Loading...
HomeMy WebLinkAbout0016 JUNIPER ROAD - Health 16 Juniper Road, Centerville llll ® �T UPC 12534 No.2�153LOR q � NASTINGNs MN V No. Fee k4� HE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes , PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS \ 2ppYication for bisposat *pstem Construction Permit Application for a Permit to Construct( ) Repair(ds Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. I G YVn� Al� Owner's Name,Address,and Tel.No. 91)9/VA Assessor's Map/Parcel a p �,1, -6i A 0 ac.3a Installer's Name Address,and el No. ,�'O �0�r .3 19 ssiggner's Name,Address,and Tel.No. & '36 QOr' 6.Q.��4-r am �r c �2�0 � iL - G'ccgge P^,1 n�c�a°'',�O.9-3-F Sa/>:) Type of Building: //�� Dwelling No.of Bedrooms Lot Size -�IyuLa,1j sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Q Design Flow(min.required) (j,j 0 gpd Design flow provided / gpd Plan Date Number of sheets Revision Date Title O [l�dJU Size of Septic Tank e (I S ° c : .&• Type of S.A.S. c�- 0,t Description of Soil Nature of Repairs or Alterations(Answer when applicable) _ J4r,6,6t) -sz)o r w, t c5 i `'U.� Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental a and not place the system in operation until a Certificate of Compliance has been issued by this Board of Health. i e Date cv Application Approved by Date Application Disapproved b Date for the following reasons .-� w rr Permit No. Date Issued 0 n. . No. / Fee Vs ! HE COMMONWEALTH OIF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OAF ARNSTABLE, MASSACHUSETTS 01ppliLation for Vsposal .p`strm Construction 3permit Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ®'Individual Components Location Address or Lot No Owner's Name,Address,and Tel.No. .�h� I17 •/knot 1k Sep=G.' S�cz 16 3"vniP"Pj• Assessor's Map/Parcel �y U a Installer's Name,Address,and Tel.No. j�j�-'��/ -�j 3%�j Designer's Name,Ad ress,and Tel.No. 6Z) 34r, C�l,Gd e",rs c �' CtaYo Type of Building: Dwelling No.of Bedrooms ,Za �qq I g � Lot Size � I'}C�tld1J sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers i YP g ( Cafeteria( ) Other Fixtures Design Flow(min.required) �j `'j gpd Design flow provided g gpd Plan Date, ,)r.o 1 3012 Number of sheets / Revision Date j Title T�;�1� � ��� CZ4® R. J Size of Septic Tank �' j s� ,e. Vk'%C)q rc Type of S.A.S. a - S 4) lq. AA JWW� X_o Description of Soil p� Q p DE R sa i Nature of Repairs or.Alterations(Answer when applicable) r - ,l j . Date last inspected: -r' Agreement: y. The undersigned agrees to ensure the construction and maintenance of the afore described on-si a ewage dispo4al system in accordance with the provisions of Title 5 of the Environmental Code—and not t place the'system in operation until a Certificate of Compliance has been issued by this Board of Health. i :ne / M n Date 30 eL i Application Approved by ' ,f Date Application Disapproved b . Date for the following reasons Permit No. Date Issued -------- '......._--------------- ti THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certifitate of Compliance THIS IS TO/CERTIFY, IIthat the On-site Sewage Disposal system Const cted( ) Repaired( Upgraded( ) Abandoned( )by 11l+'- !�' � at �� S�(���o�i— At rj �io �)�I'�P has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N . ated Installer 3 �/1('Ta�r�fC ,�� ,yr 1�� Designer #bedrooms Approved design flow gpd The issuance of this permit shall no be c strued as a guarantee that the system will(�nctio as-de '. Id Date Inspector \ t - - ----------------------------------------------------------- --------- --- No, F '.