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HomeMy WebLinkAbout0021 PRINCE HINCKLEY ROAD - Health 21 Prince Hinckley Road- Centerville P ` A = 172 167 TOWN OF BARNSTABLE o�I6'�/1�Gf y/NG.E'GE� Off.'• LOCATION SEWAGE# 'VILLAGE G E��''7� ASSESSOR'S MAP&PARCEL _oold7 INSTALLER'S NAME&PHONE NO. cTi;-* LGe'endr& f SEPTIC TANK CAPACITY F /o 0 0 9i4 1. LEACHING FACILITY:(type) (size) •3 /o• X- 9 O NO. OF BEDROOMS 2 OWNER G o PERMIT DATE: >3 —-0o'-"-- COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet Edge of Wetland and L.aching Facility(if any wetlands exist within 300 feet of leaching:facility). feet FURNISHED BY I Qei��NT fioF ` �► 8 �T B i - 3sf f- 9 3 r O G � 76 NO. SIE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH ✓� OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair (�pgrade ( ) Abandon ( ) - ❑Complete System ndividual Components 2 l f s-l vl esL' lie n cLe je-y Imo' G 1- 16 lose G C. Y®y mg �L^cati I m S� Owner's Name Map/Parcel# A dre z - gr� eve- 6 vp— Ter e�ephone# a T. :;7 J to er :e �' ^ A Ap�- De�si`g r07 ,ame �p .Address Tel�lee1JJpho�ne# Telephone# Type of Building: (X►�/'^� Lot Size 75 — Sq.feet Dwelling—No.of Bedrooms Garbage Grinder k--P�® Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min. equi d) 3� gpd Calculated design flow 3J6 gpd Design flow provided difgpd Plan: Date ZL O Number of sheets �_ Revision Date Title Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator "I ,*49 Date of Evaluation 6 ZJ O DESCRIPTION OF REPAIRS OR ALTERATIONS �C% AZQ A le" �I'd,- `—e}(-A 'y-CCLO I (ri a , )c d t, , ek 6v i The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE S and further agre t to place the s stem in operation u 'I-crd ficate of Compliance has been issued by the Board of Health. Signed J ate h 0 Laspecf ohs / FORM I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 `Nod %I♦ / THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH f N of 7�- y� 6 ~APPLICATION�FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT f Application.for a Permit to Construct ( ) Repair (1.0<Upgrade ( ) Abandon ( ) - ❑Complete System KIndividual Components Jo'je e C. YoV In 7 ZLocatio� Owner's Name Map/Parcel# Addre f of# Telephone# �I nstaller's Name Design's Name 7 1 � y 9 46( (lo)t �h Address Address 77�� 3d 6-7 � _ S?��- Ll ZP— Z- ' Tellenephone# __ Telephone# Type of Building: Lot Size /s i -7r7 Sq.feet Dwelling;w No.of Bedrooms 3 Garbage Grinder (_t)�o Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min. equi ed)�gpd Calculated design flow. 730 gpd Design flow provided 6rgpd Plan: Date 9' �l O Number of sheets /� Revision Date 's Title ' Description of Soil(s) Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS f r l elf —11i �� I"i o il f- 7 P'r/ K /4 S� a �i X d t I ' 6 "f�^Ply g i)4 + The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of K' TITLES and further agree Otto place the system in operation until-a 6i4ificate of Compliance has been issued by the Board of Health. Signed !, 1 / ,fDat '1 ® (/ /.� ^ (j. pC/ G' I . f N V U c, . FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 No. ' t� THE COMMONWEALTH OF MASSACHUSETTS- FEE �. 1;; n �'Cr ✓I} blJe BOARD OF HEALTH i V 16 CERTIFICATE OF COMPLIANCE . Description of Work: individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: at to f! (��C4�y &� i41t y 1 has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design pla /as-built plans relating to application No. dated Approved Design Flow 7� (gpd) Installer /IY�i�j,rr„���//� Designer: G`G�� //,.102/� /�► F' yv Inspector / J!lt/�� �s+��lyt�f�1I.iDatelJ/��.. � The'issuance of this certificate-shall not be construed as a guarantee that th�syste 'will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROV'gn FORM 5/96 No. HE MASSACHUSETTS OF MASSCHUSETTS uR FEE BOARD .OF HEALTH Z'f 6 DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( L-- 'U grade ( ) Abandon ( ) an individual sewage disposal system at / ✓tC.t c ., as described in the application for Disposal System Construction Permit No. dated Provided: Construction shlh be q6mpleted within three years of the date of this permi .All localsondi�tiooril must be met. Date /1 `� (� Board of Health 1 /l'�-,� FORM 2 - DSCP / DEP APPROVED FORM 5/96 I FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM PUBLISHERS- BOSTON r Town of Barnstable Regulatory Services Thomas F. Geiler,Director �^ Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 2 z !J Sewage Permit# Assessor's Map/Parcel 1.7 L /6 Installer& Designer Certification Form Designer: �AA- E= l•�Dj-rr^e"s 06 0 Installer: _11 -1 La i�CG?