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Home My WebLink About0357 LAKESIDE DRIVE WEST - Health .57 Lakeside Drive West Centerville P A = 232 050 04. !'fOrd. NO. 1521/3 ORA J� S � G1 l ur c9- G /5 f �sK�' NOTICE TO ABUTTERS The Barnstable Board of Health will hold a public meeting at the Town Hall, Hearing Room, 2nd floor, on Tuesday,January 13,2015 @ 3:00 PM to discuss the following Local Upgrade Approval and Local Variance Requests for the proposed septic repair project at 357 Lakeside Drive West, Centerville. This meeting replaces the December 9, 2014 meeting. Local Upirade Approval Requests 310 CMR 15.405(1)(b)—Reduction of system location setback to the cellar wall from the required 20 ft. to 10.0 ft. 310 CMR 15.405(1)(h)—Reduction in the separation between the bottom of the soil absorption system and the high groundwater elevation from the required 5 ft. to 4 ft. 310 CMR 15.405(1)(i)—Use of a sieve analysis where a percolation test could not be performed. 310 CMR 15.405(1)(k)—Reduction in the required amount of deep holes per disposal area from 2 holes to 1 hole. Local Variance Requests 360-1 Reduction in the required soil absorption system setback to a water body from the required 100 ft. to 51 ft. 360-1 Reduction in the required septic tank setback to a water body from the required 100 ft. to 72 ft. t a Town Barnstable ��,�� o Barnstable � Board of Health 'Ca j � r • IARNSTABLE, MARS 200 Main Street, Hyannis MA 02601 I 16S9. Fc MAI 2007 Office: 508-8624644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. JunichiSawayanagi Mr. Richard Grady, P.E. January 25, 2015 Grady Consulting, L.L.C. 71 Evergreem Street, Suite 1 Kingston, MA 02364 RE 351. Lakeside Drive,West,.Centerville = A . `232.,. -050. Dear Mr. Grady, You are granted multiple variances on behalf of your clients, Anna and Joseph Rogers, to construct an onsite sewage disposal system at 357 Lakeside Drive West, Centerville. The variances granted are as follows: 310 CMR 15. 405: To install the soil absorption system ten feet away from the foundation wall, in lieu of the minimum twenty feet separation distance required. 310 CMR 15. 405: To install the septic system four feet above the groundwater table, in lieu of the minimum five feet separation distance required. 310 CMR 15. 405: To utilize a sieve analysis where a percolation test could not be performed. 310 CMR 15. 405: To reduce the number of test holes per disposal area, from two holes to one. Section 360-1 of the Town of Barnstable Code: To install the soil absorption system 51 feet away from a vegetated wetland, in lieu of the minimum 100 feet separation distance required. Q:\WPFILES\GradyRogers357LakesideDriveWestVariances.doc Section 360-1 of the Town of Barnstable Code: To install the sepic tank 72 feet away from a wetland, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install the septic tank 31.5 feet away from a wetland, in lieu of the minimum 100 feet separation distance required. These variances are granted with the following conditions: (1) No more than four (4) bedrooms 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 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 septic system plans shall be revised to show a monolithic septic tank. (5) The designing engineer 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. These variances are granted because the proposed plan appears to meet the maximum feasible compliance design standards contained within the State Environm ntal Code, Title 5 and local Health Regulations. Sincerel yours, Wayn MilOr, M.D. Chairman Q:\WPFILES\GradyRogers357LakesideDriveWestVariances.doc - 7 IliE� DATE of r FEE: �. � SARNSrABLE,,p• � - 9�A ni63g �a;' REC. BY "`�'° Town of Barnstable SCHED. DATE: Board of Health 200 Main Street,Hyannis MA 02601 G- �(� Office: 508-862-4644 ne .Miller, FAX: 508-790-6304 Junichi Sawayanagi Q Paul J.Canniff,D.M.Iy <'® VARIANCE REQUEST FORM C` s LOCATION Property Address: 55 7 t4ld`$Ido- J`7�IJ� Assessor's Map and Parcel Number: ?i 2 Size of Lot: Wetlands Within 300 Ft. Yes Business Name: No Subdivision/Name: q APPLICANT'S NAME: �it�/rt ��Pf/�'y,t%(dtVtneQ ! ZltC Phone 7- Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME //AM��E�� } CONTACT PERSON /- / Name: ®'Titd2�=A tf J6--'-J "A L ��P,�S Name: � U��f�c-—"4.`ts Address: 3�.7 CS/ -eW43/ . C.t-'tj�/+�Z��M�Address: Q 7 ��VC/��s l B/ y� d-z6d/ Phone: g CV-3•y2g, 2-5 Phone: • yZ� �S S'�j VARIANCE FROM REGULATION(list Reg) REASON FOR VARIANCE(May attach if more space needed) f4-1-16TO Ch - �— RsJla a/C�+� IvKr� .� 5d4crt d- Ct t t r ` -4ku6 A!,,, ' 1-4 f L f S t % � arre G�c.rS�eswr p��r. %� �✓!e��t t NATURE OF WORK: House Addition ❑ House Renovation El Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit copies In 4 separate completed sets. Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BAS9P9B7\VARIREQ.DOC Page 1 of 1 Crocker, Sharon os-C From: Gary Wolcott[Gary@gradyconsulting.com] Sent: Tuesday, December 09, 2014 10:35 AM lX�� To: Crocker, Sharon �� Cc: Marianne O'Neill Subject: 357 Lakeside Drive West Sharon, Please continue the Board of Health meeting for 357 Lakeside Drive West till the next available date(January 13, 2015) so that we can notify abutters in the required amount of time. Thank You Gary Wolcott Grady Consulting LLC 71 Evergreen Street, Suite 1 Kingston,MA 02364 Phone: (781)585-2300 Fax: (781)585-2378 www.GradyConsultin .corn 12/9/2014 GRADY ` C>ONSLJLTLN.G , Registered Professional Civil Engineers Town of Barnstable Health Division 200 Main Street ; Hyannis,MA 02601 -RE:- �.357 Lakeside Drive West-Septic System Repair Applicant- Wind River Environmental ` Dear Board Members:"- On behalf of the applicant we hereby submit this'application for the repair of the system at the above referenced_ address. The applicant proposes to install a 15'00 gallon septic tank;a distribution box-a 55' long x.8 8.3' wide x 2' deep,leaching chamber"system with 6,precast concrete H-20 Loading chambers. Enclosed,please find the:following: 1: 4'sets of the Septic Repair Plan,dated November 14, 2014.` `2. Application for Disposal Systerri'Construction Permit. -3., Check:for$95 payable'to "Town'of Barnstable" 4. Form 9A Application for Local Upgrade--Approval: 5. Variance Request Form 6: Checklist Due to the proximity of wetlands and in an attempt'to limit the"amount of disturbance this project . creates we he'reb re uest the followin" Local U grade A royal and Local Variance requests! Y q g Pg pp , q Local Ilprade Approval Requests .. 4 31.0-CMR 1.5 A05(1)(b)-Reduction of system location setback to"the,cellar wall from`the required 201. to 10.0 ft 31.0 CMR 15.405(1')(h):-Reduction in the,separation between the bottom of the soil-,absorption system and the high.groundwater elevation from the required'S ft. to 4 ft.," 3.'1;0 C1VIR 15:405(1)(i) Use of a''sieve analysis where a percolation test could not be performed., 310.CMR J5.405(1)(k)'—'Reduction in"the,required amourit" of deep holes per disposal area.,from 2 holes to,l hole Local Variance Requests - 360-1 Reduction in.the required.soil absorption system-setback.to a water body''from,the required-_ 100_ft.'to"5°1 ft:` 360` 1 Reduction in the required septic tank setback to a water body from.the required.l100 ft.to r 72`ft 71fiEvergreen.Street,,Surte 1 • Kingston.MA 02364.: Tel (781)585-2300 . Fax`(781).585-2378 We believe these Local Upgrade Approval and-Local,Variance reguests'should be approved as; the:proposed"system is a substantial improvement of the existing system. : f you have any questions please do not hesitate to call, Sincerely,' GRADY CONS LTING,'L L.C. Richard Grady,L.E. -F Principal Engineer Cc-, -Wind River Environmental` 577 Main Street Hudson;.MA 01.749 l' J:\2014\14-266T(OMBOH letter.docx r ,A a _ L ' ' r t i •,i ` t ry '' �r .� e i5 T � t."t c1 t t•. f R r..'.4' ' ; .p• .A. LY r d GRA"DY CONSULTING L . L C:. Registered Professional Civil Engineers Town of Ba rnstable Health Division � y 200.Main Street 8 Hyannis;MA 02601 . 'RE:, .357 Lakeside Drive West-Septic System Repair Applicant- Wind River Environmental Dear Board Members: ` On behalf of , the appheant we hereby submit this application,for.the repair of the, system at the above referenced address. The applicant proposes to install a 1500 gallon septic tank; a. distribution box a.55' longx.8.83 wide x 2' deep leachirig chamber system with 6.precast concrete H-20 Loading.chambers. Enclosed please find the,following: 1i' v 4 sets of the Septic Repair Plan,dated November 14,2014. 2: Application for Disposal System E, onstruction Permit. I. ~Check for$95 a able to "Town of`Baarnstable PY _ 4.' Form 9A Application for Local Upgrade Approval: 5., Variance Request Form. ' . G / Checklist Due to the proximity of wetlands and in an attempt to limit the amount,of disturbance this project creates we hereby request the following Local Upgrade Approval and Local Variance requests: Local Upgrade Approval Requests 31.0 CMR 15.405(1)(b)--Reduction of system location setback to the cellar wall from the required 20 ft. to 1.0.0 ft. -310 CMR.15.405(1)(h)—Reduction in the separation between the bottom of the soil,absorption system and the high groundwater elevation from the required-5 ft.'to 4 ft.. 3'1-0 CMR 15.405(1)(i)-Use of a sieve analysis where a percolation test could not be performed. . 310 CMR.15.405(1)(k)=Reduction.