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Home My WebLink About0500 MAIN STREET (CENT.) - Health (2) -7500 Main Street (Cent.) Centerville P 207 045002 No. 4210 1/3 ORA Pendaflex K4 100 Stanton, David From: Florence, Brian Sent: Wednesday, March 27, 2019 11:49 AM To: McKean, Thomas; Stanton, David Subject: RE: 498 Main Street, Centerville as shown on plan dated February 5, 2019 This is what happens when regulatory staff are put in a position of having to do the job of lawyers. For the purposes of this discussion DEP, Board of Health and HD staff have to look at this situation through the lens of health regs. (Title 5). In this instance though there are mitigating circumstances beyond your regulatory authority that you would not necessarily be aware of unless you ask. Fortunately those circumstances addresses the DEP and BOH's concerns. As I understand it the Board of Health correctly asked a very important question about the status of the lot for reasons other than Health regulations. Specifically,they asked whether or not the property is two individual lots or one. Their question as he presented it is the reasoning for my email response to Mr. Hayes. As you know... but for Full disclosure: I worked with.Mr. Hayes in Dennis. It appears that the chief concern of the BOH and DEP is whether or not the property can be subdivided and conveyed, the fact of the matter is that it cannot for zoning reasons. The property was given what is known as an Approval Not Required (ANR) plan from the Planning Board. The ANR allowed for the creation of lot lines... however the granting of an ANR does not grant rights to the property owner to violate zoning ordinances or by-laws. There are several conditions on the site which prohibits the lots from actually being subdivided and conveyed: 1. Despite the ANR plan the property is still required to comply with the dimensional requirements of zoning...The front lot does not have a minimum 5000 sq.ft. or the required 50' of frontage as required by M.G.L. c.40A... separating the lots would create lot area violations by creating a lot that is nonconforming with law...not just our ordinance. 2. If the lots were separated it would create a condition where the structures were too close to lot lines... thus creating several setback violations. 3.There is a single-family dwelling straddling the property lines...this creates a use merger of the two lots under zoning. The ANR is recorded at the registry of deeds which is all that we need to enforce against a subdivision and/or conveyance.: Easements are not necessary nor would they help...whether or not you can grant an easement to yourself is a matter of law and not something we should or need to consider. Finally,the owners received bad advice when they obtained an.ANR...they would have been better served to create a condominium with exclusive use areas which is in effect that they did. Please feel free to touch base with me if you have any further questions. -Brian -----Original Message----- From: McKean,Thomas Sent: Wednesday, March 27, 2019 9:29 AM To: Florence, Brian Subject: FW: 498 Main Street, Centerville as shown on plan dated February 5, 2019 Good Morning Brian FYI - Brian Dudley of DEP emailed David Stanton back on 2/23/086 regarding this question . It was emailed to me again this morning, as you can see below. r� -----Original Message----- From: Stanton, David Sent: Wednesday, March 27, 2019 9:18 AM To: McKean,Thomas; Desmarais, Donald; Lavelle,Timothy; Malkus, Karen; McKenzie, Marybeth; Miorandi, Donna; O'Connell,Timothy; Parziale,Jim Subject: RE:498 Main Street, Centerville as shown on plan dated February 5, 2019 Tom, Below is the:e-mail from Brian Dudley on 2/23/2006 From one of the several cases we have had like this over the years. There was another one with Brian Grady as the applicant (I believe it was Roberta Goughs old house.) Hi David, You are correct that all the legal boundaries need to be shown. If the lots are owned by the same person, he may not be able to grant an easement to himself, but he should have proper documentation prepared to execute the appropriate easements if the property changes hands. At the very least,there should be a notice recorded with the registry to run with the property indicating that an easement will be required if the properties are owned by two separate entities. If you have any more questions, let me know. Thanks, Brian From: Stanton, David [mailto:David.Stanton@town.barnstable.ma.us] Sent: Thursday, February 23, 2006 12:06 PM To: Dudley, Brian (DEP) Subject: 310 CMR 15.220 (4)(a), legal boundaries Good afternoon Brian, I am having an issue with a land surveyor\RS that has submitted plans for a septic system. The issue I have, is he has not shown all of the legal property lines on the plan. He has removed one of the property lines from his plans. He kept saying he wanted to go to the Town assessors and just have them combine the lots for taxes so it looks good with the Town records. I told him I thought that would not work, and that it must be done legally at the Registry of Deeds. He claims that because it is the same owner of two abutting lots, we can assume they are the same lot. When I see "legal boundaries" in the State code, I assume that is from the registry of deeds and\or land court. Am I correct in telling him they must be combined through the registry of deeds,and not just the Town Assessor? He is looking at putting part of the septic system from the house onto the other lot. I also told him he may be able to file an easement with the registry of deeds. Thanks, David W. Stanton, RS Health Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 fi Direct phone: (508) 862-4647 Health Dept:: phone: (508) 862-4644 Health Dept.fax (508) 790-6304 2 -----Original Message---- From: McKean,Thomas Sent: Wednesday, March 27, 2019 8:35 AM To: Desmarais, Donald; Lavelle,Timothy; Malkus, Karen; McKenzie, Marybeth; Miorandi, Donna; O'Connell,Timothy; Parziale,Jim;Stanton, David Subject:498:Main Street, Centerville as shown on plan dated February 5, 2019 The Board granted the variances for the above-referenced property. Also, the two lots are merged per Brian Florence (e-mail below). -----Original Message----- From: Florence, Brian Sent:Tuesday, March 26, 2019 4:27 PM To:Terence Hayes Cc: McKean,Thomas Subject: RE: Zoning determination for 498 Main Street, Centerville as shown on plan dated February 5, 2019 Mr. Hayes, After a careful