� �/ � Fee j"-'THE COMMONWEALTH OF MASSACHUSETTS r1> PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ' V MiBtlD$at *pstertt Construction 3pertnit II Permission is hereby granted to Construct( ) Repair(✓'� Upgrade( ) Abandon( ) 'i System located at � �6,1,�;a n d. p.[� FBI j be and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Co structiO must be completed within three years of the date of this permit. Date Approved by t/ r JUL-11-2012 09:58 From:BORTOLOTTI CONST 5084289399 To:15087906304 P. 1r1 FROM :dgwn cape engin=ring Inc FAX NO. :15083629880 Jul. 11 2012 09:24AM P1 +�3k°d.a7D� rv8 r�S1vJ 10 \•A a�,xrar<rrn a era, �F �'1��T�8i' J�1t:f�Q1t119 �'4"iTAAId.?EfJ. w:;�p`.�sa,. y'Ionr�,illa R9tat�4.,r,�n,a,TLtsE',c�4e�r 2ti0 lV�im� trerrl.E Oy►�, ,AJA 40-7 0 T�u�ai:Eltfl+s r yp�ailr�,nr.�r d • .. ���irrow �'uu.r�t ;>t�sit�: 7_ l �+c�a, �k'�:m.anr'.>t ?..UI�' Z��3 Sn�aa��a ova' E A4aii\,V:%rr..c1-7.1d /Z.V r Destper: A dfA9'e5y: � 1p,�6 11 P wLt-,), wt�;;i.ss'uc�ci a wss�l to lusts f 1,a \lntd'LEi L'�1) i ;irutir,gy:,1C17;.1 fit�t� V._Id.rJ��. � _ 101 based o:n a deal r,.drawa by (BIgfI r.r9s) ty vvris L-Imalled SkAbstr�fltial ly em-'urrli:t F, tip � a�sl,ti "I:�ta�1 the sr,�iir.; sy;�i��:u,a. tefcrei�ceci ibuv4, E:ie t1t�i�',�, whIL-1 M.RV inUILA, w: Qt a#y,�xmved uiimps much EEC 311�;xal rp(ocatim o lim a?istribilim I box rind/cyr snTAir.tpmk. I amtify Clil+t tha seply, sys't'e►'n rcLc:zt c.r rl R1.1nve w�ta ixutal;lr", )A411 n'1ktju1 .htlagem (if-. q. �'yrmter i'I wi 101 1RUIXA1 Pefoodism of thu,,AS or an'y wrlieal, reltl+:It.dm of at�y cnnipunapt, of,thM;iglb, syAtem)bat iu.:�ccc?^elEu.�+ witli Sv to r� Txu il.Renoilp.6o .4, Plait ievisiOn 4_ +trc'ti I,yrl.a�a- y dt;ii n.ci to follow. 1H ON+Its_ DANIELA, �S17r'�El1XFJ"r l(rl�itl6Ur'•� OJVIIL rn No.48502 � • Al. i n• I1F1�1„T ,l�l:'ril 1(CU,'3 a'i'111T-I'1 TTLTO , cdkNr '�Gt,r-� a� ' PyA� ,1C .✓' !1, b'Iw ip�, Er^;�atty 41 :reaT . i " rnM1x rm;IrIl: F AS BT)U; ' t A . Ar, n j F,CMF,a 4LLTM Tijj _l.rwr TIPU. Departznwt of Regulatory Sea-vices Public Health Division Date ' � unw+arnat.e, 4 r5 �� 200 Main Street, Hyanuis MA 02601 9 � Date Scheduled / Time ]fee Pd. l��` Boat Suitability Assessmeritfor Sewage Disposal Performed By: 1Yilnessed By: ILOCATION & GENE,RA , I[NJ[+ORIVUTION Location Address ` fi /�, Owner's Name Address Assessor's Map/Parcel: 'Q/0 aO ` cn m giucer's Name 0 NEW CONSTRUCTION REPAIR Telephone if Cis(7Q,' U�land Use Slopes(%)0 —274 Surface Shines - Distance's from: Open Water Body 11 Possible Wet Arep ft Drinking Water Well �ft Drainage Way ft Properly l-lne fl Other "'" ft S E TCH' (Street name,dimensions of lot,exact locations of lest Doles&perc lesls,locale wm1wids'1n prwlinuly to Boles) �11Aq W 0 0 Parent material(geologic)_e�f� "° epLh LQ Btgl oocck ✓ G� Depth to Groundwater. Standing Water in Flole: �� Weeping lion] Pit Fftpe Estimated Seasonal High Groundwater D ET ERI14[I�TATION FOR SEASONAL HIGH GJ(-3[ WA 71 E, ABLE E McLhod used: Depth Observed standing in obs.(role: ItA. Depth to sQll IT19ll1C,y; Dcplh to weeping from side of obs.hole: Ill, OYouiidWnter Adf uslment..e —.,e......