-in the required amount of deep holes per disposal area.from 2.holes to 1 hole: .Local Variance Requests 360-1;Reduction.in.the required.soil absorption system setback to a water body from thefequired� 100 ft_. to 51 ft: 360-1 Reduction in the required septic tank setback to a water body fromahe.required 100 ft.to IM 72 ft. c-�3 _. 71 Evergreen Street, Suite 1 • Kingston,MA 02364 4: Tel(781) 585-2300 • Fax (181) 585-2378 GRAD',Y GONSULT`ING , L I - G Registered Professional'Civil En ineers -. January 14,20I5 Town of Barnstable - Health Division , 200 Main Street � Hyannis; MA 02601 RE:_ 357 Lakeside Drive West'—, Septic System Repair Applicant Wind River Environmental 1 Dear Board Members: Enclosed please find four(4) copies of revised plans for the.above referenced.pro�ect. The plan was revised to show a monolithic septic,tank as requested,by the Board at ourJanuary"13, 2015 meeting. - If you have ari Y y questions please do-not hesitate to 'contact us. Sincerely, GRADY:CONSULTING; L.L C Richard Grad .E: Principal Engineer Cc: Wind River Enviroriinerital " - . 577.Main Street r - F Hudson,,MA 01749 1 J:\2014\14-266\BOH\BOH7etter.docz r 71 Vergmen Street,Suite-1:• Kingston;MA 02364. Tel.(781)585-2300 Fax (781) 585-2378 l Town of Barnstable P# dINE Department of Regulatory Services allLM ABM Public Health Division Date 0319. �e� 200 Main Street,Hy nis MA 02601 Date Scheduled Time D Fee Pd. Soil Suitability Assessment for Se g Disposa; �'.. R1G Performed By: 1 ' 1�' 1A✓y Witnessed By: '�� /EO LO` '/ GENERAL INFORMAT�jON Location Address �7 � ` l , e /�r'� Owner's Name /J�e�-CI AW J // `J Address - /, y !/ /f eS%�/kf J l / Assessor'sMap/Parcel: 252,/ Engineer's Name /Rld-A��+� y mot N NEW CONSTRUCTION `REPAIR Telephone# I. � J•2I O6 / D/� t J- ,�-J Land Use K.0 s f�^/�'�/ Slopes(%) Surface Stones Distances from: Open Water Bodyft Possible Wet Area ft Drinking Water Well ft r Drainage Way ft Property Line 15 X1 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ci _ "f 4 .7 Parent material(geologic) Depth to Bedrock Q.Q Depth to Groundwater: Standing Water in Hole: 1 Weeping from Pit Face 1 LrK Estimated Seasonal High Groundwater V'�I � / DETERMINATION FOR SEASONAL HIGH.WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date.. Time Observation Hole# 1 /} Time at 9" Depth of Perc 3�,( Vy Time at 6" Start Pre-soak Time @ Time(9"-6") f f� J If � End Pre-soak /J Rate Min./Inch ` !i�1 uh •' Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) L" Original: Public Health Division Observation Hole Data To Be Completed on Back---------- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFOPM.DOC r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel i2''• 32 c DEEP OBSERVATION HOLE'-LOG Hole# . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION.HO'LE LO_G Hole# Depth from Soil Horizon Soil Texture Soil Co p olor Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) DEEP OBSERVATION HOLE LOG Hole.# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate Map: Above 500 year flood boundary No_ // Yes Within 500 year boundary No Yes Within 100 year flood boundary No✓ Yes_ Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughoutthe area proposed for the soil absorption system? I If not,what is the depth of naturally occurring pervious material? Certification I certify that on (date)I have passed the sot evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expert and experience described in 310 CMR 15.017. Signature Date Il7`2 14 Q:\SEPTIC\PERCFORM.DOC DOC: 1s265s317 03-18-2015 11347 .'BARNSTABLE LAND COURT REGISTRY Deed Restriction WHEREAS,the Joseph L Rogers,Jr.Family Trust and the Anna E.Rogers Family Trust with Joseph L Rogers,Jr.and Anna E.Rogers as Trustees of said Trusts are joint owners(said"owners"herein referred to as,The Trustees of the Trusts)of the property located at 357 Lakeside Drive West,Centerville,MA as shown on Land Court Plan No. 20239-C(Sheet 2)Lot 9,Property of Anna E.&Joseph L Rogers,Jr.,et al, duly recorded In Barnstable County Registry of Deeds,Registered Land Court Document No.1218558, Certificate No.200049; WHEREAS,The Trustees of the Trusts 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 r CMR 15.002 State Environmental Code,Title V,Minimum Requirements for the Subsurface Disposal of O Sanitary Sewage; rD M WHEREAS,the Town of Barnstable Board of Health,as a pre-condition to granting a disposal works O construction permit for a septic system in compliance with 310 CMR 15.000,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,The Trustees of the Trusts do hereby place the following restriction on the above- !� referenced land in accordance with the agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding upon all successors in title: 357 Lakeside Drive Wes,Centerville,MA may have constructed upon the lot a house containing no more than four(4)bedrooms.The Trustees of the Trusts agree that this shall be a permanent deed restriction affecting said property located on 357 Lakeside Drive West,Centerville,MA,and being shown on Land Court Plan No.20239C(Sheet 2)Lot 9 recorded In Barnstable County Registry of Deeds, 1 Land Court Document No.1218558,Certificate No.200049; Executed as a sealed Instrument this /Co 7hday of March„L,2015. Owners: Joseph L Rogers,Jr.Family Trust Anna E.Rogers Family Trust Joseph L.Rogers,Jr.,Trustee Anna E.Rogers,Trustee I p• Anna E.Rogers,Trustee Joseph L Rogers,Jr.,Trustee • fib,.! COMMONWEALTH OF MASSACHUSETTS SS On this A0 day of March,201S,then personally y appeared before me the above-named Joseph L Rog ers,Jr.and Anna E.Rogers, known to me to be the persons who executed the foregoing instrument and acknowledged that they executed the foregoing instrument as their free act and deed. Y Notary ublic My commission expires: 10 / a JERMA.cuwwwes � bti�E+w+�a Na to.2021 BARN STADL�COUNTY REGISTRY OF DEEDS A TRUE COPY,ATTEST JOiiN F.MEADE,REGISTER BARNSTABLE REGISTRY OF DEEDS John F. Meade, Register TOWN OF BARNSTABLE T OCATION S? Re_ SEWAGE# S- Q(© VILLAGEaNYe_r'U1f1-2 ASSESSOR'S MAP&D PARCEL tol S UITO INSTALLER'S NAME&PHONE NO. C. SEPTIC TANK CAPACITY ) J(:00 LEACHING FACILITY: (type) (�� +SCE ?�T (size) S0G QqtJ0r-J NO. OF BEDROOMS L� I� OWNER N "©r ber S PERMIT DATE: 3��`)�d (� COMPLIANCE DATE: a 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 B site or within 200 feet of leaching facility) N{ A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 0??2AQ .0.�� d F Q l ►� �o 3 L1 WeST CFee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftpliLation for -Mispo8al .pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. � { lC- rV r N Add ess,and Tel.No. a'?,R jj 2 a•Q Assessor's Map/Parcel © m Lt6 9 u-3Z r- (1dPf IJ r.)) . I stal)er's Name ddress,and Tel.No. J - ' 7 M30 Designer's Name,Address,and Tel.No. 191^ Type of Building: [ b�! Dwelling No.of Bedrooms Lot Size 5 4a.3 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures (J ) Design Flow(min.required) 7 %D gpd Design flow provided �y gpd Plan Date )�� Number of sheets Revision Date Title Size of Septic Tank ®c) Type of S.A.S. G'� Description of Soil A4 ,SAA,l j,ba^n, C I �1"t'rCY g 6 �evCX C_ SSA W „—� Nature of Repairs or Alterations(Answer when applicable) �(I,7 S'r�b) IV 21,E �' Q cy� jn N pv{ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and noA place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signe Date Application Approved by Date 114211 Application Disapproved by Date for the following reasons Permit No._ �,�j � Date Issued a r No. � lU V `• r -� Fee l.J THE COMMONWEALTH' F MASSACHUSETTS Entered in computer: , t ' - PUBLIC HEALTH DIVISION -TOWN O BARNSTABLE,-MASSACHUSETTS Yes x...- application for 3a18tlosaf'bpstrut ',t[ttIOYC vPrYriit Application for a Permit to Construct( ) . Repair( ) Upgrade( ) Abandon( ) L[g:Complete Sysfem ❑Individual Components Location Address or Lot No.35"? L-q lU Q . t Owner's Name Add ess,a�{{Tel No. q ct2 g;a`C( Assessor's Map/Parcel oZ o L C11 C( Ck tA C,9 SQr U l 1 e-,10 a DaG3a- tal)er's Name ddress and Tel No. 3(� D signer's Name,Addres ,a Tel.No. ')gl^ $g51a-3 C� c ►� -a��NCB,5� �;f ram c�,�S��-�i C, l3O)C S 9i �l , PP-Grp �' I c r'CA J 9-T,�TJ,�:jfe, 6 A) rO/V M ( Type of Building: Dwelling No.of Bedrooms Lot Size 5 ' a.3 sq.ft. Garbage Grinder( ) Other Type of Building g t4 No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ��.� gpd Design flow provided y d gpd Plan Date l/ 3 l)�'�Number of sheets Revision Date 1311 Title Size of Septic Tank U Type of S.A.S. G� Se' 4 1, lkr-S Description of Soil A- ,S`i�Qd,,) �(�AM Q- S¢�I OA✓� C I ✓V) .5;Q,0CF Nature of Repairs or Alterations(Answer when applicable) 0-, TQ) tJ e-�-V j C to �'�� JC 6—�,ov G4 ) � G��AJI��r'S �/� M�a•U Date last inspected: , Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and2place the system in operation until a Certificate of ` Compliance has been issued by this Board of Health. Sign Date Ell Application Approved by Date - Application Disapproved by Date for the following reasons , g t , Permit No. Date Issued - y --------------------------------------------------------- - ----- --=-- ----- ------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by Obc f"T G U(- C O :�f o C- at 3.5? (Ake 5/d' O(t W O-C-T has been constructed in accordance `' Arw5 with the provisions of Title 5 and the for Disposal System Construction Permit No--')C;/ 060lated / Installer Designer #bedrooms Approved design floutI , T gpd The issuance of this p its all not be construed as a guarantee that the system w' fun tiop' as design d. Dater Inspector -- - -. - No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Vspo$al *pstem Construction 3permit Permission is hereby granted to Construct/( ) Re, air Upgrad ( )�- Abandon( ) System located at 3S 7 La I��J�� QS V and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must b comr pl ted within three years of the date of this pe Date /�� Approved by f - Town of Barnstable ..