Regulatory Services Thomas F. Geiler,Director • SA BrAHLE, 9 Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: (o 0 3� Designer: f" Installer: Address: D„ 7/ 3 . Address: ,e4. ,rrla. cu6D �14tc.w�v�t-1 -Pam, uwt.+� o�,6�S On S��9�os' f///s gk6S. was issued a permit to install a (date) (installer) septic system at 4 S AC/e_/3An .#,Vo_ based on a design drawn by (address) IR,5. dated �/Z/°3i (designer) I certify that the septic system 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 tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State &Local tions. Plan revision or certified as-built by designer to follow. �yIH of T.A. DUMAS No.619 (Installer's Signature) (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETTJRN TO BARNSTABLE VBLICHEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. I � t 353�' Commonwealth of Massachusetts Lj ' 36, Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 45 Hornbeam lane, Centerville, MA Property Address "9- t Owner Owner's Name I information is MA 02632 04/22/2015 �rl � required for 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-ony way.Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not REID C. ELLIS use the return Name of Inspector key. ELLIS BROTHERS CONSTRUCTION na Company Name 23 ENTERPRISE ROAD Company Address YARMOUTH PORT MA 02675 Citylrown State Zip Code 508-362-6237 S121891 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( 10 CMR 15.000).The system: Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 1.0,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. telll'ob, - t5ins•3/13 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 w., 26 Dunstable Cross Road Property Address Owner George H & Elsie Adel Anderson, P. O Box 1099, South Dennis MA 02660 information is Owners Name required for every South Dennis MA 02660 04/15/2015 page. City/Town B. Certification (coot.) State Z Code P Date of Inspection Inspection Summary: Check A,B,C,D or E i always complete all of Section D A) System Passes: �WI have not founva-ny information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as desci ibed in the"Conditional Pass"section need to be replaced or repaired. The system, upon cc mpletion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determine "(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 exfi ration or tank failure is imminent. System will pass inspection if the existing tank is replaced with complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less thar 20 years old is available. ❑ Y ❑ N ❑ ND(Explain b low): !Sins•3113 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form a Not for Voluntary Assessments M 26 Dunstable Cross Road Property Address George H & Elsie Adel Anderson, P. O. Box 1099 South Dennis MA 02660 Owner owner's Name information is required for every South Dennis MA 02660 04/15/2015 page. Cityrrown State ZipCode Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if Pumps/alarms are repaired. B) System Conditionally Passes (cont_): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a br Dken, settled or uneven distribution box. System will pass inspection if(with approval of Board of ealth): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replace ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 tir ies a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval c f 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 evaluatic n by the Board of Health in order to determine if the system is failing to protect public health, sE fety 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 functioni rig in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a urface water ❑ Cesspool or privy is within 50 feet of a ordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form m } Subsurface Sewage Disposal System Form.Not for Voluntary Assessments M 26 Dunstable Cross Road Property Address George H& Elsie Adel Anderson, P. O. Box 1099 South D Owner owners Name ennis, MA 02660 information is required for every South Dennis MA 02660 04/15/2015 page. Citylrown State ZipCoda Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of ealth(tand Public Water Supplier, if any) determines that the system is functions ig in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil ibsorption system (SAS) and the SAS is within 100 feet of a surface water supply or tribut ary to a surface water supply. ❑ The system has a septic tank and SAE and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAE and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS ani I 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 analysi , performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the pre nce of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other tc ilure 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 clogged SAS or cesspool p due to overloaded or ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ L�J 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-page 4 of 17 i commonwealth of Massachusetts Title 5 Official Inspection Form F Subsurface Sewage Disposal System Form-Not for Voluntary Assessments •`'�4 26 Dunstable Cross Road Property Address George H & Elsie Adel Anderson P. O. Box 1099 Owner Owner's Name South Dennis MA 02660 information is required for every South Dennis MA 02660 04/15/2015 page. City(rown State Zip Code Date of Inspection B. Certification (cont.) Yes No Required pumping more than 4 times in the last year NOT due to obstructed pipe(s). Number of times pumped: clogged or ❑ ® 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 tributary to a surface water supply- or ❑ Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ Any portion of a p or Cesspool pri vy vy 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. 1 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 s stem design flow of 10,000 gpd to 15,000 gpd, y e system must serve a facility with a For large systems, you must indicate either"yes"or"n "to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a urface drinking water supply ❑ ❑ the system is within 200 feet of a ributary to a surface drinking water supply ❑ the system is located in a nitroge i sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone I 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 r failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The syste n owner should contact the appropriate regional office of the Department. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 i Commonwealth of Massachusetts r Title 5 Official Inspection Fora a _' Subsurface Sewage Disposal System FOr?rn-Not for Voluntary Assessments 5 26 Dunstable Cross Road Property Address George H & Elsie Adel Anderson, P. O Box 1099 South Dennis MA 02660 Owner Owners Name information is required for every South Dennis MA 02660 04/15/2015 page. Cityrrown State Zip Code Date of Inspection Co Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No y 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? y ❑ 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? r ❑ Were all system components, Ql ding 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: A ❑ 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 n desi : ( 9 ) Number of bedrooms(actual). DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): t5ins•3f13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pape 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 26 Dunstable Cross Road Property Address George H & Elsie Adel Anderson, P. O Box 1099 South Dennis MA 02660 Owner Owner's Name information is required for every South Dennis MA 02660 04/15/2015 page. cit crown State Zip Code Date of Inspection D. System Information Description: Number of current residents: ;: Does residence have a garbage gander? El Yes Ey< Is laundry on a separate sewage system?(Include laundry system inspection information in this report.) ❑ Yes Vo Laundry system inspected? ❑ Yes No Seasonaluse? ❑ Yes I No Water meter readings, if available(last 2 years (gP ))usage d : Detail: LJA tom_ Sump pump? ❑ Yes No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CIVIR 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 syster ? ❑ Yes ❑ Na Water meter readings, if available: t5ins-3/1 3 7 e 5 Official Inspection Form Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Dunstable Cross Road Property Address George H & Elsie Adel Anderson P. O. Box 1099, South Dennis, MA 02660 Owner Owner's Name information is required for every South Dennis MA 02660 04/15/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? or— S ❑ Yes ❑ No If yes, volume pumped: gallons -� How was quantity pumped determined? ` r - Reason for pumping: Ci�"� ? ' r�! Type ofSystem: 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-3113 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 w 26 Dunstable Cross Road Property Address Owner George H & Elsie Adel Anderson, P. O. Box 1099 02 South Dennis MA 660 information is Owners Name required for every South Dennis MA 02660 04/15/2015 D. System Information (cont.) page. City/Town State 0 Code p Date of Inspection Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? � ❑ Yes °LoI No -- Building Sewer(locate on site plan): Depth below grade: feet M..,,��atte�erial of construction: LP'cast iron U 40 PVC ❑ other(explain): Distance from private water supply well or suction line: C . feet Comments (on condition of joints, venting, evidence of leakage, etc.): ���� `�- //✓''c.�� �/9��a�G��IJ � J ate. Septic Tan (locate on site pla Depth below grade:—t-� 'A bi>f 11 �'✓ Z ��✓�� � �D'� � feet Material of construction: .concrete El metal � ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is etal, st age: /�ye;ars/// Is ag confi ' edbyaCertificate of Compliance?(attach atificate) 4 ❑ Yes No Dimensions: -;rx rx-jL -j�?,Jv , Sludge depth: A- �A t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurfa ce Sewage Disposal System Form-Not for Voluntary Assessments 26 Dunstable Cross Road Property Address Owner George H & Elsie Adel Anderson P. O. Box 10gg, South Dennis, MA 02660 's information is Owner Name required for every South Dennis page. MA 02660 04/15/2015 City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) _ - A' v: Distance from top of sludge to bottom of outlet tee or baffle �� d� �r 1/ 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 How were dimensions determined? Comments on( pumping recommendations, inlet and outlet tee or baffle condition, structural in liquid levels as related to outle ' integrity, t Inve evi � d nce of leakage etc.). 7T4 9 Grease Trap(locate on site plan): Depth below grade: feet Material of construction.