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0255 OLD CRAIGVILLE ROAD - Health
255 Old Craigville Road Centerville A= 247-109 ' /// I SMEAD No.2-153LOR UPC 12W mmadvem • us&U IW I 1rt�N�I��IM EXos7IN, DIV VA ALI i a Clusei C \A �vl T%" E4NJf inv��n7 0� __ N�w/ ON pay 1' No.Z0(Z — - i r Fee oV fat7 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitation for ]Disposal *pstrm Construction permit Application for a Permit to Construct( ) Repair(V�Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.Q5TOLD 6r&j4 v I Owner's Name,Address,and Tel.No. Assessor's Map/Parcel M a'47 Pcw I Q rc'd 4-ver 90 9 I tall 's 14me,Address,and Tel.No. _ 7-0/615 Designer's Narge,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 2 Z0 gpd Design flow provided 2..L4 5 gpd Plan Date rl I q Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by thisBoard of Health. Da I?-7 0 TM 111 lu Application Approved byp Date 61z-f Zo tZ Application Disapproved Date for the following reasons Permit No. Zo 1Z "- 69 Date Issued 1 Z. No. Fee THE COMT, NWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION- TDWN OF BARNSTABLE, MASSACHUSETTS Yes Rpplicatlon for M sposai e4pstem Construction permit ;t Application for a Permit to Construct( ) Repair(V/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.Q5 j OL(J `rQtC V!I(P Owner's Name,Address,and Tel.rn No. /� � Gd A�/e r ao rl Assessor's Map/Parcel zt{� Al1�Ce �o $r J I talle 's Name,Address,and Tel.No. ��f�_ Designer's Na e,Address and Tel.No. 8 �xcaVal1,o,6 4�7-v��3 f Wn Dn9 5��3�z•y5�l Type of Building: c Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Z Z 0 gpd Design flow provided 2,.q 5 gpd Plan Date ( q (2,.. Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of } Compliance has been issued by this Board of Health. Da 'z7 11 (, Application Approved by Date 81Z 7-0t Z Application Disapproved Date for the following reasons Permit No. Z© IZ - Z 6.6 Date Issued 270 1 Z. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( L4 Upgraded( ) Abandoned( )by cnval( U at IS b ( as been constructed in accordance p with the provisions of Title 5 and the for- tsposal System Construction Permit No.�IZ"2�'O dated r1 21- bot-?— Installer"Po v Designer -I) \,kin �_ Ni h #bedrooms Approved design flow 2 d gpd The issuance of this permit shall 'ot be construed as a guarantee that the system ill functr a .e 'gned. DateInspector v ---------- - Za No. Fev e*/00 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction J)ermit Permission is hereby granted to Construct( ) Repair( V) Upgrade( ) Abandon( ) System located at a 5 5 O l d CCn j(,, jL Q� (c oA ti y i l IP 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 be completed within three years of the date of this permit. Date c7 / ?^ Z- Approved by - - t F FROM :down cape engineering inc FAX NO. :150836213880 Sep. 04 2012 09:19AM P1 x T, 1A 43 Q )010 Rlluiia Sn-ect,f1TmP-,0s,.M A o)'26:1.).9. 508).F,62-1!644 ;mq 7YU-6304 fin0allreir SI:De"%i aex,CutOlf.-011tn'tin -Furm 4 C�r1l,nit-Y 16e AB b t 5 5 C.D.11 9 211�\*PUR'Crd D"C'sigaier �0 Vj L')O-1 Addresi. ye"rma'k. -mq s issm.ed a LU C-) .......... septic. sysIff.m.ul: U69st:rl.u,a de,;I g-n di-' by 6L vod /q, 0 14L(A- PIE fc'!rf k7l I 1.11rat. (hu,cpfir, sy9tPm referenced abuvu. w'?iS -io.sta,liecl snlbsUmLlolly- 0CGOYCling, to whiu:i m-.-y Jj.Lclud-, -nhio-i- apnrovr.--d uhealgl"s Such. Fm lu[t'nd xdoc'-4f"oll of diu, d.J,�-, --buduu box and/or tsilpflic.t"iuk' UL76fy that Cit', su-pfir syste:m. i-t-Fcruced �--.bovu. was iiist,,WEd w1'1!a 77�-ea(ur'(Laa 16' laulnil ry"the S'AS' oy ,m), yc.,,jtjr.aj.(elormbon (if iity- Cu),japmnuut by -)P OF AfAs DANIEL-A, UJAI-A civil_ rn fl o.46502 60� I - NAI.- Z— IM, (DCtjjL!,Ue1'7, Sippl.iilj t, (.,k L1, T)i i Hj TJL-1YD--' Te 1LAAt'-T,1',jj'AFf,1,E PUT'LiC g)r -F PIVC. AIND A-W-r' �ZGT 5.Lr, SS-17mi,.T) TFi� L U0111 J01 VTj.JU[J1;-' q DIVISKV-1, NK 0 U. A:........... tt' Blk 26614 P:9182 ;4�7 J6 r_ 8-24-2012 1 1 _ 52a DEED RESTRICTION WHEREAS, r' e f C n` I j I Th �V2.r' o� of (owns s ame) PeewZT�nCo tUL () MA (address) v //�} —` is the owner of f r0.ry e J `C � � located (address) at Cen e,✓� I MA (hereinafter referred to as P �.n ofi La and being shown on a plan entitled ".JUIXI In Cral 4VjlIe_ PArk MA; Property of et al, duly recorded in Barnstable County Registry of Deeds in Plan Book cO , Page—L�s`l Or on Land Court Plan Number WHEREAS, `gi ra J y6le- Qvl as the