review of the site plan dated 2/5/19 1 have determined that the two lots shown on the plan have merged as a result of use. if you have any questions please feel free to contact me. Regards, Brian Florence, Building Commissioner Building Department I Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4038 Brian.florence@town.barnstable.ma.us -----Original Message----- From:Terence Hayes [mailto:angus02631@icloud.coml Sent:Tuesday, March 26, 2019 4:15 PM To: Florence; Brian Subject: Zoning determination for 498 Main Street, Centerville as shown on plan dated February 5, 2019 Dear Mr. Florence, At the Barnstable BOH Meeting this afternoon,the board questioned whether the property shown is two individual lots or one. Has these two lots been merged for zoning purposes? Thank you for your consideration. Respectfully, Terence M Hayes Sent from my iPhone CAUTION:This email originated from outside of the Town of Barnstable! Do not click links,open attachments or reply, unless you recognize the sender's email address and know the content is safe! 3 h COMMONWEALTH OF MASSACHUSETTS�AFFAIRS EXECUTIVE OFFICE OF ENVIRONMENTAL PROTECTION DEPARTMENT OF E�gONMEN A a Y :a TITLE 5 O FFICIAL INSPECTION FORM—NOT FOR VOLUNY AR AL �FOMENTS ' SUBSURFACE SEW PAR DIASPOS CERTIFICATION Property Address: 500 Main Street, Centerville,MA Owner's Name:Kenneth E.Mills c s CA) Owner's Address: P.O.Box 1103,Centerville,MA Date of Inspection: 04/14/2008 — Name of Inspector:Reid C.Ellis cry e Company Name:Ellis Brothers Const.Co. ailing Address:23 Enterprise Road r Yarmouth Port,MA 02675 elephone Number:508-362-6237 CERTIFICATION STATEMENT dis osal system at this address and that the information reported __ certify that I have personally inspected the sewagep inspection.The inspection was performed based on my elow is true,accurate and complete as of the time of the systems.I am experience in the proper functi and maintenance of on sit0e CMR 15.000)disposal lThe system: a DEP _ ammg and p n: approved system inspector pursuant to ection 15.340 of Title 5(31 ( Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails J —� ,4, /�'; Date• Inspector's Signature: of this inspection report to the Approving Authority(Board of Health or The system inspector shall submit a copy p Tonal office 10 the completing this inspection.If the system is a shared system or has a design flow of 10,00 DEP)within 30 days of comp g report to the appropriate regional gpd or greater,the inspector and the system owner shall submit the rep opies sent to the buyer,if applicable,and the approving DEP.The original should be sent to the system owner and c authority. 1 Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. I Page 2 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 500 Main Street,Centerville,MA Owner: Kenneth E.Mills Date of Inspection:04/14/2008 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. /System Passes: j I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CARR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in he"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacernei it 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- The septic tank is:metal and over 20 years old*01 the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration tank failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structura ly sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or hi ft static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven c istribution box.System will pass inspection if(with approval of Board of Health): broken pipe(s)are placed obstruction is remo ed distribution box is 1 veled or replaced ND explain: The system required pumping more than 4 times year due to broken or obstructed i .The pipes( ) system will pass inspection if(with approval of the Board of Health) broken pipe(s)are laced obstruction is remov ND explain: 2 TitiP.5 TncnPrttinn Fran All GNlH1A 2 ' r Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 500 Main Street, Centerville,MA Owner: Kenneth E.Mills Date of Inspection:04/.14/2008 C. Further Evaluation is Required by the Board of jbye Conditions existwhich require further evaluatioBoard 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 15303(1)(b)that the system is not functioning in a manner which will 1 irotect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface i vater _ Cesspool or privy is within 50 feet of a borderin g vegetated wetland or a salt marsh 2. System will fail;unless the Board of Health(and P ablic Water Supplier,if any)determines that the system is functioning in a manner that protects the pe blic 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 waters ply. _ The system has a septic tank and SAS and the S. is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the S. is within 50 feet of a private water supply well. The system has a septic tank and SAS and the S kS is less than 100 feet but 50 feet or more from a private water supply wells.Method used to de a distance "This system passes if the well water analysis,perf rmed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates th the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitroge i is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis n ust be attached to this form. 3. Other: 3 Title 5 lnsnectinn Farm&h w7nnn 3 Page 4 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 500 Main Street,Centerville,MA Owner: Kenneth E.Mills Date of Inspection: 04/1V2008 D. System Failure Criteria applicable to all systems: You most indicate"yes"or"no"to each ofee following for all inspections: Yes Ng/ ackup of sewage into facility or system component due to overloaded or clogged SAS or cesspool harge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid.level in the distribution box above outlet invert due to an overloaded or clogged SAS or Cof quid�depth in cesspool is less than 6"below invert or available volume is less than%day flowpumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number es pumped _ y portion of the SAS,cesspool or privy is below high ground water elevation. — — Portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface �/Wate✓ supply. _ portion of a cesspool or privy is within a Zone I of a public well. portion of a cesspool or privy is within 50 feet of a private water supply well. portion of a 1 or privy is less than 100 feet but than 50 feet from a private�sP� P "Y p ate 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 most be attached to this form.] �ll C.