_Pt. index Well f# Reading Date: Index Well leYa Ad,J,f.lCtol' Aa�,CJPpundwueer 1vul R _ IPERCOLATION T E ST plate. A'Lu10 W&1 Observation `— Hole ft Thm,tit 9" W Depth of Perc �_ 1'lu'Ip at 6" _ v 5latt Pre-soak Time @ 0' ►G _ Time:(9"-6") End Prc-soak M Ralc Min./lncll G 71 Sllc Sujlablllty Assessment: Site Pessrd_ Silg-Failed: _ Additional Testing Necded(Y/N) Original: Public Flealth Division Observation Mote Data To Be Completed on Back----- - -- *"If ped'colaticla test is to be conducted vv thin 100' Of weltlaad, YOU 111UYSlt firsit Ucifify the .YYiirnstablc Conservation Divisio 1 at least one (1) week prior to begD.kwhtUg. . Q:\S EPTIC\PER CF-OREt4.DOC t Depth rrn frontSoil1'forzan ,S urfa Mole # / ce(in.) Soil Texture Sail ColorF-TOLE LOG -----f-- (USDA Soil• (Munsell] Mottling 0lher (5tructu re,Stones;Poulders, Con istarlc °a ravel -2N-e � /0 Y/Z � 44 Depth from O-REER VATION HOLE uL O G Soil Horizon Soil Texture Rule ��. Surface(in,) Soil Color _ (USDA) Soil �^ ) (Munsell) Mottling (Rructurc OtiStones0014 , ioulders. Consisren^ o Oravej 647 L IDl1EI P OBSE R 1VA7I ION ITOL C LOG fJepth tram Soil P-Iorizon ][�0➢� Surface(in), Soil TCBtnrO (USDA) Soil Color Soil (Munsell) Other — Mottling (,!structure,Stones, lculders. Consistency qp p�-,veil _r7� � innm Depth fi(an Soil,Horizon �'®� Hole Surface(in.) Soil Texture Sail Color "-' 5011 Other — (USDA) •• (Munsell} Mottling (Structure,Stones' Boulders, Consistency%pr�P"�� EI1116dl Insurance][date Map. Above 500 year flood boundary No Ycs Within 500 yenr boundary No -- Yes Within 100 year flood boundary No� Yp5�y ]�1e ➢��l I�rDtan>c�iB�—�cusr�_�n�1���va�otss 1VflaterW Floes it least four feet of naturally occurring pervious matet•ial exist in all areas Observed thl'oughout the ar-ecu proposed for the soil absorption system? If not, what is the depth of naturally occurring lervious matol'161' ._ �el['tll1FH��it>i0pll . A cer'ti;fy that art (date)I have passed the soil evaluator examination approved by the Department1102 reied of Envg, expertise ta1.1'rotection and thfit the above a•nalysjs was performed by me consistent with 9Pie required training, expertise and experience described in 310 CItdR 15.n17- signature �� Date Q!1S,VPTI'CU'ERCC0 RM.DOC RPEZ"EP LANE. .. N , , Y + - _. O T "-Z lK Q ` ,r 6 2� - LOT G 3 L o 7- 6 -:;4' I It ' f RICHAF.D y' � JAMS u RICHAftC1, G •+ /: J JAMES r� . 2i8TI4O r V No.6 1 94 ,< . 1 / /ST GISTEED CEPtIFIED PLOT LAlr1 IN lEg /\ 7;,- AlrC f= AlA ss. -- / .T GEf;'T!F-Y TILIAT THE RICf-HARD cJ. OWEARAJ, R L.S., R. S. S140WAI ON THIS PLA/V IS LOCATED 19/ MAIN ST. (R TE. 28) UN -rHE taRO UND A S. INDICATE AND WEST DENNI S , MASS . CONFORMS TO THE ZONING LAWS DAT SCALE., JOB �/O. CL/1'NT. °' Commonwealth of Massachusetts ' Executive Office of Enviroiunental Affairs Dept. of Environmental Protection One winter Street, Boston,Ma. 02108 Jolui GradD.E.P. Title V Septic Inspector Y P.O 119 t ` t, A 02536 WILLIAM F.WELD �� "UX) 564-6813 Governor ARGEO PAUL CELLUCCI Q ` Lt.Governor '~ S'cp SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO l 2 9 PART A CERTIFICATION TO4Of 199T y�lTti FPITAeIE Property Address: 16 Juniper Rd.Centerville Lot 51 Address of Owner: `y Date of Inspection:9/22/97 (If different) Name of Inspector:John Graci Joy&Jeff Slater ` 9 1 am a DEP approved system inspector pursuant to Section 15.340 of Title%(310 CMR 15.000) Company Name,Address and Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: X_ Passes This inspection is based on criteria defined in Title V Conditionally Pa ses code 310 CMR 15.303.My findings are of how the system is — Needs Fu er valuation By the Local Approving Authority performing at the time of the inspection.My inspection does not imply any warranty or guarantee of the longevity of the Falls septic system and any of its components useful life. i Inspector's Signature: Date: 9/23197 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. 