��II E,O�ti Regulatory Services Thomas F.Geiler,Director BARMSP U% Public Health Division MASS. 039• �'°rFo ter► Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: Sewage Permit#�0 Assessor's Map/Parcel Z 2 r © Installer&Designer Certification Form Designer: ,,L 6 �/ISol-7 y�v � Installer: -7 V /zi aP�« -� e.� Address: �a 6-oLw x� - Address: - L�s F 174.,4 02�? On 1 I� ��r+ our-. was issued a permit to install a (date) (installer) septic system at 4,10 based on a design drawn by (address) r'✓��'" Cad r v l-A L C c- dated i 1-14,14- (designer) v_// 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. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if re inspected and the soils were found satisfactory. ��\ OF MA - V �O� c RICHARD yGN v GRADY ti (Installer's Signature) No.38072 O1k ��ss/Q�A ST v`��G�� (Design s Si ature) (Affix famp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS - BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. q:\ofce formWesignercertification form.doc GRADY .-CONSULTING , - L L : .' Registered Professional Civil Engineers&Land Surveyors April 29, 2015 Town of Barnstable Health Division 200 Main:Street' Hyannis, MA 02601 RE:— As-built Certification,-357 Lakeside Drive West Dear Board'Members; We hereby certify that we have inspected the septic system,at the above referenced address and the system has been constructed in compliance with 310 CMR 15.000;, the.approved , design plans and all'local requirements, and that any changes to the design plans have been reflected on•the.enclosed as-built plans. Enclosed-please.find two copies of the as-built plan. If you have any questions please do not hesitate,to call: Sincerely; ; GRADY CONSULTING;L:L. 'OF MgSs40 O J. ..Richard,Grady; E. o oRAOY 38072 Principal Engineer,- REGIS No. o ��FFSS ONALjO� Cc! Anna& Joseph Rogers . . )✓/ Lakeside DliVe W CS Centerville, MA 02632 183b7. - - r.. - J:\14-266\Asbui1t cert.doc_ 71'Evergreen Street;Su><te 1 ,. Kingston"MA 02364` Tel (781- ,585-23,00 . Fax,(781) 585 2378 Commonwealth of Massachusetts CityfTown of Barnstable 9 = Form 9A - Application for Local Upgrade Approval a -,M DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd, where full compliance, as defined in 310 CMR 15.404(1), is not feasible. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.415. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of an on-site system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important:When filling out forms 1. Facility Name and Address: on the computer, use only the tab single family residence key to move your Name cursor-do not 357 Lakeside West Drive use the return key. Street Address Centerville MA 01778 rQ Citylrown State Zip Code 2. Owner Name and Address(if different from above): Anna E. &Joseph L. Rogers Jr 357 Lakeside Drive West Name Street Address Centerville MA Cityrrown State 02601 508.429.9553 Zip Code Telephone Number 3. Type of Facility(check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: Single Family House 5. Type of Existing System: ❑ Privy ❑ Cesspool(s) ® Conventional ❑ Other(describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): Leaching chambers t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 1 of 4 r Commonwealth of Massachusetts City/Town of Barnstable 1 o Form 9A - Application for Local Upgrade Approval DEP has provided this form for,use by,local Boards of Health. Other forms may be used, but the M information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: gpd Design flow of proposed upgraded system 548 gpd Design flow of facility: 440gpd B. Proposed Upgrade of System 1. Proposed upgrade is (check one): ® voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: Install 1500 gallon septic tank, a distribution box, and a 55' long x 8.83'wide x 2' deep leaching chamber system.(H-20 Loading 3. Local Upgrade Approval is requested for(check all that apply): ® Reduction in setback(s)—describe reductions: Soil Absorption System to cellar wall, from 20 ft. to 10.0 ft. ❑ Reduction in SAS area of up to 25%: sas size,sq.ft. %reduction ® Reduction in separation between the SAS and high groundwater: Separation reduction 1 ft. Percolation rate 2 min./inch Depth to groundwater 4 ft. t5form9a.doc•rev.7/06 Application for Local Upgrade Approval, Page 2 of 4 Commonwealth of Massachusetts City/Town of Barnstable W Form 9A - Application for Local Upgrade Approval ^� DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. B. Proposed Upgrade of System (continued) ❑ Relocation of water supply well (explain): ❑ Reduction of 12-inch separation between inlet and outlet tees and high groundwater ® Use of only one deep hole in proposed disposal area ® Use of a sieve analysis as a substitute for a perc test ❑ Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(h)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Donna Miorandi 10/28/14 Evaluators Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: Due to the elevations of the plumbing and the existing high groundwater elevation a fully compliant system is not feasible. Reduction in groundwater separation allows a gravity system. Limited space on lot limited perc test options, want to limit amount of disturbance on the site. 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: An alternative system would face the same limitations as that proposed. t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 3 of 4 Commonwealth of Massachusetts City/Town of Barnstable a Form 9A - Application for Local Upgrade Approval ^M y DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using this form, check with your local Board of Health to determine the form they use. C. Explanation (continued) 3. A shared system is not feasible: Abutters have individual septic systems. 4. Connection to a public sewer is not feasible: Sewer is not available. 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes): ® Application for Disposal System Construction Permit ® Complete plans and specifications ® Site evaluation forms ❑ A list of abutters affected by reduced setbacks to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification "I, the facility owner, certify under penalty of law that this document and all attachments, to the best of my knowledge and belief, are true, accurate, and complete. I am aware that there may be significant consequences for submitting false information, including, but not limited to, penalties or fine and/or imprisonment for deliberate violations." t Z Fa ilit Owner's Signature Date Anna A. &Joseph L. Rogers Print Name Grady Consulting L.L.C. 11/14/14 Name of Preparer Date 71 Evergreen Street Kingston Preparer's address City/Town MA/02364 781-585-2300 State/ZIP Code Telephone t5form9a.doc•rev.7/06 Application for Local Upgrade Approval* Page 4 of 4 OF fHE rp� DATE: FEE: + BMMSTABLE. MASS. g �A ibgy. ♦� REC. BY 'F1639. Town of Barnstable SCHED. DATE: Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION r �^ Property Address: �5 7 Assessor's Map and Parcel Number:/ ,Z Size of Lot: Wetlands Within 300 Ft. Yes i/ Business Name: No Subdivision Name: q APPLICANT'S NAME:�itl/rtG��f/�N✓/(m1w1Q4/L t 41!r- Phone �� Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON r Name: �1e1�� ¢ J63%� Name: �`�f Address: 357(A'CS/4t)7ve&3r Ct✓t1)Pi'✓,74A .ddress: Zd 1�O— -4-// 4144 7q� 6-Z4o Phone: 5M- yZ9. 15Y3 Phone: 5b 9 • IZI '755-3 VARIANCE FROM REGULATION(List Reg) REASON FOR VARIANCE(May attach if more space needed) t' otG —rtdiri tKr - arc ip.► o ! U SlP i �cIQ Sts�wt p��t/X�C :ndev AA rt ef S�G lan��Cd S1GL area —/ 1 set% NATURE OF WORK: House Addition ❑ House Renovation Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC 232024 t!348 232072 q5 !Jr,/';/ ri/f%.�.'tr r ,i::'.,�,�.;:i�;:�i 232075.`;:�':•:;:::':i:..:::' %`/fi r f//i'/!/rf%1 r,,'`!:f'.i:• d?r';!'^''%;r'.`,rt"i:�j" :•. t f / •11" z�:,.. ,�',�c. ':: ;:':�:: �'� •� .232074'•'•'•:`i.2.....�:�•'� . '•% r r%f :%••t'%•:E'�.v.•r`••r�.,fx:/ .z„��';.. . 232073 J .r.•.: : .:z� •• . .,•r f t" ?f: • : fit O ',��/ r•' ..r/ %�?'�.'. -f.•,'%r1f'.j. r` >:. y f .J.:; .. . ./r, r J�' i • :% .. ' r:. 1 / 'yes 5• ,/� 'r7.•.13.r%f/:1;.r� i' 2 ``:i. `:`..'•:::::., 'a.. �•!.:/.i<. ?;l�r •,..�x�:!. .f •: 32048 .f�.