�t� Address: q(G, C S•-t 1-0 Address: �z On J —�` �� was issued a permit to install a (date) (installer) septic system at `� 1 ��'I�+(P or,Cy'aV based on a design drawn by (address) 6rrt 61 �� �� dated (designe—r) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of th Y Pp g e distribution box and/or septic tank. Stri out (if required) d) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local ulations. Plan revision or certified as-built by designer to follow. Stripout (if r ected and the soils were found satisfactory. ��P� ss� GLE�{N o HARRIMM � (Installer's Signature) v S►� I S1 (Designe Sig ture (Affix Designers Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice formMesignercertification form.doe FROM :down cape engineering inc, ,FAk NO. :15083629880 Jul. 11 2008 01:13PM P2 down cape engineering, inc. SIEVE SOILS ANALYSIS_21 prince hinkley Harrington.xlsx DATE OF REPORT: 7/11108 JOB : GRAIN.SIZE ANALYSIS-SIEVE TEST SITE: 21 Prince Hinkley- Centerville LOCATION: Glen Harrington TH 2nd SIEVE ANALYSIS .Weight Sample(Grams): 703.3 SIZE ;WEIGHT RETAINED ; % RETAINED ; % PASSED (sum 3/4';---------;--------------------- a-o";-----------_00%: ------ 100.0% ------ - a---------------••---- -y------_--- --------- 1/2" 0.0: 0.0%: 100.0% ^-------- .}----------------- T-- .. -_p�}•----^-^--------p- 3/8" 0.0; 0.0 :, 100.0/o #4 -------- ^: .........................��---------- 0-0%-;----------100.0% #10 75.4' 10,7%: 89.3% #20 -- __219.9 31.3%: 68.7% ------------- #d0 --- 460.0 65,5%' 34.5% #50 559._5: 79.6%; --- --------- --------- 660 3:----------93.9%: --- -- .6.1% #100------- ................. .677_$m ---------96.4%°: ----------- ----- #200 700.1 99.5%: 0.5% . --------------i.---.-----------.....•-- a----------------- --------_--------- PAN: 703.3; 100.0%; 0.0% SAMPLE:__T----------------^___703.3'---------_- ---_--- ------ - , NOTE:TEST ON PASSING#4 ONLY, 23% RETAINED ON#4 <45%OX. RESULTS: SOIL CLASSIFIED AS AASHTO A-1-b(GRANULAR,SAND)(UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE MEETS : #4 100% (TEST ONLY MATERIAL PASSING#4) #50 10%-100% #100 0%-20% #200 0%-S% REQUIREMENT FOR"FILL" IN TITLE 5. <5% PASSING 9200 SIEVE � �kiOFMAa� DANIFLA. Gm RESULTS: PERMEABLE MATERIAL-CLASS I <5 MINJIN. MATERIAL U.IALA NONCOMPACTED " CIVIL En SOIL DESCRIPTION: MEDlCOARSE SAND WIGRAVEL,CLEAN No.46507 ,S T 4 n 1. `Jjt1 �D� 4- COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION SNAP2-- PARCEL --- LCT TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 21 Prince Hinckley Road _ Centerville, MA 02632 Owner's Name: Estate of Louis Gamble Owner's Address: Date of Inspection: May 21, 2004 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford s Mailing Address: P.O. Box 49 3 r t`tj Osterville,MA 02655-0049 ZE Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT a v ,. :tom I certify that I have personally inspected the sewage disposal system at this address and that the nforma rep!j. ed below is true,accurate and complete as of the time of the inspection. The inspection was perfo ed bas7 on training and experience in the proper function and maintenance of on site sewage disposal syst ms. I atn a DP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The ystem: � ►— ✓ Passes Conditionally Passes Nee s Further Evaluation by the Local Approving Authority Fail Inspector's Signature: Date: May 31, 2004 The system inspector shall submi copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 21 Prince Hinckley Road Centerville, MA Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ 1 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 I 1 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 21 Prince Hinckley Road Centerville, MA Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 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 Page 4 of 1 1 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 21 Prince Hinckley Road Centerville, MA Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 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.1 No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large 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 Il 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 z Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 21 Prince