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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: 1 Check A, B.C, or D: A] SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system, upon completion of the replacement or repair,passes inspection. Indicate yes, no,or not determined(Y, N,or ND). Describe basis of determination in all instances. If "not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank.was installed within twenty(20)years prior to the date of the inspection; or the septic tank,whether or not metal, is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 0427197) One Winter Street 9 Boston,Massachusetts 02108 • FAX(617)556-1049 9 Telephone(617)292-5500 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 16 Juniper Rd.Centerville Lot 51 Owner: Joy&Jeff Slater Date of Inspection:9122/97 — Sewaae backup or.breakout.or. hiahstatic water level observed.in.the distrihution box is due to a broken. or obstructed pipe(s)or due to broken, settled or uneven distribution box.The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced —The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed Cl 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER, IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: — The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. — The system has a septic tank and soil absorption system and is within a Zone 1 of a public watersupp►y well. — The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. — The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presense of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method usedto determine distance (approximation not valid) 3)Other D] SYSTEM FAILS: You must Indicate either"Yes"or"No"as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No _ — Backup of sewage in facility or system component due to an overloaded or clogged SAS or cesspool. — Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged cesspool. SAS is in hydraulic failure. (revised Q4127/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 16 Juniper Rd.Centerville Lot 51 Owner: Joy&Jeff Slater Date of Inspection:9122197 D] SYSTEM FAILS(continued) Yes No 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 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or,privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area (IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 064127197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CH ECLIST Property Address: 16 Juniper Rd.Centerville Lot 51 Owner: Joy&Jeff Slater Date of Inspection:9l22/97 Check if the following have been done:YOU must indicate either"Yes"or"No"as to each of the following: _X_ — Pumping information was requested of the owner,occupant, and Board of Health, x None of the system components have been pumped for at least two weeks and the and the system has been receiving normal — flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined. Note if they are not available with NIA. X — The facility or dwelling was inspected for signs of sewage back-up. x — The system does not receive non-sanitary or industrial waste flow. _X_ — The site was inspected for signs of breakout. x All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened, and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge, depth of scum. X _ The size and location of the Soil Absorption System on the site has been determined based on The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal Systens. X Existing information. Ex. Plan at B.O.H. x Determined in the field(if any failure criteria related to Part C is at issue, approximation of distance is unacceptable)115.302(3)(b)j (revised 04127/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 16 Juniper Rd.Centerville Lot 51 Owner: Joy&Jeff Slater Date of Inspection:9122/97 FLOW CONDITIONS RESIDENTIAL: Design flow: 440 g•p•d./bedroom for S.A.S. Number of bedrooms. 