� /..i:: r. .. J a?rry;.....,:f . r r �.' �.. ; ;cr.f:,f ;'.,,j�.,., •:;....;. .. N329 :' •} /rr/,/f //� f ff'r' t' ti/•'t / ' ��`f 232053 #309 ,r t rf •t, .r J,• r r ',r,r;. /,/!ff'�lrr':t;/j''/,r•/ ,f r�1. r /,t�`/ f r' 232021 t•. .r'•f' // / / /r',j r .i.,' MA3 t 232022. tlV'405� Feet AbutterReport Page 1 of 1 Conservation Notice of Intent tNOI-) Abutter List for Map & Parcel (s): '232050' Property owners within 100 feet of the perimeter of the subject parcel upon which work is proposed. Total Count: 8 ® Close Ma &Parcel Owners Owner2 Addressi Address 2 Mailing Country Deed P Citystatezip 232020 TAYLOR,JENNIFER 339 LAKESIDE CENTERVILLE, C195762 q DRIVE WEST MA 02632 GRAUEL, %GRAUEL, 379 LAKESIDE CENTERVILLE, 232048 THEODORE A JR& THEODORE A JR& DRIVE WEST MA 02632 C134908 JANE H JANE H 232049 TARSY, DANIEL& L TARSY REALTY 16 DAVIS BROOK NATICK, MA C151009 LOUISE TRS TRUST DRIVE 01760 232050 ROGERS,ANNA E& ANNA E&JOSEPH L 357 LAKESIDE CENTERVILLE, C200049 JOSEPH L JR TRS JR ROGERS F T DRIVE WEST MA 02632 232051 FALKSON,SUSAN 329 LAKESIDE CENTERVILLE, C128509 DRIVE WEST MA 02632 232074 FALKSON,JOSEPH C/O FALKSON, 334 LAKESIDE DR CENTERVILLE, C96738 SUSAN WEST MA 02632 232075 FALKSON, SUSAN 329 LAKESIDE DR CENTERVILLE, C96741 WEST MA 02632 232076 FALKSON,SUSAN 329 LAKESIDE DR CENTERVILLE, C155998 WEST MA 02632 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 9/29/2014. http://maps.townofbamstable.us/arcims/appgeoapp/AbutterReport.aspx?type=NOI 9/29/2014 �dr-) G1 G /5 d e. y 5 i 0 � Briggs Engineering & Testing A DnvisioN OF PK AssociAres,/Nc. - November 11,2014 Grady Consulting, LLC 71 Evergreen Street,Suite 1 Kingston, MA 02364 Attn: Mr. Richard Grady, P.E. Title V Soil Analysis Address: 357 Lakeside Drive West Centerville Briggs# 82829 Tested: 11/10/14 1• Lab Ref. No. Description Source M-25010 -#10 Fraction 357 Lakeside Drive 2. Particle Size Analysis {ASTM D 4221 West Centerville Sieve Size Results Standard Alternate f% Passing by Wt.} 2.0 mm #10 100 0.850 mm #20 74 0.425 mm #40 36 0.180 mm #80 17 0.150 mm #100 15 0.053 mm #270 7 0.0386 mm 6 0.0246 In 4 0.0143 mm 3 0.0102 mm 3 0.0072 mm 2 0.0036 mm 2 0.0015 mm I 3. The above analysis was performed in accordance with D.E.P. policy#BRP/DWM/Pep-001-1, Appendix 2. Respectfully Submitted, BRIGGS ENGINEERING &TESTING A Division of PKAssociates, Inc. Sean Skorohod Director of Testing Services Construction Technology Division enclosures: graph — — www briggsengineering corn -- ----- -- -- 100 Weymouth Street- Unit C-2 100 Pound Road Rockland, MA 02370 Cumberland,RI 02864 Phone (781) 871-6040 a Fax(781) 871-4340 Phone(401) 658-2990 o Fax (401) 658-2977 -Date Tested: 11/10J14 Lab Ref.No.: M-25010 ownewom mmomil END Mill I mmom ME®® m�mmommon 111 FAMIM slow MMIMW amMImlNumMmEmMiMl MOORE Nmmmmi N 10MNMMN 0 MIOffimml nmmmom loss®®®®®low W1 0 Iffifflffilig omiommog MRM MINNS NMNSM iWIMMN MENNEN ®ITEM IME@919 on MEMEM Mill Wiffiffifill [Mom MEN Emomimmmmo ED 11W 1IMMIMIMEM immmilima MINME@90 ®wile®®®®®® ®immmimon iffililifflil ®Mlifflommil ®mmmoomm MIIIIJWMMlMI 0 MM me �mmi a ME mmommo IMFJNNH� migummooly ■ B mmmmuli Mailml MENIMONNIMIM MEMMEEME NEON on] filifflill nom(BEEME� MR 1EMMEMEN m IN WN III EN IffilliffiNiffilffill Immommism ORION mamimmulmm MIERMIMME IN MEM Hill Iffiffiffilmlem MEN NONMEMBER Ml ON 11MMINOW �MINMEININ MMMMMIFAESIN liffiffliffill ®immmimm ®mmlimmmom MEMENVAnglo ®®®MINNOW � a mmmim Wiffimmill EMMEM MMMMIM MWENSIN EMENEENNIN �mmmimm mmmiimmmmm IN Emil �m IN ®EMBER®®® IMMENIM ENEMMUAEOIN im oil ®mmmmimm mmosm �WIMSMERM MMINFIDOWN WINNOW a Milliffifflilmil �mmmiss mmmmi M0111001 menimmsfammm aliffil IN ®mmmimm mmgm M lmommmm mEgmummmmm ®®®®MERE ®mmmism RYOMMI MENglommum man WIN ®®mmmien mmumi mom BEIM 91 Ell Emmmmmm wmmimm am 110immimm 011MMMINM ®mmimmmm9m mmsmvm Emmism�� EmimmEno Iffliffillom EMMIRMEEN ®omim SEE ��mmoism MMMEMIN = a immimagm ME ��mmmilms �ENIENES99M ®9M.Maimilim ®EMMMEEN mmmilmo E��mmomme NO! INMEMB miwimmmmm BY mmmomomm Emil MEMIENERN ��mmmiloo l�INEE 9EMERE �WAMMENE ��EMMMENE ��mmmimom 1010MINIIIIII a FIR4mmmEmpm �EMMMENE mm MMEMEM I INN �mmmmmilmonn imimi�gwwmiu ��EEMOMEM � m N MM1101 �®mmmmsso ®mmmmmmimm NI �miamomm MNOOM ® MMINNo nEM M Mlm@ENN ®Emoommm �Mim wlimmmimil MN@mmm ®®®MINNOW BIEMMMMERM ®wommimilm mmmmiggim 9WE mmmmiog onammo ®BMB@90mmm mmmmmo mmmimm liffiffillimmill molmommmmmm 0 is MMINSMIN MINIM I mommomm 01111911111MIMIMM! ommmmmo mom 0 go maims Immmmmm MaMMEMN mom®mmmimm affinan M MOMBIMEN am MMINIfflififfilas AM MMMMINIM MMMEM MIMIMEM2 Immmmimm MMMMMIM offiffilolffill omm[mommum BMWNIIIM ea®®®®® ffifflWffil WR IMEammomml OF MEMENN wmmmimm lmimumEmig NN IS WNMINiNm ON mm�mmmim MMMMINEMMEENAMEMN Bi �mommam m ®mmmmimm m- am Hog Offiliffimilliffill 19 Miami r' i t 310 CMR: DEPARTMENT OF ENVIRONMENTAL PROTECTION CLASS IV Clays, Silty Clay Loams Sand Clay Loams with 27% or more Y tY Y Y Y Clay, Clay Loams and Silty Clays (2) Textural Classifications are made based on the relative proportion of sand, silt and clay in the soils and in accordance with the following textural triangle: SOIL TEXTURAL TRIANGLE 100 ,O 90 ry0 so �O 70 lay o4 u� 60 ion 50 40 s I y I to cl ^o 30 s n cla oa 20 10 san loa I a si Io 00 a silt � 'o o co `o 16 00 100 a percent sand CAI dd 0 Ot of U t � �" r i • • - j m I• • Q _ • f 0C3 Q, 0 ``ice• F I C •I A ' • S � r O F• � IC� •I q� ( q Lr) ArL Ir Postage $ �f� Ln Postage $ Certified Fee _ t� Certified Fee1,30 C3 r` 6°' Postm rk ( '� CJ ® Postmerly ; p Return Receipt Fee a a Return Receipt Fee 1 (Endorsement Required) �� (� Here -T M (Endorsement Required) 10 Here Restricted Delivery Fee ( ) P.y Restricted DeliveryFee `e t m c O (Endorsement Required) 6 i p (Endorsement Reuired) l ae Lrl ra 0 Total,Post—a r aoa aac � ' ' ® r. C3 Total Pnctanw R F sent To � Sent To TARSY DANIEL& S C3 __________ GRAUEL THEOD A JR&J H o sneer,: L TARSY REALTY TRUST � Street,Apt: ,---- , �`- or PC Box 379 LAKESIDE D ST r. or POE 16 DAVIS BROOK DRIVE Ciry Srare; CENTERVILLE,MA 02632 ----- City sti NATICK,MA 01760 —0 I• 1 ••• M I• • C3 C3 OFF111CIAL USE Ir "i Ir Ln Postage $ 0 y`(" Qom- Postage $ VG" Certified Fee > r-1 Certified Fee ' ostmark Q) M O Return Receipt Fee Here 1ti Return Receipt Fee • ) O (Endorsement Required)C3 (Endorsement Required) a C3RestRestricteFee d Delivery Fee `=* pEndorrsemeicted Dnt IRelvequired) M (Endorsement Required) r., J LI) M Total Po' ip�r ! Total Postage B.Fees — e � r �- Sent To �- Sent To FALK - N JO EPH �° FALKSON SUSAN C/O FALK SUSAN O Street;Ap d Srreer,Ap tti or PO Boa 329 LAKESIDE DRIVE WEST t� or Poeo 329 LAKESIDE DRI ST ------- City State CENTERVILLE,MA 02632 Ciry Srari CENTERVILLE,MA 02632 • • M rx Er t i'tpo Ln PostageEr Certified Fee Q C3 t'C,_3 Postmark Return Receipt Fee 7 Here M (Endorsement Required) r( P Restricted Delivery Fee E ), �� r' CI (Endorsement Required) u'1 q; � Total POStane R Faac �- senrTo TAYLOR IFER A. o f`- o oO r PO Bo ri oB P x N t� 339 LAKESIDE DRIVE WEST City,Stafe,z CENTERVILLE,MA 02632 Complete items 1,2,and 3.Also complet / A. nature ® Complete items 1,2.,and 3.Also complet Si tur item 4 if Restricted Delivery is desired. 60 ❑Agent item 4 if Restricted Delivery is desired. ❑Age Print your name and address on the reverse ❑Addressee ® Print your name and address on the reve s so that we can return the card to you. B, ceived by ed ame) C. Date of liv ry so that we can return the card to you. VDH B. ece' ed by(Printed ame) C. Date f Delive Attach this card to the back of the mailpi e, S ® Attach this card to the back of the mailpiece, or on the front if space permits. ( �o(O V or on the front if space permits. ��:` D. Is de' ry address different from item 19 ❑Yes D. delivery address different from item V Pn Yes Article Addressed to: If YES,enter delivery address below: ❑ No 1. Article Addressed to: If YES,enter delivery address below: ❑ No FALKSON SIUSA `! GRAUEL THEODORE A JR &JANE 1; � 379 LAKESIDE DRIVE WEST 329 !_A[; ES1D.r r_.:l: !', E: wr'S�I CENTERVIL.LE, NIA 02632 3. Service Type Ci;i\'i ER`vl, (.,r_.. i�i:t l (;,:,, 3. Service Type 83Mertified Mail® ❑Priority Mail Express"' ertified Mail® ❑ �j Priority Mail Express- Registered ❑Return Receipt for Merchandise Registered ❑Return Receipt for Merchandl; ❑ Insured Mail ❑Collect on Delivery ❑ Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 4. Restricted Delivery?(Extra Fee) ❑Yes Article Number 2. Article Number (transfer from service label) 7014 0510 0001 9597 0090 (transfer from service label) 7014 0510 0001 9597 0076 3 Form 3811,July 2013 Domestic Return Receipt PS Form 3811,July 2013 Domestic Return Receipt i o • • • • • • • • a • • • I Complete items 1,2,and 3.Also complete A. Sin7eddress A. Signature ® Complete items i,2,and 3.Also comple�tf ❑Agent item 4 if Restricted Delivery is desired. p ❑Agent item 4 if Restricted Delivery is desired. /JO (,(/�/' I Print your name and address on the revers X ❑Addres: so that we can return the card to you. ❑Addressee M Print your name and address on the rever I Attach this card to the back of the mailpiece, eceir' ame) C. D e o. livery so that we can return the card to you. B. Received by tinted Nam41te C. Date of Deliv or on the front ifs ace permits. C S w' ® Attach this card to the back of the mailpiece, Q p p / f G �iQ {.S L Article Addressed to: D. Is deli different from item 1? ❑Y s or on the front if space permits. ` up(j D. Is delivery address different from19 ❑Yes If YES,enter delivery address below: ❑ No 1. Article Addressed to: If YES,enter delivery;address below: ❑No FALKSON JOSEPH TARSY DANiEL, &: i_C)UISC TRS �- C/O FALKSON SUSAN L T.ARSY RE.1( .i Y f RL I ST \` r 329 LAKESIDE DRIVE WEST 3. Service Type 16 CIAVIS BRO()K .DRIV�; 3. Service Type '•.,. \,rr'` CENTERVILLE, MA 02632 Certified Mail® ❑Priority Mail Express- NATICK, NIA 01760 � � [ U Certified Mail '�;�Fro i f31i1 Express" Registered ❑Return Receipt for Merchandise ❑Registered ❑"Return-Receipt for Merchanc ❑Insured Mail ❑Collect on Delivery ❑Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 4. Restricted Delivery?