Hinckley Road Centerville, MA Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 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 Page 6 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 21 Prince Hinckley Road Centerville, MA Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 1 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): n1a [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: Currently occupied 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: Pumped January 2003-per owner 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: Installed 8122177-per as built card 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: 21 Prince Hinckley Road Centerville, MA Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 BUILDING SEWER(locate on site plan) Depth below grade: 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: ✓ (locate on site plan) Depth below grade: 16" 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: 1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 5" Distance from top of scum to top of outlet tee or baffle: 5" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Cement tees were present. The liquid level was even with the outlet invert. There did not appear to be any signs of leakage 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 Page 8 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 21 Prince Hinckley Road Centerville, MA Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 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: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level. No solids were present. 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: 21 Prince Hinckley Road Centerville, AM Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1 -6'x 6'(1000 gal.) 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.): The pit had 4'ofwater on the bottom. The scum line was at the same level There did not appear to be any signs of failure The bottom to grade was 9. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 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: 21 Prince Hinckley Road Centerville, MA Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. �C 3 a � O O A Q C. � aa` y3 3 a�b Sa 10 Page 1 1 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 21 Prince Hinckley Road Centerville, MA Owner: Estate of Louis Gamble Date of Inspection: May 21, 2004 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 a Barnstable topographic map and water contours map the maps were showing approximately 30' +/- to ground water at this site. This report has been prepared and the system inspected and passed 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. 1] TOWN OF BARNSTABLE 1,6C:ATION b2 1 Pr;AC& SEWAGE # VILLAGE /nTaw►�� ASSESSOR'S MAP & LOT L H- 162 INSTALLER'S NAME&PHONE NO. Lam'" I&D SEPTIC TANK CAPACITY r OW LEACHING FACILITY: (type) A-r LX(O (size) NO.OF BEDROOMS 3 BUILDER OR OWNER Lava CAM D PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachi g facility) Feet Furnished by �A4A'Un �d/ \� V 3 a � O � �► a c � aa� y3 a �8 �� W � 3 a�6 Sa L`O,,C A�T ION E W A G PE RMIT NO. _L c0 VILLAGE` / INSTA LLER'S NAME & ADDRESS B U I'L D E R OR OWNER L A,� - l/ DATE PERMIT ISSUED = DAT E COMPLIANCE ISSUED a J. 1 � � \ I �� �� �� ` �' , 0 a. No..- Fni&................... THE COMMONWEALTH OF MASSACHUSETTS BOARD W HEALTH OF....... .... . ... .. .. ................................................. Aplifiration -for 43W.Voiial Works Towitrurtion Vrr uv-t Application is hereby'made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ........................................................................ --------------------------------------------------------------------------------7--------------- Location-Address or Lot No .................................. ..................... .....e.........*............... ...................................... Address 4—&5' -------_----_ ....................................... Installer Address Type of Building Size Lot... ------Sq. feet U Dwelling—No. of Bedrooms------------'��?—------------------------Expansion Attic') Garbage Grinder (1V0 Other—Type of Building ---- ...................... No. of persons---------------------------- Showers Cafeteria 0.i Other fixtures ------------------------------------------------------ W ----------------------------------------------------------------------------------------------- Design Flow--------------------------------------------gallons per pet-son per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity. :W�_ _gallons Length________________ Width--__-.._.