4 Number of current residents: 4 Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No Water meter readings, if available:(last two(2)year usage(gpd): n/a Sump Pump(yes or no): No Last date of occupancy: n/a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow:0 gallons/day 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: n/a OTHER: (Describe) n/a Last date of occupancy: GENERAL INFORMATION, PUMPING RECORDS and source of information: r System was last pumped 3 months ago by Ace System pumped as part of inspection:(yes or no)No If yes,volume pumped: 0 gallons Reason for pumping: n/a TYPE OF SYSTEM X Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) ( if yes, attach previous inspection records,if any) I/A Technology etc. Copy of up to date contract? Other: APPROXIMATE AGE of all components,date installed(if known)and source information: 1977 Sewage odors detected when arriving at the site: (yes or no) No (revised 04/27/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 Juniper Rd.Centerville Lot 51 Owner: Joy&Jeff Slater Date of Inspection:9/22/97 SEPTIC TANK: x (locate on site plan) Depth below grade: 1' Material of construction:x concreate metal FRP Polyethylene_other(explain) If tank is metal, list age o . Is age confirmed by Certificate of Compliance No (Yes/No) Dimensions: L B'6'H 5'7'W 4'10' Sludge depth:1" Distance from top of sludge to bottom of outlet tee or baffle: 26" Scum thickness:0 Distance from top of scum to top of outlet tee or baffle:6" Distance form bottom of scum to bottom of outlet tee or baffle: 0 How dimensions were determined: Measured Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) Septic tank and all components are structurally sound.Recommend pumping system every year for maintenance. GREASE TRAP: (locate on site plan) Depth below grade: n/a Material of construction: _concrete_metal_FRP_Polyethylene_other(explain) 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 pumpingnia Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) n/a BUILDING SEWER: (Locate on site plan) Depth below grade: 1'6" Material of construction:_cast iron x 40 PVC_other(explain) Distance from private water supply well or suction linOown Diameter: 4' (n/amments: (conditions of joints,venting, evidence of leakage,etc.) (revised 04127/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 Juniper Rd.Centerville Lot 51 Owner: Joy&Jeff Slater Date of Inspection:9/22/97 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_FRP_Polyethylene_other(explain) Dimensions: n/a ` Capacity: n/a gallons Design flow: n/a gallons/day Alarm level:—n/a Alarm in working order?_Yes No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches, etc.) n/a DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: n/a Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box etc.) n/a PUMP CHAMBER: r (locate on site plan) Pumps in working order:(yes or no)No Alarms in working order(yes or no)_yes Comments: (note condition of pump chamber, condition of pumps and appurtenances. etc.) n/a (revised 04127/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 16 Juniper Rd.Centerville Lot 51 Owner: Jay&Jeff Slater Date of Inspection:9122/97 SOIL ABSORPTION SYSTEM (SAS):X (locate on site plan,if possible: excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: n/a Type: leaching pits,number: 1,000 gallon leach pit leaching chambers,number:n/a leaching galleries,number: n/a leaching trenches,number, length: n/a leaching fields, number, dimensions:n1a