- El concrete ❑ metal ❑fibi r lass 9 ❑ polyethylene El other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or affle Distance from bottom of scum to bottom of outlel tee or baffle Date of last pumping: 15ins•3/13 Date Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 10 of 17 Commonwealth of(Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Dunstable Cross Road Property Address George H & Elsie Adel Anderson, P. O. Box 1099 South Dennis MA 02660 Owner Owner's Name information is required for every South Dennis MA 02660 04/15/2015 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 pu d at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal fiberglass ❑ polyethylene El other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): " Attach copy of current pumping contract( required). is copy attached? ❑ Yes ❑ No t5ins-3113 Title 5 official inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 f Commonwealth of Massachusetts Z Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '�. 26 Dunstable Cross Road Property Address Owner George H & Elsie Adel Anderson, P. O Box 1099, South Dennis, MA 02660 information is Owner's Name required for every South Dennis MA 02660 04/15/2015 page. City/Town State Zip Code Date of Inspection Do System Information (cont.) Distribution Box(if present must be opened) (l(locateTort plan): Depth of liquid level above outlet invert /�L� � � e Comments (note if box is level and distribution to outlets equal, any evidenci of s ids carryover, any evidence of leakage into or out of box, etc.): �. �/rA �' �� Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms a ms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, c(ndition of pumps and appurtenances, etc_): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: / . ` (sins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwaalth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Dunstable Cross Road Property Address Owner George H & Elsie Adel Anderson, P. O. Box 1099 South Dennis MA 02660 information is Owner's Name required for every South Dennis MA 02660 04/15/2015 page. Ci frown State Zip Code Date of Inspection D. System Information (cont.) Type_ `" RI t✓ ❑ leaching pits number: leaching chambers number. ❑ leaching galleries number. ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc,;.,. IA zyo e9 ell 4"1 < 4- 'A f > �� J Cesspools (cesspool must be pumped aas. of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Office., el Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °�•. y 26 Dunstable Cross Road Property Address George H & Elsie Adel Anderson, P. O. Box 1099, South Dennis, MA 02660 Owner Owners Name information is required for every South Dennis MA 02660 04l15/2015 page. Cftyrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): // ° Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of t ydraulic failure, level of ponding, condition of vegetation, etc.): 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 14 of 17 Commonwealth of Massachusetts - Title 5 Official In spection ect'®n Form ®rm _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 0 26 Dunstable Cross Road Property Address Owner George H & Elsie Adel Anderson, P. O. Box 1099, South Dennis MA 02660 information is Owners Name required for every South Dennis MA 02660 04/1512015 page. Cityfrown D. System Information (cont.) State ZipCade Date of Inspection 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 ;rhand-sketch public water supply enters the building. Check one of the boxes below: in the area be low L. ❑ drawing attached separately n ' /y/fQ' i' •`'fl y'(//. � Z,`?J q 17 131 ': t5ins-3/13 Tifle 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachuseft Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 26 Dunstable Cross Road Property Address Owner Geor e H & Elsie Adel Anderson, P. O. Box 1099, South Dennis, MA 02660 information is Owner's Name required for every South Dennis 2660 page. cityfrown MA State 0 0 Code 04/15/2015 Date D. System Information (cont.) p of Inspection Site Exam: ❑ Check Slope ZU_ ❑ Surface water IVIO?V'-2 ❑ Check cellar �� � „, 1 . ❑ Shallow wellsJ =4- 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: JAI You must describe how you established the high ground water elevation: 4 = �11 f I Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts �., Tale 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 26 Dunstable Cross Road Property Address Owner George H & Elsie Adel Anderson, P_ O. Box 1099, South Dennis, MA 02660 Owner's Name information is required for every South Dennis MA 02660 15 page. City/Town State Zip Code Dat Hof nOspection E. Report Completeness Checklist IV, spection 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 LJ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•page 17 of 17 Town of Barnstable R Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. May 19, 2005 Mr. Robin W. Wilcox, P.E. Sweetser Engineering Co. P.O. Box 713 South Dennis, MA 02660 RE 45 Hornbeam Lane, Centerville A 2Q'6=066 Dear Mr. Wilcox, You are granted conditional variances on behalf of your clients, Peter and Janine Dallow, to construct an onsite sewage disposal system at 45 Hornbeam Lane, Centerville. The variances granted are as follows: SECTION 360-1: The soil absorption system will be located 49 feet away from a coastal bank, in lieu of the one-hundred (100) feet minimum separation distance required. SECTION 360-1: The septic tank will be located 71 feet away from a coastal bank, in lieu of the one-hundred (100) feet minimum separation distance required. SECTION 360-1: The distribution box will be located 73 feet away from a coastal bank, in lieu of the one-hundred (100) feet minimum separation distance required. SECTION 360-1: The septic piping will be located 67 feet away from a coastal bank, 1n lieu of the one-hundred (100) feet minimum separation distance required. SECTION 360-1: The reserve area for the SAS will be located in the coastal bank (-5 ft.), in lieu of the one-hundred (100) feet minimum separation distance required. WilcoxDallowO5 _ These variances are granted with the following conditions: (1) No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The designing sanitarian shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised plans dated May 10, 2005. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to the close proximity a coastal bank adjoining the property. It is the opinion of this Board that the proposed new soil absorption system is designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sinc elYyours, Wayn4 Miller, M.D. Chairman WilcoxDalloWO$ 05/18/2005 15:41 15084309979 PAGE 01/03 h MICHAEL D. FORD,ESO UIRE ATTORNEY AT LAW 72 NL-0 f STREET,P.O.BOX 665 WEST HARWICH.'NIA 02671 S� Ar� � G h —"PLEASE NOTE NEW FAX.YD E-MAIL ADDRESS"** PHONE(508)450-1900 FAX(508)430-9979 V� VNIAIL: mdfesglCverizon.net DATE: TELECOMyIL-1VICATION INFORMATION SHEET PLEASE DELIVER THE FOLLOW2'iG PAGE(S)TO: nrns4kle oaar-<4 "-en iu Recipient's Name (1 Company Telephone Number r7 aQ-(30 4 Telefax Number THIS MATERIAL IS FROM: Michael D. Ford. Esquire Sender's Name (508) 430-1900 Telephone Number �M(508) 430-9979 Telefax Number TOTAL PAGES (NOT TNCLUDWG COVER). IF YOU DO NOT RECH E ALL THE PAGES'S PLEASE CALL SENDER'S TELEPHONE NUMBER AS SOON AS POSSIBLE. REMARKS: a N0=1 OF C3N7mrTTUGTT- THIS TRANfMMAL M1 Y CONTAM NTORWATR)N TKAT IS PRIVUORD ANO CONFI M MAL YxD 0%JMMED ONLY FOR T14P L•SE OP T11E MIVMVAL OR rNMY NAMED ABO�L 7 T1iE READER OF TU6 "-&3b.lTT.L m NOrTwe NT6NOc0 lt=ywxT 0R 1701 EMPLOYES OR T11E AOLNT RESPONSMLE FOR DELMVR 0 TO T1JE NTENDED RECIPVvf,YOU AkE HEREBY NOT7MO THAT ArFY DISSeMWAT1ON. D3l.mL f10N OR COPYO+C OFT70S COMM%.MUTTON 6 STRJCTLT PRONMIIYD,7 YOU KAVE RECENEOTwZ cOMML^OCATION N 0.ERR0 iLEAsr Naar V3 L4P•eDtArLLr aY ZLLT��ON6 TO.wa.rcc Ica N9TRVC10NS AYD♦OJICE 05/18/2005 15:41 15084309979 PAGE 02/03 B k 19836 P is 335 33113 05-18-2005 a"1 sal234P DEED RESTRICTION. WHEREAS,Peter and Janine Dallow of P.O. Box 5886, Montecito, CA 93150 are the owners of 45 Hornbeam Lane located at Centerville, MA and being shown on a plan entitled Plan of Land in Centerville, MA for A.H. Rand, duly recorded in Barnstable County Registry of Deeds in Plan Book 13, Page 73; WHEREAS, Peter and Janine Dallow as the owners of said lot have agreed with the Town of Barnstable Board of health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 C.M.R. 15.000 State Environmental Code, Title V; Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 C.M.R_ 15.200, State Environmental Code,Title V Minimum.Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the Issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document; NOW THEREFORE, Peter and Janine Dallow do hereby place the following restriction on their above referenced land in accordance with their agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: Any house constructed upon the lot shall not contain more than four(4)bedrooms and we, Peter agree that this shall be permanent deed restriction affecting Lot 8 located on and Janine Dallow, gr hx p g Hornbeam Lane, Centerville, MA, and being shown on the plan recorded in Plan Book 13, Page 73. For title reference, see the following deed: Book 15553, Page 286. E cuted as a ed instrument a day of oOms Peter Dallow i ani a Dall —1— 05/18/2005 15:41 15084309979 PAGE 03/03 STATE OF CALIFORNIA SANTA BARBAI2A, SS. "' 2005 On this the day of , 2005,before me,the undersigned notary public,personally appeared Peter and Janine Dallow, proved to me through satisfactory evidence of identification which was nV to be the persons whose name are signed on the preceding or attached docume t, and acknowledged to me that they signed it for its stated purpose. F.e.GRIFFIN Notary P bl' Commission*1319673 M commission expires: Notary Public-California y p Santa earbare County Comm,Expires Sep 1,2005 _2_ 15:41 15084309979 PAGE 02/03 Bk 19836 P %3335 33113 ..,. / 0-35-18--2005 a 01 =34P DEED RESTRICTION. WHEREAS,Peter and Janine Dallow of P.O. Box 5886,Montecito, CA 93150 are the owners of 45 Hornbeam Lane located at Centerville, MA and being shown on a plan entitled flan of Land in Centerville, MA for A.H. Rand, duly recorded in Barnstable County Registry of Deeds in Plan Book 13, Page 73; WHEREAS, Peter and Janine Dallow as the owners of said lot have agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 C.M.R. 15.000 State Environmental Code,Title V; Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS,the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 C.M.R. 15.200, State Environmental Code,Title V Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the Issuance of a building permit for the construction of a single family home on this property,is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document; NOW THEREFORE, Peter and Janine Dallow do hereby place the following restriction on their 'above referenced land in accordance with their agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding upon all successors in title: Any house constructed upon the lot shall not contain more than four(4)bedrooms and we, Peter and Janine Dallow, agree that this shall be permanent deed restriction affecting Lot 8 located on Hornbeam Lane, Centerville, MA, and being shown on the plan recorded in Plan Book 13, Page 73. For title reference, see the following deed: Book 15553, Page 286. cuted as a ed instrument E day of 1� Peter Dallow i an' Dall t s E ;41 15084309979 PAGE 03/03 STATE OF CALIFORNIA SANTA BARBARA, SS. 2005 On this the day of , 2005,before me,the undersigned notary public,personally appeared'Peter J 'ne Dallow, proved to me through satisfactory evidence of identification which was nJ to be the persons whose name are signed on the preceding or attached docume t, and acknowledged to me that they signed it for its stated purpose. Notary P bl' Coeninissionlf 1319873 My commission expires: ©yl Notary Public-CaliforMis sante Barbara County Comm,Expires Sep 1,2005 t��rCF'1HE'1�,_ DA ie t iJQ��.. FECP r< 4 y etAsB. REC. BY Town: of Barnstable �— �- $CHED -,ON Board of Health 200Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.FL Ralph A.Murphy,M.D. LOCATION VARIANCE REQUEST FORM Property Address: 45 Hornbeam Lane,Centerville,MA Assessor's Map and Parcel Number: MAP 206 PARCEL 66 Size of Lot: 48,550 S.F. Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: APPLICANT'S NAME: Peter Dallow Phone: Did the owner of the property.authorize you to represent him or her? Yes No 1I0 tj PROPERTY OWNER'S NAME CONTACT PERSON Name Peter&Janine Dallow Name Robin W. Wilcox/Sweetser Engineering Address 725 Ashley Road Address P. O. Box 713 Montecito, CA 93108 South Dennis, MA 02660 Phone Phone 508-398-3922 VARIANCE FROM REGULATIONS REASON FOR VARIANCE Town of Barnstable§360-1—Location of Septic Components to Coastal Bank— 100'required Distance of Septic Tank to Coastal Bank is 71'+/. A 29'+/-variance is requested Distance of D-Box to Coastal Bank is 73'+/- A 27'+/-variance is requested Distance of S,AS.to Coastal Bank is 43'+/- A 57'+/-variance is requested Distance of Piping to Coastal Bank is 65'+/- A 35'+/-variance is requested Distance of Reserve S.A.S.to Coastal Bank is-12'+/- A 112'+/-variance is requested NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of the.completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) 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 ownerfleasee 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 Susan G.Rask;R.S.,Chairman (J� NOT APPROVED Sumner Kaufman,M.S.P.11 REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. �(f° Q:/WP/VAR=Q Pot- L T G SWEETSER ENGINEERING 235 GREAT WESTERN ROAD - P.O. BOX 713 -SOUTH DENNIS -MASSACHUSETTS 02660 TEL (508) 398-3922 FAX(508) 398-3063 LAND SURVEYING - ENGINEERING - TITLE 5 SEPTIC SYSTEMS April 4, 2005 NOTIFICATION TO ABUTTERS OF: Applicant: Peter Dallow CERTIFIED MAIL 725 Ashley Road RETURN RECEIPT REQUESTED Montecito,CA 93108 Re: Septic System upgrade at: 45 Hornbeam Lane,Centerville,MA Dear Abutter, A public hearing has been scheduled for the Barnstable Board of Health to take action on an application for variances from the Regulations of the Mass. Department of Environmental Protection, Title 5, and/or the Town of Barnstable Regulations for Subsurface Disposal of Sewage, as follows: BARNSTABLE BOARD OF HEALTH REGULATIONS• Chapter 360,Section I Town of Barnstable§360-1—Location of Septic Components to Coastal Bank—100' required Distance of Septic Tank to Coastal Bank is 71' +/- A 29' +/-variance is requested Distance of D-Box to Coastal Bank is 73' +/- A 27'+/-variance is requested Distance of S.A.S.to Coastal Bank is 43' +/- A 57' +/-variance is requested Distance of Piping to Coastal Bank is 65' +/- A 35' +/-variance is requested Distance of Reserve S.A.S.to Coastal Bank is-12' +/- A 112' +/-variance is requested The application and plans are available for review at the Barnstable Health Department, 200 Main Street, Hyannis, MA 02601, Monday through Friday(excluding holidays)from 8:30 AM to 4:30 PM.A hearing date is scheduled for April 19,2005 beginning at 7 PM, please call Barnstable Health Department to con date and time(508-862-4644) Since Robin W. Wilcox Sweetser Engineering Sweetser Job#5582 ABUTTERS OF AM 206/66 BILODEAU/DALLOW Locus 45 Hombeam Lane, Ceterville File# 5582 BOH AM 206/66 PETER&JANICE DALLOW Owner 725 Ashley Road Montecito, CA 93108 THOMAS HAMILTON AM 206/50 P.O. Box 106 Centerville,MA 02632 JANE M. JACKSON AM 206/64 &AM 206/67 2560 Warwick Road Shaker Heights, OH 44120 GERALD E. ANDERSON M E. Anderson �'Y _ AM 206/65 75 Hombeam Lane Centerville,MA 02632 JANICE A. HARVEY AM 206/69 531 South Main Street Centerville,MA 02632 STUART D. WOODRING AM 206/70 Heather D. Woodring 31 Stonehead Way Acton,MA 01720 E 0 , .' �►�. ol K 4low Yy, O LF d I 'o yo\ �• „� -Je v f 6S O z 17, I IS sc, t I (1-1ddV) 00 4 0L 2-99 • 'fib£ °' -qS --- �• '-�K lir qr IF f` �iw Y 'F 41 ac / ,R W M I IF IF VF a0 \\ I a r / \ 99 % ,f \ �� w ,F \ 0 J Y J I \ I o IF wr � 4r � .� yy` 1 � �• ri. IW 29 FROM THE HARDING COMPANY PHONE NO. 440 423 1030 Apr. 16 2005 05:54PM P1 Barnstable Health Department 200 Main Street Hyannis, MA 02601 Referral: Septic System upgrade at: 45 Hombeam Lane Centerville, MA 02632 Hearing Date: 04.19.05 7:00 PM As abutters on Hornbeam Lane since 1962, our family is very much concerned about the distance variances being requested from the requirements of the Barnstable Health Board of Regulations designed to protect the coastal bank. We appreciate your careful consideration in deciding this matter. Yours truly, i� Jane Masson Jackson Roger S. Jackson 19 Hornbeam Lane Centerville, MA 02632 r ■C�t_ I04-07-2005 11:54AM FROM SWEETSER ENGINEERING TO 5087906304 P.01 - = ' SWEETSER ENGINEERING P.O.BOX 713—SOUTH DENNIS—MASSACHUSETTS 02660 TEL(508)398-3922 FAX(508)398-3063 LAND SURVEYING—ENGINEERING—TITLE 5 SEPTIC SYSTEMS FAX TRANSMITTAL To: Health Department From: Gail Wilcox Fax#: 508-790-6304 Date: April 7, 2005 Pages 2 (including this page) Re: Dallow Property—45 Hornbeam Lane, Centerville Comments: The following page is authorization from the Dallows allowing Sweetser Engineering to represent them at the Board of Health hearing. We will turn in the original document at the hearing. If you have any questions, please call. Very truly yours left C' -0 Q V L� N � . fT� 04-07-2005 11:55AM FROM SWEETSER ENGINEERING TO 5087906304 P.02 Peter and Janine Dallow 725 Ashley Road Montecito,CA 93108 April 4,2005 Barnstable Board of Health c/o Sweetser Engineering P_ O. Box 713 South Dennis,MA 02660 RE: Representation at Board of Health Hearing This letter authorizes Robin W. Wilcox of Sweetser Engineering to represent me at the Barnstable Board of Health Hearing regarding the proposed septic design variances for my property at 45 Hornbeam Lane,Centerville,MA. inc ly, Pete allow anine allow TOTAL P.02 McKean, Thomas From: McKean, Thomas Sent: Thursday, May 05, 2005 4:42 PM To: wamdoc@aol.com; sonnykoff@aol.com; srask@cape.com Subject: 45 Hornbeam lane F.Y.I. According to Reid Ellis (362-6237), septic installer and inspector, the septic system at 45 Hornbeam Lane "failed" inspection. The leaching facility is located on a drastic slope, it is breaking-out. The leaching facility is only 45"from a ditch that has water in it. The dwelling is really a four bedroom house (not six). C U r-Ile I Health Complaints 25-Mar-05 Time: 9:30:00 AM Date: 3/25/2005 Complaint Number: 17995 Referred To: DAVID STANTON Taken By: DAVID STANTON Complaint Type: TITLE V SEWAGE Article X Detail: ILLEGAL OPERATIONS Business Name: Number: 45 Street: Hornbeam Village: CENTERVILLE Assessors Map_Parcel: Q_O � -O 4AP Address: Telephone Number: Complaint Description: DS SPOKE WITH OWNER ABOUT THE PROBLEM WITH THE PROPERTY, AND WHY THE SEPTIC COULDN'T BE ISSUED, AND THE PREVIOUS ONE WAS VOIDED BECAUSE THE ENGINEER FAILED TO SHOW THE COASTAL BANK ON THE ORIGINAL PERMIT, AND IT IS NOW KNOWN THAT THE COASTAL BANK IS LESS THAN 100' FROM THE COASTAL BANK. THE OWNER SAID THE POOL COMPANY ALREADY CLEARED THE LOT AND STARTED DIGGING. Actions Taken/Results: DS WENT TO SAID LOCATION WITH DARCY FROM CONSERVATION. THEY HAVE CLEARED THE LOT. THEY DO HAVE THE SILT FENCE UP. DS TOLD THE POOL CONTRACTOR, THAT THEY WILL NOT GET THE BUILDING PERMIT FOR THE POOL UNTIL AFTER THEY GO BEFORE THE BOARD OF HEALTH FOR A VARIANCE AND GET AN ANSWER FROM THE BOARD. Investigation Date: 3/25/2005 Investigation Time: 10:15:00 AM 1 OF `77�, DATE: • .. FEE: REC. BY Town of Barnstable Ste. DATE: Board of Health 20OMain Street,Hyannis MA 02601 Office: 508-8624M4 Susan G.Rask,R.S. FAX 508-790 6304 Sumner Kaufman,M.S.P.11 Ralph A.Murphy,M.D. LOCATION VARIANCE REQUEST FORM Property Address: 45 Hornbeam Lane,Centerville,MA Assessor's Map and Parcel Number: MAP 206 PARCEL 66 Size of Lot: 48,550 S.F. Wetlands Within 300 Ft. Yes _ Business Name: ill No Subdivision Name: APPLICANT'S NAME: Peter Dallow Phone: Did the owner of the property authorize you to represent him or her? Yes No i ether fv I l o tj PROPERTY OWNER'S NAME CONTACT PERSON Name Peter&Janine Dallow Name Robin W. Wilcox/Sweetser Engineering Address 725 Ashley Road Address P. O. Box 713 Monteeito,CA 93108 South Dennis, MA 02660 Phone Phone 508-398-3922 VARIANCE FROM REGULATIONS REASON FOR VARIANCE Town of Barnstable§360-1—Location of Septic Components to Coastal Bank— 100'required Distance of Septic Tank to Coastal Bank is 71'+/- A 29'+/-variance is requested Distance,of D-Box to Coastal Bank is 73'+/- A 27'+/-variance is requested Distance of S.A.S. to Coastal Bank is 49'+/- A 51'+/-variance is requested Distance of Piping to Coastal Bank is 67'+/- A 33'+/-variance is requested Distance of Reserve S.A.S. to Coastal Bank is-5'+/- A 106'+/-variance is requested NATURE OF WORK: House Addition Q House Renovation ❑ Repair of Failed Septic System Checklist(to be completed by off ice staff-person receiving variance request application) Four(4)copies of the.completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) 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/leasee 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 Susan G.Rask;R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/VARIREQ. I dF:1NF+, o� DATE: '�J.• FEE: .. 