-.._.. Diameter__-.------...._... Depth..-__.__...... y/_ _ Disposal Trench—No_-------------------- Width....__._....._...... Total Length__......__.......--. Total leaching area-------------- -----sq. f t. Seepage Pit No_____________________ Diameter........ Depth belo inlet_.. ._............. Total leacl *Ilg area------------------s(l. ft. Other Distribution box Dosing tank 07- ,a C- -------- 7— 7Y Percolation Test Results Performed by.......... --------------------------------------------------------------- Date..........._-------------------------- Test Pit No. 1................minutes per inch Depth of Test Pit......•............. Depth to ground water------------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.-.__--__-_________- Depth to ground water--._....---.-_-.---_---. f4 ---------- 0 _7------- Description of Soil---------- f---------- ------ .2.............4 U -------------­- ......... ---------------------------------------------------------------------------- ------------------------------------- ----------------------------------------------------------------------------------- ------------------------------------------------------------------------------ U Nature of Repairs or Alterations—Answer when applicable.,-------------------------------------------------------------------- -------------------------- ---------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned I rther agrees not to place the system in operation until a Certificate of Compliance has been iss by the boa d of ealth. X� ........ .................... ... ................................ .............. Z �ate Application Approved By.._........... ... . ..... - Date Application Disapproved for the following reasons:..................... ---------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Date PermitNo................................................... ... Issued........................................................ Date - ----------------------------- L No......................... Fiziz .� ........ ...... THE COMMONWEALTH OF MASSACHUSETTS -'� BOARD OF HEALTH / �:_.....0F....... i �. Jl�-z� (��l Appliration -for M-4po ial Eorks Towstrurtion Vrruift Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: t/ ?! /C _ Y - -...------•-�-------------•---.....-•------•---._......----•-----------_--------------•• Location-Address _ or Lot No. ' Owner Address Installer Address UType of Building Nay Size Lot...f_y_,___---- feet Dwelling—No. of Bedrooms............ ________________________Expansion Attic ( ) Garbage Grinder (/k)/C—) aOther—Type of Building ____________________________ No. of persons..-__-__-_-_____--_----_. -_ Showers ( ) — Cafeteria ( ) d Other fixtures w Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. P4 Septic Tank—Liquid capacity-??gallons Length---------------- Width_----__...... Diameter___---_.___-__- Depth.__..____-._-.-. Disposal Trench—No. .......... ......... Width-------------------- Total Length-------------------- Total leaching area......--------------sq. ft. Seepage Pit No-------------------_ Diameter........ ------ Depth below inlet.................... Total leacl -ng area_-_-.-_-.-.___--sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a�_ /d C/i _ /d'' ) 7" 7 Percolation Test Results Performed by-------------------------------------------------------------------------- Date--------=-_. -------_-.----.------------ a Test Pit No. 1................minutes per inch Depth of 'Pest Pit.................... Depth to ground water.._--_-.__.---._-.-__-. f4 Test Pit No. 2................minutes per inch Depth of Test Pit_--_-____________._ Depth to ground water-----------.____-_-_---- Description of Soil-------- f . � � �_ 3 � C`°��- 3 �D y ------- ------ -----_---------------- ..A - ------------------ i ----- ----- ------------------------- --------------------------------------------------------- ------------------ .........•_.------------------------------- --------------- --------------- ------------------` U Nature of Repairs or Alterations—Answer when applicable--------------------------------------------------------------------- ........._______________.. -------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beenisis�sufed.by the board of��health. � Signed - ------ :, ------------- �4.7 ate Application Approved By..... Date Application Disapproved for the following reasons:-•-----------------------•--------------•------•--------•---------------•-•-------•-------•--•------••---------- •-----...