owner of said lot has (owner's na e) 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 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage;. WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, dm& '. Bk 26614 Pg 183 #48756 NOW, THEREFORE, 6/Qt,Q-f- t, Xe, ll�uw oes hereby place the (o ers name following restriction on his above-referenced land in accordance with his -agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 0 Ci('a re,V i aj may have constructed (address) upon the lot a house containing no more than - 'Vo '(1.)bedrooms. Bradt Cyrt�i's.. 14✓u4an agrees that this shall be permanent deed . (owners name) restriction affecting-LetIlL located on MA, and being shown on the plan recorded in Plan Book_6 Z- , Paged Iyf Or on Land Court Plan For title of see the following deed: Book ZbSZZ , Page 170 . Or Land Court Certificate of Title Number Executed as a sealed instrument "''� .�� day of AA �{ Dec wan i�signature re Own signature O 7 t Owner's signature COMMONWEALTH OF MASSACHUSETTS 1,00 rcg s fc $ ss S t 201'2- Then personally appeared the above-named - C � � known to me to be the person who executed the foregoing instrument and acknowledged the same to be ff ei r free act and deed, before me, ►,�„ e�I �I. 15;kA 4'-OF Notary r ; My commission expires: er V. (date) Notary Public NEAL H.SHAFFER '',o rq RY' pv0 ;` 'r.. My C0-'nMkion Expires S pt�20,20l3 Sk 26614 Pg 184 #48756 Note : This restriction is automatically removed if in the future the property is connected to town sewer,as the site will no longer be restricted to the number of bedrooms allowed. BARNSTABLE REGISTRY.OF DEEDS TOWN OF BARNSTABLE LOCATION_r7SS OLD eFaigU�I I c `Ro� SEWAGE# ,go VILLAGE__CcrAc r u i 1 l e, ASSESSOR'S MAP&PARCEL aq'7 - /O Q ,INSTALLER'S NAME&PHONE NO. f -4 i.3 EXeauv�-li�� SEPTIC TANK CAPACITY /SOO qCJ LEACHING FACILITY:(type) rencl,eS �c Z. (size) 2 x 3 x a;t NO.OF BEDROOMS 9. OWNER B racl A vt.r s o n PERMIT DATE: •a 7- 1 M• COMPLIANCE DATE: $-07 -)a Separation Distance Between the: 4 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 e AZ_ A , c3z- go, A3- Al" 3 -o 53- ;.s` Ay- $q' 3& ` G 70 Frond Fe 3 0 OLD TOWN OF BARNSTABLE LOCATION aS5 01� Cr'AI$UAL Re- SEWAGE # VILLAGE Ce/erd.14- ASSESSOR'S MAP & LOT0—y' /O INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 5 1 A � � U INSPECTION LEACHING FACILITY: (type) (size) NO. OF BEDROOMS I BUILDER OR OWNER �� • KC SItAi PERMITDATE: —OkPLLNCE 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 leac jng facility) I J Feet Furnished by Z Tgn Fot G i sv� �ronT Al /a— 171 16_116 a Ve�-�o Town of Barnstable Departmolit of Regulatory Services � ll)<b flC 11 cAft�gDivision Date l� �Z aAM&TAHLE, a � e5'L& �a� lvJa' trhilyanuis MA 02601 7 U MIAzt CM C W - Time FLe Pd. Date Scheduled Soil Sziitabil sty Assessnilent for Seitg .e Dgspos'& Pcrfonnud Dy; 1'YllnessetJ By; ILOCA7[ION & GENE,RAJL IN]FI GIUVV.A7 ION Location Address S5 O/� Owner's Name �r\�Cn/✓1 l Address Assessor's Map/Parcel: '1�g7110 engineer's Nautc , 0 LV f� ce NEW CONSTRUCTION REPAIR Telephone It 004 Land Use• Y?v->t6aj_ nA!1,.e _ Slopes(`Y.) 1 Surface Shines Dlslances from: Open Water Dody>-049 It Possible WeL.Areo >1044 it Drinking Water Well —4C2 ft Draiho.ge Way Ft Properly Line 16, ft Olhar Ii F SKl+ETCH: (street came,dimensions of lot,exact locations of lest holes do pore tests, locate wetlands'in pro)tinuly to Boles) l 9 , t -ToZ ` V ' v r V an 30(9 Parent materal(geologic)` 3 � b C l' �j Depth Lp Qudrock �d Depth to Oroundwatcr: Standing Watcr In I-fole: hG Weeplitg Pruitt Pit Pace e, T Estimated Seasonal High Oioundwater /V DE T ERAUINrr�.T]fON FOR SEASO. A lL HI[GH WA71'ER uA ll3sLE Mclhod used: Depth Observed standing in obs. hole: —in, Deptlr to soil Izloltlss.