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HomeMy WebLinkAbout0044 POINT OF PINES AVENUE - Health 44 POINT OF PINES AVE Centerville A = 210 — 104 - 002 db N SMEAD No.2.153LOR UPC 12534 amaad.com • Made In USA WW FeER IJS®N MS PIl000C71l� SFIMffT MSOUOCNGQEOURAIM OFT1*SMPa G M CERTIRED SIXIRCMG WWWSFWAOGPAKG f4 Commonwealth of Massachusetts Title 5 Official Inspection Form =Y'. Subsurface Sewage Disposal System Form-Not for Voluntary Assessments riQ 44 Point of Pines Property Address §a Wellington Snares Owner Cwner's Name .� Information is Centerville MA 02632 10-9-17 • 10, required for every page. CitylTown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important When A. General Information on the computer, / filling out foP s /�&� `, ( ���� use only the tab 1, Inspector: .���a� �S4C�''G —Y ,... , key to move your s ate; y�y cursor-do not _ ' •,cA z use the return James D.SeafS =X; JAMES m G : key. Name of Inspector a :" Ca ewide Enterprises } r o Company Name -.fir T I ,.• q �. 153 Commercial Street '.,, Company Address glur�lufa Mashpee MA 02649 CityrTown State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes (] Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority OyAg4t� 10-14-17 I ctor's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system 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. ""*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. t5inc.doc•ray.W16 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 1 of 17 9t a5ed xe:1 dH U66 L60Z 96 130 S Commonwealth of Massachusetts Title 5 Official Inspection Form i� Subsurface Sewage Disposal System Form•Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Soares Owner Owners Name information is Centerville required for everyMA 02632 10-9-17 page. Cityrrown State Zip Code Date of I nspection B. Certification (cont) Inspection Summary: Check A,B,C,D or E/always complete ail 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: The system is a 1500 Gal. Tank D Box and 18 Chambers 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. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following,statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or 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. ❑ Y ❑ N ❑ ND (Explain below): t5ins.doc•rev.6/1E Title 5 Official Inspection corm:Subsurface Sewage Disposal System•Page 2 of 17 61, abed Xe:1 dH 6 6:6 6 L 602 9 6 lop t Commonwealth of Massachusetts Title 5 Official Inspection Form j Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Scares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. Cilyrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass Inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ 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 ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further 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 15ins.doc-rev.6116 Title 5 OMdal Inspection Forth:Sut*Wace SawaGe Disposal System•Page 3 of 17 Oz a6ed xed dH l•6:61• L 1.02 9 6 PO Commonwealth of Massachusetts Title 5 official Inspection Form d Subsurface Sewage Disposal System Form- Not for Voluntary Assessments y 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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 fecal coliforrn bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component 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 is less than 6" below invert or available volume is less than 1/2day flow TA r6;r*i t5ins.doc•rev.6/15 Tale 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 6Z a6ed xe:l dH 6 L:6 I L 1,02 9 6 130 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments t vz�;-J-1- 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 fecal coliform bacteria Indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. Ej ® 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. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. 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. t6ina.doc rev.6116 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 22 a6ed Xed dH 2 6:6 6 L 602 9 6 130 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form . Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. Citylrown State Zip Code Date of Inspedion C. Checklist 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 NIA) ® ❑ 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 ete mined based on: ® ❑ Existing information, For example,a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) (310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 god x#of bedrooms): 440 15ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 EZ a6ed xed dH Z V61• L 60Z 9 6 lc0 Commonwealth of Massachuse tts efts Title 5 Official Inspection Form vSubsulrtace Sewage Disposal System Form - Not for Voluntary Assessments s 44 Point of Pines Property Address Wellington Scares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. City/Town State Zip Code Date of Inspection D. System Information Description: 1500 Gal. Tank D Box and 18 Chambers. Number of current residents: 5 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2015-71,0000als g y g �gp )�' 2016-22,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: PresentDate Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc,): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: 15ins.doe-rev.V6 Title 5 Official Inspectlon Form:Subsurface Sewage Disposal System•Page 7 of t7 VZ a6ed xed dH E V6 6 L 60Z 9 6 130 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 44 Point of Pines Property Address _Wellington Scares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: NA Was system pumped as part of the inspection? ❑ Yes ® 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)and a copy of latest inspection of the IIA system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ns.doc rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 SZ a6ed Xed dH £6:6� L 1,0Z 91. PO C, Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Dispasal System Form - Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 2008 Permit #2008-212. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 20"feet Material of construction: ❑ cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH -40. Septic Tank(locate on site plan): Depth below grade: 10 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gal. Precast H-10 Sludge depth: 3' t5ins.doc•rev.6116 Title 5 Official tnspeclioi Form:Subsurface Sewage Disposal System•Page 9 of 17 9Z a5ed xe:1 dH b 6:61• L 60Z 91, 130 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 27 . Scum thickness 2 Distance from top of scum to top of outlet tee or baffle 6 i Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Asbuilt-Plan-Tape Slud9 a Judge 9 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank and covers at 10" below grade. In and outlet tee's. No sign of leakage or over loading. Tank to be maint pumped after inspection, Grease Trap(locate on site plan). Depth below grade: feet 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: Date t5ins.doc•rev.el'6 Title 5 Official Inspection Fonn'.Subsurface Sewage Disposal System•Page 10 of 17 ZZ abed xed dH b 6:6 6 Z 60Z 9 6 1:)0 Commonwealth of Massachusetts IffWSEN Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. Cityrrown State Zip Code Date of InspWlon D. System Information (cunt.