----•-••--•-----------••-••---• •-----------------•--------------------------•--------•-•------------•-----------------------•----------------•------------• ----------••---------------------- Date PermitNo......................................................... Issued........................... ............................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... ... t/�...........*OF..........0o6..r-E ✓L ..... Tntif irate of TOntphaurr THIS IS TIP C IF ,'hat the Individual Sewage Disposal System constructed ( �or Repaired ( ) by-- =-- :------ ----_-------_ F I sta ercr/ f r � has been installed in accordance with the provisions of Ar c e XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No... 7�_-____ ------------ dated...... . ............... THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. �DATE---- --/---_.f �---6---�--�-, ------------------------------------ Inspector------- --- ---------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH z ......... .... .........OF....... ....... No. . .......... FEE.... ........... � ,� ..� � rltrtt�lt �rruttt Permission is hereby grante .- ---------•-------••-�.... to Constr Aror Repair ) an Indiv ual Se a e Disp l yst j < Street / �j as shown on the application for Disposal Works Constru ion Permit-.N ____________________ at l?._".' _ -�_. ...1-....... Board of Health DATE.................Aa Y?--•--------------------•-- FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS � IG3•oo too loon Gay tSl2�� 5F I 1 o FIT f N 0 � � � � P,eoP•� N COI o l GQ� It loco I 6AL p_ c TV- ``� ,M W LB 44. M m ��• • -��.©� E'er . 7&)-sal= ia�t 5�' �"►.",.:a`..� l `_i4 CERTIFIED pt..0'7" Pi.._.��J LbGATio" �CQ rQ' Z <1 I 5cn�E= n-136 ba-T.t= I [.6RTtt=Y T14AT T14G FOUWT>AT►o" S"Co%AjtJ Pt_At�.l REi` tZ� G� t-1�IZ E tsi.1 -CAAPLYS WIT" TiAG: 51 of L I alb LoT (c%--�> AUa %T-BAr-IG QE4ucIZEMEwT6 OF TNe -TOW U C>V= • ti tZS&KMIZGED LAWC:) 15U ZVE%(C) ZS TNI5 DLAW IS .JOT BASEV 0114 AN USTE2�/iL.t..G � MASS. %IJSfQ1,.J"F-kJT SUZ\/M%f 4 Tk•iE SI-IOuj r-> APPt_t GAtr.IT t1vT 6s uscc> To De:TEtZMk*tt= L.O-r UW(ES �LA{,} Snn4,Lc_ , F Town of Barnstable P# Department of Regulatory,Services 0`Ile A Public Health Division Date 200 Main Street,Hyannis MA 02601 wwsreeM _ .F Date Scheduled / � Tune Fee Pd. >�,16 �— - Soil Suitability Assessment for Sewage Disposal Performed By: V 6�&Vr/KS 1/�IG�J Witnessed By: �. :h:iL::�:::,..,a.:,:r:v�u rva:F..i:IV..::..:.r•e;;:rN.::.:.L:...:;::.,,......::.. r:i4:�.r..:i::;::i.:r.r.:.:::::r.r::::::..:,.:,:::::J::mJ:;,,,;,,. .� .. 'r:::isv::.n,...;::::�:::�::•e;:�::J....:.:::: ...I......... ::- :I,..:;!:•,.!a:ll.!1h4o:Jlts:r.!:.. NNW ,.t. ,7•� �J1II !IC'.�:NAiIRfi !:.. II M_ ^-' � � � 8rx�ii� ?^ jl!r7 1:11! al Il.n:r ! I Iu a..1.F Location Address ,Qd r !� /f Owner's Name C. bvv q m Address S 944-A / Assessor's Map/Parcel: (72-A(7 Engineer's Name Ar.V_14*1 NEW CONSTR�fU�C�TI�O�Ny�� pREPAIR Telephone# SD P' �{ Land Use 1t/""'�`/.�tr-�^�` Slopes(%) 0 Surface Stones eVV Distances from: Open Water Body _.,44 ft Possible Wet Area Drinking Water Well -t-04 ft Drainage Way ft Property Line Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) .l T �• -,E a � x C fi 7. m lye y Parent material(geologic) 0 yd-Ovf-,d 4 Depth to Bedrock i Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face et"191 f..X Estimated Seasonal High Groundwater A10 h4- wav!.J:ri,r::r,a�:: a!;=:,:'er::aa=eaaJ:-roe=.mr•"�.:I Rii��!!::•ecar,e!=!ival.^.u:.a=;.rr:**:,'�e�.:dsm:+.!::::�r:;:n.: c�:!rn;,a-::(!1�.=.•r,,ni!r;!;:,e,!.a•::!,;!.;,=,o:WNW, uc:rml r:l=:n:nrr::caarnr,r:mnn::is!x:urnn:�i:exl:n::�:;ll•:!r:n:vl:::.:;r:..�•;e:mr; 1.�tL�!,y,,;� t �[{�,,' 'ry '� I I T i I 111A :J P . !FJ.:L W�i�E+�..,,i�' S :�_ it�..:..r ^,'�lti;�p�1 i : j 1 Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ :..1 I rl I!';r'.'us ..1:1 I ars,!r., °'a ..........._1 L._.....r..............�ea..__..._d...,.........,r.._..... tur.... .1.2�•__._... ...r.:._._:....,r.....r:.....: ...ir....r,.........._... ..._.... .... .! : ..rr.. � !ill.°�'.=.n...�: r :.,. }L F1i +n:ra::��nur._:.L:;r!:nL�Ir:r!:•a:..:::.::A,.J::::r: Observation Hole# Time at 9" Depth of Perc Time at 6" Start Pre-soak Time Q Time(9"-6") End Pre-soak *4- & d RateMin./Inch `.h ly .