(Extra Fee) ❑Yes Article Number (transfer from service label) 7014 0510 0001 9597 0106 2. Article Number 7014 0510 0001 9597 0083 (transfer from service label) Form 3811,July 2013 Domestic Return Receipt `f PS Form 3811,July 2013 Domestic Return Receipt TO-Wg N OF Z_MSTABLE --QCATION3 %U (° ++� SEWAGE# VII.LAG O SSESSO MAP&LOTa`3 .Zvs��s / ep*igabWNAME&PHONE NO. 12 P /l7P� 02 SEPTIC TANK CAPACITY W6 GY.+/Vl �� l cSX)X LEACHING FACILITY: (type)( �e;i-P/0) (size) CV L )e- )•;O.OF BEDROOMS � BUILDER OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 t of 1 ac ' g ili Feet Furnished by C7 / OpS Qo i douSF qe � G �t Town of Barnstable Department of Health, Safety, and Environmental Services H e,►tUMuBtE• ' Public Health Division �� 367 Main Street,Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health February 17,1998 Hugh H. &Sara H.Macarthur 67 St. Germain Street,apt.15 Boston,MA 02115 ORDER TO COMPLY WITH 310 CMR 15.00,THE STATE ENVIRONMENTAL CODE,TITLE 5. The septic system owned by you located at 357 Lakeside Drive West,Centerville was inspected on July 15, 1997 by John Graci,a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00)due to the following: • 'Distribution box was rotting" You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office(Town Hall, 367 Main Street, Hyannis)that will bring the septic system into compliance with 310 CMR 15.00,The State Environmental Code,Title 5 within(14)fourteen days of receipt of this notice. You are also directed to bring the septic system into compliance within thirty(30)days of receipt of this order letter. You are further directed to.maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings,onto the surface of the ground,or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PE I ER OF THE B OF HEALTH Thomas A. cKean,R.S.,C.H.O. Agent of the Board of Health q\heaith\dbfi1es\tit1e5 i.doc l AAP 7-3 Z' PARCEL ' -0 LOT ; COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION d RECEIVED ( W APR 7 2004 TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A ' CERTIFICATION Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 3� 5 Owner's Name: SARA POULTON Owner's Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Date of Inspection:3/15/04 Name of Inspector: (please print) JOHN GRACI,INC. Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02536 Telephone:Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes _ Conditionall asses _ Needs Furt Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 3/15/04 The system inspector shall submit a opy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspecti n. 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 SYSTEM PASSED TITLE V INSPECTION. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. ****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. Titles 5 Tncnactinn Fnrm h/1 5MOO 1 Page 2 of I 1 ti OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 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 described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: SYSTEM PASSED TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE. B. System Conditionally Passes: _ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. 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 irmninent. 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 break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): _ broken pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: 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 _obstruction is removed ND explain: n/a Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 C. Further Evaluation is Required by the Board of Health: _ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water . _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone I 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 "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: n/a Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 Failure Criteria applicable to all s D. Systempp stems:y You must indicate"yes"or"no"to each of the following for alLinspections: 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 '/z 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 n/a. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy 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 1 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. ]This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] NO (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large 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) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IW PA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. a Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 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 dwelling inspected 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 CMR 15.302(3)(b)] 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 4 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: 1 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 aOU� Water meter readings, if available(last 2 years usage(gpd)):42 CD 3 - U Sump pump(yes or no): NO O 4 _ 00 Last date of occupancy: n/a a COMMERCIAL/INDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR 15.203): 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: n/a 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 DEP approval Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1995 PER ASBUILT Were sewage odors detected when arriving at the site(yes or no): NO A O F Page 7 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 BUILDING SEWER(locate on site plan) Depth below grade: 18" Materials of construction:_cast iron X40 PVC_other(explain): n/a 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: 12" Material of construction: Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: L 8' 6" H 5' 7" W 4' 10" Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle:33" Scum thickness: 0" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 18" 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.): SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEMS USEFUL LIFE. GREASE TRAP:_(locate on 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 recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 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:X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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.): D-BOX WAS VIDEO INSPECTED AND APPEARS TO BE STRUCTURALLY SOUND. 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 R Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 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: 0 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a 1 leaching fields, number: 24' L X 8'W n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil, signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): LEACH FIELD IS STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.SOIL PROBED DRY-SYSTEM SHOWS NO SIGNS OF FAILURE.BOTTOM IS AT 5 FT. 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 4 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 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. 1.A b F_j I AA l� 3q � + 3� y in Page 11 of 11 r a OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 357 LAKESIDE DRIVE WEST CENTERVILLE,MA 02632 Owner: SARA POULTON Date of Inspection: 3/15/04 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 8 feet Please indicate(check)all methods used to determine the high ground water elevation: YES Obtained from system design plans on record-If checked,date of design plan reviewed: 8/27/03 NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-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: 8 FT.PER ASBUILT Town of Barnstable snt NSTABL , Department of Health, Safety, and Environmental Services = Public Health Division p 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health TO: a„�l 5ra / ''fd r S� DATE: ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located t 35 rJ Lal;.5i Je- Qiw--wo-J - was inspected on :fJIu 1917 by C lr t Cr1�ac� , a Massachusetts licensed septic inspector. `-J� The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: D 6b !-Add 2 � �1G You are directed to hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5 within (14) fourteen days of receipt of this notice. You are also directed to bring the septic system into compliance within thirty (30) days of receipt of this order letter. You are further directed to maintain the system by hiring a licensed septage hauler to pump the septic system to prevent discharge of sewage or effluent into the buildings, onto the surface of the ground, or in to surface waters. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health gUdlhWbfJwkiUeSi.doc Commonweafth of Massachusetts ExecutNe Office of Environmental Affairs John GradD.E.P. Title V Septic Inspector Department of P.O. Box 2119 ' Environmental Protection Teaticket,MA 02536 (508)564-G. 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM CO IjjP^q ? dO PART A ✓/' +� CERTIFICATION V4 ,A to, 18 1 �+ Property Address: 357 Lakeside Dr.West Centerville Address f different Owner: yg0�ggNsl 99� Date of Inspection:7115197 Name of Inspector:John Gracl Feinberg Company Name, Address and Telephone Number: Zi 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: _ Passes This inspection is based on criteria defined in Title y x Conditionally Pa es code 310 CMR 15.303.My findings are of how the system Is _ Needs Fu er aluation By the Local Approving Authority performing at the time ofthe 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. Inspector's Signature: / Date: 7115197 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: Check A, B,C, or D: A] SYSTEM PASSES: _ 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. 