7 Boa • REC. BY ED M10d�' Town of Barnstable S®. DATE: Board of Health 200Main Street,Hyannis MA 02601 Office: 508-862.4W. Susan G.Rask,R-S. FAX 508-790-6304 Sumner Kauf man,M.S P.H. Ralph A.Murphy,M.D. LOCATION VA.REANCE REQUEST FORM . Property Address: 45 Hornbeam Lane,Centerville,MA Assessor's Map and Parcel Number: MAP 206 PARCEL 66 Size of Lot: 48,550 S.F. Wetlands Within 300 Ft. Yes Business Name: �l1 l4 No Subdivision Name: APPLICANT'S NAME: Peter Dallow Phone: jr Did the owner of the property authorize you to represent him or her? Yes No tl0uJ PROPERTY OWNER'S NAME CONTACT PERSON Name Peter&Janine Dallow Name Robin W. Wilcox/Sweetser Engineering Address 725 Ashley Road Address P. O. Box 713 Montecito, CA 93108 South Dennis, MA 02660 Phone Phone 508-398-3922 VARIANCE FROM REGULATIONS REASON FOR VARIANCE Town of Barnstable§360-1-Location of Septic Components to Coastal Bank- 100'required Distance of Septic Tank to Coastal Bank is 71'+/- A 29'+/-variance is requested Distance of D-Box to Coastal Bank is 73'+/- A 27'+/-variance is requested Distance of S.A.S.to Coastal Bank is 49'+/- A 51'+/-variance is requested Distance of Piping to Coastal Bank is 67'+/- A 33'+/-variance is requested - Distance of Reserve S.A.S.to Coastal Bank is-5'+/- A 105'+/-variance is requested NATURE OF WORK: House Addition 0 House Renovation 0 Repair of Failed Septic System Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of the.completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) 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/leasee 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 Susan G.Rask;R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.11 REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/VARIREQ SWEETSER ENGINEERING 235 GREAT WESTERN ROAD - P.O. BOX 713 -SOUTH DENNIS - MASSACHUSETTS 02660 TEL (508) 398-3922 FAX (508) 398-3063 LAND SURVEYING - ENGINEERING - TITLE 5 SEPTIC SYSTEMS April 4, 2005 NOTIFICATION TO ABUTTERS OF: Applicant: Peter Dallow CERTIFIED MAIL 725 Ashley Road RETURN RECEIPT REQUESTED Montecito,CA 93108 Re: Septic System upgrade at: 45 Hornbeam Lane,Centerville,MA Dear Abutter, A public hearing has been scheduled for the Barnstable Board of Health to take action on an application for variances from the Regulations of the Mass. Department of Environmental Protection, Title 5, and/or the Town of Barnstable Regulations for Subsurface Disposal of Sewage, as follows: BARNSTABLE BOARD OF HEALTH REGULATIONS: Chanter 360,Section I Town of Barnstable§360-1—Location of Septic Components to Coastal Bank—100' required Distance of Septic Tank to Coastal Bank is 71' +/- A 29' +/-variance is requested Distance of D-Box to Coastal Bank is 73' +/- A 27' +/-variance is requested Distance of S.A.S. to Coastal Bank is 43' +/- A 57' +/-variance is requested Distance of Piping to Coastal Bank is 65' +/- A 35' +/-variance is requested Distance of Reserve S.A.S.to Coastal Bank is -12' +/- A 112' +/-variance is requested The application and plans are available for review at the Barnstable Health Department, 200 Main Street, Hyannis, MA 02601, Monday through Friday(excluding holidays)from 8:30 AM to 4:30 PM.A hearing date is scheduled for April 19, 2005 beginning at 7 PM,please call Barnstable Health Department to confirm date and time(508-862-4644) Since Robin W. Wilcox Sweetser Engineering Sweetser Job#5582 McKean, Thomas From: McKean, Thomas Sent: Thursday, May 05, 2005 4:42 PM To: wamdoc@aol.com; sonnykoff@aol.com; srask@cape.com Subject: 45 Hornbeam lane F.Y.I. According to Reid Ellis (362-6237), septic installer and inspector, the septic system at 45 Hornbeam Lane"failed" inspection. The leaching facility is located on a drastic slope, it is breaking-out. The leaching facility is only 45�from a ditch that has water in it. The dwelling is really a four bedroom house(not six). 1 � y ABUTTERS OF ALLOW 45 Hornbeam Lane, Ceterville File# 5582 BOH2<,�t«S y/I /OS l J Y UNITED STATES POSTAL'SEWME 1�ml -•�Fi lass Mail-°'°'-PtsstageA,Eaes Paid -LISPSPerMit-N0..07jq_. • Sender: Please print yourga i b ss, and ZIP+4 in this box• SWEETSER ENGINERRINQ P.O. BOX 793 SOUTH DENNIS, MA 0200® illlf}Iflll!!�llflllfll!ll�Itllll!!IIllflllli?tl111!llllt;?�i� R. COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. SiKZ nt item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ddressee so that we can return the card to you. B.jeceivd by(Printed me) C. 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'(1 ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No JANICE A. HARVEY { 531 South Main Street 3.Fertified ice Type Centerville, MA 02632 Mail ❑Express Mail egistered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number �.l t 7 GO 2 0 8'`01110 0 031 :4 02 4 10 7 611 ' (transfer from service label) k PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 Certified Mail Provides: ■A mailing receipt ■A unique identifier for your mailpiece a A signature upon delivery ■A record of delivery kept by the Postal Service for two years Important Reminders: s Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. o Certified Mail is not available for any class of international mail. in NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail ■For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is required. ■For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". •If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,April 2002 (Reverse) 102595-02-M-1132 r4 U.S. Postal .DCERTIFIED MAIL RECEIPT 0 (Domestic ti m; 1 =70 r U--S E ni 55BZ80H C3 Postage $ c 37 Sp Certified Fee p2 U �C 0 Return Receipt Fee _ P9stmerk fn � (Endorsement Required) -Were ere z 0 Restricted Delivery Fee O Cj (Endorsement Required) rU Total Postage Fees. - 0 00 Sent To JANICE A. HARVEY or apt.No.' 531 South Main.Street O or PO Box No.. aw,.sate,-ZIN Centerville,MA 02632 _.. ..... UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box• I I 1..A , P.0, B()IX.713 I I i 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. K(- ❑Agent X ■ Print your name and address on the reverse Addressee so that we can return the card to you. ceived by(Printe `ame) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No JANE M. JACKSON 2560 Warwick Road Shaker Heights OH 44120 3. S ice Type ertified Mail El Express Mail Registered ❑ Rett rrr#eceipt for Merchandise ❑Insured Mail ❑C Op 4. Restricted Deljvery?(Extra Fee)x �' ❑Yes 2. Article Number (Transfer from service fabe0 .700.2. 0 8 6 0- ,0 G0 3 =4 0'2 4 0723 PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 Certified Mail Provides: is A mailing receipt ■A unique identifier for your mailpiece e A signature upon delivery s A record of delivery kept by the Postal Service for two years Important Reminders: ■Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. s Certified Mail is not available for any class of international mail. O NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is required. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ®If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,April 2002 (Reverse) 102595-02-M-1132 m U.S. Postal ru� CERTIFIED MAIL RECEIPT p D. ru 0 5582t�AF ge $ . ./ SO(i O certified Fee 30 z —� 1:3P-W -0 ostmerk Return Receipt Fee (Endorsement Required) O Here co p vd Restricted Delivery Fee i (Endorsement Required) Total Postage 09 azo ru 0 i � Sent To JANE M. JACKSON or PO o. 2560 Warwick Road or PO Box No. ciiy,"state, iPi Shaker Heights, OH 44120 UNITED STATES POSTAL SERd�E';�` 111 i />9 First�Class Mail Uj P v Postage&Fees,Paid FUSPS 7. `permit No..G-10 E • Sender: Please print our name, address;and ZIP+4 in this box• Pr Y I I I I SWEETSER ENGINEERING I� P.O.Sox 713 I South Dennis,MA 02660 I I I I I i SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. 'g ature item 4 if Restricted Delivery.is.desired. ❑ ent ■ Print your name and address on the reverse X Addressee so that we can return the card to you. B. Re eived by(Printed Name) �(C CQ to of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. b '��` c82 Q^ D. Is delivery address different from item 1? ❑Yes 5 1. Article Addressed to: J If YES,enter delivery address below: ❑No STUART D. WOODRING Heather D. Woodring 31 Stonehead Way 1,2—erivice Type Acton,NIA 01720 ertified Mail ❑Express Mail ❑ Registered ❑Return Receipt for Merchandise I ❑Insured Mail ❑C.O.D. I 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label) 7002 0860 0003 4024 0747 PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 Certified Mail Provides: ■A mailing receipt s A unique identifier for your mailpiece Is A signature upon delivery m A record of delivery kept by the Postal Service for two years Important Reminders: ®Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. 0 Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For I valuables,please consider Insured.or Registered Mail. is For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach.a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse naiipiece"Return,Receipt Requested".To receive a fee waive,for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is required. ®For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery. e If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,April 2002 (Reverse) 102595-02-M-1132 r- Postal Service CERTIFIED MAIL RECEIPT 0i (Domestic Mail Only; No Insurance Coverage Provided) fll 1 A L m P6OH 5-562- C3 C3 Postage ►$ . 3 Cj 7 0 Certified Fee M Rahm Receipt Fee -0 (Endorsement Reclub" cc r3 (Endorsement Fee 9 0 nt Required), ru Total Postage& C3 C3 Sent To STUART D. WOODRING Heather D. Woodring or PO Box No. 31 Stonehead Way City,siaie,�iia". Acton,MA 01720 p U.S. Postal rti C3 (Domestic Mail Only; No Insurance Coverage Provided) : CERTIFIED MAIL RECEIPT rt.l o '' F I C I ik L rr 6582-6014 zio p Postage $ 37 p a p Certified Fee 30 -a a ' U) PJstmark Z` p Return Receipt Fee -76 -0 (Endorsement Required)Rtricted re ee p (EnnddoorsementiReivequirfed) t U99z� d�\ rU Total Postage&Fees_ -- C N sent-- GERALD E. ANDERSON E Street, No. Mary E. Anderson i or PO Box No. 75 Hornbeam Lane City.seeie,ziaa Centerville, MA 02632 Certified Mail Provides: ■A mailing receipt n A unique identifier for your mailpiece ■A signature upon delivery ■A record of delivery kept by the Postal Service for two years important Reminders: ■Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. n Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. n For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is required. ■For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". n If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3800,April 2002 (Reverse) 102595-02-M-1132 UNITED STATES POSTAL RIv !% ~ 2 � a&Ma# / p/ \ \ \ mslg%Fees Pd �/ . P. Permit A,G+ - Sender: Please print\o § address, an+Z|P+i'tbo-X- — I � � I j \§FISER E ' \\ P.O. Co' 7;3 SOUTH DERky, ?2 0 I � I I � I I I | � ( � | M e I11 111111 IM.till IIII=ns§h am\:".!III , . . SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature_ Q item 4 if Restricted Delivery is desired. X ❑Agent ( ■,Print your name and address on the reverse ((� ✓✓✓111 ❑Addressee i so that we can return the card to you. eceived by Name) C. ate of Del've ■ Attach this card to the back of the mailpiece,:_= y(S.