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): Tight or Holding Tank(tank must be 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 per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping; Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 15ins.doc-rev.5116 Title 5 official Inspection Form:Subsurface Savage Disposal System•Page 11 of 17 9Z a5ed xed dH b L:6 t L 1,02 91. 100 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Box is 16"x 16"-26" below grade. Box is clean and solid w/two lines out. No sign of over loading or solid carry over. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: 15ins.doo rev.5116 Title 5 official Inspection Form:Subsurface Sewage Dlwsal System•Page 12 of 17 6Z a6ed xeJ dH t7 6:6 6 L 60Z 91. 130 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 18 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: I ❑ 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.): Leaching is two rows of nine infiltrators per row wl3' stone (40'X164"). Ck D Box and camera out to chambers. Clean wino sign of holding water. 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 ❑ No t5ins.doc•rev.6116 Title 5 DtYdal Inspec4lon Form:Subsurface Sewage Disposal system-age la or 17 0£ abed Xed dH 9 6:6 6 L U 9 6 1)0 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M ` 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction, Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5trn.doc•rev.6116 Tide 5 Official Insfoaclion Form:Subsurface Sewage Disposal System•Page 14 of 17 6£ a5ed xed dH 9 V6 6 L I.OZ 9 6 130 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. CityfTown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately rAR-A��oNr t o o '� 3 i 30 y.s t5ins.doc•rev.em Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 15 of 17 Z£ a6ed xej dH 9 L:61 L 60Z 9 6 130 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments rw 44 Point of Pines Property Address Wellington Soares Owner Owner's Name information is required for every Centerville MA 02632 10-9-17 page. Cityrrown State Zip Code Dale of Inspection D. System Information (cons) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Nv Estimated depth t high ground water: 14 feet Please indicate all methods used to determine the high ground water elevation.- Obtained from system design plans on record If checked, date of design plan reviewed: 10-22-99 Date ❑ Observed site (abutting propertylobservation hole within 150 feet of SAS) ❑ Checked 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: T.H.on Design plan 10-22-99 14' no G.W.. Bottom of leaching at 3' below grade. Bottom of leaching at 11'aboveT.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc rev.W16 Title 5 Official Inspection isorm:Subsurface Sewage Oisposel System-Page 16 of 17 ££ a6ed xed dH 91•:6 6 L 602 9 t 100 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 44 Point of Pines Property Address Wellington Soares Owner Owners Name information is required for every Centerville MA 02632 10-9-17 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5lns.doc•rev.6116 Title 5 0tkial Inspection Form:Subsurface Sewage Disposal System•Page 17 017 �� a5ed YU dH 9 6:6 6 L 602 9 6 130 MRR-19-2015 00:47 From: To:15087906304 Pa9e:3/4 r FROM :down cape engineering ino FAX NO. :15OB36298W Mar. 18 2015 12:17PM P2 Town of Dams-11table Wry Sr"Mr'es' Thomo F.4'eiLer,'DirettOr sQ•�' Thomas MCK91U,DiMdOr 2f1011Kaarl dy re4,'tea 6fl'MA 0260 , Feat: 50�-"190•-690h Offi.fl' 508-962-4644 Sewage.PerIneiO 2- 044 / [.eri ��Il3fixa➢1®u; 4✓ !u 1 (�+�fl �?c At��nreee3: NoWOn Qz ...- ..