{y hsk v`0 x. c Site Suitability Assessment: Site Passed_,� Site Failed: Additional Testing Needed(Y/N) Original: Pubic Health Division Observation Hole Data To Be Completed on Back-----�— Q:HEALTH/WP/PERCFORM At " r Town of Barnstable P# r-7 Department of Regulatory Services �pIMEI� Public Health Division Date S 3d o8 200 Main Street,Hyannis MA 02601 • IAIWSTABM //// e MAB59. S. / / /p^ A o tArn" Date Scheduled Time_� Fee Pd. ld Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: it c ... .. ... Location Address z ,Q r !lK`� /f� Owner's Name U< jTYvX,�J e` 1 Address S�C,w� Assessor's Map/Parcel: (/2"'101 7 `(jam Engineer's Name NEW CONSTRUCTION REPAIR Telephone# Land Use Slopes(1/0) Surface Stones Distances from:, Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line It Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater Ni Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level .... F;A PEC1Lt�TIN T T:;IN- Itt xtmI .: Observation Hole# Time at 9" Depth of Perc Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----�-� Q:HEALTHNVP/PERCFORM ; :::;.:.::.;.:: ;.. lute Depth from Soil Horizon Soil Texture $oil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency o Gravel) 0—°I �.S 10 y rZ 7/1 1.1/v 'I LI 0 Y r G A-V 3 co 3 C LAI e S z.,r6 tiv Fi-.• atolbl° Loa-(V CZ _e zd USET .. .............. Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % 0' LS !ri 6c/ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. % >:>; DEC�L .... .................Iu�e.#........................................:....:..:.:.. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. " Gravel) Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No_ Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? X RA If not,what is the depth of naturally occurring pervious material? Certification I certify that on (d 1 9 ) (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 the required training,expertise and experience escrib in 310 CMR 15.017. Signature !� Date EXISTING DWELLING EXISTING GARAGE El EXISTING PROPOSED ®® PROPOSED I I ( ;i DWELLING ADDITION �� � � ®®�® ADDITION i E®®E I► �11 - - -- - - - - - /fir r Cam/ .�r��/\r.��\r/\r/�/. . �/\/�r/�/��\r/Crri .�r/�/.\r�\r/�r� \fin\�\,\n\n\n n\fin\!n\n\�!\�\ \n\ n\fin\ n n .\ n\ n\n \K\�\n\ n\ �\ n\n �\ ♦. �n\ten\ n\4�\�\n\n\n\ n\ \fin\ \n\�\ \�i� / �}� >\mx/��/�<, �v LEFT ELEVATION FRONT ELEVATION RIGHT ELEVATION 1/8„ = 1' ) ( 1/8„ = 1' ) PROVIDE ACCESS EXISTING REPLACE EXISTING INTO CRAWL SPACE BASEMENT THRU EXIST'G. BASE. B SLIDER W/ AND. #TW2846_2 VERIFY W/ OWNER DOWEL INTO EXISTING 17'-0" CONC. WALL (TYP-) 4'-9"t EXISTING 8" x 4'-0" CRAWL = PORCH GARAGE EXISTING CONCRETE WALL SPACE aIo (ABOVE) DINING LSTSABE " " » R M 2" x16" O CFTERS, 2 x 10 RIDGE 2 x16" O.C. RAFTERS, LASPHALT SHINGLES/ 12 16" x 8" FOUNDATION 12" x 48" 1 SHEATHING OD 6 CONTINUOUS VENT (TYP.) {CO3CfPIER " FOOTING AS REQUIRED T2" x CL'G.MATCH TRIM DETAIL J16" O.C. (TYPICAL) TO EXISTING FOUNDATION PLAN STEEL HURRICANE 2/ 2" x 8" P.T. LINTEL 1/2- PLYWOOD ( 1/4" = 1' ) EXT. SHEATHING —� ANCHORS (TYP.) 3 1/2" EXISTING FOYER (R,3) POSTS L. 4" P.T. BEDROOM EXISTING * VERIFY ALL DETAILS W/ BUILDER ON SITE LIVING & ADJUST AS REQUIRED 2" x 4" x 7'-4" STUD WALL 10'-0" EXISTING ROOM * ADJUST FOR CONTINUOUS 5/4" DECKING ON DOOR SOFFIT 5/8" PLYWOOD 2" x 8" P.T. (REMOVE) SUB FLOOR JOISTS, 16" O.C. KEEP KEEP 2" x 6" P.T. SILL EXISTING EXISTING ON SEALER (BOLTED} 2 x 8 JOISTS, 16' O.C. WINDOW WINDOW 2 2" x 8" P.T. GIRDER 6'-0" O.C. MIN. 6" INSUL. ADJUST TO MATCH '. (R19) EXISTING FIRST FLOOR ELEV. 8 " CONCRETE WALL 17-0 I I I CLQ� ss 4 -0 f HT. DUST SLAB I I I 12" x 48" I 16" x 8" J L IER (7'-3Ct PO C.) M o o EXISTING CONCRETE PORCH FOYER I GARAGE (TYYPICAL) CEO. EILNG FRAMING SECTION "M" FIRST FLOOR ( 1/4" = 1' ( 1/4" = 1' ) 5'-0" 5'-0'$ * VERIFY ALL DETAILS WITH BUILDER AREA = 80 ± SF. A ADJUST AS REQUIRED (PROPOSED FOYER ADDITION) 10'-0" 14-6" AREA = 116 ± SF. (PROPOSED PORCH ADDITION) EXTERIOR MILLWORK SCHEQULE rr, ll KEY ITEM QUA. DECRIPTION ROUGH OPEN'G PROPOSED FOYER & ENTRY PORCH 1v AND. #TW2446 D.H. 30 1/8" x 57 1/4" "'\ r A WINDOW 1 W/ AND. #CTN24 CIR. TOP��V (OVER) SEE BUILDER B WINDOW , AND. #TW2846-2 D.H. 67 7 8" x 57 , 4" JOSEE CARDINAL YOUNG 21 PRINCE HINCKLEY ROAD CENTERVILLE ALL CONSTRUCTION TO BE PERFORMED IN STRICT I DOOR 1 3/VERIFY S$IYL�E (DECORATIVE) SEE GUILDER " COMPLIANCE WITH THE MASSACHUSETTS STATE BUILDING FLOOR PLAN--ELEVATIONS--FRAMING SECT.