�(Y�o)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 thi following: (The following criteria apply to large systems m add ition to the criteria above) yes no — — the system is within 400 feet of a surface 1 6ikmg water supply — — the system is within 200 feet of a trib to a surface drinking water supply — — the system is located in a nitrogen sensiti area(Interim Wellhead Protection Area—IWPA)or a mapped Zone H of a public water supply well If you have answered"yes"to any question in Secti n E the system is considered a significant threat,or answered "yes"in Section D above the large system has fail 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. I 4 Title 5 Incnectinn Fnrm A)i innnn 4 I Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 500 Main Street,Centerville,MA Owner: Kenneth E.Mills Date of Inspection:04/14/2008 Check if the following have been done.You must indicate"yes"or"no;"as to.each of the following: No Ping information was provided by the owner,occupant,or Board of Health Were any of the system components pumped out in the previous two weeks? as the system received normal flows in the previous two week period? _ Have large volumes of water been introduced to the system recently or as part of this inspection? — Were as built,plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up _ Was the site inspected for signs of break out? Were all system components,excluding the SAS,located on site Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of th affles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Ye Existing infonnation.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)) 5 Title 5 Insn&-hnn Fnrm(lt,;nnnn 5 Page 6 of l I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 500 Main Street,Centerville,MA Owner: Kenneth E.Mills Date of Inspection: 04/14/2008 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): . Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms) . Number of current residents: Does residence have a garbage grinder(yes or no):— Is laundry on a separate sewage system(yes or noW if yes separate inspection required] Laundry system inspected(yes or no);/L�17 Seasonal use:(yes or no);o�Water meter readings,ifavailole(last 2 years usage(gpd)): 06 A A-- 07 q3 k - Sump pump(yes or no):;A�J Last date of occupancy: COMMERCIAL%INWSTRIAL / Type of establishment: Design flow(based on 310 CMR 15203): Basis of design flow(seats/personstsgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system 0 es or no):— Water meter readings,if available: Last date of occupancy/use: OTHER(describe): �P GENERAL INFORMATION Pumping Records Source of information: Was system pumped as p` of the' on or no): If yes,volume pumped allons—How as pumped determined?' �� J` AvG/V Reason for pumping: �"� OF SYSTEM �+++//// Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool Privy —Shared system.(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) —Tight tank _Attach a copy of the DEP approval —Other(describe): A proximate age of all components,date installed(if known)and source of information: - i✓ e , -- Were sewage odors detected when arriving at the site(yes or no): ,-OVJ i 6 Title S ImnPrtinn Bnrm 6h gnnnn 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ' SYSTEM INFORMATION(continued) Property Address: 500 Main Street,Centerville,MA Owner:Kenneth E.Mills Date of Inspection: 04/14/2008 BUILDING SEWER(locate on site plan)/40 Depth below grade: ,Materials of construction: cast iron PVC_other(explain): Distance from private water supply well or suction line: � ' Comments(on condition of joints,venting,evidence of e, N-4f- SEPTIC TANK:1 ocate/onsite plan) k L Depth below grade:�_ o Material of construction:_; concrete metal fiberglass __polyethylene —other(explain). — — A14 If tank is metal fist age: Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) .4 Dimensions: SG Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: f;P Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffie: How were dimensions determined: Comments(on pumping recommends ions,inlet and outlet or baffi ' .con n,structural integrity,liquid levels as related to outlet.rove evidence of leakage,etc.): r_Zd A 31 GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction: concrete metal fiberglass lyethylene—other (explain): — — — Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffi . Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,;evidence of leakage,etc.): 7 Ti'..rn.liI f/)AAA 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: 500 Main Street,Centerville,MA Owner: Kenneth E.Mills Date of Inspection: 04/14/2008 ' e of' 'on locate on site plan) TIGHT or HOLDING TANK: (tank must be p at time mspech X P Depth below grade; Material of construction: : concrete metal fib-,mlass polyethylene other(explain): Dimensions: . Capacity: gallons Design Flow: gallons/day Alarm present(yes-or no) Alarm level: Alarm in working order(yes or no) Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:Pof present must be opened)(locate on site plan) Depth of liquid level above outlet invert:/�' 1O Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of bqx etc.)- rt.-1--Ne �S. 7 a/ ICI c�._a t.✓ob, 3 PUMP CHAMBE R. (locate on site Plan) Pumps in working order(yes or no): Alarms in wonting order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 500 Main Street,Centerville,MA Owner:Kenneth E.Mills Date of Inspection:04/14/2008 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type eaching pits,number. s leaching chambers,number. leaching galleries,number leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number innovative/ahernative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc. - i CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic fiti lure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on.site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydra 'c failure,level of ponding,condition of vegetation,etc.): 9 9 Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ,� f SYSTEM INFORMATION(continued) Property Address: 500 Main Street,Centerville,MA Owner: Kenneth E.Mills Date of Inspection:04/14/2008 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. ,ol �r - -2- 2, 2B -3411 e' r i 10 tr y 341 ,r:+I^c r......,....:—V......kn cr►nnn 10 Page I I of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART C SYSTEM INFORMATION(continued) Property Address: 500 Main Street,Centerville,MA Owner: Kenneth E.Mills Date of Inspection: 04/14/2008 SITE EXAM Slope Surface water <... Check cellar Shallow wells Estimated depth to ground watea feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Necked with local Board of Health-explain: Checked with local excavators installers-(attach documentation Accessed USGS database-explain: You must describe how you established the high ground water elevation: /�/�► (n1 L' �lei.! _ e7. 