• J w issued a gevri to ink a p,eltio vjAremmu at'— _h rd one a dcsi},m dr�wp.by dms) t j dL ru T.cerztify't1 t the.S tilt syq�rdnzemced ibo've was i0t111et1 s�hstrtn�alEp acct7rrlln t� Itte design,w,I�ich may mr..lnde jrurulr arpzoved e} 3n�es3 scictti as lataznl ct;locanu of Ehe tli�ntrxb�iuxti bn��]!rn;3egtir,t�►c k . , ' I ceziiip t�zat tl+r. septic cyst cn-re a,-,uee6 above was in;flaTlPd voi'd1 i m.M c �r r�nejeit — _ geAter,thsn l0' laf=r-11 eja(%st[ou of-d.w 5A5 oT any v�t�.cul,rc:iomdull of aZy co�nl+ of tint:5eI►iil E;Sf9tem b•st in iuicuxclaxize•avt(h,Stare 14_1,u081 Aegulations. 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IT'S S:t�l1atute) - `• CIVIL &n No,46542 �GI bTf- �� ss'0""` �e:i9 R,11CY�^u�X�t1D.�J�T.4"J' (A�'X�e3IQ�:4'r�9 Stfl'11�,D T4fiTfi� NtbT 1 a�'i:17 F1t'�TTGa T fUp_. _ - MAR-19-2015 00:48 From: To:15087906304 Pa9e:4/4 «i TOWN OF BA RNSTABLE LOCATION SEWAGE# - VILLAGE 7 •��-- INSTALLEW S NAME&PRONE NO, -n��c` �' Gc•l _ rd ? r-�?:���7 SEPTIC TANK CAPACTTY L'EACIE NG FACILITY.(type) r tr'Z.� _ (size} ,� r -T F-MO ef, NO.OF 33EDROOMS OWNER PERMYT DATE: CONQLTANCE DATE: Separation Distance Between the; r Maximum Adjusted Groundwater Table to the]Bottom of Leaching Facility `� Feet Private Water.Supply Well and Leaching Facility(If any wells exist on PJ ,dam Feet site or within 200 feet of leaching facili tY) ridge of Wetiand and Leaching Facility(If any wetlands exist within Feet 300 feet of leaching facility) yuWgiSHED BY .. h L1 iroN a 'V � .�.� 00 It A - jA ti Y TOWN OF BARNSTABLE LOCATION 4* i crt &f- -4,j,5- SEWAGE# _A007--4-(.-- VILLAGE /_1'a7u/e LLJ ASSESSOR'S MAP&PARCEL 40 ;o4-er_ INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 01 LEACHING FACILITY.(type) 2ri t2_&� (size) -0O K 1 S7 be-> � NO.OF BEDROOMS -,ef "jL •'.4�oV'q L9A- OWNER v.A-tom€- �LL PERMIT DATE: •,IZ-6'5' COMPLIANCE DATE: V Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 5 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 �y 'I t NO �I�K f twu�t. y fey Al:0Pf } a ovf(--k A Al t 4,51 - � r No. Lo oU- 2 1_Z Feet THE COMMONWEA MASSACH SETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes pplication for Migo5a[ �&pq;tem con0tructiou 'Permit Application for a Permit to Construct(vf Repair( ) /Upgrade( ) Abandon( ) 2Complete System ❑Individual Components Location Address or Lot No.� /0 ,0,/JLJ wner's Name,Address,and Tel.No. ��Tzci2v�1%L �.eov�s_, �4 v�fY�tJ Assessor's Map/Parcel a`�j—!©y-^ �D �- pc�/,Ur o /ELLS. Installer's Name,Address,and Tel.No. b0&N) Designer's Name,Address and Tel.No. �dVr�o a 36a Type of Buildin : 7el�`�—w— � c,7d Dwelling 52 No.of Bedrooms OLot Size a©� o� s . ft. GarbageGrinder y q g ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date 11 ^15^ 1 CA q!j Number of sheets k Revision Date 12 f y, :S �23�a8 Title Let S Av 4q ro► dR 121 Nts AV, C 1-31 k AAP I U-IL Size of.Septic Tank /S00 Type of S.A.S. �0�X /S� c.7tH7-a Description of Soil S'EL OCR"- Lo4 - Nature of Repairs or Alterations(Answer when applicable) n 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 Boay of Health Signed C%- Date Application Approved by Date r 2 00 Application Disapproved by: Date for the following reasons Permit No. ZOO 0 ^ V 2— Date Issued J^- 2 3 2 0 G fj THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( V) Repaired ( ) Upgraded ( ) Abandoned( )by G1 y G L-/ (%Lc,^'E S at L{ 6( Po W l C V I G L l: has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 G 2-1 Z dated $ Z 3 Z 0 o Installer Designer �U�^'^� C A ^'�i rg C- G c y #bedrooms Approved design-flow � ,� �,�' n gpd A / f/ The issuance of this perrriit hal�no/tube construed as a guarantee that the system w�ifu ltionas drjeti�g ed. Date / /-� Ins ector / Y/ /j�LC P No. Fee G THE'COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS 'WigOnt :�p tem (fott!gt ucti0n permit Permission is hereby granted to Construct ( ,/) Repair ( ) Upgrade ( ) Abandon ( ) System located at r and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty '. to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this pe it. Zc' o Date Approved by l• l A 11Z E No. �JFeed THE COMMONWEAL WOF MASSACHUSETTS Entered in comluter: PUBLIC HEALTH DIVISIONj'4TOWN OF BARNSTABLE, MASSACHUSETTS Yes f- Application for Wgo!gar *p9tem (ton5tructiou Vermit Application for a Permit to Construct("SRe air Upgrade Abandon O ©.Complete System ❑Individual Components II Location Address or Lot No. ��/,/p0%�U � � � Own/e�r's Name_Address,and Tel.No. 1 r s Assessor's Map/.Parcel o?(� 0f '^"/G7 y---- G?O �- �.G �v/rC.l t / stal er's ame,Addres ,and'el.No.��+�7'�1,'-�T,� Designer's Name,Address and Tel.No. I ft%cL ca.16" --isus + r Type of Buildin • �( '' �-- 3`7<r Dwelling 'No.of Bedrooms ; �v Lot Size a� ' sq. ft. Garbage Grinder ( ) Other Type of Building s No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 4 O gpd Design flow provided y y z� gpd , Plan Date 1 ti ` t S' i Number of sheets Revision Date 12 rz y• S 2 S C1 { , Title l a 3 t)ti J9 o G' Qr NpS z4v, C S:NT rf r`-I L,- . Size of.Septic Tank /S O Q Type of S.A.S. X z, ti "�T�9 TGQS ' ,,Description of Soil i At Nature of Repairs or Alterations(Answer when applicable) 7. Date last-inspected: Agreement: The undersigned agrees to ensure theq 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 unt�rtificate of Compliance has been issued by this Board'of Health. Signed 4 Date Application Approved by 23 -/ Date Application Disapproved by: /� J Date ` + for the following reasons "Permit No. ZOO 21 IZ Date Issued :5 3' 2 G G6 i ( I LOCATION SEWAGE PERMIT NO. VILLAGE INSTALCER'S NAME & ADDRESS ��. 6®X B UI'LDE R OR OWNER DATE PERMIT ISSUED ��•: `�-'�.� �� �'�%,rah,G DATE COMPLIANCE ISSUED �� �` �q a�a ifDoc�r` S�jo�?��'�C t�7 ioo o sg� ��� srp rB Tw�K - �, (�lo' - ems/,o '�. �---- �q o �— - - -- -� i � � �/.o � 'r. a � �� ! No...........` . Fps.... 5...Q9......_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................Tom...---.....OF.....Barns tab le.-.-.--------------------..._..._..........._......-- ApphrFatiou for Uiipos al Varks Tomitratffioat rami# Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: ............P.cdat...of..kWas_......lQt...a.......................... Location-Address or Lot No. .....------B pepJae.1><--� 1d...................................... _.....Centerville Owne Address a Joseph..P:..MacMber & Son- Inc= Centerville --- Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms_________________________________ _Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' 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........................................ 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........................ ---•-•---•-•-----------•--•--•---•.._.---••-------•--•---•-•--------------------------------•----------------•--•-.._........__. _:'..�1- DDescription of Soil.......................................... ?....................... ---------------------------- ­1 / V x --------------------------- ••--•----•-- ............................................................ U Nature of Repairs or Alterations—Answer when applicable---Ftepl c-frig-.-eXiS_tin. ---svztEIri.................... ............................................................Plan•-attached----------- --------------- - : . 