overflow cesspool, number:n/a Alternate system: n1a Name of Technology:_n/a Comments:(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.) The leach pit is structurally sound and functioning property.It had 3'3'of water in it Shows signs of being 314 full CESSPOOLS: (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert: n1a Depth of solids layer: n/a Depth of scum layer: n1a Dimensions of cesspool: n1a Materials of construction: n/a Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection) n/a 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 (revised 04127/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 16 Juniper Rd.Centerville Lot 51 Joy&Jerf Slater 922/97 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references, landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) 41 (revised 0427/97) page ! of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 16 Juniper Rd.Centerville Lot 51 Joy&Jeff Slater 9f22/97 Depth of groundwater 12, Please indicate all the methods used to determine High Groundwater Elevation: Obtained from design plans on record. Observation of Site(Abutting property,observation hole, basement sump etc.) Determine it from local conditions Check with local Board of Health Check FEMA Maps Check pumping records Check local excavators, installers x Use USGS Data Describe in your own words how you established the High Groundwater Elevation.(MUST be completed) USGS Maps and Charts (revised 0427197) tray 10 of 10 LO,C AT ION SEWAGE PERMIT NO. Ju nl a4,,E VILLAGE C1y�er vi��t 1NSTA LLER'S NAME & ADDRESS .1 BUILDER OR OWNER �i.7f 3 61no _ DATE PERMIT ISSUED _ �2, '27 D A T E COMPLIANCE ISSUED 77 P. p 1-�-'-- �` ---�� TOWN OF BARNSTABLE LOCATION io6 `11>cz k SEWAGE# -.�QIJV- ).f3 VILLAGE���-p. j 1WLLLG ASSESSOR'S MAP&PARCEL j,-�o INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 4 °i f ter /,oce� "J.0 ( �® LEACHING FACILITY:(type) (size),k�NO.OF BEDROOMS OWNER Ar n PERMIT DATE: Jjt- 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) P4 Feet FURNISHED BY� ✓ G t,�t �Mt'/'-��-v.+r �rAr e t_ a 7'-20 6+-0" 61-by 61-b' 8i_On 71_D" I _ 2. 2 BATH / 2E LAUNDRY � z < _ GARAGE - - ., 2A O G I JJJ V U A II`11GR61 —— _PLUMBING'CHASE KITCHEN �I I 2Q I hI1 WJI 4 �dli 2� in FAi IL REF. -------- , f a1 v— ,l, V. 1��'+„^111 F✓'}M1 fI Yt7�t1�W]' �^ 1 i { , �I n REMOVE HALLS 24i 1 24i2446 I ABove ARM-i ' V's N i ININ ❑ W U Z UP mm fx T-4" i T-4" 3'-e" NOTE, 4 WINDOW DESIGNATIONS ARE 24'-O' ANDERSEN WINDOWS. CONTRAC70R SHALL VERIFY LOCATIONS 4 DIMENSIONS PRIOR TO WINDOW ORDER 4 INSTALLATION FIRST FLOOR PLAN 5GALE, 114" 11-0" NEW WALL REMOVED HALL C--------3 SHEET . - 3 EXI5TIN4 WALL AB gDA7t=2/18/07 0207 WN BY+ KW T + .I ® I tl_ Li i BATH — Q Jrol l 5 / v < L LLX ALEX'5 ROOM HALL 5NANNON'5 ROOM o ON rp -------------- __J L_--__ J L---------- _ = BEDROOM a? . 2446 2446 — 2444 LLI to 2i_pn 4�—pn 4'—On Bi_pn 4i—of Bi_p. 41—pn --- — .pe— —-- Q 0. J WINDOW DESIGNAT045 ARE ANDERSEN WINDOWS. CONTRACTOR SHALL VERIFY LOCATIONS ♦ DIMENSIONS PRIOR TO WINDOW ORDER t INSTALLATION SWEET SECOND: FLOOR PLAN NEW WALL SCALE: I/4" 9 V—O" A4 n REMOVED WALLC___--___7 J0a, 02C EXISTING WALL© DRAWN 6Y, Kt* i DATES 2/i0. ALL SHALL TE SYSTEM PROFILE MARK DS WITHC MAGNETIC TTAPE OR BE PROVIDE MIN. 20" DIAM WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. 