7 E [ ®'JV A/w�4i ice'4� � 1 -L L6C Il T:slo[T......e..ti....'C...-..4/1[hAAA 11 Town of Barnstable OF THE Tp� Regulatory Services , ,STAB Thomas F. Geiler, Director 0 9. Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 REGARDING SEPTIC INSPECTIONS BY PRIVATE CONTRACTORS DISCLAIMER This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original or copy of the report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observations and interpretations contained within this report. In addition, by receiving this report' the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would be listed on the ."Disposal Works Construction Permit". If you should have any questions regarding this report, please contact the certified Septic System Inspector who conducted the inspection. QASEPTIODisclaimer Private Septic Inspections.DOC TOWN OF BARNSTABLE LOCATION- CdQ SEWAGE# VILLAGE C-e n--*-,ryy 1 ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. h,P-e C j'v4, SvEPTIC TANK CAPACITY r 1 S a�ty ors' C�%rSl LEACHING FACILITY:(type) (size) l� 'NO.OF BEDROOMS OWNER 14 -e h n,-1"h PERMIT DATE: /"---- COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted.Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY all wells wrthi.: ;y enters the building . to A 3 23`4-° y1,V 4, f4 v. 311 i .c2�� COMMONWEALTH OFpp M SSACHUSETTS b R EXE ''>✓£ }F ITOF kNVIRONMENTAL AFFAIRS DEPL� N-"&ONMENTAL PROTECTION A,� ��N�60�� h PARCEL LOT TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 500 Main Street,Centrville,MA 02632 Owner's Name:Kenneth and Lisa Mills Owner's Address:500 Main Street,P.O.Box 2086,Centervill,MA Date of Inspection: July 12,2004 Name of Inspector: REID C.ELLIS Company Name: ELLIS BROTHERS CONST.CO. Mailing Address: 23 ENTERPRISE ROAD, P.O.BOX 59,YARMOUTH PORT,MA 02675 Telephone Number: 508-362-6237 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 pursuan7P"asses tion 15.340 of Title 5(310 CMR 15.000� The system: Conditionally Passes Needs.Further Evaluation by the Local Approving Authority Fails Inspector's Signature: �� Date: 7-1 . The system inspector shall submit a copy of this inspection report to the Approving AuthoritYBoard o f ` Health DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 1 Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 500 Main Steet,Centerville,MA Owner:Kenneth and Lisa Mills Date of Inspection:July 12,2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not fo d 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: 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 o ir repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the fo the following statements.If"not determined"please explain. The septic tank is metal and over 20 years old*or d a septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or failure is imminent.System will pass inspection if the existing tank is replaced with a complying septic tank as al proved by the Board of Health. *A metal septic tank will pass inspection if it is structuralli sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is availabl ND explain: 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 dig ribution box.System will pass inspection if(with v approval of Board of Health): broken pipe(s)are rep aced obstruction is removet distribution box is lev led or replaced ND explain: 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 rep) cat obstruction is removed ND explain: 2 Y Page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM . PART A CERTIFICATION(continued) Property Address:500 Main Street,Centerville,MA 02632 Owner:Kenneth and Lisa Mills Date of Inspection:July 12,2004 L/� C. Further Evaluation is Required by the Board of I lealth: 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 dete . es in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which vy H protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surfi x water — Cesspool or privy is within 50 feet of a bord ring vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(a d Public Water Supplier,if any)determines that the system is functioning in a manner that protects th,,public health,safety and environment: _ The system has a septic tank and soil absory tion system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface wat supply. _ The system has a septic tank and SAS and 9 te SAS is within a Zone I of a public water supply. The system has a septic tank and SAS and d ie SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and a SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to detrmine distance "This system passes if the well water analysis, er formed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicat s that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nit ogee is equal to or less than 5 ppm,provided that no other failure criteria are triggered_A copy of the analy.is must be attached to this form. 3. Other: 3 'I Page 4,of i l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:500 Main Street,Centerville,MA Owner:Kenneth and Lisa ATMs Date of Inspection:July 12,2004 D. System Failure Criteria applicable to all systems: You must'vidicate"yes"or`IW'to each of the following for all inspections: Yes N _ t ckup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or spool ry iquid depth in cesspool is less than 6"below invert or available volume is less than 1/2day flow ired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number mes pumped portion of the SAS,cesspool or privy is below high ground water elevation. p ortionn of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. ��Zy portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the welt 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 ware triggered.A copy of the analysis must be attached to this form.] y are 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 se a facility with a design flow of 10,000 gpd to 15,000 gPd You must indicate either`yes"or`5no"to each of the fol owing: (The following criteria apply to large systems in additio to the criteria above) yes no the system is within 400 feet of a surface drini ing water supply _ the system is within 200 feet of a tributary to I surface drinking water supply the system is located in a nitrogen sensitive ar, (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. 