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 agrees not to place the system in operation until a Certificate of Compliance has bee issue by ,he b r of health. Signed_. - ..1....r... ��� ° 1 8/101.. Z.._._.._. Date Application Approved By------- ( % • . ................................. Date Application Disapproved for the following reasons:................................................................................................................ ....................................................... ----------•---••---------------------•--•-•---•-•-------------------.--.------------------•-----------------------....--•----------•------------ Date PermitNo.......................................................- Issued-.................-..................................... Date THE COMMONWEALTH OF MASSACHUSETTS �/�� C � BOARD OF HEALTH .......................T.o.►M......O F..B.arnat ab l e................................................... Tatif iratr of TaautpliFaatrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X) by...-----JQuph... _...Macomber- &...Son.•_Inc . .......... Installer at_-_Trot 3 `Point of Pines Centerville Wald ________---•---•-•------------------------------------------------------ has been installed in accordance with the provisions of TI 5 of The 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 THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................................•---._._....-----....--•-----•-------...--_. Inspector.................................................................................... No................ .......................... THE COMMONWEALTH OF MASSACHU"SETTS ` BOAR® OF HEALTH 'Iov., ;:......oF.::.Bernst ra1c 40rat la, for,Diip al Workg Tontitrurtuan-ramit; Application is hereby made for a Permit, to Construct ( ),or. Repair' (X ) -an Individual Sewage Disposal System at ..... ..... .... ._.. ..... 7.......................................................... -• ------•.. ..................................... ..... .......--.......... L'ocahon-Address l or Lot No. k �hen .Iry d ¢ Cent.ervil.11.e --......-•-•••--c ............ -------••---•-----. �.......................... ......----- ---•---------••••••-• ---------.............•------• •--.....-- -- Owner Address W•' CNJ.aeph P L-lac,,)mber �c 10l MC ,. Cent,erv'_21e . ....... ...... ......... ....... ........ ...._.. _ Installer Address Q Type iof Building Size Lot...... .................Sq. feet V Dwelling—No. of Bedroom .................... Expansion Attic ( )" . Garbage Grinder 1 p I Other- ',Type of Buildiii .......... ;No. of persons------------------------____ Showers — Cafeteria Q' Other fixtures d W - Design Flow..........................................___gallons perTerson per day. Total daily flow............................................gallons. 1:4 'Septic.Tank—Liquid capacity gallons Length ........ Width Diameter ...., Depth................ Disposal Trench--No. _ ----__-_-:.... Width............I....... Total Length _____....... Total'leaching area------ ft.' Seepage Pit No... .:..:..:.::.... Diameter--__:- __-._...._: Depth below inlet.................... Total leaching area.................sq. ft. Z Percolation Test Results )' Performed tank Other Distribution box.• armed by............:... - Date...= . a Test_Pit No. 1___-------------minutes.per inch Depth of Test Pit.................... Depth to ground water. .......:........_.. LL, Test Pit,No. 2........ '...._minutes per inch Depth of Test Pit................:... Depth to ground water................------- ----------------------------------------------------------- ----- --- - -- .......................................... O Description-of Soil ... • -- •-----. --- ....