„�_ , � lu, DcpLh to weeping from side of obs.hole: _� iLL druuu dwuler Ari)uslntent In lcx Well 4 Reading Date: Index Well IeYal Ac�j,fiactor A�J,droundwuter Uvel FObse,rvatiaii ]PERCOLATION T �S".Q' Time,nt 9"ar perc `� Tl t u" Slott Pre-soak Tinto @ _ Time(9`4') End Prc-soak c (� Rate Min./Incll �� ��� 1 17G�J. site 5ujlabillLy Assessment: 51Le Messed_ site Failed: Additional Testing Needed(Y/DI) Original: Public Health Diviaion Observation Mote Data To Be Colnpieled on Back----------- ***If pextcolatiou test.is to be conducted vviLliin 100' of vvell aild, you ¢gvuYst first Uotity the Barnstable Conservntlon Divisio11 a`1t leist one (I) vveelc prior to begilm1mg. Q:\S EPT(C\l1i3RCF1ORM.DOC ID11EIEP.OBSRI T �. �� AT ION i-10 L]E]LOG --— I)cplh franc Soil Horizon Hole # Surface(in.) soil Texture(USDA) Sail Color Soil (Mansell) Mottlin Other �- _ # 6 (Structure,Stones'; Con ista c a rDld eers, fo------------- g l yA S� -72 -l�� C ��YAy�� . Depth from Soil Horizon Hole # Surrace(in.) Sail Texture Soil Color (USDA) Soil (Mansell) er Mottling (Structuree,iStones, Boulders. Consistencv % arrival' is RV& - to Depth from Soil-Horizon Hole # Surface(in.J Soil Tcxture 5011 Color �----- (USDA) (Man Soil sell) Mottling (Structurc,lStones.Boulders. ' Consistengy 9'we — _ • l )i111E]EIlb OR,SEj][R 1 TIO g,]E Depth fi-om S Soil Horizon )L0G Hole# Surrace(in.) oil Tcxhire Soil Color 50(I (USDA) (Mansell other Moluing (Structure,Stones; Boulders, Consistency� 6 Oray�� 16➢eac➢Y nsurance Rake IVgap- Above 500 yearflood boundary No Ycs Within 500 year boundary No_ yes ' Within IoO Year tloodboundary No— y65 ID)e tk +atulray O, CIRVI-i_ng pgiryjoljs erir�� Does at least four fe©t of naturally occurring pervious mite-'a' exist in all aretls observed thl•oughout the area proposed for the soil absorption system? If not, "'hat is the depth of naturally occurring pervious marol'iw c'e�t➢lfiica taon A certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental.Protection and that the above analysis was performed by me consistent with Ilia regldred training, expertise and experience described in �10 CA 15.017, Signature Date • Q\S,b,PTlC\PE1tCP'ORM.DOC trte r Town of Barnstable Barnstable Board of Health cac j nA �.e,ASSS M 200 Main Street, Hyannis MA 02601 O D MASS. a o°ArFD;A: a`� 2007 Y Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi CERTIFIED MAIL # 7011 0470 0001 4525 5372 September 30, 2011 Mr. Harold C. Kearsley 255 Old Craigville Raod Hyannis, MA 02601 YOU ARE SCHEDULED TO APPEAR BEFORE THE BOARD OF HEALTH on Tuesday, October 11, 2011 at 3pm in the Town Hall, Hearing Room, 2'd Floor, 367-MainlStreet, Hyannis, MA due to your failure to repair or replace the failed septic{systernoty,255 Old Craigville Road, Centerville, MA. The State Environmental Code Title V requires all failed septic systems to be repaired or replaced within two.years. The Town of Barnstable Board of Health has more stringent deadlines dependent upon the type of failure identified. In this case, the septic system has been in failure beyond the established deadline. rT You will be given the opportunity to testify, present witnesses, documentary evidence, and other official information regarding this case. PER ORDER OF THE BOARD OF HEALTH Wayne Millet,(M.D., . Chairman.-i 1. 4 - 1.�. •..L v il.. .S.i lei;. ' I Q:\SEPTIC\Letters Septic Inspection Failures\255 Old Craigville Cent BOH Oct201 l.doc Opp ° Town of Barnstable Bartz Board of Health ,� �aElra 200 Main Street, Hyannis MA 02601 �t659 ,(b (:107 FD MA� Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. hilichi Sawayanagi October 24, 2011 Harold Kearsley 255 Old Craigville Road Centerville, MA 02632 RE: 255 Old Craigville Road, Centerville, MA Map/Parcel 247 - 109 Dear Mr. Kearsley: At the Board of Health meeting held on October 11, 2011, The Board voted to grant you an extension to upgrade your failed septic system because the house is vacant at this time. The Board voted to give you an additional twelve (12) months to repair or replace your septic system at 255 Old Craigville Road; Centerville, MA. The septic system must be repaired or replaced before October 11, 2012. If the house - - remains vacant past this deadline and additional time is needed to replace the system, you may request another hearing for an extension from the Board. - PER ER OF THZnOARD OF HEALTH ayne iller, M.D. Chain-n - Q:\WPFILES\255 Old Craigville Rd Cent BOH Oct201 Ldoc of`ME r Town of Barnstable Barn "°� Board of Health micaC j i nA MASS.S. • 200 Main Street, Hyannis MA 02601 I 9 1639- 2007 MAC Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi CERTIFIED MAIL # 70060810 0000 3524 5515 December , 2011 Mr. Harold C. Kearsley 255 Old Craigville Road Hyannis, MA 02601 YOU ARE SCHEDULED TO APPEAR BEFORE THE BOARD OF HEALTH on Tuesday, October 11, 2011 at 3pm in the Town Hall, Hearing Room, 2nd Floor, 367 Main Street, Hyannis, MA due to your failure to repair or replace the failed septic system at 255 Old Craigville Road, Centerville, MA. The State Environmental Code Title V requires all