4 i it Page 5 of i 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:500 Main Street,Centerville,MA Owner:Kenneth and Lisa Mills Date of Inspection:July 12,2004 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Y 77ere pinginformation was provided by the owner,occupant,or Board of Health any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage crack up? Was the site inspected for signs of break out? Were all system components,Xluding the SAS, located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of t e battles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based o& Y no Existing information.For example,a.plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] 5 Page 6;of 1 l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address:500 Main Street,Centerville,MA Owner:Kenneth and Lisa Mills Date of Inspection:duly 12,2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): ) Number of bedrooms(actual): J? DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder(yes or no)X.,0 Is laundry on a separate sewage system(yes or no)./6v[ifyes separate inspection requ ed] Af/y Laundry system inspected(yes or no)� 7f� �i N A-,,- A P Seasonal use:(yes or no)./� p Wate meter readings,if available(last 2 years usage(gpd): � ! A- _Od 3 Z OAt_' Sump'pump(yes or no): .4�01 Last date of occupancy: ..// COMMERCIALRNDUSTRIAL ,Vf� Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system I or no _ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): /v GENERAL INFORMATION Pumping Records Q�� Source of information: 4� , Was system pumped as part of the inspection(yes or no): If yes,volume pumped-/, aIlons—Ho. was }ant ur, eddetermined? Reason for pumping: 'JiPW . TYE OF SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool —Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate agegf all components,date installed if known)and urce of mfi ation: CA E+ Were sewage odors detected when arnvmg at the site(yes or no): ZOjN �9� 1914V IN / C , Page 7 of 1 l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:500 Main Street,Centerville,MA Owner:Kenneth and Lisa Mills Date of Inspection:July 12,2004 BUILDING SEWER(locate on site plan) /O a Depth below grade: - / Materials of construction: cast iron V 40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on Fndition off•°ts,venting,evict ceef leakage,etc.): / —T SEPTIC TANK: locate on site plan) Depth below grad "Apo Material of construction:_concrete metal_fiberglass_polyethylene other(explain) tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) i Dimensions: Sludge depth:: Distance from top sludge to bottom of outlet tee or baffle: . Scum thickness: 3 p Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: ~ How were dimensions determined: Comments(on pumping recommen • s,inlet and outleffm or balffe con (tion,structural integrity,liquid levels as related to outlet invert,evidence of leakagF,etc.) r�l o LaC GREASE TRAP: (locate on site plan) Depth below grade:_ Material of construction:_concrete metal fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or e: Distance from bottom of scum to bottom of outlet t or baffle: Date of last pumping: Comments(on pumping recommendations,inlet an I outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc. 7 Page 8 of l l OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 500 Main Street,Centerville,Ma Owner:Kenneth and Lisa Mills Date of Inspection:July 12,2004 N TIGHT or HOLDING TANK: (tank must be pum at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal—fibe,glass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: allaaisJday Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: 4if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out o£box, c.): , S 4 pw &'46 /I4 ,1A W4' USli'4L PUMP CHAMBER: locate on site plan) ( P ) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:500 Main Street,Centerville,MA Owner:Kenneth and Lisa Mills Date of Inspection:July 12,2004 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type ching pits,number:_ [� eaching chambers,number: 714��`►� "—� �- A o,l cj� ,q/l oywe� 7 leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): A1,45 w u CESSPOOLS: (cesspool must be pumped as part f inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic fa lure,level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraul failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) N Property Address:500 Main Street,Centerville,MA Owner:kenneth and Lisa Mills Date of Inspection:July 12,2004 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.Pie PV tip P w o O ! 0 15 S if 3 el 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 500 Main Street,Centerville,MA Owner:Kenneth and Lisa Mills Date of Inspection:July 12,2004 SITE EXAM Slope .e- Surface water Check cellar �y Shallow wells � ` Estimated depth to groundwater feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ecked with local Board of Health-explain: /Checked with local excavators,installers- attach d�ocy�jnennta�tion) Accessed USGS database-explain: 67C1A A10 6 Z f:w You must describe how you established the high ground water elevation: N -�' J; p � -b- Cab fY /v J —�r— AQL-T, z .f3 " - 3.3 11 l TOWN OF BARNSTABLE �L LOCATION SEWAGE# Ra 0 o2 7 VILLAGE CCgW�-Vl L&6- ASSESSOR'S MAP& LOT 29 INSTALLER'S NAME&PHONE NO. J�e5 /1j/lo 5. Ca ti'S( �a�- 3loa��a37 SEPTIC TANK CAPACITY. Soa LEACHING FACILITY: (type) 2 5700 (f (size) ��/Xo2�Xv?�610�0 NO.OF BEDROOMS 3 UI DER OR��WNER.) L- PERMTTDATE: COMPLIANCE DATE: U 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 feet of teaching facility) Feet Furnished by U? ov I r , ` \�, No.� � Fee THE COMMONWEALTH OF MASSACHUSETTS £c PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Application for Migpogar *pgtem CZongtruction Permit Application is hereby made for a Permit to Construct( )or Repair( V)an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. ,7 7 L1 L' ,i-0 8 ms i In S'a Z j �h �PJ"h r,-), Installer's Name,Address,and Tel.No. 3(per 1�v3~� Designer's Name,Address and Tel.No. tiu I"S 0so'cTw ri CarL$d,,m�C 1 I1,A.,e.I CV .*S`/i1--e^.0✓� l '?.. h4i� / 3 /a l r-/dLe w' e`s7s ��J !