1. DATUM IS APPROX. NGVD \_0 6�00t ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE i \ TOP FOUND. EL. XX.X' FILTER FABRIC OVER STONE 2. MUNICIPAL WATER IS EXISTING o L ocu 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 47.0' - 48.0' Wequaquet 4. DESIGN LOADING FOR ALL PROPOSED PRECAST PRECA ST BLOCKS OR UNITS TO BE AASHO H-10 Lair RISERS PRECAST RISERS 47.0 4"OSCH40 PVC MORTAR ALL H-10 • PIPES LEVEL 1ST 2' �4, COMPONENT(TYPS) 3' 4, 5. PIPE JOINTS TO BE MADE WATERTIGHT.SIDES 36'ENDS GAL H-10 14' • P _ _ o 0 0 0 o WITH 310 CMR 15 000 (TITLE ) IN ACCORDANCE ego E P Heys 45. 6. CONSTRUCTION DETAILS TO BE ` TEE SEPTIC TANK TEE °°°°°°°°r o 0 0 0 0 0 0 o o 0 0 0 TI 5. *45.6t ��� (]FOCI �(��0 O �0��6" MIN. SUMP ° ° ° ° ElEnrlooao 0000�oaaoao ° ° ° °° ° ° ° ° ° 7. THIS PLAN IS FOR PROPOSED WORK ONLYAND°° °°°°°°°°° ° °° NOT TO BE USED FOR LOT LINE STAKING OR ANY Lo GAS BAFFLE::; °°(°,°�°,.1 - 12" MIN INT. DIM. c i ;00000000 � � � � � o � � � o 0 0 0 0 0 0 0 0 0 4' LIQ. LEVEL (ACME OR EQUAL) 44.80' 44.63' °o°o° °0 42.53 OTHER PURPOSE. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. Rd' I `H-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. Old Pas ALL AR AROUND DOUBLE WASHED STONE 4' MIN. (2) UNITS REQUIRED 9. COMPONENTS NOT TO BE BACKFILLED OR o ALL AROUND PRECAST STRUCTURES CONCEALED WITHOUT INSPECTION BY BOARD OF 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE:-25 X 12.83 HEALTH AND PERMISSION OBTAINED FROM BOARD COMPACTION. (15.221 [2]) 6.03 OF HEALTH. ( 1 % SLOPE) ( 1 % SLOPE) 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING DIGSAFE (1-888-344-7233) AND LEACHING VERIFYING THE LOCATION OF ALL UNDERGROUND & LOCUS MAP A FOUNDATION- 10' SEPTIC TANK 40' D' BOX 12' 36.5' BOTTOM TH-1 FACILITY NO GROUNDWATER FOUND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. NOT TO SCALE *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 210 PARCEL 120 PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON H-10 SEPTIC TANK IF NOT SUITABLE. SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED OR PUMPED AND FILLED WITH CLEAN LEGEND SAND. 99- EXISTING CONTOUR X 99•1 EXIST. SPOT ELEV. 99 PROPOSED CONTOUR 198.41 PROPOSED SPOT EL. ' TH, SYSTEM DESIGN: TEST HOLE ,�/� \ GARBAGE DISPOSER IS NOT ALLOWED 2!-- SLOPE OF GROUND ,�,�/ ���3.78 UTILITY POLE0.00/ ��'y DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD ate/ sTONE' USE A 330 GPD DESIGN FLOW � FIRE HYDRANT � tiYo SEPTIC TANK: 330 GPD (2) = 660 NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING **RE-USE EXISTING 1000 GAL. SEPTIC TANK TEST HOLE LOGS °� PAVED _ LEACHING: DRIVE/ OQ' / \ SIDES: 2 (25 + 12.83) 2 (.74) = 112 GPD ENGINEER: ARNE H. OJALA, PE, SE �' °� / xs0 BOTTOM 25 x 12.83 (.74) = 237 GPD WITNESS: DON DESMARAIS, RS / \ TOTAL: 472 S.F. 349 GPD Q� o' DATE: JUNE 14, 2012 \� o / £ IN /l TH '�� \ USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) PERC. RATE _ < 2 MIN/INCH , GARAGE { / �2 �� WITH 4' STONE ALL AROUND SLAB H 1 � \ CLASS I SOILS P# 13671 BENCHMARK COR BLKHD l/ EL.=48.5' ELEV. ELEV. c EXISTING {tr Olt 47.5' O" 4 47.5' \ DWELLING Olt TOP FNDN.A A EL. = 48.5' V OAK ON �\ STD gyp. MA 10YR 2/1 10YR 2/1 S L S L SLAB GAS \ �,'� ' _.OAK APPROVED DATE BOARD OF HEALTH 8" 899 METER 10 b Q B B ACED TITLE 5 SITE PLAN EXISTING LS LS 97 6 PATIO �b DWELLING OF 10YR 5/6 10YR 5/6 `� °� 24" 45.5' 24" 45.5' 16 JUNIPER ROAD 'Pjyj4" OAK CENTERVILLE 9 SHED C C PREPARED FOR PERC 10" OA BORTOLOTTI CONSTRUCTION/SLATER MCS MCS \ JUNE 18, 2012 2.5Y 6/6 2.5Y 6/6 ^��,� �,SH OF Mqs� off 508-362-4541 fax 508-362-9880 o DANIEL DANIELA. y�N N�, I downcape.com 0JALA a " A -+ �, o No..4098 `° down cope engineering, inc. CIVIL " 132 36.5 120 37.5 No. 02 civil engineers Scale: 1 = 20 F NG. �� u a f land surveyors NO GROUNDWATER ENCOUNTERED ���',Z ( NA- a 939 Main Street Rte 6A 2- 156 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 �,