-FOUND. PLAN —are d¢82gn8 — CODE, SIXTH EDITION AND ANY APPLICABLE LOCAL ALAN R. CABRAL BUILDING REGULATIONS. 508.255.2589 * VERIFY ALL MILLWORK PRIOR TO PURCHASE OCTOBER 26, 2005 1 OF 1 I EXISTING BASEMENT WINDOW UP II II 14'-2"t I I 4'-10"t 26'-O"t EXISTING D I I ? (TO REMAIN) I I STOR. ��+s EXISTING I I CLO. Js DOUBLE 2/6 BASEMENT INSTALL (LOUVER6 WINDOW 6" F.G. I I EXISTING INSULATION I I FULL (CEILING) ADJUST WALL Ipl BASEMENT z o V cj UTILITY LOCATION TO (UNFINISHED) x v, o ROOM rn INCLUDE WASTE x; © � .- (UNFINISHED) LINE (SEE BUILDER) w IN I NEW ;CLO. "(ON FLAT) STUD ALL I EXISTING 3/ 2" x 8" THRU-OUT fl ! GIRDER STORAGE (UNDER STAIRS) BOX EXISTING INSTALL LALLY COLUMNS 1 1/2" RIGID W/ 1 x 6 INSULATION NEW (FINISHED) PINE TRIM EXISTING SUSPENDED THRU-OUT BASEMENT CEILING RECREATION WINDOW ROOM EXISTING NEW u 2' SCEDINGDCOSLABTE LAMINATE FLOORING �w'VERIFY STYLE CARPETING NEW W/ OWNER VERIFY STYLE W/ OWNER 3'-6" CASED 3'-6" CASED EXISTING OPENING OPENING GARAGE 15'-8"t 3'-4"t 21'-10"t (FIRST FLOOR) EXISTING 8" x 7'-9"t CONCRETE WALL BASEMENT FLOOR PLAN ( 1/43) PROPOSED FINISHED BASEMENT JOSEE CARDINAL YOUNG 21 PRINCE HINCKLEY ROAD CENTERVILLE ALL CONSTRUCTION TO BE PERFORMED IN STRICT BASEMENT FLOOR PLAN ~are designs — COMPLIANCE WITH THE MASSACHUSETTS STATE BUILDING CODE, SIXTH EDITION AND ANY APPLICABLE LOCAL ALAN R. CABRAL BUILDING REGULATIONS. 508.255.2589 OCTOBER 26, 2005 1 OF 1 a /�f� NOTES ; VFjL T1U•T0R " /-I I Y H 6AA4GI7Y V!rl-,k0)5? P L 5 T-6-M 1. All construction methods shay r� conform -o the Title V (310 33'L, f io 0,9 ,N d El,ALL.) s c R L E I I :: 0 CMR 15 . 000) and the Barnstable Board of Health Regulations . v 2 . There are no known private or public wells within 150 feet/400 feet of the proposed leaching Field. The proposed 3� 1 leaching field is not within 100 feet of a wetland, nor is I _ it within 200 feet of a river front . hO 0 �o o D 4 4 o v 'rod bU(LS Ft' W/4- 3. The existing leaching pit shay_ be pumped and backfilled U� with clean fill prior to installing the new septic tank. The existing septic tank shall be inspected by the i I contractor and design engineer. If the existing septic tank o o v 736 po' ' is found to be structurally unsound, the tank shall be o o 4 A �`'� 4 ,,N �+,N j 4. v O replaced with a 1500 gallon septic tank (Model: Shorey ST-1500-H-10) _ ED&E dF a Install a new 4" SCH 40 PVC outlet tee and filter within the C� vFk Cr`4c,y��E - 1 " W N rrN _,4P,4( , �a�; PaYEM�Nr q q outlet of the existing septic tank. Install a new 4" SCH 40 - /< DJ ` CAfrr 9x. r✓ PVC pipe from septic tank to the proposed D-Box (S= 0 . 01 - N_ min. ) . �a /q 3 4- 1-ora S:, r qot n V. j 4 . No changes are to be made in the field without the approval OR r/Lr,,Q of the Board of Health and the design engineer. I � S . The proposed leaching area is not designed for use with a garbage disposal . Remove any existing garbage disposal . ' _ <j The Hlgh Capacity SideWlndsr Chamber 6. Contractor to notify Dig Safe 72 hours prior to construction SEPri� >�NK (800) 344-7233. All system components to be covered by rSr//�!(r magnetic tape. 3 6Fz>Roo,"I iSEG /v 3 (( i ►,) o 1 7 . Property line information taken from Deed, Book 18923, Page h4o�SE p 043 and Plan 306, Pages 17-24 . The septic plan is not to be I J I \` I FFE7rol,.z � o used as a property line survey. i V t �' E��5riN6- -, � o,JC. PAr D 8 . Contractor shall verify all plumbing from existing structure will be connected to the new septic system prior to -z P L4 9 4''S� y goA,L rEF L4YE (41/ ' construction. If any existing plumbing exiting the / q"sc go,P��G rfl/L�•}DF,U CaP Tti �a,�UE structure is found to be different then that shown on the ��,►. : l� q 4 o p�� C.5�'�, ,., ,�, ) ' approved septic system plan, the contractor shall notify the v q9 designer and corrections to the septic design will be made ---_. _-_-_-_.._.. _....._._..___. _ .. .___..-._-______-----.. .._____ __ .__ _ __._.__....___--_-----.___ .-_.