� 1 1 ) 1 'U or on the front if space permits. 6 i-)'c 5552 D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No GERALD E. ANDERSON Mary E. Anderson 75 Hornbeam Lane 3. ice Type Centerville, MA 02632 ertified Mail ❑Express Mail Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label) 7002 01860 0003 4024 0730 PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 I UNITED STATES PQSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • r !i!°aagg a P.®. U 1, a e t SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signs u item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. Received by(Printed Na e) C. D to pf Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. Mi ��� n�,9 D. Is.delivery address different from item 1 ❑Yes 1. Article Addressed to: C�v f'J If YES,enter delivery address below: ❑No j THOMAS HAM1LTON P.O. Box 106 3. SS ice Ty1 co l Centerville,MA 02632 AJ Oertified ❑Ex EF Registere �� Retur t for Merchandise ❑Insured Mail � 4. Restricted Delivery?(Extra Fee), ❑Yes 2. Article Number (rransfer from service label) 7002 0860 0003 4024 0754 PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 I Certified Mail Provides: ■A mailing receipt ■A unique identifier for your mailpiece p A signature upon delivery ■A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. ■Certified Mail is not available for any class of international mail. • NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the j fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is required. ®For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,April 2002 (Reverse) 102595.02-M-1132 � -:r- U.S. Postal Service �nCERTIFIED MAIL RECEIP T � C31 (Domestic Mail Only; W. fU O i = 7FFc�Q U m 82o�ge $ 3 �� 0 Im Im Certified Fee ✓� CO Retum Receipt Fee � Post/6 .A (Endorsement Required) N\ s Hco ers1 ( O Restricted Delivery Fee (Endorsement Required) nJ Total Postage&,Fees_ O Sent O 1 THOMAS HAMILTON Stre®y ApLNo.; or PO Box No. P.O. BOX 106 ciry,"Siai�, iP+ Centerville,MA 02632 I ru a SOA . ,EGA 310i_ L U p5 F T m Postage $ a7TV"M#- O' O Certified Fee y Return Receipt Fee S �lm� ...� (Endorsement Required) v CleY1 a Kok CD O Restricted Delivery Fee (Endorsement Required) 04/04/05 fU Total Postage&' N8aOSent To PETER &JANINE DALLOW o`6oMo°" 725 Ashley Road city siate,iiP: Montecito, CA 93108 Certified Mail Provides: a A mailing receipt o A unique identifier for your mailpiece o A signature upon delivery o A record of delivery kept by the Postal Service for two years Important Reminders: ©Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. a Certified Mail is not available for any1class of inter natonal_mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. n' is For an additional fee,a Return Receipt may be requested to•provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and:;add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a LISPS podm"_ark on your Certified Mail receipt is required. ®For an additional fee, delivery may.sbe restricted+tojthenaddressee or addressee's authorized agent.Advise'therclerk or'r'riark t6 nailpiece with the endorsevnt"Restricted Delivery" Svcs "GG1..V ii k3 a@��T.. 17 If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed detach and affix label with postage and mail. _:_,--A.....ant it whop mnirinn an innuirv. UNITED STATES POSTAL SE V117161A� First�las_kMail Q)� 10 L�V Postage ees Paid V UPES 1cp U ! ermit No.G-10 GJ CV • Sender: Please,prl ar' me, addres and�ZIP+4 in this box SW EETSER ENGINEERIIY G l P.O. Box 713 South Dennis,NIA 02660 :.4 i SENDER: ■ Complete items 1,2,and 3.Also complete A. Sia6a re item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. s eive (Pri ted Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, 1, ` or on the front if space permits. ` d/ J D. Is delivery address d' t4r=—item 1? ❑Yes 1. Article Addressed to: t� a r80 If YES,enter deli erestLtelgW-, ❑No PETER&JANINE DALLOW I - I 725 Ashley Road 3. Se ice Type Montecito, CA 93108 rtified Mai �� � Express Mail;P. ' Registered $ etum Receipt for Merchandise of ❑Insured Mail ❑C.O.D. I 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (rmsfer from service labeo j j j E 1 7002 0860 10003 M024 0778 PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 L '7F F COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS T DEPARTMENT OF ENVIRONMENTAL PROTECTION � Z MAP t O ,W PARCEL : ® � LOT =- TITLE 5 OFFICIAL INSPECTION iFORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION R CE9VED Property Address: 45 HORNBEAM LN CENTERVILLE,MA 02632 Owner's Name: SCUDDER 14 NOZ Owner's Address: 14 ROSEWOOD DRIVE PITTSFORD NY 14534 JUN TOWN OF BARNSTABLE Date of Inspection: 5/21/02 HEALTH DEPT. Name of Inspector: (please print) JOHN GRACI �� Company Name: SEPTIC INSPECTIONS I r Mailing Address: PO. BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT certify that 1 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.Tile inspection was performed based on my training and experience in the proper functign,and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.3.40 of Title.5(310 CMR 15.000). The system: ,I X Passes Conditionally es _ Needs Furth aluation by the Local Approving Authority Fails Inspector's Signature: Date: 5/21/02 The system inspector shall submit copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspec on. 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 y THE SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING EVERY YEAR TO PROLONG THE SYSTEM'S USEFULL LIFE. ONE CESSPOOL WAS ABANDONED AND PLUMBING WAS RECONNECTED TO WORKING CESSPOOLS. ****This report only describes conditions at the time of inspection and under the conditions of use al that time.'Phis inspection does not address how the system will perform in the future under the same or different conditions of use. 'ritla 5 Imnr`rtiml I nrm (;/1 51141f111 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 45 HORNBFIW,LN CENTERVILLE, MA 02632 Owner: SCUDDER Date of inspection: 5/21/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: X I have not found any information which indicates that any of the failure criteria dzscribed in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: THE SYSTEM PASSES TITLE V INSPECTION. RECOMMEND PUMPING EVERY YEAR TO PROLONG THE SYSTEM 'S USEFULL LIFE.ONE CESSPOOL WAS ABANDONED AND PLUMBING WAS RECONNECTED TO WORKING CESSPOOLS. B. System Conditionally Passes: _ One or more system components as&scribed 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. 1• u Answer yes,no or not determined;(Y',N,ND) in the for the following statements. If"not determined"please explain. ,t n/a The septic tank is metal and over`20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration.or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if It is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a Observation of sewage backup or breakout or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken`pipe(s)are replaced _ obstruction'is removed _ distribution box is leveled or replaced ND explain: n/a ` n/a 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 :'obstr`uc'tion is removed ND explain: n/a `` Page 3 of I 1 b ' OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A :CERTIFICATION(continued) Property Address: 45 HORNBEAM LN CENTERVILLE, MA 02632 Owner: SCUDDER Date of Inspection: 5/21/02 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. 4. 1. System will pass unless Boardsof 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 arid the environment: _ Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 501 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic,tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. E; _ 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 n/a l"This system passes if th6'ivVll'water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates That the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is.equal to or less than 5 ppm, provided that ro other failure criteria are triggered. A copy of the analysis must be attached'to this form. 3. Other: n/a t Page 4 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM. INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 45 HORNBEAM LN CENTERVILLE, MA 02632 Owner: SCUDDER Date of Inspection: 5/21/02 a,t. i D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: Yes No X Backup of sewage into-facility or•system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped PUMPED ON 5122 BY CANCO. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or jrivy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. _ X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool `or'privy,is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. 1This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.l. (Yes/No)The system fails..I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The-system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) It yes no X the system is within 400 feet of a surface drinking water supply X the system is within 160 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public Water supply well If you have answered,"yes"to,any'giiestion in Section E the system is considered a significant threat, or answered j i., . , "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 sliall upgrade the system in accordance with 310 CNIR 15.304. The system owner should contact the appropriate regional office of the Department. d Page 5 of I I " OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 45 HORNBEAM LN CENTERVILLE,MA 02632 Owner: SCUDDER Date of Inspection: 5/21/02 Check if the following have been done. You must indicate "yes" or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health _ X Were any of the system components pumped out in the previous two weeks X Has the system received normal flows in the previous two week period `? X Have large volumes of water been introduced to the system recently or as part of this inspection '? X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwalt ng' nspected for signs of sewage back up X _ Was the site inspected for signs of break out? X _ Were all system components;excluding the SAS, located on site'? X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction, dimensions,depth of liquid,depth of sludge and depth of scum ? X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems`? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no X _ Existing information. For example;a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CM 15.302(3)(b)]` i t,t .. 