�►Zq��1 ✓Lwa�I �y! 94-7e:/J' 5ev Type of Building: - Dwelling No.of Bedrooms Garbage Grinder(ho)j Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow //0 X 3 3 3 or gallons per day. Calculated daily flow gallons. Plan Date 1;T4 Number of sheets Revision Date 1 . 7rJ 11� Title Description of Soil Nature of Repairs or Alterations(Answer when applicable) �e �Q, C 0!!�IS 17 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 Env' onmental Code and not t place the system in operation until a Certifi- cate of Compliance has been issued _ is Board o Hea Signed Date Application Approved by 4j Application Disapproved for the ollowing reasons Permit No. a,0 0 1-1 F7 Date Issued No. ,-`� ` , Fee �v THE COMMONWEALTH OF MASSACHUSETTS c,�%' PUBLIC HEALTKDIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS S . Zippfication for 30i5pogal &pgtem Congtructiott permit Application is hereby made for a Permit to Construct( )or Repair(1-1")an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. '?7 — 0144 C e� o-vl !► r� o -Oyr-a a ztD,0.03 14 Installer's Name,Address,and Tel.No. ( W 3 Designer's Name,Address and Tel.No. 1 l i cc,'Sd . C"0 a",:— crV -el,5,I/1 135 - -7, }, S L,74»/77' /117? Type of Building: Dwelling No.of Bedrooms Garbage Grinder(hQ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow //0 3 3 a gallons per day. Calculated daily flow Ce., coo- gallons. Plan Date 1;/ Number of sheets �/ Revision Date 1 ?1 G•. Title Description of Soil_Y vo ar Nature of Repairs or Alterations(Answer when applicable)S P P Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system ' ` in accordance with the provisions of Title 5 of the Environmental Code and not to place the system iri`operation until a Certifi- " cate of Compliance has been issued by s Board Hea Signed _ `-C.� Date Application Approved by 41 Application Disapproved for the ollowing reasons A Permit No. -7,0 J 1 R 7 Date Issued THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE. MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System installed( )or repaired/replaced( r Ton on 01-1;'A0by LoIi1S / r- for '411 fy J as Soo M rA"A S-f: f a"le.L,/le has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.,2 f)? -.4k 7 dated Use of this system is conditioned on compliance with the provisions set forth below: 14� Im 5pe elv,, No. Fee .v THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE., MASSACHUSETTS 30i.5pont bp5tem Construction hermit Permission is hereby granted to /l,S d36a-J,lyds C C by • r r7 to construct( )repair( )an On-site Sewage System located at .S 00 lM j)l n and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/he r duty t o comply with Title 5 and the following local provisions or special conditions. All construction must be completed within two years of the date below. Date: 1- C Approved by 1 )a� TOWN OF BARNSTABLE F L LOCATION l SEWAGE# A0 o of— /,E 7 VMLAGE Chi� I LL€ ASSESSOR'S MAP&LOT 29 7-- -'ZS A INSTALLER'S NAME&PHONE NO. fGGi 5 SEPTIC TANK CAPACITY LEACHING FACILITY: (type),, 57oo CdhtA?�s (size) �✓?Xo2SXo�� NO.OF BEDROOMS,Ag 3 EJILDEP- A L L PERMITDATE: COMPLIANCE DATE: U�L 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 feet of leaching facility) Feet Furnished by ,z l 5'(00 bt tIq(1✓ Pr I4 , S t o - _ 2-Aa' t -3� N .g) .. .� - 4 FEE.... ..d............. THE COMMONWEALTH.OF MASSACHUSETTS BOARD OF HEALTH l Pl P _0 7 oO 04 ..................OF... 'G..�.T................................ �p-a ,� 1W *TA. plirtt#ion for Diopottttl orko Tontttrnrtion Vrrmi cation is hereby made for a Permit to Construct (A) or air (*-A an Individual Sewage Disposal System at: I—a'r ..: 9.e M .!.^.. ..........S. . � .��'...... ............, -� ................................................................. . ..,.Location-Address or Lo No -� .....__ o ti?t �.q. .....�:1 :� t ------•...:............. .....r:`A. r�S S I ------------------------- .......-----------......._..._..- ------------------ Owner Add ess ,. Installer Address Type of Building Size Lot..SAA.4......_..Sq. feet U Dwelling—No. of Bedrooms............ ........................Expansion Attic ( ) Garbage Grinder ( ) 'PL4-� Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures -----"--"............................................... .. W Design Flow......` ........$J�_..._gallons per person per day. Total daily flow.................. 1.............gallons. WSeptic Tank—Liquid capacity.. D.gallons Length......`........ Width......,7..... Diameter................ Depth............. x Disposal Trench—No..................... Width.................... Total Length.....................Total leaching area..._................sq. ft. Seepage Pit No.........L,........ Diameter.....$n.57.... Depth below inlet---%...Q...... Total leaching area A-Z:4.7......sq. ft. Z Other.Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by••-•••••-••-•••••••.....................••-••••.••-•-................._. Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ x ••---•......-- •-•--- ... ...._ ....................•---•----•-•-----...................----------••......•--•- 0 Description of Soil....... !9 ( . ? .2..._..f!_.4.A.2 1-'....---`00W.0 V.......... �-sA^..�----- �----------------------- ............................................-- -..............---- UNature of Repairs or Alterations—Answer when applica le..._....:` SCC�I �' .:_..1- ?�,?5�:.:........................... . ...... X t .r..l.►•�c�..........:sYsury........... AVIQ..... ?.%...Q.........5..7TI X..................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage'Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agree"iot to place the system in opera 'on until a Cer " of Compliance has been,issued by th�boar "fl.,ealthm.. Signed...... .--- -t---------- ... ....................... .......................... -" ica.tiQ^o Approved .,y--. ,.r_..!QI"....� •.. ...................................... .l ..""----- Date Application Disapproved for the following reasons:------""-•-----------------------•----------------............................................................. --"-"--------------------------"---•--•------•--"---•-------.........---------------------"--------..............-------"------------.........---------------•--"-------...--•--•----------•----•--.----- Date PermitNo..................................................._.... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL T ,(. ..........:OF—..... ..... ... f�rr#if irtt#r of �n�t�littnrr TH TO CERI'IF , That thA Individual Sewage Disposal System constructed ( 1�or Repaired ( ) by----------- ------------ .t.t.