• -- •-- -----.. ----•--` .......... UNature of Repairs or Alterations—Answer when applicable T.r..�...r... t:i n''_._G zrc'r a_t� " Plan a' -ched Agreement The undersigned agrees to install the aforedescribed' Individual Sewage Disposal System in accordance with the provisions of TITL L 5 of the State Sli itary Code` The undersigned further agrees not to place the system in operation until a;Certificate of Compliance has been.issued'by the board'of health. 10 /77 Application A roved 'B �.__.. .•--• ----•-•• •-•--• --- -- . Pp PP Y L /• _ Date Application Disapproved jort the following reasons; - ' •--------- - ----- ------ ---••----------------------------------------------------------- - ------- Date Permit No. Issued..... Date �. THE COMMONWEALTH fOF MASSACHUSETTS BOARD OF HEALTH Town n . ....oF... z^n :=e.............................. .- i rtiftrzttr of Toutpl dt rr. THIS IS TO CERTIFY.; That.the Individual Sew age.Disposal�S�stem constructed ( ) or Repaired (X ) by -JDse-h P= MacomWtr � .�on Inc = - Lot 3 POI nt Of � �1KL w �. i11.!ervi Ile nstaller ' Wald at ................................................... .............. --• ... •---- . ... • --•--• --•- ••-•-•--•--........ =-------•-- has been installed in accordance'with the prop isioi s of T 5 of The State Sanitary Code as described in the application for Disposal Works Construction` Permit No rj__ _ ______________ da.ted.. --.1 .'-�7_ _ _-__.___. THE ISSUANCE OF THIS CERTIFICATE 'SHALL NOT BE CONSTRUE® AS`A GUARANTEE THAT THE SYSTEM WILL FUNCTION- SATISFACTORY.. DATE.............. n I Spector W. THE,aCOMMONWEALTH'OF M'ASSACHUSETTS BOARD: OF HEALTH.' Tpwn F Ba,r ti -able V / r ...... \� No. FE ......... i rn tt1 park � a�latratrtimri• amit Permission is hereby granted .J�Sex?h ,hi�CnCrib�r $c' So JnC ._ ) .r. ...... .................. --- to Construct ( ) or Repair. ( an Individual Sewage Disposal System L�tia �l l fin ,. tJe it,�r �y Lie Wald o. : . Street as shown on the,applicatiori for Disposal'Works'Construction Per No Dated J� � p 77 -----.....- . -- -- ... Street B I a h' DATE_._ d419,4 Board of He • FORM 1255 HOBBS & WARREN INC .PUBLISHERS D 14 .2446, 7 - VC 10 Bdrm Q m G 5 5' - -- 23 _ _ _._ -- --__ 32 60611_ 2436 2446 2446 2436 _ 19 7 bath Kit Dining 1 4 M Bdrm L \ M B611i 8i--1 0 Bdrm ,.. N - 1 0!1 0!! _ - 4 - _ 31 2 - Powder rm 4 13 0. Mud Closet ' 2 Great Room i _"_. i N Bdrm - _---� - _ - - - -- 9 - - stairs. - office .. 8 T - 4 5" 2446 2446 2446 2446 - - - 2' 5 Porch m 6 .8„ 23 i I N Q 9'X 7` I Garage I I Overhead Proposed new home for; Wellington Sogres Door I BonusRoo►n i 44 Point of Pines Ave I Above I I I I I 3Q Centerville, MA p l F ' 'Q4 , I I F 1 st Floor Plan 9'X7' ' I I - - OveFheadj 'Door i t I N I I I 4' 2446 4 2446 2, - 2446 4' 24 G T.O.F. AT EL. 43.5' SYSTEM PROFILE TEST HOLE LOGS ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) 4" INSPECTION PORT TO GRADE ACCESS COVER (WATERTIGHT) TO MAGNETIC TAPE OVER ALL COMPONENTS ENGINEER: M.S. FARIA, SE WITHIN 6" OF FIN. GRADE ED BARRY MINIMUM .75' OF COVER OVER PRECAST /� 2% SLOPE REQUIRED OVER SYSTEM WITNESS: �- ; 43.0 1 2" DOUBLE WASHED PEASTONE DATE: 10/22/99 LOCUS 41.33' FOR FIRST RUN PIPE 2�L 41. < 5 MIN/INCH a PROPOSED150 _ ' p PERC. RATE = o o� 41.13' !'A GALLON SEPTIC 40.88 � oo CLASS I SOILS P# 9572 s TANK (H- lO ) GAS 40.60' 0 40.58' VARIES = o '''' •' BAFFLE 40.77' oo� $o o"0 40 p+ GREAT MARSH ROAD ( 2 % SLOPE) �6" CRUSHED STONE OR MECHANICAL $ LOTS 1/ (2 5) COMPACTION. (15.221 [21) 4 (6) ELEV. Q DEPTH OF FLOW = 4 ( 1 % SLOPE) �" 41.5' 0" `�4•0, TEE SIZES: 3/4" TO 1 1/2++ DOUBLE WASHED STONE 0/A 0/A INLET DEPTH = 1 p SL SL NO SCALE OUTLET DEPTH = 14" 