__ ,;t ON , if applicable. All internal plumbing shall be connected to N� 24 E�r,r�K+� q - 1/4 r/ETR�►ro2 "14'(rN �AeAL r rY the ex: gt inq septic tank, ljnless otherwise 3peci f ie," . DISTRIBUTION BOX H 20 Q , S/rS 3 0 L X (O,3'W X D, 9'H MODELREMOVABLE COVER /f ` p-goy \ 04 -Z0) ' /� � 4"SCH 40 OUTLET LATERALS 9. Remove 5 feet horizontally around the proposed leaching area / SHALL BE SET LEVEL FORA ,E-7 g ; DISTRIBUTION BOX TO MEET ---- 9$ and to a depth of approximately 8 .5' below grade (fill, REQUIREMENTS OF 310 CMR MINIMUM OF THE FIRST Two - -�� I 15.232 fwATERTIGHTNESS. FEET AND CONNECTED TO " - ooc I=EnrCr topsoil, susbsoil and C1 layer [friable -film medium sand CONSTRUCTION ETC). T Z.Ib (� i I - -� WITH SDOUDISCHI40 PVC PIPE ON UNE layer) ) , and replace with Title V Fill, 310 CMR 15.255 . ; � 1�E/I" °�£ `APlffz ,) The total amount of fill (sand) is approximately 205 cubic q "SCH 40 �- b Jtrr NO. OF OUTLETS I LAGL yards. Note that the amount of fill (sand) may vary due USED 2 - SEC O 0 5 (MIND o -CRUSHED STONE </-3/4" P- rp-r 99 to natural, geological changes that can exist throughout the o 0 0 a o DIA. STONE TO BE ba,7 _ - - proposed leaching area. 'SCH 40 PVC TEE ' MECHANICALLY '481E l.F1EL SASE h'OMPAC!EC z 10 . Contractor to install an observation port using a 4" SCH 40 _, PVC pipe (perforation holes within the stone of the 14aching ,�i ,. / 1 area) and removable PVC cover at d J �" ? ti e grade. r I q^ t 11 . I certify that on I have passed the soil evaluator `'� `°"""r y1 examination approved by the 'Department of Environmental y r��-�,. 4 r 2i Protection and that the above analysis was +asr y performed by me �� �c �s � � ! a consistent with the required training, expertise and Jr . , { experience described in 310 CMR 15.017. t, + ' C r^, °F 0, T 'I, qe lea ,. Signature Date w+N; Ole 5 EPr�C 5 Ys TCr1 a� Tf o P' M t} SGN 4J a 4M ~0 1 ca f pr o s V +p A I 0 M ? ,.� i r,nt•^'. ram(. TEE ' `OM�o E�rSr �(s 6/ vL 3 �MI�,) 1y ? y. :� AR us �+ ► ? -� -._....._....�__.....__._............._ ..-�,. _._.- ......_r...._.,._ ._.-_._.... _._.._. too W TEST PIT DATA 9 9 X7 9 3-A77 LEGEND C"XrSri,�(r '- ---r-- Performed By: Glen Harrington P-' S CR - Existing Contour 98 - �E+n►ER. ���C, - - Witnessed By: Don Desmarais � 98 (Wl1 rE`c TrUI1r� � '� ) � Proposed Contour 98 9 r►a,� � 8 Tn �rTi� 6 Date: June 23, 2008 _ Test Pit Gf-401 S j TP-1 95 73t (EL. 98.7). I Finished Floor Elev. FFE b EfrSr/NG- So '�----__ (98 . 1) A, 0" - 7" 10YR2/1 Loamy sand ' 97, 96.9 ± f NE Wj - �_�_ - I M is b (95. 9) Bw, 7 - 34" 10YR5/6 Loamy sand Basement Floor Elev. BFE Eyrsr/�°b *rsTinlr SLH90 °rr0 (90. 1) Cl, 34 -103" 2 . SY6/4 Medium sand (firm) ��C ( nl: ru rn= rp- 2 &EL•= 9S.z� ; .._ .. Water Line ----- W i (85. 7) C2, 103 156 2 .5Y6/3 Medium-coarse sand S -- I DR t J 8"''�, No Observed Groundwater Electirc cable E & C R LD D_8oY rp- rrL.= 95,9) ( ( Tp-2 ' EL. a 98 . 6) I Telephone Line --- T 1711 4asp ! (97 . 3) Fill 0" "- 16 (96. 9) Ab, 16" - 21" 10YR2/1 Loamy sand 4-(95 . 1) Bwb, 21" - 41" 10YR5/6 Loamv sand - -- -- - - -- - ----- --- - 7 � 4(( 90 . 4) Cl, 41" - 98" 2 . 5Y6/4 Medium sand ( firm) CALCULATIONS rAf4K , , 85. 6) C2, 98" -156" 2 . 5Y6/3 Medium-coarse sand q- �NFrLTR-�4�R- Cstr /4orC 3) 8•g �14, &14 (_APA<-'rY No Observed Groundwater 3 Bedrooms (existing' C i 110 GPD/Bedroom X 3 Bedrooms = 330 GPD µ-1o) PERCOLATION TEST DATA �orro+� CI Percolation Rate : < ? MP (0 . 74 G/SF) 0 /I/c /, S;11 rp.A F L, =90.9� Date: June 23, 2008 9 L l PROPOSED LEACHING AREA: BEM °V` ToN+�or Cr i Soil Class : Class I (0. 74 G/SF) Infiltrators : 38' L x 10 . 8' W x 0 . 9' H Side Area: 87 . 8 SF X 0. 74 G/SF - 65. 0 GPD layer_..' Bottom Area : 410 . 4 SF :{ 0. 74 G/SF = 3Q3.7 GPD -- ` e SCL nl oT'L- Total Leaching Capacity: 368 .7 GPD Sieve analyst' s performed in C2 layer of TP-2 (> 80% sand) aJ IS /2 CO2jLCCXj51-*.*:l t,iL TE..r oA7,o4 /'X-oF/LLf lerLL^/. r zF P- 7A SCNZDt1IZ OF ZiZVATICM,rl A A on (Existing) SUBSURFACE SEWAGE DISPOSAL SYSTEM I Inv. Out Foundation (Existi 97 . 3 86 Inv. In Septic Tank (existing) 97 . 1 � �r� . n "'` 21 Prince Hinckley Road, Centerville (Map 172 , Lot 167) � ►_ / = Inv. Our Septic Tank (Existing) 96. 9 SCALE DRAWN BY 80 rTo.-- TP-I Inv. In Distribution Box 95. 59 1' 0 �L = 3S,b �L,' BS.� Inv. Out Distribution Box 95 . 42 a ) �) DATE 9/22/0e Glens sur:ngtasa, R.s. RsvlsEa /U4 065 6- 'l CSHw7* 06 lr"'r�s�"' r ! Inv. In Infiltrator 95. 40 01 repaxed Josee Young � For: 21 Prince Hinckley Road, Centerville, NA 02632 Bottom of Infiltrator 94 . 50 ' .•S �10�����, ;�_ , Bottom of TP-1 (Ho Obs. GW) 85. 7 /TP.9,,�-'' p., o p+2o Ot3a pf6o �foa / t /ra0 /+90 i di0 1-* To �` ,,, � repay C3LS2( L Hl►idtTl/tTfOM, R.B. (508) 128-3862 DRAWING NUMBER Bottom of TF-2 (No Oba . GN) 85. 6 ' Ft' 9 :,eda Rose "no. NarsLona hills, MA 01640 ,