•tea........................... ------------------------------------------------- -- at........................9�•-•--• ----•-. !' :�_...... ---------••---...---"-------------------------------•- z fr ha§'beei>'m'stalled in accordance with the provisions of TIhe State Sanitary Code.as described in the application for Disposal Works Construction Permit No—............. ........... .......... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THf. SYSTEM WILL FUNCTION SATISFACTORY. DATE. ........................................ ......... Inspector........ ...... -................................... ..............•....... THE COMM?NWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........:...............................OF... <......_..................................._....................:........._..... No....... r..y.,� Etapostt mir o T - #r i n rrmit Permission is.. er by granted..... to Construct ( t� or epaii an.Ind" Se�ir e i s stem at No...........•--••: 3r�.. '* -="---------•------.----"---•-•-----•------------------"----------------------------------------••----------•-•.-----------------•-- Street as shown on the application for Disposal Works Construction TkrM Now............ ! D !.. .............. ............................................. *. / Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 08-13-1999 11:31AM CENT OST FIREDEPT 5087902385 P.02 Make application to local Fire Department Fire Department retains original applications and issues dupGrate as Permit . r. f+ j 11 e r __ APPLICATION and PERMIT Fee: Q for storage tank remcv=.3 and transportation to approved tank disposal yard in accordance with:the provisions of M.G.L. Chapter 148,Section 38A, 527 CMR 9.00, application is hereby made by: 7Address 1 , e(piczsa print) Clarence Mills X498 Main Street, Centerville Sheer City .SI M L p FIT= • N1• • • Company Name Advanced Environmental Co,or Individual Advanced Environiental P?Mt p r Address P.O. Boh 472, S. Dennis Address Print Pmr Signature(if appl 'rc'cr=ermit) Signature(if applying`cr=ermit) IFCI Cart;,SE they IFCI Certified = '. .-D n Other Tank Information, Tank Location 498 Main Street, Centerville steer Aaaress r,� Tank Capacity(gaitcns. 275 Substance Last Store_ #2 Fuel Oil Tank D`mensions, ' rc,_r x length) r Remarks: Firm transporting was-F Advanced Environmental State Lic 4 MV5083856100 Hazardous waste mar:: E.P.A.# Approved tank dispcs J•r-fd Abandon in Place Tank yard# n/a Type of inert gas Tank yard address Centerville 01920 City or Town FDIO# Permit# August_13, 1999 August 27, 1999 Date of issue Date of expiration Dig safe approval nurr,&--- 19993208954 Dig Safe Tclt F:--Tel. Number-800-322-4844 Signature/Title of Of`ic�'_ranting permit - _Tn after removal(s)rcnd Fir., ?.29OR signed by Local Fire Oept. to UST Regulatory Compl - Unit, One Ashburton Place, Room 1310, Boston, MA :�_;';,S-1618. TOTAL P.02 < � ,� _ � ,. k s`." s r'� ,N � f - ZV v(,� ;. tt � :X. � � ,• ��+ ..y� �` ?�. �. � .� i;; 4 OF_BAD BARNSTABLE COUNTY o '� DEPARTMENT OF HEALTH AND THE ENVIRONMENT U SUPERIOR COURT HOUSE r POST OFFICE BOX 427 BARNSTABLE, MASSACHUSETTS 02630 `rACHUsti Phone:(508)375-6613 FAX(508)362-4136 FAX(508)362-2603 TDD(508)362-5885 UNDERGROUND TANK TEST RESIA.T.S NAME: CLARENCE MILLS DATE: 8/12/99 TANK LOCATION: 498 MAIN STREET, CENTERVILLE MAP PARCEL: 207-045-001 TAG#: 245 YEAR INSTALLED: UNKNOWN CAPACITY: 275 The recent check of the vapor monitoring well(s) near your underground storage tank (UST) did not detect any significant contamination. Because the use of soil vapor monitoring for UST leak detection is a limited technology we cannot,however,guarantee that your tank has not leaked. You should also realize that a "good" result from our test is no indication of how long the tank will remain sound. Due to fiscal constraints,the Barnstable County Department of Health and the Environment has instituted a nominal test fee of$30 for one well and$10 for each additional well at a site. Accordingly, would you please send a check for$ 30 , made payable to BARNSTABLE COUNTY to: Charlotte Stiefel Barnstable County Department of Health&the Environment P.O. BOX 427 Barnstable, MA 02630 The following items, if checked, also apply to your UST: _2L.We encourage the removal of older tanks before the expected leak(s)develop. _.2L—We encourage the removal of tanks under 300 gallons as they were not made for underground use. Your UST doesn't appear to be registered and tagged as required by your Board of Health. It would be advisable to mark your monitoring well to prevent accidental usage. The soil conditions surrounding your tank are nd ideal and may accelerate tank leakage. A copy of this letter has been sent to your Board of Health and the records reflect the results of this tank test. If you have any questions please contact Charlotte Stiefel at(508)-375-6620. cc: Board of Health: BARNSTABLE Whereas,the escape of fuel from an underground storage tank may result in civil and/or criminal liability of the owner,lessee,licensee, licensor,and/or other persons in control of the premises; Whereas,the use of vapor monitoring procedures is only one of several procedures that may be used to detect leaking or escaping fuel; Whereas,the reliability and experience of the testing procedure is limited;and Whereas,from location to location and soil to soil test results may vary due to a number of factors; The County of Barnstable and the Barnstable County Department of Health&the Environment represent that while the test results give a fairly accurate reading of the vapor content in the well sites at the place and time of the testing,the soil conditions and condition of the tank and connections may be such that leaks could occur at the time of testing or shortly thereafter without detection. Similarly,the equipment is sufficiently sensitive as to detect fumes when, in fact, no actual tank or piping leaks have occurred at all. Therefore,no party shall rely exclusively on the results of the vapor monitoring test. Neither the County of Barnstable nor the Barnstable County Department of Health &the Environment shall be liable to any person either for the failure of the test to detect a leak when such a leak has,in fact,occurred or for the detection of readings which may indicate that vapors are present in the soil when,in fact,no leak has occurred. Neither the County nor any department thereof shall be liable for any faulty or overly sensitive readings resulting from the taking of such test. TOWN OF BARNSTABLE LOCATION F0CI �ti�"}'1 ,Sr , SEWAGE # VILLAGE ( �;ry� �""�► ASSESSOR'S MAP 6i LOT INSTALLER'S NAME & PHONE NO. Are^9 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED- VARIANCE GRANTED. �es No l dau dol ' 4p�� M"' �P,.