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, cracked,structurally unsound,shows substantial infiltration or exfiitration,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 11115195) One Winter Street • Boston,Massachusetts 02108 . FAX(617)556-1049 • Telephone(617)292-5500 1 r PAR ] Real Estate System - General Property Inquiry] Help [ ] Parcel 'Id: 232 050- - Account No: 144463 Parent : Location: 357 LAKESIDE DR Neighborhood: 51WB Fire Dist : CO Devel Lot : 9 LC20239-C S-2 Lot Size : . 34 Acres Current Own: MACARTHUR, HUGH H & SARA H State Class : 101 67 ST GERMAIN STREET APT 15 No. Bldgs : 1 Area: 2306 Year Added: BOSTON MA 2115 Deed Date : 070197 Reference : C145235 January 1st : FEINBERG, JEFFREY L & Deed MMDD: 0995 Deed Ref : C138405 Comments : Values : Land: 100500 Buildings : 201400 Extra Features : Road System: 357 Index: 865 (LAKESIDE DRIVE WEST ) Frntg: 130 Index: ( ) Frntg: Control Info: Last Auto Upd: 101197 Status : C Last TACS Update : 100997 Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0191 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [232] [051] [ ] [ ] [ ] SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 357 Lakeside Dr.West Centerville Owner: Feinberg Date of Inspection:7115197 Sewage backup or breakout or high static water level observed in the distribution box is due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed X 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 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 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 water supply 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 is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria volatile organic compounds indicates that the well is free from pollution for that facility and the presence of ammonia nitrogen and.nitrate nitrogen is equal or less than 5 ppm. 3) OTHER D] SYSTEM FAILS: 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. 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 11115195) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 357 Lakeside Dr.west Centerville Owner: Feinberg Date of Inspection:7115197 D] SYSTEM FAILS(continued) 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: 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: 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 11115195) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECLIST Property Address: 357 Lakeside Dr.West Centerville Owner: Feinberg Date of Inspection:7115197 Check if the following have been done: _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 N/A. 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 existing information or approximated by non-intrusive methods. X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Sub- Surface Disposal System. (revised 11/15195) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 357 Lakeside Dr.West Centerville Owner: Feinberg Date of Inspection:7115197 FLOW CONDITIONS RESIDENTIAL: Design flow: 440 gallons Number of bedrooms: 4 Number of current residents: 11 Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yes Seasonal use(yes or no): Yes Water meter readings, if available: Na Last date of occupancy: 2 months ago COMMERCIAL/INDUSTRIAL: Type of establishment: 11d Design flow:6 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: n1a Last date of occupancy: n1a OTHER: (Describe) nla Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System was last pumped in 1994. System pumped as part of inspection: (yes or no)No If yes,volume pumped: o gallons Reason for pumping: n1a 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) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source information: 26 years. Sewage odors detected when arriving at the site: (yes or no) No (revised 11115195) 5 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 357 Lakeside Dr.West Centerville Owner: Feinberg Date of Inspection:7115197 SEPTIC TANK: X (locate on site plan) Depth below grade: 12" Material of construction:X concreate_metal_FRP_other(explain) Dimensions: L 8'B'H 5'7"W 4'10' 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:2.5 Distance form bottom of scum to bottom of outlet tee or baffle: n1a 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 septic system every two years for maintenance. GREASE TRAP:_ (locate on site plan) Depth below grade: n1a Material of construction: _concreie_metal_FRP_other(explain) Dimensions: nla Scum thickness:nla Distance from top of scum to top of outlet tee or baffle:n1a Distance from bottom of scum to bottom of outlet tee or baffle:n1a 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.) nla (revised 11115195) 6 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 357 Lakeside Dr.West Centerville Owner: Feinberg Date of Inspection:7115197 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: Na Material of con struction:_concrete_metal_FRP_other(explain) Dimensions: n1a Capacity: n1a gallons Design flow: n1a gallons/day Alarm level: n1a Comments: (condition of inlet tee, condition of alarm and float switches,etc.) Na DISTRIBUTION BOX: x (locate on site plan) Depth of liquid level above outlet invert: rda Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box etc.) Distribution box is rotting.Distribution box must be replaced.Pipes connecting D-box should be replaced also. PUMP CHAMBER: (locate on site plan) Pumps in working order.(yes or no) Comments: (note condition of pump chamber,condition of pumps and appurtenances, etc.) n1a (revised 11115195) 7 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 357 Lakeside Dr.West Centerville Owner: Feinberg Date of Inspection:7115/97 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: n1a Type: leaching pits,number: n1a leaching chambers,number:n1a leaching galleries,number: n1a leaching trenches,number, length: nla leaching fields,number, dimensions:one 24%x 8'W overflow cesspool,number:n1a Comments:(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Sas is functioning properly. CESSPOOLS:_ (locate on site plan) Number and configuration: nla Depth-top of liquid to inlet invert: nia Depth of solids layer: n1a Depth of scum layer: n1a Dimensions of cesspool: rda Materials of construction: nia Indication of groundwater: nia inflow(cesspool must be pumped as part of inspection) nla Comments:(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Na PRIVY:_ (locate on site plan) Materials of construction: n1a Dimensions: n1a Depth of solids: n1a Comments:(note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.) nla (revised 11115195) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 357 Lakeside Dr.West Centerville Owner: Feinberg Date of Inspection:7115197 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' J l� l 10 � I DEPTH TO GROUNDWATER Depth to groundwater:e' feet method of determination or approximation: USGS Maps and Charts. (revised 11/15195) 9 BORTOLOTTI CONSTRUCTION, INC. •r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM/ Address Prop�� SIde'01-10(5 Date of Inspec} Owner -�s Map=�fa" 2 arces�3 2 � �� ,�Gr��r�o� PART A — CHECKLIST CHEECCK IF THE FOLLOWING HAVE BEEN DONE: Y PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND BOARD OF HEALTH. Ll NONE OF THE SYSTEM COMPONENTS HAVE BEEN PUMPED FOR AT LEAST TWO WEEKS AND THE SYSTEM HAS BEEN RECEIVING NORMAL FLOW RATES DURING THAT PERIOD. LARGE COLUMES OF WATER HAVE NOT BEEN INTRODUCED INTO THE SYSTEM RECENTLY OR AS PART OF THIS INSPECTION. ✓ AS-BUILT PLANS HAVE BEEN OBTAINED AND EXAMINED. NOTE IF THEY ARE NOT AVAILABLE WITH N/A. THE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK-UP. THE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT. A" ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE. l' 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. !/ THE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR APPROXIMATED BY NON-INTRUSIVE METHODS. =l�THE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER MAINTENANCE OF SSQS. PART B — SYSTEM INFORMATION RESIDENTIAL FLOW CONDITIONS No of Bedrooms _ No of Current Residents Garbage Grinder Laundry Connected to System ��Seasonal Use C�sz��vrl�b�� NON RESIDENTIAL: Calculated flow WATER METER READINGS,IF AVAILABLE: i GALLONS ing Record aM Source of Information: SYSTEM PUMPED AS PART OF INSPECTION? �IF �VOLU�MEUMPED= GALS Reason for Pumping: TYPE OF S TEM: I Septic tank/distribution box/soil absorption system Single Cesspool Overflow Cesspool Privy Shared system (if,yes,attach previous inspection records, if any) Other:.