8" 1OYR 4/1 8" 1OYR 4/1 LOCATION MAP + B B LEACHING FOUNDATION 10' SEPTIC TALK 11 D' BOX 3' FACILITY 5 0 LS LS ASSESSORS MAP 210 PCL 104-002 24„ 10YR 4/6 39 5' 24" 10YR 5/8 42.0' ZONING DISTRICT: RD-1 Cl YARD SETBACKS: MS FRONT = 30' .00 HIGHEST WATER LAKE EL. 35.0' 60" 2.5Y 6/3 SIDE = 10' -38 C C2 REAR = 10' PLAN REF. - ® MED/COS ® MED/COS 38.06 FLOOD ZONE: C ASSESSORS MAP 210 PCL 104-001 a 2.5Y 5/6 96++ 2E5Y5/6 AP OVERLAY DISTRICT #48 10YR 5/8 @g 39 20% GRAVEL C +39.14 - - 7,5 120" OBS. WATER 31.5' MED/COS +39.49 2.5Y 6/3 LOT 3 150" 29.0' 168" 30.0' 20,0031 SF ' NO WAT17R NOTES: 40 ASSESSORS MAP 210 CL 104-002 +. N SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED ) 1 . DATUM IS BASED ON ABLE LAKE DATUM SYSTEM AVAI DESIGN FLOW: 4 BEDROOMS ( 110 GPD) = 440 GPD 2. MUNICIPAL WATER IS AVAILABLE +39.49 y +39.10 �^ 0.o USE A 440 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1%8' PLR F0`0T. 9 i� - -39.3 SEPTIC TANK: 440 GPD (2) = 880 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 5. PIPESJOINTS TO BE MADE WATERTIGHT. �40 <\o��� �� - USE A 1500 GALLON SEPTIC TANK 6. C014STRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. �-39.26 +40.3� LEACHING: ENVIRONMENTAL CODE TITLE V. 35.1' __ � SIDES: N/A 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE 40 x 15 (.74) = 444 USED FOR LOT LINE STAKING. \ #44 I BOTTOM: 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 41 TOTAL: 600 S.F. 444 GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT PROP. 4 BR 135.5' i USE 2 ROWS OF 9 STANDARD QUICK 4 INFILTRATORS EACH WITH INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED DWELLING TF = 43.5' FROM BOARD OF HEALTH. I o N 3' STONE AT SIDES, 3.3' BETWEEN ROWS AND 2.0' AT I ENDS 10. ENGINEER TO CONFIRM SOILS AT TIME OF INSTALLATION. +40.20 +39.61 N 5' REMOVAL OF UNSUITABLE SOIL - Q , MAY BE REQUIRED AROUND 39.90 42•0 1 1 PERIMETER OF SYSTEM IN AREA SHOWN. REPLACE WITH CLEAN MED. 00 ;�� 41 6, 1� , SAND. ENGINEER TO INSPECT ` 41.94 7 REMOVAL.TH GINEE TO INSPECT LEGEND SITE AND SEWAGE PLAN \ 0 1 % SUITAB F SOILS AT TIME OF v , S M INSTALLATION, 24 HOUR 100.0 PROPOSED SPOT ELEVATION ' O �1 NOTICE REQUIRED 1-508-362-4541 1009 �.2 ' � ` � OF 100x0 EXISTING SPOT ELEVATION LOT 3� #44 POINT OF PINES AV. ^° INSPECTION �� oo G • IN THE TOWN OF: i I 43 i+4V 100 3.4 PROPOSED CONTOUR PORT ( CENTERVILLE) BARNSTABLE +42.91 6 L 100 EXISTING CONTOUR .00 .'� V PREPARED FOR: J. CRONES +43.09 +43.48 20 0 20 40 60 Feet I'Y16 /' BOARD OF HEALTH ASSESSORS MAP 210 PCL 104-003 ' APPROVED DATE SCALE: DATE:4.58 MA 1" = 20' NOVEMBER 13, 1999 O #32 00 BENCHMARK REV. 5/23/08 (TH NOTE) {-45.52 W MAIN�� HYDRANT S/O TA G BOLT # 616 off 508-362-4541 ELEV = 48.16' fox 508 362-9880 ZHOFMgS F3''�HOFMASS ° DANIEL down C �cyG� �o ape engineering, inc. DANIEL NIELADJAL o A. 0 CIVIL N " OJALA +44.89 CIVIL ENGINEERS ,0 No.46502 No.40980� P LAND SURVEYORS °�' SoIsT ``�.�`� �9 OSs \j�o �jI2?jlD$ 939 main st. yarmouth, ma 02675 9 9-3 > 0-3 DANIEL A. OJALA, P.E., P.L.S. DATE 14 D C 5' V N 10 Bdrm Q - m � 55' - - �� 60611 23 2436 2446 - 2446 2436 O 4.6.,y -- - 5' 41 1 �4- 76 7 bath - O f Kit Dining 1 4 M Bdrm a `. M Bath 0 v 4 8''10 Bdrm \ f 4 31 pocW do" 3+ g 2 d � FPpwderrm 4 � staI irs 13 Mud IIII Closet 12 III Great_ Room 4 N Bdrm 9 office stairs 10' 6' 8 - I 10 4 7, 4'\` r 2446 2446 2446 - 2446 2, 5 Porch L ---- - - - - [- - - - - - I I-� 2 1 Q 1, �/ D I �� 81, f - - 23 - Q 9,X 7, I I Garage I I Overhead Proposed new home for: Wellington Soares poor ; I Bonus Room I I 44 Point of Pines Ave { Above 30 Centerville, MA I ! (0o N N-0 F 1 st Floor Pian 9'X7' ; I Overh6ad' r I I � I Door N I II I ' 2446 4 4' 2446 2446 4' 24 -