failed septic systems to be repaired or replaced within two years. The Town of Barnstable Board of Health has more stringent deadlines dependent upon the type of failure identified. In this case, the septic system has been in failure beyond the established deadline. You will be given the opportunity to testify, present witnesses, documentary evidence, and other official information regarding this case. PER ORDER OF THE BOARD OF HEALTH Wayne Miller, M.D. Chairman Q:\SEPTIC\Letters Septic Inspection Failures\255 Old Craigville Cent BOH Oct2011.doc Town of Barnstable Barnstable +r~ y Department `�1Ce j Regulatory,Services Y k " 3ARNbTABL:E. i Public Health Division rF°"�yA 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 568-790-6304 Thomas A.McKean,CHO 03/09/09 O p Harold Kearsley 255 Old Craigville Rd. Centerville, MA 02632 FINAL ORDER ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at, 255 Old Craigville Road,Centerville, was last inspected on 05/03/2005,by James M. Ford a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: "Single cesspool automatic failure". The deadline for repair has past. We, The Department of the Board of Health, have not been informed that you have taken any steps to bring your failed system into compliance. Therefore, you are ordered to repair or replace the septic system within 60 days from the date you receive this notification. You may request a hearing before the Board of Health, a written petition requesting a hearing on.the matter, within seven(7) days after the day this order was received. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health i Town of Barnstable Barnstable a Regulatory Services Department AlM, eficac RY A " . Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO May 6, 2009 Harold Kearsley 255 Old Craigville Rd Hyannis, MA 02601 Re: 255 Old Craigville Rd. Centerville, MA You are scheduled to appear before the Board of Health at their public meeting scheduled on June 16, 2009 at 3:00, to show-cause why your property or dwelling should not be condemned to continued use of a failed septic system. According to our records, your septic system failed on May 03, 2005 and you were notified by certified mail to repair or replace your failed septic system on 03/09/09. However, to date, the system has not been repaired or replaced. The purpose of the hearing is to provide you the opportunity to provide testimony, documentary evidence, and/or witnesses pertaining to the repair or replacement of your septic system. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health C:\Documents and Settings\malkusk\Desktop\255 Craigville board meeting request.doc i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION Z 4-1 TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 255 Old Craieville Road Centerville. MA 02632 a Owner's Name: Estate of Harold Kearsley � \ , Fi�y°��® Owner s Address: Date of Inspection: May 3, 2005 Name of Inspector: (Please Print) Jaines M. Ford Company Name: James M.Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number: (508)862-9400 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 CAM 15.000). The system: Passes Conditionally Passes c Needs urther Evaluation by the Local Approving Authority K ✓ Fails F F. Inspector's Signature: Date: Mav 9. 2�� X -v The system inspector shall sub a copy of this inspection report to the Approving Authority(B and of IWWalth of� DEP)within 30 days of completing this inspection. If the system is a shared system or has a desi flow W10,0a gpd or greater,the inspector and the system owner shall submit the report to the appropriate regi al offi&bf tha�- DEP. The original should be sent to'the system owner and copies sent to the buyer,if applicable and the approv ng 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. Title 5 Inspection Form 6/15/2000 page I Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 255 Old Craizville Road Centerville, MA Owner: Estate ofHarold Kearsley Date of Inspection: May 3 2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: 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: 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. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: 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: 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: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 255 Old Craigville Road Centerville, MA Owner: Estate of Harold Kearsia Date of Inspection: May 3, 2005 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 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "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: 3 i • Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 255 Old Craizville Road Centerville, MA Owner: Estate of Harold Kearsley Date of Inspection: May 3, 2005 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to 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 SAS or cesspool ✓ 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 '/z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply 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. [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.] Yes (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. NOTE:Single cesspools automatically fall in the Town of Barnstable. E. Large System: 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 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 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 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 255 Old Craizville Road Centerville, MA Owner: Estate of Harold Kearsley Date of Inspection: May 3. 2005 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ _ Was the facility or dwelling inspected for signs of sewage back up? ✓ _ Was the site inspected for signs of break out? ✓ _ 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 the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes 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 C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 r Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 255 Old Craizville Road Centerville, MA Owner: Estate offlarold Kearsley Date of Inspection: Me 3. 2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x 4 of bedrooms): 220 Number of current residents: 0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL 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(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unavailable Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: _gallons--How was quantity pumped determined? Reason for pumping: TYPE 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 age of all components,date installed(if known)and source of information: Date of installation unknown. Were sewage odors detected when arriving at the site(yes or no): No 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: 255 Old Craieville Road Centerville, MA Owner: Estate of Harold Kearsley Date of Inspection: May 3, 2005 BUILDING SEWER(locate on site plan) Depth below grade: None Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: Sludge depth: ' Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): GREASE TRAP: None (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 baffle: Distance from bottom of scum to bottom of outlet tee or baffle: 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 I Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 255 Old CraiQville Road Centerville, MA Owner: Estate ofHarold Kearsley { Date of Inspection: May 3, 2005 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _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: None (if 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 of box,etc.): PUMP CHAMBER: None (locate on site plan) 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: 255 Old Craizville Road Centerville, MA Owner: Estate of Harold Kearslev Date of Inspection: May 3, 2005 SOIL ABSORPTION SYSTEM(SAS): None (locate on site plan,excavation not required) If SAS not located explain why: Type ' leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): CESSPOOLS: ✓ (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: I single cesspool Depth-top of liquid to inlet invert: 2' Depth of solids layer: 6" Depth of scum layer: 2" Dimensions of cesspool: 5'W x 6'T x 8'bottom to grade Materials of construction: Cesspool block Indication of groundwater inflow(yes or no): No Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): The cesspool had 4'ofliguid on the bottom. The cover was 16"below jzrade. NOTE:Single cesspools automatically fail in the Town ofBarnstable. PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic 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) Property Address: 255 Old Craijville Road Centerville, MA Owner: Estate of Harold Kearsley Date of Inspection: May 3, 2005 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. C'rn�T a3 a� 10 ' ov _ 7 S E W A GE PERMIT NO. 0 10 N&,b l u l lPjc� V 1 L'L`vt INSTA LLER'S NAME i ADDRESS -�Y- P Moo-o>k bev- .