5 Page 6 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 45 HORNBEAM LN CENTERVILLE, MA 02632 Owner: SCUDDER Date of Inspection: 5/21/02 ; FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 0 ,Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR;15:203 (for example: 110 gpd x#of bedrooms): 440 Number of current residents: 0 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)):itft C5b _Sol pCX) Sump pump(yes or no): NO 0 DD-D Last date of occupancy: 4/1/02 COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR.I5.203): n/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title 5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a ' OTHER(describe): n/a GENERAL INFORMATION Pumping Records Source of information: PUMPED,;0N;t5/22'BY CANCO Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons `How was quantity pumped determined? n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box,soil`absorption system _Single cesspool _Overflow cesspool Privy _Shared system(yes or no)(if yes, attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the bEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1946 BY OWNER Were sewage odors detected when arriving at the site(yes or no): NO :k 4 r l Page 7 of 1 1 OFFICIAL INSP.EC.TION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 HORNBEAM LN CENTERVILLE,MA 02632 Owner: SCUDDER Date of Inspection: 5/21/02 1 BUILDING SEWER(locate on site plan) Depth below grade: 12" Materials of construction:_cast iron _40 PVC Xother(explain): ORANGEBURG Distance from private water supply well or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) Depth below grade: 6" 1 Material of construction: Xconcrete. -metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a ks agd confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 6' X 6' BLOCK CE5$1?OOL" Sludge depth: 0" Distance from top of sludge to bottom of outlet tee or baffle: 0" Scum thickness: 0" Distance from top of scum to top of outlet tee.or baffle: 0" Distance from bottom of scum to bottom of outlet tee or baffle: 0" 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.): BLOCK CESSPOOL AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. CESSPOOL WAS EMTPY AT TIME OF INSPECTION. RECOMMEND PUMPING EVERY YEAR TO PROLONG THE SYSTEMS USEFUL LIFE. GREASE TRAP:_(locate'oIn site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommeidatons, irilet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage�'ek.): n/a t C.. f 7 1 Page 8 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE`SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 HORNBEAM.LN CENTERVILLE, MA 02632 Owner: SCUDDER Date of Inspection: 5/21/02 TIGHT or HOLDING TANK:. (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A` Alarm level: N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: _(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: n/a 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.): n/a ` PUMP CHAMBER: _(locate on site plan) Pumps in working order(yes or no): NO' Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a .ct , t R f - Page 9 of 1 I ` t OFFICIAL INSPECTIONfORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 45 HORNBEAM LN CENTERVILLE,MA 02632 Owner: SCUDDER Date of Inspection: 5/21/02 SOIL ABSORPTION SYSTEM (SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type n/a leaching pits, number: n/a n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a 6' X 6' BLOCK CESSPOOL overflow cesspool, number: 1 n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,dan-,p soil,condition of vegetation,etc.): THE BLOCK CESSPOOL IS STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY. THE CESSPOOL SHOWS SIGNS OF BEING 3/4 FULL-AT TIME OF INSPECTION WAS EMPTY DUE 70 HOUSE BEING VACANT. BOTTOM AT 8' CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a . Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): n/a r - t 4 Page 10 of I I OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 45 HORNBEAM LN CENTERVILLE, MA 02632 Owner: SCUDDER Date of Inspection: 5/21/02 1 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 enters the building. I i 1`• I 1 n S UT. " n V. lop c' a �. ll to- ,, gAl • m • r•t � r fr;� 1a�IS 2uipiplu I / i h tll `1 P&ge I I of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 45 HORNBEAM LN CENTERVILLE, MA 02632 Owner: SCUDDER Date of Inspection: 5/21/02 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of 1-lealth-explain: n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: GROUNDWATER WAS DETERMINED BY AUGER AT 12+FEET �t. r Y� . S �1 t Il TOWN OF B}AR,NSTABLE LOCATION �JSDY��11 ( XYYI l�F:ln1L SEWAGE # '►,-,VILLAGE I ASSESSOR'S MAP Tb_� o. INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type)VV l_r�l&0 C M (size) ( Lib ( NO. OF BEDROOMS L BUILDER OR 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 Furnished by a , Sz1 (Z �.' Page 10 of I I j OFFICIAL INSPI?C'1'ION FORM - NOT FOR VOLUNTARY ASSESSMENTS j t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 45 HORNBEAM LN C11-'N•1'GRVILLE, MA 02632 Owner: SCUDDER Dale or Inspection: 5/21/02 " SKETCH OF SCWAGC,DISPOSAL S1'S•1'I;M Provide a sketch of the sewage disposal system including ties to at least Iwo pernrinent relerence landmarks or benclumarks. Locale all wells within,t 00 feel. Locale where public water supply enters the building. ._ Dill:v..,//�.•..,p/.n.l�u.�lj; u,erl/iu,i�j•,lui�.l•�✓�I� . L 1 I � I d It i_ `T I I w M 1 t N V= 11 F It o ,[ 1 u 0 � I I I+It ;a�S 2UII)11118 I ` In t- 04-27-2005 11:11AM FROM SWEETSER ENGINEERING TO 15087906304 P.02 SWEETSER ENGINEERING P.O.BOX 713-SOUTH DEJNMS-MASSACHUSETTS 02660 TEL(508)398-3922 FAX(508)39"063 LAND SURVEYING -ENGINEERING-TITLE 5 SEPTIC SYSTEMS April 27,2005 Board of Health Town of Barnstable 200 Main Street Hyannis,MA 02601 Our File #5582 RE: 45 Hornbeam Lane,Centerville Dear Board Members, Mr. Peter Dallow hereby requests that his application for Variances on the above referenced parcel be withdrawn. The presentation by your agent,Mr. Thomas McKeon,that there is a septic inspection with a pass on File convinced him that there is no benefit to him in upgrading the system at this time. Very Truly Yours, Robin William Wilcox Professional Land Surveyor TOTAL P.02 04-27-2005 11:11AM FROM SWEETSER ENGINEERING TO 15087906304 P.01 S 9METSER ENGINEERING P.O.BOX 713-SOUTH DENNIS--MASSACHUSETTS 026W TEL(508)398-3922 FAX(508)398-3063 LAND SURVEYING ENGINEERING-TITLE 5 SEPTIC SYSTEMS FAX DATE: April 27,2005 TO: Barnstable Board of Health FROM: Robin Wilcox,Professional Land Surveyor RE: 45 Hornbeam Lane,Centerville PAGES: 2(Including Cover Sheet) COMMENTS: If you have any questions please feel free to call(508)398-3922. THANKS!! c, <I N > CD X N C� CD t" -_J General Notes: O I.All work to be performed in accordance with Massachusetts State Building Code,780 CMR,Ninth Edition, -rq IAC 2015,and applicable codes included by reference.Fmming to be in accordance with the American Wood Council Wood Frame Construction Manual.110 MPH Zone.All work to he as approved or directed by local authorities having jurisdiction. 2.Contmetmr to secure all permits,and to arrange for inspections by local authorities bavingjurisdiction,as may be required. 3.Work to be left in clean condition,ready for use and occupancy.All debris to be disposed off sire in a legal 15-O O manner. r co rq 4.Contractor to install or upgrade all plumbing.electrical,heating and venting systems as required,per code. /., Install and upgrade all fin,protection systems per applicable codes,or as may be required by local authorities _ havingjurisdiction,including smoke and carbon monoxide detectors. 'y t� AENoYATED W G // //21" "/ , / ,/, / i/ /,';/.�' NI `v SOiA.LEXLSTW_4_WAI:L'_AgEA.= 6842 5•f- m �/ /'/ —ARt;:A-:51J6JEci 10 RECONSTqutTtoN= 948 -3—F•_-- 13.9 �_. ._ / / /'�/' /.� ' /'/ ' •'� — ±Wr ."EXISTING ttooF. AKEX _ 41138 5.F: _7KAEA SU... DJEcr? Go RE-O.NSSRUG11oN+ 1330 :S:F._' Renovations to o OVER AL!—e—WILDIWG spl3 —e�AN — 8° 45 Hornbeam Lane 04 Centerville, MA 0232 ' I, Andrejs R.Strikis Arebitect 85 River View Lana-Centerville MA 0263]-Telephane(508)790-0930 Plan of Existing Footprint Al f,- 45 Hombe=Lane,Centerville,MA 02632 : Ab r i ----_l I W1NDOw _SGILEU.CE _ I. i hF w "(YPE _. -_Slt�'(uoM.L_RI_o_DEL�r�4�NDERSFN� I I �- ii I _ n -------- ==lFDN-3Z_¢_[i . I i lk- I I I EXl4-ffi�GA4A4E—___._ � I I !i I _ I � I i v tz--. vu UP YYff LL Lg � O —yrrsu� { -con -A D I I I I�-rD.ST � 11e66 Z�1` 'w' S •� ��. =c ** O li A A A IA'o" _ _... 8-p° LX1f71NG=5P.a'=�LINDOW AndrejsR.Shikis 3G'•o" 8%0' 14=0° 8sRi-vi Architect tang C--ille.MA 02632-T )roue:(508)7--'-' iPirst Floor Elan A�. --T-54CW-£=a��s-1�=0° 45 Hornbeam Lane,Centerville,MA 02632 I lZe I=Q' in-&.1, AKS I I I C"ERiSSYd_4_l IJ I DN h O tl eN MAC O - A A O d O Y�6G8 OWN D \ M � -N 0. 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Lac] . 4 61 Co We r$7tC T�rL lT P4 A4�1 �GALff::r:�"s I!or._ _ An kts �_�L"f6'_sir....�Ra..rIF3�;::::YLS1l:;:.::::511&Ft...._AE� ..,.. dre•sR Slti _... _.... ._... 1 --[.-TIA3FS :IJY[EII M T7 Architect 83IU V¢w Lane.Cenlemlle,MA 02672-Teicp6o1re:(508)79Oa)72U .... f' Basement Plan - --- j ' 45 Hornbeam Lane,Centerville,MA 02632 A9 ---- -- ----- -- - - SOIL TEST ------ BUCHUM DATE OF SOIL TEST DEC. 12`2002_ P 100390 " TOP OF FOUNDATION 20 FT. MINIMUM FROM CELLAR SOIL TEST DONE BY SWFUTSER ENGINEERING ELEV. � 2 10 FT. MINIMUM FROM SLAB OR CRAWL SPACE CLEAN SAND WITNESSED BY ' 9_00 -.� 10 FT. MINIMUM (� (N.G.V.D.) CONCRETE \ 085ERVA710N HOLE 1 ELEV.-__27.80 OBSERVATION HOLE 2 INSPECTION PORT i COVERS PERCOLATION RATE <Z M!N./INCH AT 59 INCHES PERCOLATION RATE _ <_2 MIN /INCH IN ' -- 4" SCHEDULE 40 PVC PIPE LOAM AND SEED MIN. PITCH 1/8" PER FT. 1 \� 2" LAYER OF DEPTH HOP,i'.'_ TEXTURE COLOR MOTT. OTHER DEPTHHORIZ TEXTURE COLOR �- 1/8" TO 1/2" 0-7 A SANDY LOAM 10YR2/2 0-10 O/A SAND`! LOAM 10YR2/2 ! 2�50 MAX WASHED STONE I VENT 4" CAST IRON PIPE r� 3. 22.28 INN. NOT REQUIRED _ ~ i 5.00 I 0 EQU ED j (OR EQUAL) MINIMUM 7 22 B FOAMY SAND 1OYR5/5 � 10-30 B LOAMY SAND 10YR5/F' II PITCH 1/4" PER FT. 2 Z Pht I 1 22-120 C MEDIUM SAND 10YR6/4 I i 0-1321 C MEDIUM SAND 10YR6/4 I FLOW LINE 0. ,S0 I 0 I I 6 _7:�:ELEV. _ _24,00_ tIN I MIN. I I 2.0« o = LEv. a _2t.70 LEVEL t o Ij `�0 _ - - -oo _ a 7 o ELEV. -20.42- I �6•t 'i I ELEV. _ _21.95_ GABS ELEV. _ 6" SUMP ELEV. _ -s2�._- - f BAD. LE DIST�RIBUTION � a I ` J ELE LIQUID OUTLET y H-20 1� STANDARD INFILTRATORS WITH (TO BE PLACED ON FIRM BASF) ��^ ( ) -'�'�- STONE IN A 2 5 _ ` 4 FEET 14 INCHES TO BE WATER TESTED 3' X 20' X T FIELD FORMATION 2 5't2 NO WATER ENCOUNTERED AT __�"_ ELEV. = �Zpp NO WATER ENCOUNTERED AT --] 2_'_ 5 FEET 19 INCHES IF MORE THAN ONE OUTLET BVII' 5 FEET 24 INCHES 1500 GALLON �nWELL��■5 48 ,�7 ` ,v 7 FEET 24 INCHES (TO BE PLACED ON FIRM BASE) SOIL ABSORPTION ONE N/A l - 4 ^ ` any 8 FEET 34 INCHES SEPTIC-20) 3/4" TO 1 1/2" CLEAN SYSTEM (SAS) INDEX 5 - _ ► _ _ � - _ - _ DOUBLE WASHED STONE JJ ` / ADJUST LEGEND: DESIGN CALCULATIONS � FREE OF FINES & SILT NUMBER OF BEDROOMS - - 8.3 EXISTING SPOT ELEVATION 00,.0 GARBAGE E DISPOSAL UNLIT K0 _ - - � - 1 - - - - -- - • USGS PROBABLE WATER TABLE ELEV. _ EXISTING CONTOUR - --00---- SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. = _ _ FINAL SPOT ELEVATION . 