(explain) Appr Amato agwof.4111'pomponents. Date Installed,if known. Source of information. Aha�e /cs P �//-r SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE? ��F_ V r L -- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued) SEPTIC AN Depth below grade: % Dimensions: / Materiel of construction: Concrete Metal FRP Otherl Sludge Depth 62 Distance from top of sludge to bottom of outlet tee or baffle Scum Thickness ZDistance from Top of Scum to top of outlet tee or baffle Distance from bottom of Scum to bottom of outlet tee or baffle Comments: d13 e go i1ale Z ijG / , DISTRIBUTION BOX: �!2a _1eaval D PTH OF LIQUID LEVEL ABOVE OUTLET INVERT Comments: 0 PUMP CHAMBER: Pumps in working order? Comments: SOIL ABSORPTI N SYSTEM SAS IF NOT PRESENT,EXPLAIN: TYPE: Co ments: CESSPOOLS: Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimension of cesspool Materials of construction Indication of groundwater inflow(cesspool must be pumped) Comments: PRIVY: Materials of construction Dimensions Depth of solids Comments: '.SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued], SKETCH OF SEWAGE DISPOSAL SYSTEM: INCLUDE TIES TO AT,LEAST TWO PERMANENT REFERENCES,LANDMARKS OR BENCHMARKS. LOCATE ALL WELLS WITHIN 100' y0 11 46 �a � avC�b �co DEPTH TO GFtOQUNDWMR: DEPTH TO GROUNDWATER METHOD PROXIMATION: ... i 4 q^y r1r`Sr .•a � f rti I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM V,7 PART C — FAILURE CRITERIA '(Ind, Y-yes N-no ND—not determined.Describe basis of determination.If"not determined",explain why not) Backup of Sewage into Facility? /1 Discharge or ponding of effluent to the surface of the ground or surface waters? Static liquid level in the districution box above outlet invert? Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow? Required pumping 4 times or more in the last year? Number of times pumped Septic tank is metal?cracked?structurally unsound?substantial inflttration?substantial exfiftration? .tank failure imminent. Ai any portion of the SAS,cesspool or privy, below the high groundwater elevation? Wtthln 50 feet of a surface water? Within 100 feet of a surface water supply or tributary to a surface water supply? Within a Zone I of a public well? Within 50 feet of a private water supply well? Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools&privies only, not the SAS)? 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,amonia nitrogen and nitrate nitrogen. PART D — CERTIFICATION INSPECTOR:. ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS COMPANY: BORTOLOTTI CONSTRUCTION INC. MA 02648 (508)771-9399 CERTIFICATION STATEMENT 1 CERTIFYTHAT I HAVE PERSONALLY INSPECTED THE SEWAGE DISPOSAL SYSTEM AT THIS ADDRESS AND THAT THE INFORMATION REPORTED IS TRUE,ACCURATE AND COMPLETE AS OF THE TIME OF INSPECTION. THE INSPECTION WAS PERFORMED AND ANY RECOMMENDATION REGARDING UPGRADE,MAINTENANCE AND REPAIR ARE CONSISTENT WITH MY TRAINING AND EXPERIENCE IN THE PROPER FUNCTION AND MAINTENANCE OF ON—SITE SEWAGE DISPOSAL SYSTEMS. CHECK ONE: 1 HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED ARE AS STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. I HAVE DETERMINED THAT THE SYSTEM FAILS TO PROTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN 310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. INSPECTOR'S SIGNATURE: DATE: ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(d applicable),APPROVING AUTHORITY f i 144 ��'r drr .•n ,r+i,r k � ' i^�ek4 ''jll�3ya ct 1r'k�� a� � ' i�¢r 2 n�±. '" 'r, °�`•.:sEw2�'la�� L -; £ .t� X t1 - s �..� Q _ rr�� •tM d":. �' dr� 'dC,i° �'!. 1rK ¢� A.` 3! !t °nri l 'F'a 1tFN,7' 'k ° s' Y,.'.npkyaS9 1 VS r d� ••fc'ftA � :. .err },'+Sxviy s4x�'�F,•M �� 4r.�r ��"�r tz{.µ ��w!�tre r.,§.5.�. �i,+t'�i r e.r.F 4`yrrr..+r'k 1y tf.ar,y tit x� <' � MOO. , LOCATION SEWAGE PERMIT NO. VI L L A G E INSTA LLER'S NAME & ADDRESS R U I L D E R OR OWNER J-.ecv�2 s _ Ivec rn�n DATE PERMIT ISSUED DATE COMPLIANCE ISSUED ,1 3: " t t 1 a -- - - - - -- - - - - - - _ \ — — — _ _ _ EXISTING sosa - - - - - _ - - .. - - - - - - - - - - - -- - — — — — — — — — \ — — — — o �EXISTING 6068 of \ II I 13 � � \ _ I #2 PINE T&G N (RAISE r I I ----- I Lo o z U a FLOOR) I DOUBLE TRAGK I I * " v FAMILY ROOM INCREASE FX15TING 3'-0" N TO BE ' X' OPENING IN, - existing 25' i / STORAGE - \ EXISTING WALL TO I I j'' TRIPLE TRAGK `� W LU 25-1 5/8" IL CD APPROX SPAN OF NEW BEAM EX LALLYS I Q 4 12'c6 3/5"-cv I I w 0 --- -- ----------- 3D—_— suss 11 ------- ' i B1E S830 w 2' UTILITY OFFICE STORAGE 24'-6" ROOM `a existing existing _ _ STORAGE 4' to remain ,n L aN 6066 �J/// / L==j - 7 --- I I m > v DUCTS TO REMAIN 6 2 STAIR—existing I I n r - - - r _____________________ _ _______________________________________________ _ NG - - - - � r— - - - — — — — — — — — - - - - ao _ - - - - - - - - - - - - - - - - - - - - - ►_� I I = - -_j I I o N Date: Revisions: 11-22-13 12-1-13 f 12-2-13 21'-9 1/2" �'-6" 26 t n 12-19-13 1 n1-3-14 Gabin Cabinet Plan 2 B 55-16 BUILDER TO CONFIRM ALL existing REYI5ED PLAN scale: 1/4=1-0 I ` ' I G CONDITIONS AND DIMENSIONS ON SITE 10-5-16 Note: These plans are for the sole purpose and use of Gapizzi Home Improvement and are not ` 1 to be distributed or used for construction other I — — — — — — — — — — — — — — — — — — - — — — — 0 than by Gapizzi Home Improvement. _jr-' (T&- 4, e'�VAU t � � 13' 15'-4" 39'-2" v o> ' i` � c�v - - - - - - - o) � o 0 > O — — _ SHTRK ABOVE " — — — — — — — — — — I — —48 m ! EX FND WALL \ �� L— — — *'FYI 606&SLLDEFt EXISTING Z m = NEVqV - -- - - Nam + v GLOS ® REMOVE CLO ET -4 I a X EW GA5 FP LOG TION I I V v (RA15E r I I _ NOTE: =F RAFT FLOOR) I 5/8"5HTRK @ D GAREA / \ I I FAMILY ROOM G INSUOLATIONND v z VINYL FLRG / I NOTE: I OWNER SUPPLIED 28 T&G @ VARIOU5 WALL5 EXISTING WALL TO REMOVE EXI5TING W I LALLY BOX-IN EXI5TING THROUGHOUT I I p BE REMOVED FIN.LIVING 5PAGE W GGE55 NEW I ADD ENGINEERED BEAM LALLY TO REMAIN IT� ABINETFROM = _ _ _ _ _ = :::�Jj — _ _ _ _ — = a N — — — existin W N _+ I5 5IDE to remain n + FLR TO GLG' I 25'7 5/8" 28'-b" W W W LEAVE APPROX SPAN OF NEW BEAM I � J (6 _ NEW SHELVING EX m N B24B CUSTOMER SUPPLIE SPACE N + TO REMAIN ~ - ------ - ----- Z kn OW 6os6 NER 2 s6 _ W NEW I agB�e II solo I EXTEND G UNT I W SUP AND BASE -3 BASE GABS./ FOR REF INNDER N POTTING N -b UTILITY SINK IE 2' >� W — AREA OFFICEI Q IL UTILITY STORAGE 24'6" W NEW N (UNFINI5HED) ROOM ARE existing LU �m VINYL FLRG (UNFINI5HED) t__ 5268 — 11'-b" 4' to remain _ soss existing NEW 4 „ WA5H R LOUVERED BF g 5HONEZ o NEW 2-6 LZ Lmml 5TORA __ GE BOX-IN EX. 86 DUGT5 TO REMAIN PI 5 „ 3' 6'-2" existing EX. L------------------ - ------------- ----- r — NEW SINK, STAIR STEAM _ �_ _______________ I SB33 UNIT in FREE STANDING — — 5 NANDSE in ROOM GOUNTERTO I ( U)i u> DIVIDER J m UP O H — — — — — — — — — — — — — — — L NOTE:DUCT WILL PROTRUDE u�i ;. ., IN TO TOP OF DOOR OPNG; p — — — — — — — — — OWNER SUPPLIED DOOR; I I X BOTTOM OF DUCT AT 6-4 1/2 Ul - AFF I _r_ Ln w m 12'-2 1/2" 21'-9 1/2,, r T b" 26' N existing I ' I Date: to remain FINI5HE0 LIVING AREA PLAN scale: 3/16=1-0 I ` I I '' I Revisions: - - - - - - I 11- 1 — — — — 13 12 11-13 - 12-2-13 I L- - - - �NO�U3 1 3 BUILDER TO CONFIRM ALL 1-3-143-14 w d' GONDITION5 Final Plans: Accepted by: Date: `� AND DIMEN51ON5 ON 51TE p rev,uvj ^ ' Note: These plans are for the sole purpose and PA use of Gapizzi Home Improvement and are not S��J (� 2 f� 4/' to be distributed or used for construction other • Accepted by: Date: F�y than by Gapizzi Home Improvement. U AA UqLv.I yea,ty,f ar' � i` � � E ooav 06 V N ✓ E N Z •N to ` 0 U, v N � � v 13,- 15'-4" 39'-2., V E7mirIN7— .._ :... SHTRKABOVE 46" EX F.Np WALL. C7 F IjTIN -- LU ? O GL05 :. W GA�FP LOG TI: 1t--4—►I. :: - w fo ;I NE ON V X^3 .x ,, (RAISE. W X pzt, ,. GRAFT FLOOR) : Y'. " p YIN �RG. _ - .. .' FAhIjLY ROOM v I - -i 28' NOTE FINISHED AREA BYGHI:9BB.45F U-I (n EXISTING WALL TO REMOVE EXISTING r(�� BE REMOYED SLY BOX-IN EXI5TIN6` I '� W ADD ENGINEERED BEAM /LALLYTO REMAINFIN Z v :ACCESS NEW EXISTING FINISHED AREA:195.35E ® W 0 73 CABINET,FROM :- i;+ - } N n FLR TO'GLG I iEAVE - P257518 - _ 28'-b" n ( t. -.N4 -...:SHELVING -;PAGE - + /EX LrkLYS s EXISTING UNFINISHED:694:b 5F CUSTOMER 5U PPLIE _. r I(70 OWNER .., .. . SUPPLIED SINK .. �3 - ..::. v: :. - qEV4 d ,: EX7END'G UNT £ ANDBASE POTTING ' FOR REF; NDER. .OFFICE - NEW (UNFINISHED) -.� A6FA q' 5TORAGE V LNYL FLRG.: _ WASHER °J � •� � NEW 2=b m DUCTS TO REMAIN 3- b 2 - I STEAM w '� -,... SINK 0ASEj. UNIT E GOUNTERTO F s ? NOTE:DUCT W ILL PROTRUDE I.. - -'^" - '� `•" IN TO TOP OF DOOR OPNG; OWNER SUPPLIED DOOR; BOTTOM OF DUCT AT 6-4 1/2 AFF I:.` I (� Q U) fi 12'-21/2" 21'-91/2" T-b" b' PLAN SHOWING FINISHED/UNFIN I5HED N m I I Date: 11-1q-13 Revisions: 11-22-13 12-1-13 BASEMENT PLAN scale: 1/8=1-0 12-2-13 12-1 q-13 t BUILDER TO CONFIRM ALL 1-3-14 CONDITIONS Final Plans: Accepted by: Date: AND DIMEN51ON5 ON 51TE Note: These plans are for the sole purpose and use of Gapizzi Home Improvement and are not Accepted by: Date: to be distributed or used for construction other 20 than by Gapizzi Home Improvement. SEPTIC SYSTEM AS-BUILT ASSESSORS PARCEL #232050 #357 LAKESIDE DRIVE WEST CENTERVILLE, MASSACHUSETTS ELEVATIONS INSTALLER: TOP OF FOUNDATION =45.30 ROBERT B. OUR CO. INC. BLDG OUT(A) =42.69 P.O. BOX 1539 BLDG OUT(B) =42.69 HARWICH, MA 02645 SEPTIC TANK IN(A) =41.77 SEPTIC TANK IN(B) =41.79 SEPTIC TANK OUT =41.46 WEQUAQUET LAKE D—BOX IN =41.43 D—BOX OUT =41.23 CHAMBER IN =41.69 EDGE OF WATER(PER PLAN EDGE OF WATER EL._3 \ 4.2 9/30/14 N LOT 9 LAND COURT PLAN No. 20239C i AREA=15,423t S.F. Z 10 `�1 N W -P EXIST t�- . PORCH I ` EXISTING DWELLING #357 TOP OF FOUNDATION ELEVATION=45.3f CLEANOUTS A A 22.7A r 1500 GAL 8.2D 51 B 6.01) MONOLITHIC 9.OA SEPTIC TANK O 17.313 B VENT 32.OA 18.36 0 0 0 29.7A 33.56 55' LONG x 8.83' WIDE x 2' DEEP 18.56 LEACHING CHAMBER SYSTEM (H-20 LOADING) INSPECTION 20.00 PORT(TYP) BENCHMARK W E T S SETLAKESIDE DRIVE ELEVATION77ON = 40.99 OF MA N.G.VD. 29 DATUM P��N ssq _ — — — -- RICHARD � GRADY U NO 38072 RFGISTER�� FSS/p'AL CN'\- GRADY CONSULTING, L.L.C. OWNER/APPLICANT: ♦ Civil Engineers and Land Surveyors ♦ APRIL 27, 2015 ANNA & JOSEPH ROGERS 71 EVERGREEN STREET, SUITE 1 — KINGSTON, MA 02364 SCALE: 1"= 20' 57357 LAKESIDE DRIVE WEST Tel. (781)585-2300 — Fax. (781) 585-2378 JOB No. 14-266 CENTERVILLE, MA 02632-1836 1-24"0 MANHOLE COVER BROUGHT WITHIN 6" OF FINISH GRADE EL 45.3t PROVIDE ONE RISER WITHIN ° Ir ' , )l INSTALL ACCESS COVER WITHIN 3" OF FINISHED GRADE PROP VENT I° ' (INSPECTION PORT) Lewis �, 8.5 x 4.83 LEACHING CHAMBER x44.3 WATOERTIGHT COVER) 898� �` island °`- 'y c * x44.5 ( ) I1 I ' EXISTING GRADE (H-20 LOADING) RAISE INTERIOR PLUMBING FINISH GRADE +42.8 p„nd x43.5 PROPOSED GRADE - •. Shalt zc: Fend n n 1,.