-t S,)I-) , nc°- U I L 0 E R OR OWNER (-)0p-i DATE PERMIT ISSUED DATE COMPLIANCE ISSUED -7_ k/- g0 � �or C)Q\, c(o"spoo o. Neva f • Page l l of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 255 Old Craigville Road Centerville, MA Owner: Estate of Harold Kearsley Date of Inspection: Me 3. 2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30+/- 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) Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours maps, the maps were showing_approximately 30'+/-to ground water at this site. This report has been prepared and the system inspected and failed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed,written or implied,relating to the system, the inspection and/or this report. 11 1 ........... ry Fzc$. vU THE COMMONWEALTH OF MASSACHUSETTS BOAR® OE .H'E� JAB JLTH ........... .....� ��..0F... ...................................... Applira#ion for Dispoii al. Worko Tonkrur#inn Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal ••cation:Address r t o .- O ne Address Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a Other fixtures ---------------------------•---• W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.....................Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.....................Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ 1.4 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_--_-_-_--_------__-..- a ODescription of Soil................. 1---------•----•------•..................••----•---- ----•--............................ x �., ...........---------------------- W -------•--------------------------------•-----------------------------•----......••----•-•--•--•---•----------------••-,------------•-•---------.) ---------............. UNature of Repairs or Alterations—Answer when applicable........-_..)0.10... ��` Q Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Dispo 1 System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further,agrees not to place the system in operation until a Certificate of Compliance has ee issued by the board of health/ ' Date Application Approved By.......... ,t / '. '.-. ®.:.._._ �� .. Date Application Disapproved for the following reasons:-------•------------------------•---------------------------...-•------------------------------------••••------- --••---•-•-------------------------------•-•-----....----•--•----•---------------------•---...---•----------------------••••-------•-----------•-•------•------•---•-•-•--------•--------------••---•--- :; ................Date jf 7--Q�'-a w Permit No......................................................... Issued.---- --�- � ---•----•-- Date AMMOM +.��,.. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA cee No......................... ........... THE COMMONWEALTH OF MASSA0HU,SET_TS.,,,A" BOARD OF' HEALTH ..................................... ...................................... Appliration for Disposal Works Tonstrurtion lirrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at, 'I'd *,,_,i. .............. L6cation Address or Lot No ---------- ----- ....................................... ........... ... .......... Owner -- -------- -------------------------------- Address 7 ................................................. ............................... .. .................................................................................................. Installer Address Type of Building l Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder P4 Other—Type of Building ............................ No. of persons........................_... Showers Cafeteria Otherfixtures ............................................................................................ ------------- ------------------------Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 11 7e is T k—Liquid capacity............gallons Length................ Width-..-__-____-___- Diameter-_______-___.._- Depth....._._........ Dispo I nc —No..................... Width...._.........._._.. Total Length..................._ Total leaching area....................sq. ft. �isp .................. .. Diameter..........:..._.............. Depth below inlet.................... Total leaching area..................sq. f t. e iPit N 0 s Dosing tank stri Z t er on box Percolation st Results Performed by......................................................................... Date........................................ 