6 8 '`� NOT TO SCALE BOTTOM OF TEST HOLE ELEV. _ _�,'�.�Q_ ��t-- FINAL CONTOUR ( 110 GAL./BR./DAY X � BR.) 441P, �,, ,-�,D -___ ■ 11 8 c � �- SOIL TEST LOCATION 9 REQUIRED SEPTIC TANK CAPACiT'r _8�'`' ' 9 _ - - _ _ --���r0�� UTILITY POLE -O- - 1500 0• --J-_ ____ \ y ACTUAL SIZE OF SEPTIC TANK, / I` - ,,,� 5 ' TOWN WATER -WSW SOIL CLASSIFICATION __.l. . �11ta5.� 5 � " 8.% c+ - \"�8 5� CATCH BASIN JI DES!GN PERCOLATION' RATE <_ _ EFFLUENT LOADING RATE 0,74 GAS LINE GG 5 i - \\ 6., y� CLEAN C 0.V LEACHING 30 X �0 6 V OUT -^�' ' iy■ CESSPOOL .,.P. O LEACHING CAPACITY (AREA X RATE) n \ ' , I �± �, a- 600.00 X 0.74 1 �' 1 i - / �� '9j� \ RESERVE LEACHING CAPACITI Bvw ,, _ _ ; , _ _ - _ -- - • 1� ' -�.Q 12 NOTES: L O CJ` \ 1 ALL WORKMANSHIP AND MATERIALS SHALL CONFORM I 3 t a 3 TITLE 5 AND THE TOWN'S RULES AND REGULATION �/ �+` �n THE SUBSURFACE DISPOSAL OF SEWAGE. 'r / / '6 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGH` ". WITHIN 6" OF FINISHED GRADE. I 3. ALL COMPONENTS OF THE SANITA.P,) SYSTEM SHALL 5E �;�r -fit; ; i i J \ " / / / / ► '� _ - __""l ,3.2 '(?2' \ \ r ? i \ WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER _ A;"-'k ; 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHAL' P USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING APE 1S- Cpq q� 4. ANY BE MORTAONRY RED INNITS PLACE.ED TO BRING COVER_ 0 RAf1E S!' ; ! LC) \ BVw 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING REGULATIONS. OWNER / APPUCANT iS Th f �� / / /'Y ,✓/ - I r \` OBTAIN SUCH DETERMINAATION FROM APPROPRIATE AUTHORITY. p 25, I 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION T ONTRACTO IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAS HOURS \ \ \\ PRIOR TO COMMENCING WORK ON SITE. iL 22• 7 CONTRACTOR IS ,O VERIFY GRADES AND ELEVATIONS AS WELL AS y \8 4 SITE CONDITIONS PRIOR TO COMMENCING WORK ON S!T� 29,9 3A.96 1 8 , \ \1 / IS TO BE BROUGHT TO THE ATTENTION OF THE 'MMEDIA.TELY 8. PARCEL IS IN FLOOD ZONE A10(EL11), B, & C k/ 0.577N /` (TO BF SHED O) 1 q� // 9. LOT IS SHOWN ON ASSESSORS MAP _ 206 AS PARCEL 86 01\, / 10 EXISTING SEPTICS ARE TO BE PUMPED AND BACKFILLED - -- z ki InKELLUVC. h-` 11. INTERIOR PIPING IS TO BE REPL UMBER TO EXIT AS SHOWN 21'1 I 12. ALL UNSUITABLE MATERIAL IS TO BE REMOVED FROM UNDER AND FnR 91 r OR;VE 4 BEDROOMS' _ ! I i \ - J OUND SOIL ABSORPTION SYSTEM AND BE REPL.?CE:C ` I � � - - A MINIMUM OF 5' Aa c ; WITH SAND AS SPECIFIED IN 310 CMR 15.255:(3). 13 ALL DISTURBED AREAS ARE TO BE REVEGETATED �y 'V !/ 14. VARIANCES TO BARN5TABLE REGULATIONS; ! .« S++ 1 - \ o A ALL SEWAGE DISPOSAL COMPONENTS LESS THAN 100' FROM 24.66' ?' - t- 1 P.4CPOSED ADD;PCA�S: WATER BODY (C^ASTAL BANK) - - - - - - - l ��` T / \ l0 _- GRN. / 20..E = 4' HSE I' / 0!T-DPI VE r6 291 / 1500 GALLON R , z " SEP77C TANK 4�C�!=WAc 5_a. STONE p;t 70 SCILT r! 6 1 c J / ,r 13.4 SOIL- $T 1 p 16� r ,' PROPOSED POOL F/L T-ER 20 c'. E / / OFF 1 3 c. T. A. MAAS q(_E WORK LIAII / / C 41 " No. 619 w 1 HA .., q �t 2 r o 'i4R1�N B/ \ i ZONE �'$, APPROVED: BOARD OF HEALTH ! � - ' .� �� \ ,,� = • - B� ! �•��_-%� -- I PROPOSED SEPTIC DESK STET I IJR 5�TM PETER AND JANINE DALLOW r2 T avw i \ i °ROB )EC' LOCATION --- i LOT S 4.5 v 1 45 HORNHi:�AI� , B17.1vNSTL.u.1 1 vl - �`i�VJ �- 2 --- - I ( N Speriwism? ENGINMR2NG 8 vw B vw ' *1 I Rio/ c�i7ER�LLE 508- 2�5 GP. 0. BOX 713 P�AO 398-3922 SOUTH DENNIS, MASS. 02660 {{4f v ++ - -7 I- DATE JAN. 12, 22003 J ALE 1 _ 20 POND REVISED ( JOA N0. l �- APR. 28, 2003 5582--00 I Ij4Y roe `voS______ ,____rl LOCATION MAP + REVISED APR. I 2005 SHEET 1 OF 1 J �_- c: 'S6 PROJ`5582-00 � w9'15562-00.^wC 02003 SWEETSER ENGINEERING �# 3'-0" 12'—L" or -- ---- --—---- - ---- it 2 CLOS IN ERT o ARCHITECTS, INC. BATH j I PO BOX 343 YARMOUTHPORT, MA 02675 — 1 ♦` { TEL/FAX (508) 362-8083 PLAY ROOM ci ci BEDROOM #5 BEDROOM #6 CLOS ' - - D OW RESIDENCE Ll 4-5 HORNBEAM LANE GARAGE STORAGE EXISTING CONDITIONS J ` I `\ to ♦ \ ♦ \ in IN IN Y LADDER `. TO STORAGE �! TH a PL Si: ANS ARE NOT TO )3E USFI7 \ o O E0;3 PuI'MIT'IING OR CONSTRUCTION ♦♦ I O WITH AN ORIGINAL ARCHITECT'S OR `♦ MAIL LAUNDRY PURPOSES UNU, STAMPED & SIGNED . { ENGINEERS STAMP AND SIGNATURE. 18'—O" 1 o� �; `, IL'-8" � L'-3 I/2" 21'-0" T DATE ISSUED: REVISIONS: O ---------------------------- OUTDOOR SHOWER I ° o I CLOSET/STORAGE _ b KITCHEN BUILT- INS - BATH ro ` BATH PERMIT SET - - - - - ------------- PROGRESS SET PRICING SET c::D CLOSET ROOF OF GREENHOUSE BELOW PROGRESS SET lcl) Fo CLOS El TE�l El co IC. El \ Fol 0 Fol Fol ♦` -FP El Nff H u `MUDROOM BEDROOM aye irk, �� ♦♦` ��� H OF o r REGISTRATION DINING ROOM ENTRY CLOSEl FOYER -- -- r SCALE: BEDROOM #2 BEDROOM #4 L � BEDROOM #1 0 1 2 4 8 --�`� O 1 SHEET NO. - ARCHITECTURAL a A - � . o TOTAL NUMBER OF SHEETS 1N SET: rj to -o" J THIS SHEET INVALID UNLESS ACCOMPANIED BY A COMPLETE SET OF WORKING DRAWINGS I i w _. > C DATE, QF ;pSC�IL JTEST 2 2002 r U^iD.AT10N 1Q FT. M14iMUM FROM C�L!_AR SOIL TEST DONE BY 51 . TK LNGINEUING I 39.00 0 �T.wUINIMUIJ -- 10 FT MINIM 1M FROM SLAB OR CRAWL SP4CE TT^�j WI?TIESSED BY ELEV.V - 1 S != CLEAN ANL Q' ( 4_ CON(;RETE " v ` P 1_ � C, R�r ' 'P EL V s 27.80 E LEV �r, { (N.G.VD.) n - L.)AA4 AND �tEU i, !+{ �� V°.x�-�. MIN WCH AT ___�_`+___ ,iJctlt .�£Rb'ATy 1cH �, 4 r�Ira. INCH IN C ! �RIzoN r-,NS. EC7lO,J OF<' t ------- - CO RS SE- PtRUtRA uJ+?. K. TE �__ 4 SCHEDULE 40 PVC PIPE - I 7 ! OEPTH�HGP,iZT 'rXTURE COLOR- N!OTT. QTHER ddEP,�+ ► hORi7� TEx' ;Ic T^COLOP.TMO OTHER MIN. Pi T C'H 1/8'• PEP F•. 7, \ 1 , � .�,. F � -t---� - r-------- - F _-__r I I ` � LAYER 0 /8" TO 1 /2' ��-•� I p_7 q SANDY LOAM 10Yt�2/2 ! I 0--10 O/A SA^:C`! LOAM t0YR2/2 t ---•-_ _.__-.�- �--____ _____ �24.50_MAX. � ` 1•` \V1ASH�:C` .,'"ONE i VENT t Ig,1ryp 4" CAST IRON PIPE { �- r -�x' � ---r`�C _-- - `-(} 2i.25 MIN. I NOT REa!),RED 17-22 I B LOAMY SAND 10YR5/6 10-30 B LOAMY SAND 110YR5/6 I 1 { (OP EQUAL) MINIMUM ` \1 PITCH ;/4" PER FT � -`- �-' I \ 22•-12GI C MEDIUM SAND 10YR6/4 0-1321 C MEDIUM SAND 1 10YR6/4 ii `1 � I ! i PLOW LINE I-�1�_ _�_ --_w _ �----- 21.50 I I ( t - Ow �F -- -� „7 MIN ` r+----r- I . -�•,•-4- I\_ELEV. _ _ 21.70 r 0 I �. L�, i I I I I I L - DEL c ►- _. i ` - - _ ELEV. - �1:���--''" BP�'FI.E _ 21.60_- �6" �, '�� L- ' ELE.V 2042 � � I ELEV. DISTRIBUI i 7Oi�f j� 1 t z ELEV.= I T. 7 T I 1 9 VW '- !! - 1 OUTLET '1 l-_ -� C-OX _20i _3LDQ.. } � s STANDARD r,ND AR.'Sl DN�TRhA,a RS WI H i 1 CEV ON FRA BASF, J TO 1G $E 'WATER, 4ESTED j ( � �5.12 � 3J' X 3G' X 7' FIELD FORMATION NO WATER ENCOUNTERED AT --- }�Q". EL-V. __1ZflC NO WATER c.NCOUNTENEO AT _._1j„�""_.. ELEV. v i /_-� 5 FEET is IN F+ s •} :J V���('1� IF MORE THAN ONE OUTLET , ++ - 6Viy BI W 6 FEE 24 INCH S T G' F, --�- * p•�•��` ;0 BE PLACED ON R d BASE) S �`!_ t'�� � I� t tVl<�f WELL__N_ZA_ I gf7 ,�• � 7Q FEET 29 INCHts P r,r` 7'AJ-i � � `" J/' ZONE £VJy BIM L�' � �I t Y . 3/4" TO 1 1,2" CLEAN - INDEX Y ( ' FEET 34 INCHES i - _-- • r~- �J DOUBLE WASHED SCONE '-SYS : :M (SAS)' I aD USt__- ILD ENS?: �EciGtq CALOU:--ATIONS � 1 FREE OF FINES fc SILT � EXISTING `-PUT ELEVATION 00 0 1 U?v',E3Lr{ 3El:F<�vA,,� G ca 6 I / _-_-_ EXISTING CONTOUR JA-� 00--K - GARBAGE DISPOSAL UNITNG _ 5 I .- 6 SEWAGE DISPOSAL' SYSTEM PRC)~ SI E SG5 ER TABLE WATER 'AE3LE ELEV. = --- S -� ! o SYSTEM r i .L �-• :�BSERV{:U V'IAi'ER 1A$L.E ( ,' � ) ELEV• = FINAL SPOT ELEVATION � TOTAL ESTIMATED FLOW I htOT TO BOrt"CQM OF TEST HOLE ELEV. _ .-�`�l. FINAL CONTOUR----' r� ( 110 CsAI�SR./1DAY X ,,,�_ 8R.) --� Q GAL.;DA.Y I i SOIL TEST LOCATION V REQUIRED SEPTIC TANK CAPACtT'r _� ?_ GAL. 1 I 909 r , _ `�2_ gi/w UTIUTY POLE -co--': i • { ` '• � ACTUAL SIZE OF SEPTIC TANK _��_ GAL. I TOWN' BASIN WATER �,y' yet-tea SOIL CLASSIFICATION DESIGN PERCOLATION RATE <_._ __ VIN./IN. I �.1 _ EFFLUENT LOADI GAS LINE - - --- _ /:-•- NG RATE -Q.Zs•= G /DA S.F. ^ - --- LEACHING AREA. 9MPQ SQ! FT. " .LEAN OUT �•�.'• --- I • Cam, ; CESSPOOL r.',F. U 30 X 30 i CAPACITY (AREA X RATE; 6�6,OQ GAL./DAY f LEACHING i 666,00 X 0.74 RESERVE i_EACHINC CAPACITY 015012 GAL./DAY E t�vw NOTES: i ' I I %� • / r-T 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TC D.E.P. L LJ CJ T ( + ! TITLE 5 AND THE O'Wh+ S RULES AND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 4 5`5 I , ✓`J - \ 2. ALL COVERS TO SANITARY UNITS SMALL BE BROUGHT TO ! . Y VN!THIPJ 6" OF FINISHED GRAUE i A -. - , LL COMPONENTS Of THE SANITARY SYSTEM SHALL 9E 'CAPABLE OF j °°, l • `"-" -----� �) WITHSTANDING H 1G LOADING UNLESS TFi{_Y 4P,E 'JPJCER OR WITHIN I • \ / �, _ _ a•., �* 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL 8E 1 •~/` i USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. - I 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL - BE MORTARED iN A{-ACE. „r f 80f, 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH SHED { \ ,�r1 dEEDEC OR 7.ONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DE'fEf<l41NATION FROM APPROPRIATE AUTHORITY. 1 •-•-�--'-� Q 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR IS O CALL "DIG-SAFE" AT , - 21 PRIOR TO COMMENCING WORK ON3SITE4-7t 3 A7 LEAST 7^ HOURS ?. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS . __--.- :4<.-,,..:-" ..•34-�b .i' � U HT TO THE AT N OF t DESIGN ENGINEER SITE TO PRIOR TO COMMENCING WORK T'~! D JSIT£c ANY VARIATION 15 TC, 9E f3RQ' G I IMMEDIATELY. ,1 1 8. PARCEL IS IN FLOOCI ZONE Al EE-11 8,a( ). er: c I i I `., - I WOOD SHED i 9. LOT IS SHOWN ON ASSESSORS MAP - �01116-- _ AS PARCEL c l a_z TING I (TQ BE Rc,vo D) _ ff 1Q. Ekl$TING SEPTICS ARE ?Q QE PUMPED AND E3ACKfiILLED. I • I E 9EDFi'Oi�hd ' E I 1. INTERIOR PIPING` DWL2L1,'JG. ! i 1 ? !S TO BE REPLUME3Ea TO EXIT AS SHOWN. { \ - _ - - - _ �' I l I I 12. ALL UNSUITABLE µAT R1Al IS TO .BE REMOVED FROM LINGER AND FOR 1A , S/r-DRIvi I A M!NIMUM OF 5' AROA)ND SOIL ABSORPTION SYSTEM AND BE REPLACED WITH SAND AS SPECIFIED IN 310 CMR 15.255:(3). 13. ALL DISTURBED AREAS ARE TO BE REVEGE:TATED. I 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATION$ AS 'frLL A5 �- I �(, �T.1�" �{ I• _-1 } 4_. -: 11 '` SITE CONDITIONS PRIOR f0 COMMENCING 'JJORK ON 5(TE. ANY VARIA_nON IS TO BE BROUGH? TO THE ATTENTION OF THE DESIGN ENGINEER i wi �'% ;'4.r;h' -✓ $.;� a :::: 1m IMMEDIATELY. ! I GRIV t I Ln ` HSc 1 3'7--✓Rl✓c i I 7500 GAL�O/v'_ ! ' SEP 7)C TANK �^�` �•: I - - SOIL " D STONE Pr TIG , t�_Kr �� -- " 1 ' i S7' �' PRC�pOSED POOL s __ T OF i '" - = ------- 5' 4VERDIGcr 3. _ - �; I~L `t • t, D Jh ASS j 1G Ea 19 .,. ... BOARD HEALTH I APPR xa 1 1 / ou 'L I � ,\�' / �� B✓K' � � �•\ i PRO,)ECT LOCATION LO T 8 LNJ i �� �• i► ♦ n r ti r •t t / Fr JAM I4 ` ( I S �''�s E i � ! L.5`' v6'�C ��•J i tt^C'•' �� I B6'W I I ,^£N7ERrlCLf k , 508- P. L. BOX 713 '9 _���� SOt1TH DEWS, MASS. _ 0266!