�. � /� +42.8 _ � . . r._ � � � '�' • ; '" FILTER FABRIC +42,2 PROPOSED OUTLET PIPES EL 42.25 4 PVC SCH 40 " PVC SCH 40 „ FILTER FABRIC EL 41.80 W »• '� Tf 3 a „ �; ( 4 DIA PVC_ 1=1 a _ _ 3 EX/STING OUTLET PIPE A' EL 41.67 S=.02 MIN ---+• s 4 PVC 5CH 40 - _ o w l C .�M � tee? 76 R « * t-_ 4 _�! 1 3 4n =.01 `^�-i1 ,1 ,,I E u, !ul ui !� - i a o 0 0 0 0 a _ 1 1-I a _ a I EXISTING OUTLET PIPE B" E . z " 5=.01 Win°?-, o o �;;��:_.�. r� � .,. `� ;� �►1� S-0.01 (MIN) _ ! � a. �- ,-� -=� i L 41.46 EL 41.65 � GAS . � _ �, �, 41.20 CRUSHED [ONE 2-0 8-6 2 0 EL EEL 41 AO Gooseberry `» •: " t i-I I -!, 1 EL.38.1 f bar ,,. = a 41.40 EL. 38.80 Cilsiand .L • b :: I;III= 2'-0" ��J C C� 4'-10" � r a 2'-0" III 5'_p" 1 �l � : . � t,�,'; 7° r I_I-i l _ - I 1 REIN. CONC. DIST. BOX J _ BAFFLE L. 00 v idler , ;, • ., . �. r �. v _ _ _ _- = I I USE 1-55 LONG x 8.83 WIDE x 2 DEEP ► ,•; 1 =�: a I f I L � u _ NOTE 1 o MIN W 5 OUTLETS o ! I_I I,-,P :,-,,,-,,.-, __ - ,,-,e, -,,,-,,I1- :'-w LEACHING CHAMBER SYSTEM WITH . •. � N , - i-1 i _!!,=1,!=i 11=1 I I-I I!=I,I . I I, i i 1-1 I,_,I 1=!I I=, I_;I I I I I !I- I I-ili_�1 I_!11=f I I=ill. CONTRACTOR TO VERIFY ELEVATION ��" Pt ;.'. '�� `' A � ' =1 II ICI l 1=11�_�!'_!!'_!!!=I I i=1 I�LL'J� �- -- 'I 1=)I I=`:.I =1(1='I(_!I 1=1 I 1=1 I I;(I 1=1 i 6„ CRUSHED STONE 24"-3 4" TO 1 1 2" 6 PRECAST CONCRETE LEACHING CHAMBERS �` • , OF EXISTING OUTLET PIPES PRIOR * 1 « fin R •' e , , , W Little N'� � r ,/� � �.� yin � O�'� PROPOSED 40MIL ; TO SETTING SYSTEM COMPONENTS. 10 MIN TO SLAB 10 MIN. � D U L -WA H �H-20 LOADING) Pt ;., .� r } , r, POLY BARRIER 1 55' CL _ ' ` •� LEACHING CHAMBER X--SECTION TOP EL.=41.9 i 1500 GAL (MIN.) PRECAST CONCRETE •$.t ' ,•'I•' F ' •: BOT EL.=37.9 � u ' MONOLITHIC SEPTIC TANK W 2 PVC SCH 40 TEES v ' 'a,+N =. •. (NOT TO SCALE) i / o J LOCATION MAP SCALE:1 "=2000' CD 0 GROUNDWATER EL. 34.80 SUBSURFACE SEWAGE DISPOSAL SYSTEM (NOT TO SCALE) (PER BOARD OF HEALTH) w SEPTIC DESIGN (NOT DESIGNED FOR GARBAGE GRINDER) oI C1_EANOUT HOMY 1. DESIGN DAILY FLOW: 4 BR. x 110 GPD = 440 GPD W CAP GRADE PRECA�ll AC DR _. 4"0 PVC WYE 45-BEND � �4"0 PVC WYE - 500 GALLONS 2. SEPTIC TANK: 440 GPD x 2 = 880 GAL. USE: 1500 GAL (MIN) 27BEN SEE PLAN VIEW DETAIL CONCRETE H-20 N C EANpOUT PRODUCTS 3. LEACHING CHAMBERS: P.R. 2 MIN/IN �CLASS I (SEE SIEVE ANALYSIS) W CA USE. 1 8.83 WIDE x 55 LONG x 2 DEEP LEACHING CHAMBER SYSTEM v CLEANOUT DETAIL TITLE V z PROPOSED AREA: 2(2x8.83) + 2(2x55) + 8.83x55) = 740.9 S.F. CAPACITY: 740.9 S.F. x 0.74 GPD/S.F. = 548 > 440 GPD(D.D.F.) SEPTIC NOTES 1. PROPERTYLINE DATA FROM LAND COURT PLAN No. 20239C, SHEET 2. WEQUAQUET LAKE 2. TOPOGRAPHIC SURVEY BY GRADY CONSULTING SEPTEMBER 30, 2014, ---_, 3. SOILS TESTING BY RICHARD GRADY, GRADY CONSULTING WITNESSED BY BOARD OF HEALTH AGENT DONNA MIORANDI OCTOBER 28, 2014. TB6 4. CALL DIG SAFE 1-888-344-7233 AT LEAST 4 DAYS PRIOR TO COMMENCEMENT OF CONSTRUCTION. EDGE OF WATER(PER PLAN 5. NOTIFY TOWN AND GRADY CONSULTING PRIOR TO BACKFILLING OF SYSTEM. (� EDGE OF WATER EL` 6. NO KNOWN WELLS EXIST WITHIN 200' OF THE PROPOSED SYSTEM �, ;j`36�+'•• �y�T �`B�2 '!9/30/�4 1 � �� 3*-0" 7. THE SITE IS LOCATED IN AN AQUIFER PROTECTION ZONE IL TB 8. ALL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC MARKING TAPE OR A `� � O t j � ? ``� �,� �%�'Gq��•.•, T -�-�� can Tg2 ~� 1 ( COMPARABLE MEANS IN ORDER TO LOCATE THEM ONCE BURIED (310 CMR 15.221(12)) r v L 1 9. WETLANDS EXIST WITHIN 100 FT OF THE PROPOSED SYSTEM. LOT 9 - 10. THE SITE IS NOT LOCATED IN A FLOOD PLAIN DISTRICT. LAND COURT PLAN No. 20239C X Z �a ' � 1 11. NO KNOWN EASEMENTS ARE IN THE AREA OF THE PROPOSED SYSTEM. ,? AREA=15,423E S.F. 1 �, �, 1 12. EXCAVATE ALL MATERIAL A,B LAYERS & EXISTING SYSTEM TO MEDIUM SAND C1 LAYER 32„ °72 5' AROUND SYSTEM. REPLACE WITH CLEAN COARSE SAND IN ACCORDANCE WITH 310 C{R )M < 15.255 (3). EXCAVATION TO BE INSPECTED BY GRADY CONSULTING L.L.C. AND TOW { ) N PRIOR TO SOIL REPLACEMENT. f (+ �.� _ <<� I il� I EXrsr ,�� II, I Ii � _ __. ;I ,I� ; 1 t APPROXIMATE PERC SAND VOLUME - 65 x 18.83 x 41.8 40f 27 + 20% = 98f G.Y. t � _ h „� [ ( } / EXlST1NG N � 1I�i ,, PORCH � 1 ADE STOCK !f, �IIIIIII, � FENCE �� - _ ZONE tot tX� ' LOCAL UPGRADE APPROVAL REQUESTS -_ 1 UFF% P FapO , PROPOSED 15a0 � EXISTING DWELLING - t H. ,,.,� GAL MONOLITHIC �i #357 - f 50 QROX�MPi 1. 15.405(1)(b) REDUCTION OF SYSTEM LOCATION SETBACK TO THE CELLAR SEPTIC TANK �� TOP of FouNDAMON � � WALL FROM THE REQUIRED 20 FT. TO 10.0 FT. ELEVA170N=4531 �LEANOUT j _ ' 2. 15.405(1)(h) REDUCTION IN THE SEPARATION BETWEEN THE BOTTOM OF THE ExrsTiNG 1 - PROPOSED VENT PROPOSED SHED sEPrl� TANK 10.9' 1o'MIN I �� SOIL ABSORPTION SYSTEM AND THE HIGH GROUNDWATER ELEVATION FROM "-' PROPOSED 55' LONG x 8.83' WIDE x 2' DEEP (OR APPROVED EQUAL) THE REQUIRED 5 FT. TO 4 FT. 37.3 �,12� ' ; $4 WYE *10.0' N 1 LEACHING CHAMBER SYSTEM (IH-20 LOADING) (20'MIN) I /t 3. 15.405(1)(i) USE OF A SIEVE ANALYSIS WHERE A PERCOLATION TEST COULD 0-0-0 - _ SHO Y PRECAST CONCRETE PRODC MS NOT BE PERFORMED. R0 MrrLL LIMIT OF EXCAVATION EXISTING � , T I � � _ ------- •-- ._ A21 EMO (SEE NOTE 12) 351 VNtesP { )( ) WATER SERVICE R >>�."; " - � -� � 4. 15.405 1 k REDUCTION IN THE REQUIRED AMOUNT OF DEEP HOLES PER o z /3(101 �, S.Ya rmouth MA 02 o o APPROXIMATE LOCATION / M N ._ , PROPOSED 40 MIL DISPOSAL AREA FROM 2 HOLES TO 1 HOLE. X o Q EX/STING LEACHING FIELD i� O `` t POLY BARRIER (800)43g� 5 *'(508)7,60-1070 W W (REMOVE AS NECESSARY) €' ' - _ ' to REMOVE �.._. Z r g0' BUFFER ZONE LOCAL VARIANCE REQUESTS PROPOSED ASPHALT Ld "`,-- � ��s;' -� - -�� - ---� INSP TIO ti I ' DRIVEWAY 16501 5.F. EXlS77NG ' -�� "� ` 1. 360-1 REDUCTION IN THE REQUIRED SOIL ABSORPTION SYSTEM SETBACK TO m r - ` PORT 9,I ) A WATER BODY FROM THE REQUIRED 100 FT. TO 51 FT. z W= ASPHALT ORII/EWAY �- 4? w" EXISTING *EN77RE PARCEL lS WITHIN SOIL LOGS o J�� / "" �l f '1.: :_ ' GA5 sERUICE THE 100' BUFFER Z0/NE REQUIRED INSPECTIONS 2. 360-1 REDUCTION IN THE REQUIRED SEPTIC TANK SETBACK TO A WATER m (1948f S.F.) C,�s J f L '136.00 ; R=400. 0 o Q (REMOVE) 0�PAVEMENT BODY FROM THE REQUIRED 100 FT. TO 72 FT. Z}25 z `=- --- -- ---- - EDGE 1. AFTER EXCAVATION OF LEACHING AREA PRIOR TO INSTALLING SAND. T.H. 2 10 F EXISTING O!/ERHEAD m J BENCHMARK PROPOSED ASPHALT ELECTRIC sERt/rcE 2. AFTER SYSTEM CONSTRUCTION PRIOR TO BACKFILLING. EL. 43.20 Z" z DRIVEWAY o 0 SPIKE SET VT E S 3. AFTER FINAL GRADING IS COMPLETED. T REVISPONS V)Z Q o ELEUAnDN = 40.99 LA K E S I D E �\ j �1F� (ADDITIONAL INSPECTIONS MAY BE REQUIRED BY THE BOARD OF HEALTH) 0"-12 1/12/15 C2 HORIZON CHANGED TO SAND W g Q (NO VD. 29 DATUM) z o F°c wF5 wF6 - -' PROPOSED SILT SACK typ) A 1/13/15 MONOLITHIC SEPTIC TANK PER BOH ( SANDY LOAM 42.20 ��wo _ `� ED OF w GF PAI/EMEN 2" 2" o C - T W Z V _ , ,. j y 4 1 -3 } -o �ti �.`�...; ... '*51.5' B J a o z �� ,r- �' 72 7, ( " SANDY LOAM SEPTIC REPAIR PLAN Ul Z W �F� _ * 100 MIN-TOWN) 40.53 W O (100' MIN-TOWN) (50 MIN-STATE) 12 DIA. BIODEGRADABLE SILT SACK FILLED STAKE EVERY 4 FEET PERC �WZ h� 0 (25' MIN-STATE) WITH WOOD CHIP COMPOST BLEND 32"-66" ASSESSORS PARCEL #232050 � Z �•: 00a C1 OF MASS Q~ A�%��'' -- PROTECTED -�` �. DISTURBED AREA-► " " cti 357 LAI�:ESIDE DRIVE WEST - W�Z w ��•� #WETLANDS DELINEATED BY JOHN MED SAND 32 -50 �,�P k�p �sN �r` ZIMMER SEPTEMBER 30, 2014 RESOURCE AREA - WATER FLOW P.R.<2 R1GN .5 MIN/IN o GRApY- CENTERVILLE MAS SACHUSETTS z &° TRAPPED SEDIMENT 37.70 o WEQUAQUET LAKE I(I�il� I I I =1 I I I!-'I i�r - o� REcisIE. �� APPLICANT z _- ' FSSio Al.c�� NOVEMBER 14, 2014 1EEM , WIND RIVER ENVIRONMENTAL U " � `, I!I- I I=�I -S i-,!!--!I I-'I I=i11=1� CONSISTENT 66"-114" SIEVE SCALE: 1„=20' wo�o E- ! -i - ! - _ -1 . -. 1=1 f 1-.111=11!=1 I!-1 11=1=1 I!EH I 1 GROUND CONTACT SAMPLE 577 MAIN STREET SUITE 110 �r©i. 20 0 20 40 60 '1!-i I I-I I 1-1 I i=1 I = C2 TAKEN JOB NO. 14-266 Q<� 1=!1=1` SAND HUDSON, MA 01749 �o c p 4 Q o�8 o z Scale 1 " = 20' SILT SACK DETAIL D-9,-6" 33.70 GRADY ONSULTING, L.L.C. �o� WATER 71 Evergreen Street, Suite 1, Kingston, MA 02364 0 o Q w� NOT TO SCALE 0 9 9 Ir" Phone (781) 585 2300 Fox (781) 585-2378 (L=Q� 9'-4" v z�o Q (EL.=33.86) SHEET 1 OF 1 Oz N u-► ct) w UJ tu LEC-cENU z � Ow PROPOSED L� 2x6 STUD WALL cA N z 2'-8" WIDE x &'-5" HIGH o� SWINGING DOOR � PROPOSEDLU la 2x4 STUD WALL Cl z o ui=4 o a WINDOW UNIT Z — �, -4 I EXISTING Q A STUD WALL z ain } Lu EXHAUST FAN () � p � r F�z� 4 z ® WOOD POST w E_ _ SO CFM MIN, 'ma r Tq W VENTED u- TO EXTERIOR Lu N EzU- � u wQ Q0 > ; w (� 7 w W Lu y Al—Cy7/8 �-- •R— � �� — L1 t Q F— PD12b6 3 zip - _.... . 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