'e D' ee po c e ther D '.Pik t N Ich L 0. Istrl U.10 n P rcol t t r e a Ion TestP Pit o. I................Minutes per inch Depth of Test Pit................_.._ Depth to ground water.._.-.............._.-_. T P 44 Test pit o. 2........,,,__minutes per inch Depth of Test Pit.................... Depth to ground water......____..........___. P4 ...T.-...................................................................................................................................................... 0 Description of S . ............................ ............................................................................................................................... j..................................................................................................................................................................... ................................U Nature of Repairs\o..... .............................................................................. ....................................... ---------- r----1 nations tAnswer when applicable------------//,/ - -------- ...................... - ------------ ------------- .................................... ......;,� .................................................................................................................................................... Agreement: The undersigned% ees to in4all the oredesciibed Individual Sewage Disposal System in accordance with the provisions of TIT..,:. of the S' tate..Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate o Compliance has been issued by the board of health. ........... �Signed .......................... ....................... ...........DaXd.. ......... ...... ... Application Approved By ..... ..... ............. ............................. Date Application Disapproved for the following reasons:................................................................................................................ ...................................................................................................................................*-------*------------------------------ Date Perriit No......................................................... Issued ....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................... ................OF..... ......(9rdifiratr of, Toutpliattrr THIS IS TO CERTIFY, That the Individual-Sewage Disposal System constructed or Repaired by............. .........................................................................................................................................- at..' ............................... _rtaller IT § ...................... ........ ................ ........................................................I............................... 7 ---------------------------- has been installed in accordance with the provisions of V"41 f The State Sanitary ode as ibed in the ......... ...... application for Disposal Works Construction 9(.....g-Cj............... daied-_X7� a ---- ----------- ..... .................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NO NSTRU�kD AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SA)4SFACTORY. tor.......................... .....................................'DATE.....7..........e. ......7............................................ e&c THE COMMONWEALTH OF MASSACHUSETTS BOARD-,-,OF HEALTH . ......................... i.......I...j.................................................................0 F....." .............. FEg...................ILI ...... Disposal Works Tonstruction rrqtit Permission is hereby granted... ......................... __4 ..................................................................................................... to Const'=7 or Repair .;in Individual Sewage, Disposals Systeyn at No...... M ................................... ..............�_---I ................. ....... 7 as shown on the application for Disposal Works Construction P S et N(��Datedl...-............ ................ C4 4 Board of Health DATE-- V -•---------------------------------••------------•--•---- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS ALL SYSTE SHALL SYSTEM PROFILE MARKED WITHC MAGNETIC TTAPE OR BE PROVIDE WATERTIGHT MIN. 20" DIAM. (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. NOTES ti• ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 1. DATUM IS APPROX NGVD 40.6' 2. MUNICIPAL WATER IS EXISTING o �� 39.0 MINIMUM .75' OF COVER OVER PRECAST 27. SLOPE REQUIRED OVER SYSTEM PROVIDE INSPECTION PORT TO WITHIN 3" OF FINAL GRADE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. � o PRECAST H-10 PROP. TEE m R RISERS (TYP.) 4. DESIGN LOADING FOR ALL PROPOSED PRECAST = Lo u 2'0 4"OSCH40 PVC UNITS TO BE AASHO H-10 ,.: 2" DOUBLE-WASHED PEASTON OR GEOTEXTILE FABRIC *38.6't 10" 1500 GAL H-10 14" 5. PIPE JOINTS TO BE MADE WATERTIGHT. a 36.25' TEE SEPTIC TANK TEE 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE 36.0 6" MIN. SUMP ° O ° O ° ° ° ° ° ° ° 000°°°°°°°°°°°°° ' °°°°°°°• °°°°°°°°°°°°° WITH 310 CMR 15.000 (TITLE 5.) .. o 0 0 ° 0 ° °°°°°°°°°°°°°°°°°°°°°0°°°°°0°°°°°°°°°°°o`�o°°°o°o° °°°°°°°°°°°°° °o°o°o°o°o°0 12" MIN INT. DIM. 35.1 7 0°°0°0°°0°°0°°0°°0°°0°°0°°0°°0°°0°°0°°0°0°°0°°0°0°°0°o °o°°o°o°°o °o°°o°o°°o°0°0°00 GAS BAFFLE :` ° ° o ° °_ ° ° ° ° ° ° ° ° ° ° ° ° ° ° 00 ° ° ° ° ° ° ° ° ° ° ° ° ° e - °°°°°°°°O°°°°°°°°°°°°°°°°°°°°°°°°°°°°°° °°°°°° °°°°°°°°°°°°°°° 33.06 000 ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° , ° , ° ° ° ° ° ° ° ° 1. THIS PLAN IS FOR PROPOSED WORK ONLY AND 4' LIQ. LEVEL (ACME OR EQUAL) 35.36' 35.19' 4" PVC SET AT .005'/' SLOPE NOT TO BE USED FOR LOT LINE STAKING OR ANY OTHER PURPOSE. + ; ;: . .:•:• .::. .....: ;-.. ON 6" DOUBLE WASHED 3/4"- 1 1/2" STONE To eY J°O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O�'l. - O°O°00000000000000000000000000000000000000000 „ ,,°°00o0o0O o 001°n00000000000�0*0°�000g0000000. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. _D 6" CRUSHED STONE OR MECHANICAL 5.06' . 9. COMPONENTS NOT TO BE BACKFILLED OR Croig016 Beach Rd. Smith COMPACTION. (15.221 [21) CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED FROM BOARD ( 12+% SLOPE) (12+7. SLOPE) ( 1 SLOPE) OF HEALTH. BOTTOM TEST HOLES 1 & 2 EL 28.0' 10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP FOUNDATION- 19' SEPTIC TANK 5' D' BOX 4' LEACHING CALLING DIGSAFE (1-888-344-7233) AND FACILITY VERIFYING THE LOCATION OF ALL UNDERGROUND & NOT TO SCALE *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS ASSESSORS MAP 247 PARCEL 109 PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEACHING FACILITY. 12. EXISTING LEACHING FACILITY SHALL BE PUMPED L n y I D AND REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. 99- EXISTING CONTOUR X 99.1 EXIST. SPOT ELEV. 99 PROPOSED CONTOUR PROPOSED SPOT EL. TH, SYSTEM DESIGN: TEST HOLE 2YYi GARBAGE DISPOSER IS NOT ALLOWED SLOPE OF GROUND CQo UTILITY POLE �0 LO5014F��� DESIGN FLOW: 2 BEDROOMS @ 110 GPD = 220 GPD USE A 220 GPD DESIGN FLOW** FIRE HYDRANT NOTE: NOT ALL SYMBOLS MAY APPEM IN DRAWING 'vo, FULL SEPTIC TANK: 220 GPD (2) = 440 BASE. -- �p T.F. = EL USE (1 ) H-10 1500 GAL,. SEPTIC TANK / .� TEST HOLE LOGS 1g; 4°.6' '� LEACHING: \ � SIDES: 2[2 (22 + 3) 2 (.74)] = 148 GPD ENGINEER: ARNE H. OJALA, PE, SE � �� CRAWL. / 39 (CONC. ENCH MARK - TOP OF BOTTOM oo BOTTOM 2[22 x 3 (.74)] = 97 GPD STEP ELEVATION = 39.6 NOTE: TOP OF SAS IS BELOW THE WITNESS: DON DESMARAIS, IRSCRAWLSPACE ELEVATION TOTAL: 331 S.F. 245 GPD DATE: JULY 6, 2012 e� I O USE (2) 22' LONG x 3' WIDE x 2' DEEP PERC. RATE _ < 2 MIN/INCH < F '` 3 O LEACH TRENCHES OF PERF. SCH. 40 PVC PIPE AND STONE 13682 +� ��d CLASS SOILS P# �f cP > **2 BEDROOM DEED RESTRICTION REQUIRED ELEV. ELEV. � ' p" 4 38.0' 0,, 38.0' . - A A 'o LS LS WATERLINE MUST BE SLEEVED WHERE \ O MA 1OYR 3/2 1OYR 3/2 WITHIN 10' OF SEPTIC SYSTEM OP APPROVED DATE BOARD OF HEALTH 7" 7" COMPONENTS • 38 B B � s�°� * TITLE OVER HEAD UTILITIES � ` 1• 5 SITE PLAN LS LS �J OF 16" 1OYR 5/8 36.6' 16„ 1OYR 5/8 X, 255 OLD CRAIGVILLE ROAD PERC C1 C1 00 CENTERVILLE LS LS PREPARED FOR 72" 1OYR 4/6 72„ 1OYR 4/6 B&B EXCAVATION/AVERGON JULY 9, 2012 C2 C2 off 508-362-4541 MS MS eon' tiG �I �., 4 fax 508-362-9880 s DANIELA. � DAN L o OJAA A. \`` \w downcope.com 1OYR 7 4 10YR 7 4 vIL OJALA / / down cafe eagineeriag, Inc. 120" 28.0' 120" 28.0' N .46. N 40.,�0 i /' i•. .ti �sr� ��``s SS c" " - civil engineers Scale: 1 = 20 (� S � ^^o° "� land surve o NO GROUNDWATER ENCOUNTERED -7 (O Z 51,) ✓ '�UR_.E y rS 939 Main Street ( R to 6A) 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675