� i t �, spa ► _'/ /.•= y \\ 0A?E�Ary^ "i '�r)o S� 4 SCALE e � ��l�r`[.� I � REVIsED 1 SOB No:�S582---Cyr • I ! i �_ _ J __ -__ _ _____--•---- _ L _ LOC,�a ION ��AP - I zE'�'I��:e --- __ __---- - S EST C)� i ----__-__ _______._.____1_�__.__.__.--------_..--------________�----•-__-_-` � C: '�Sf��?RO✓1558? (70 jow�c t55 _pOr .^WG 02003_ '�F:ETSF_ SOIL TEST DATE OF TEST DEC. 2 02 BMHlUJM SOIL TOP OF FOUNDATION 20 FT, MINIMUM FROM CELLAR SOIL TEST DONE. BY T ELEV. 10 FT. MINIMUM 10 FT. MINIMUM ITROM SLAB OR CRAWL SPACE - CLEAN SAND 0 1 N E S S E D BY --------- (N.G.V.D. OBSERVATON HME 1 ELEV.-__L180 OSSERVAriON HOLE 2 ELEV.-__Z6_30 CONCRETE INSPECTION PORT COVERS PERCC)LATHON RATE M!N./INCH AT INCHES 7LOAM AND SEED MINJINCH IN C HORIZON j)-f T_T j:) HER 4" SCHEDULE 40 PVC PIPE -RE-7---co-OR T MIN. PITCH 1/8" PER FT. 2" LAYER DEPTH HOPIZ TEXTURE COLOR I OTT, OTHER DE R171 TEXTURE 7" ER OF -T 1 /8 TO 1/2" IOYR2/ 1 i 10-7 A SANDY LOAM, ICYR2/2 0-10 O/A SANDY LOAM 2 I ( � �_6 MAI 24.50 MAX. WASHED STONE VENT 15.00 17-22 B LOAMY SAND IOYR5/6 t= 10-3Q 8 LOAMY SAND 4" CAST IRON PIPE 22.2541N. ��T REQUIRED D OYR.5/6 (OR EQUAL) MINIMUM --- Z PITCH 1/4"' PER FT. r � I i \ 2-1201 C MEDIUM SAND 10YR6/4 30-1321 C MEDIUM SAND I 10YR6/4 9 Off/ 2 FLOW LINE 21.50 10" T:ELEV. -TMIN. _11-70 7"i. ELEV. Li VOE L 20.42 1 ELEV.6" SUMP M' 21.43 ELEV GAS , ELEV. 6" SUM' -ELEV. = 7 I BAFFLE DISTRIBUTION E EL--V. 16 STANDARD INFILTRATORS WITH LIQUID OU TLE T I BOX (H-20) STONE IN A DEPTtL__ T�c_F Z_ (TO BE PLACED ON FIA SASE) 1 5.12 4c'EET 1.4 R HES TO BE WATER TESTED 30, X 30, x 7' FIELD FORMATION NO WATER ENCOUNTERED AT __j2D' ELEV. _11-8L NO WATER ENCOUNTERED AT _._lU"._ ELEV, 5 FEET 19 IF MORE THAN ONE OUTLET 8vw ALLON WELL N/A 8 i/w 6 FEET INCHES 1500 ev 24 INCHES ,F7 7 FEET 29 INCHES (TO BE PLACED ON FIRM BASE) SOIL ABSORP7190N ZONE 1#15 LjAET 34 IN CHFS SEPTIC TANK 3/4" TO 1 1/2- CLEAN J '_;3,YSl_EM (SASN INDEX �H-20) ),014 DOUBLE WASHED STONE ADJUST--- LEGEND: DESIGN CALCULATIONS FREE OF FINES & SILT EXISTING SPOT ELEVATION 00,0 NUMBER OF BEDROOMS Z�_ USGS PROBABLE WATER TABLE ELEV. = ------ EXISTING CONTOUR ---- GARBAGE DISPOSAL UNIT FINAL SPOT ELEVATION TOTAL ESTIMATED FLOW EWAGE DISPOSAL SYSTEM PROFILE 'F ( 110 GAL/W/IDAY X A OR.) GAL./DAY S OBS_RvED WATER TABLE ELEV. = ------ NOT TO SCALE BOTTOM OF TEST HOLE ELEV. = FINAL CONTOUR SOIL TEST LOCATION REQUIRED SEPTIC 'TANK CAPA(.iTY GAL. HVW ACTUAL SIZE OF SEPTIC TANK GAL,UTILITY POLE -c- TOWN WATER W-qwpm—W SOIL CLASSIFICATION C I BASIN 4\ DESIGN PERCOLATION RATE ATCH \1 EFFLUENT LOADING RATE 4_7A6 3AL,,/DAY/S, GAS LINE AREA SO. FT. CLEAN OUT LEACHING 30 X 30 CESSPOOL c.P. 0 L.EACHING CAPACITY (AREA X GAL,/Dkf "6.00 X 0.74 RESERVE LEACHING CAPACITY f?KQQ GAL./DA', Iz' NOTES: qvw A2 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5 AND THE TOWN'S RULES AND REGULATIONS FOR THE SUBSURFACIE. DISPOSAL OF SEWAGE. 4 8, SSG 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE. SYSTEM CAPABLE OF 3. ALL COMPONENTS OF THE SANITARY SYS SHALL BE WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OP WITHIN -20 LOADING SHALL BE Ilk. 10 FT. OF DRIVES OR PARKING AREAS. H USED UNDER OR WITHIN 10 FT, OF DRIVES OR PARKING AREAS. 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED iN PLACE. 5- HAS BEEN MADE. AS TO COMPLIANCE WITH IL NO DETERMINATION 5�iFD DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. -------- 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CON-F?:, IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 PRIOR TO COMMENCING WORK ON SITE. 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WEI. AS SITE CONDITIONS PRIOR TO COMMENCING 'WORK ON SITE. AN VAR- 3HT TO THE ATTENTION OF THE DESIGN ENG!' �7R 96 IS TO BE BROUGHT IMMEDIATELY. FLOOD ZONE _�_190 Ltll 1 C 8. PARCEL IS IN NE WOOD SHED 9. LOT IS SHOWN ON ASSESSORS MAP AS PARCEL ro ef, REMO 1 10. EXISTING SEPTICS ARE TO BE PUMPED AND BACKFILLED. IAI 11. tNTCRIOR PIPING 15 TO BE REPLUMBED 'TO EXIT AS SHOWN. LIWEYLINO 12. ALL UNSUITABLE MATERIAL IS TO BE REMOVED FROM UNDER _1� 1�. ED 8/r-DRI VE' A MINIMUM OF 5' AROUND SOIL ABSORPTION SYSTEM AND BE R�J L 2 �MTH SAND AS SPECIFIED IN 310 CMR 15,255 (3) 3. ALL DISTURBED AREAS ARE TO BE REVEGETAT &17 t HS4 3/,r-DRI VE '7 7 1500 fGALLL*l SE .77C TA VK 6 _71 -ONE PA/70 ID. 8ox 5, IrS 7' 1 i AfEA 7rR _ _..__ \ y sulk T 2 PROPOSED POOL F1 r R 8ACKWUH 22 $10A JO.00 L 1AP or r 5' 0 VERDIG y FLEV. I A 5 r Q LIM'T WORK A Y13AL-E Alo PRC\./P,- D: BOARD OF HEALTH, DATE A 6 E NJ T^ PROPOSED SEPTIC DESIGN Q AI STR TH, PE'fER AND JANINE DALLOW EET OL "CATION _R vm/ PROJECT-LOCATION__—_. LOT 8 45 HORNBEAM LAN,- BARNST nT co Locus s ENGINAWRVVG 23- G RE AT WE77ERN ROAD B l, P. C' 7 13 3vw CENIFRALLE I "'. BOX 528 SO(JITH DDINNIS, MASS'. [35 �8 3 2 2 02 DATE SCALE AN. 12, 2no,3 000 r. J09 NO REVISED APR. 28, 2003 5582-00_1111 S MAP HEET I OF 1 LOCATION )6. SU_m,,P c V2!)C,3 ETS P E ED, ENGINE J R. SOIL TEST BENCH 24 FT, MINIMUM FROM CELLAR DATE OF SOIL TEST DEC-12`2002 _T P 10,390 ! TOP OF FnI Ir!DA T;ON SOIL TEST DONE BY SwEETSER_ENGINEERINC I ELEV. = 29.00'_ 10 FT. MINIMUM 10 FT. MINIMUM' FROV SLAB OR CRAWL SPACE CLEAN SAND WITNESSED BY _tZ�TA�ITgN_-_---__-_ i (N.G.V.D.) \ CONCRETE 09SMfAlION HOLE 1 ELEV.-__22:80_ OBSERVAj)ON HOLE 2 ELEV.� 26_.30_ COVERS - INSPECTION PORT 5 _Y INCHES PERCOLATION RATE ___<__2__ MIN. INCH IN C HORIZON 4" SCHEDULE 40 PVC PIPE -LOAM AND SEED PERCOLA,ION RATE _<_Z__ MIN./INCH AT -__9 / -"- MIN. PITCH 1/8" PER FT. 2" LAYER OF DEPTH HORIZ TEXTURE COLOR MOTT. OTHER I DEPTH HORIZ TEXTURE- COLOR MOTT, OTHER ---- X�l ,/8" TO 1/2" �� 0-7 A SANDY LOAM 10YR2/2 0-10 O/A SANDY LOAM 10YR2/2 M X, 24.50 MAX. ASHED STONE I VENT � 5,00 1 4" CAST IRON PIPE 22.25 MIN. NOT REQUIRED 7_22 B LOAMY SAND 10YR5/6 10-30 B LOAMY SAND 10YR5/6 (OR EQUAL) MINIMUM r - PITCH 'j 4" PER FT. �� I Z 22-120 C MEDIUM SAND 10YR6/4 0-1321 C MEDIUM SANG t0YR6/4 - FLOW LINE --- 21.50 _ L 10" l i E Ev. _ _24.00_ -TMIN _ 2 0 J LEV. a 21J0 c LEVEL o '� yR `a I o 7 ELEV. _ 20.42_ ELEV. = 21.95 -'' GAS, _ _ s� A �_� - ------ ELEV. _ _�1.60_ 6" BUMF ELEV. _ _21.43_ eAFF E DISTRIBUTION ELEV. _ LIQUID OUTLET 11 STANDARD INFILTRATORS ` lTH �- Tc �-- �` BOX (H-20) _,��,9Q_ STONE IN A - - -� (TO BE PLACED ON ?M BASF) Z L 5. 4 FEET 14 INCHES ' TO BE WATER TESTED �. � T 30' X 0' X T FIELD FORMATION � 5'12 NO WATER ENCOUNTERED AT 1?0= ELEV. _ __aZ,p�O NO WATER ENCOUNTERED AT __],�"_ ELEV. _ j�yly 5 FEE., 19 INCHES IF MORE THAN ONE OUTLET __ ____-__, •.�5 5 FEE' 24 INCHES 1500 GAL . .ON �T ', �'S 7 FEET 29 INCHES D•� (TO BE PLACED ON FIRM BASE) SOIL ABSORPTION WELL N/A `B�'1K-- �41/II' 8FEET 34 ,NCHES J SEPTIC IC T� NK ZONE - - - -- !H-<0� 3/4" TO 1 1/2" CLEAN - "YSTEI<A (SAS} INDEX r��• DOUBLE WASHED STONE_ ADJUST LEGEND: DESIGN CALCULATIONS FREE OF FINES Ac SILT µ _ EXISTING SPOT ELEVATION 00x0 NUMBER OF BEDROOMS USGS PROBABLE WATER TABLE ELEV. _ __--__ EXISTING CONTOUR - --00---- GARBAGE DISPOSAL UNI' z SEWAGE DISPOSAL SYSTEM PROFILE OBSERVED WATER TABLE ( / / ) ELEV. = __ FINAL SPOT ELEVATION TOTAL ESTIMATED FLOW BOTTOM OF TEST HOLE ELEV. _ FINAL CONTOUR �r--- ( 110 rAl/8R./bAY X 9R.) `f� GAL./DAY a Q REQUIRED SEPTIC TANK CAPACITYr � ,_. GAL. -_ -I � \,` �&\ 3vyy SOIL TEST LOCATION � ACTUAL SIZE OF SEPTIC TANK ��• GAL. A� 6 �$.� \ y TOWN WATER �W�w SOIL CLASSIFICATION j UTILITY POLE �- -r- -- -3- , ?T g - 8.5Q DESIGN PERCOLATION RATE S_}��_ MIN. N. 8-6 \ CATCH BASIN ` GAS LINE GG� 1 EFFLUENT LOADING RATE 3- GAL./DAY/S.F' 5 P C. LEACHING G SO. FT. a • 8.i 8 c� �� CLEAN OUT AREA CESSPOOL C.P. 30 X ZO LEACHING CAPACITY (AREA X RATE) f�y0 GAL./DAY '` �j1.. ,\ ,� RESERVE LEACHING 749jV CAPACITY o GAL,/DAY BVW NOTES: L D U \ 1 ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO O.E.P. F \ ? ' TITLE 5 AND THE TOWN'S RULES AND REGOL.ATIONS FOR !� pp �n c THE SUBSURFACE DISPOSAL OF SEWAGE. u' 5�J J 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO \ \ • j k - - - - -- _ _- �, \ \, WITHIN 6" OF FINISHED GRADE. .- g L3 2 ` \ \ \ 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF i ? . / - <,..- 9.1 ` `ti WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS, H-20 LOADING SHALL BE USED UNDER OR WITHIN 10 FT, OF DRIVES OR PARKING AREAS. = ` 4. ANY MAS014RY UNITS USED TO BRING COVERS TO GRADE SHALL BE MORTARED IN PLACE. AL \ SHED - Q^� 20.'n \ Bvw 5. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH 1011 DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY, 26 3 \ \ 6. UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR Cy yL d IS TO CALL "DIG-SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE. `.0.0 4 7. CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. ANY VARIATION IS TO BE BROUGHT TO THE ATTENTION OF THE DESIGN ENGINEER k/ �. WOOD SHED X 8 7 IMMEDIATELY 8. PARCEL IS IN FLOOD ZONE A10(El..it). B. It C EX!SnNG ;C; I(TO BE REMO i7J I 1 9. LOT IS SHOWN ON ASSESSORS MAP _Z�_ AS PARCEL S6__� `- a 111 fit'` 10. EXISTING SEPTICS ARE TO BE PUMPED AND BACKFILLED. • \` DWELLING �` 11. INTERIOR PIPING IS TO BE REPLUMBED TO EXIT AS SHOWN. �- W • Blr Dd?/vE !�► BEDROOMS \ 12. ALL UNSUITABLE MATERIAL IS TO BE REMOVED FROM UNDER AND FOR A MINIMUM OF 5' AROUND SOIL ABSORPTION SYSTEM AND BE REPLACED 'NN - __4 _ cam:: WITH SAND AS SPECIFIED IN 310 CMR 15.255:(3). 13. ALL DISTURBED AREAS ARE TO BE REVEGETATED. 8.1T' ;`t- 0 14, VARIANCES TO BARNSTABLE REGULATIONS: I - µ A. ALL SEWAGE DISPOSAL COMPONENTS LESS THAN 100' FROM f ; RES£pl� I 2d 66' 1 tom" WATER BODY (COASTAL. BANK).ORAI AiFP 4 / 71T-DRIVE' ; Y 4 c �.W HSE lEf� 28. - 1500 GALLON - - ,SEP77C TANK s 770 STOW' PA 6 - �..x., 1£51' t1 __. NEATER ST PROPOSED POOL f/LT'ER 6 I r 1 ?0 A'� / :IA�I \BACKAIINSH 22 w, _ OBI �.�. J��* T. tt, K LrMrr� J, �� Ill. v A. �. - v s 41 � No. 619 op APPROVED: BOARD OF HEA!TH i 7.6 F. / iSyw. ` / / i VJ / i SA • t 2 i DATE AGENT 5.5 ---- -- x PROPOSED SEPTIC DESIGN / 'SHED f STREET FOR j S PETER AND JANINE DALLOW � PROJECT LOCATION ` ----- _----- LOT 8 45 HORNBEAM LN, BAR]NSTABLE N , = LOCUS -----___ -- _---_ - - , � P, S . E'?`S'ER ENG�IV ER M Bvw 19V M �tip, GREAT C'ST OX 7R3 ROAD ,p1 "a`1D c£v1ERI�L[E � `'08- SOUTH DENNIS, MASS. Rim 98-3922 02C6C� � EEL �__ _ ,-�;�� �.� DATE BAN. 12, 200� SCALE _-L0, n q� �"01 VD R� _�..... _.._,. _. \ REVISED �^ 1 J09 N0. - ---- I -APR. 28, 2003 , 5582- 00 - ,�lAy lot 0005- LOCATION .,/1AP I REVISEDAPR. 1, 2005 1 i SHEET 1 OF 1 -� f - -- - -- - - - ----_-L- C' ',56�P R0,/-\55B2---OU - - w �DO. ; 2003 Sr.tET5E--? -- _nGINEERINp