• v. p�Nr' ;Z s �•3 a3'b' 8' a 3'f to oex iaa�Ni a7do5 p �1 3 ��n�oisS *AnU�S oy. his hod ao0aaaaao�b 85`.rfs FMMIL4 o H J3NIIHM Nnsor o r W Nn 3SOf nsor•a or N'yo �ss+y/io�s� , ao xis .SL6!•:`xa�d�rid�..`..�,.�:. 1a�-�OZ =HEN// .a�e��s + J�� 99 so-a�a pro -=/O C2J�7dDdd p CNd.S7717,:YaH-4 H-LIM SW�OdNO� :SSb`j/�77�d1 SN449- 7 W -271A0.21 N-J� v Q� 1 iw —J® N&7� Nd7e S/Hl 1 dH1 . Oa'dOg ON/NNd7d�778dtSlYTJd$ .9NINOZ o- 7ayIn6�78ir No/s/iivsns -afrl 4YROIYIj 7d/1o'?Jddb LOZ nN d6111V sa'oss�ss/y w 1 y Nd7�/yoO �,dab, "� -�5>vidW o8s n .03 7-_ itt.5�5-9ZogLS £O OSElk _ r42E6 _t 3 . � s El W 9Fv16/ da/00�N.CM'9/fj� ld/y SA&MZ>17n o t 10/77J 4 .c7a�awaro� 77�8dwd, f11t�.�'o7 �0 U1 , 7V&-7& sn--55 7. r .0 C ! z ,r�j� Si531i �. a gZ / acno�+ EGTION - SEWAGE f — SEPTIC TANK — - "D'''BOX — — LEACH_ TOP OF 1ST. �C.OQtZ• ._ _ \ (MSt)x WASHED STONE eel IG 5n te�Tc+�i t�lO Gt tAtJGr«; eat= 1LI ST+tom';G / r / E Cl ;00. IN L42�' IN- OUT. In. ! �.s � 7. EPTII .41.'7 4 . SE'TIC TANK ��o.'�1 / ELEV. ELEV. ELEV. ELEV.. fal \ ELEV. ELEV. .� of pia'•- ,;;::: . WASHED STONE PEST HOLE LOG TEST Bv \WITNESS L�� BEDROOM HOUSE DESIGN --- .__ u�, T.H. # 1 T.H. 2 L L E V. ._.. rat.t. r./.___.. c.t..E V. G ?�,,, r;f .>�,.>a.l i�•.% NO i 12- MIN/IN. DISPOSER DISPOSER \ �' // �• PERC RATE __�_..� 44 1}� `c GAL./DAY) FLOW RATE }-tom( ------ =-- - �. !t. \ lC I C'{=',� 1-r 33 SEPTIC TANK 44-CD �t } pc' L , REQ'D SEPTIC TANK SIZE ----— - � u -- ° a �trr� I f LEACH FACILITY i I ' I � SIDE WALL _ ._.._l Z,� j _ j BOTTOM — GID T 40(4 O T A L Z0 3 5:- ~ �, i1d, f t�af �i r t-► !ez t� T"� 'GxtSTtrC: ��lLQt't*� ' f =a;q t,B 1 __.�_�—:.LEACHING --- I USE: __ i i C�! A i(.g.L1t vs t3 1,G?V\J l t.kVt t2'T _....._..- „4 --WATER ENC(3UNTED NOTES: (UNLESS OTHERWISE NOTED) ---.__-•_-----QUADRANGLE MAP 1. DATUM (MISL)+TAKEN F ROM �. _"• :� 2. MUNICIPAL WATER ---Ilk--------------• AVAILABLE I .3, PIPE PITCH: ua"PER FOOT _ 4, .k: m v _.. DISTANCE AS CERTIFIED. 0.. DESIGN LOADING FOR ALL PRE-CAST UNITS: AA$HO-.�-�'� .--'&4 � - - -- c S:MIN GROUND COVER OVER AILL5EWAGE FACILITIES: (1) FT. SITE PLAN 6, PIPE JOINTS SHALL BE MADE WATER TIGHT E: + ' I HEREBY CERTIFY THAT THE BUILDING 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. �.4 �. '�`? � SHOWN ON THIS PLAN IS LOCATED ON THE LCSTS. ' 'Z .A4tt� STATE ENVIRONMENTAL CODE TITLE 5 LOCUS:_ --=- 7 �[ GROUND AS SHOWN HEREON&THAT IT._-_—.. f TM +�R+ CONFORM TO THE ZONING BY LAWS OF THE CCIt3 ��'� I ��1"� ! _ � -- -- oee 14 i } 4r. TOWN OF _ - --- - — REG.PRo L ENGINEE.: WHEN CONSTRUCTED. DATE REF; -haCaG �� QfON/I! Cape engineering PREPARED FOR: T CIVIL 8NGINEER$ _ ••' Ct`'-tom \/ILL'-------G��' �. f LANDSURVEYORS REG. LAND SURVEYOR BOARD OF HEALTH I SCALE -I DATE r3AeLt5-?zR-L '"nn r Yarmouth &Orleans,MA t-o TOP FNDN EL, 50.2' SYSTEM PROFILE TEST HOLE LOGS ACCESS COVER TO WITHIN 6' OF FIN. GRADE (NOT TO SCALE) SHORT ACCESS COVER (WATERTIGHT) TO ENGINEER:ROCK WALL ARNE H. OJALA, PE LOCUS (ONO N BASE. MINIMUM .75, OF COVER OVER PRECAST /` WITHIN 6' OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM � WITNESS: DAVE STANTON I � 50.0 RUN PIPE LEVEL 2' DOU13LE WASHED PEASTONE\ _ DATE: 12/13/O1 -I. OH �* FOR FIRST 2' \ < 2 MIN/INCH cHU� 3 MAX PERC. RATE _47.57'JIM 47,8�' CLASS SOILS P#AS 0000447.08'AFFLE 47.25' CI M M 0 0 ED L M L.3 MIN o 47,0' M M [] Q ED E] M [� �] 0 4' AT SIDES [� ELEV. ( 2 % SLOPE) \_6' CRUSHED STONE OR MECHANICA E] E71 [] ,I-_] O� 50.0' C❑MPACTION, (15.221 [23> $ 2' C7 0 C7 C] CI C..� 0 4�V 1. DEPTH OF FLOW = 4 ( SLOPE) ( 1 % SLOPE) FILL 5 TEE SIZES, 10" 3/4' TO 1 1/2' DOUBLE WASHED STONE 8„ 50 INLET DEPTH = OUTLET DEPTH = 14' A LOCATION MAP NOT TO SCALE LS FOUNDATION— 13' SEPTIC TANK 4' D' BOX 10' LEACHING 16 10YR 4/3 ASSESSORS MAP 207 PARCEL 45-2 FAC :L1+Y B ** UNKNOWN INVERT, PROVIDE GRAVITY FLOW TO 5.0' LS PROPOSED SEPTIC TANK AT MIN. 2% PITCH 32" 10YR 5/6 47.33' + A 4 48A I \'� C 40,0' r MED/COS '► 10YR 5/8 "z LOT 2 57 79 5,497t SO. FT. 120" 40,0' + 'b EXISTING DWELLING EXISTING DWELLING + y NO WATER ENCOUNTERED 4v� +4A � NO � BASEMENT NOTES" DECK (ON POSTS) "' P GARAGE EXISTING '� t ,+r-- ----_ �� . o ; >E '��r :2i :�,.- E nt�nnSr.. Tr Nn� A[-'.')WED --— — — ) UM _— TED FROM GIS ELEV�MSL _ _ a _ 1. DATUM IS APPRQXIMA BE TO +sa `''�� pRNE - �` DESIGN FLOW: _ B-DROOMS (]10 GPD> = 330 GPD 2. MUNICIPAL WATER IS EXISTING '�' AVED -_____---- ------ REMOVED a 4" - + ., USE A 330 GPD DESIGN FLOW 3, MINIMUM PIPE PITCH TO BE 1/8' PER rOOT, r4v� LANDSCAPE TIES G L // // SEPTIC TANK, 330 GPD < 2 ) = 660 4, DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 ARWND RAVE�„a -____,_____ 5, PIPE JOINTS TO BE MADE WATERTIGHT, PARKING USE A 1500 GALLON SEPTIC TANK (PANE um") 4„ ---- 6, CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS, CP NSG03 LEACHING: ENVIRONMENTAL CODE TITLE V. Y BENCH MARK — CTR 2(25 + 12.83) 2 (.74) _ 112 7, THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE TH s OF MAN HOLE COVER SIDES: o EL. s 4s.4 (AssMD MSL) - USED FOR LOT LINE STAKING, BOTTOM: 25 x 12.83 (.74) - 237 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4' PVC. +5a9 TOTAL: 472 S,F, 349 GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT REMOVE ANY CONTAMINATED SOILS WITHIN V OF PROPOSED LEACHING FACILITY INSPECTION BY I f` ) 500 GAL. LEACHING CHAMBERS (ACME ORFROM BOARD ❑F BOARD OF HEALTH AND PERMISSION OBTAINED EQUAL) WITH 4' STONE ALL AROUND 10. PUMP & REMOVE EXISTING CESSPOOLS, NOTE: WATERLINE NOT MARKED AT TIME OF PERC TEST. CONFIRM LOCATION PRIOR TO ANY EXCAVATION. SLEEVE WHERE WITHIN 10' OF SEPTIC SYSTEM (OR RE-LOCATE TO BE 10' FROM COMPONENTS) LEGEND 11 TITLE 5 SITE PLAN ?3- t d«� / l9vI I �/I,��, 100.0 PROPOSED SPOT ELEVATION OF 500 MAIM STREET CI V, 10®x0 EXISTING SPOT ELEVATION � � � ��}ju IN THE TOWN OF: SQo I 100 PROPOSED CONTOUR ( CENTERVILLE ) BARNSTABLE rn j� 100 EXISTING CONTOUR PREPARED FOR: KENNETH MILLS y� n /VQ v-� I uc `� I � 20 0 20 40 60 l BOARD OF HEALTH APPROVED DATE MA SCALE: 1" = 20' DATE: DECEMBER 19, 2001 JANUARY 9, 2002 off 508-362-4541 fax 508 362-9880 0ii OF Alt down Cape engineering, inc, Alt" �F ARNE H. ARNE ?^� �. CIVIL ENGINEERS CI L N Q v . z 4 ,o t LAND SURVEYORS lop, �sz 939 vain st. armouth rya 02675 Jy Gl '�, IVac II '��' 01---306 Y H. OJALA, P.E., P.L.S. DATE