HomeMy WebLinkAbout0346 RIVERVIEW LANE - Health ✓��'� Riverview Lane
A= 228— 102 (was 22 Riverview)
Centerville
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UPC 12634 # '
No.2�153LLOR
MADTINOs.90
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COMMONWEALTH OF MASACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET BOSTON MA 02108(617)292-3500
TRUDY COXE
Secretary
ARGEO PAULCELLUCCI DAVID B.STRUHS
Governor Commissioner
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092 ,
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Address of Owner: 1582,RT 132 HYANNIS MA.02601 ATT DONNA HUME �
Date of Inspection_:_ 7121 OD--
Name of Inspect rr, JOHN GRACI G'
lam DLQ.approved system inspector-pursuant to Secbon 15.340 of Title 5(310 CMR 15.000) rooms `J
Ma ling Address: P.O.BIOX 2119 TEATICKET,MA.02636 w� �o�rsr ?0lQ1
Telephone Number: 608-664-6813 FAX 508-564-7270 \ 4
CERTIFICATION STATEMENT ®� '
I certify that I have personally inspected the sewage disposal system,at this address and that the information reported below'is-tru',accurate
and complete as of the time of Inspection.The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sewage disposal systems.The system:
X Passes
_ Conditionally Passes
_ Needs Further Evaluati By the Local Approving Authority
Fails
Inspector's Signature: Date:7125100
The System Inspector shall sub it a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection.The original should be sent to the
system owner and copies sent to the buyer,if applicable,and the approving authority.
NOTES AND COMMENTS
"The inspection is based on criteria definea in Title V code 310 CMR 15.303.My findings are of how the system is performing at the time of inspection.My
inspection does not imply any warranty or guarantee of the longevity of the septic system and any of its component's useful life"
THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING THE EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE.
revised 9/2/98 Page 1 of 11
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7/21/00
INSPECTION SUMMARY: Check A, B, C, or D:
A. SYSTEM PASSES:
X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated
are indicated below.
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.
Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not.
n& The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance
attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,
whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The
system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health.
Iva Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due
to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health).
_broken pipe(s)are replaced
_obstruction is removed
_distribution box is levelled or replaced
n& The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if
(with approval of the Board of Health):
_broken pipe(s)are replaced
_obstruction is removed
rt,
revised 9/2/98 Page 2 of 11
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7/21/00
C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety
and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 16.303(1)(b)THAT THE SYSTEM IS
NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well.
}f
The system has a septic ta i nk and soil absorption system and the SAS is within 50 feet of a private water supply well,
The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a
private water supply well,unless a well water analysis 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,Method used to determine distance n(a(approximation not valid).
3) OTHER
n/a
_ Ir
revised 9/2198 Page 3 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7/21/00
D. SYSTEM FAILS:
You must indicate either"Yes"or"No"to each of the following:
I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is
identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure.
Yes No
_ X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool.
X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool.
_ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool.
X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow,
X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Il.
X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation.
X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
X Any portion of a cesspool or privy is within a Zone I of a public well.
X Any portion of a cesspool or privy is within 50 feet of a private water supply well,
X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality
analysis.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,
ammonia nitrogen and nitrate nitrogen.
E. LARGE SYSTEM FAILS:
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:
it,
The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and
safety and the environment because one or more of the following conditions exist:
Yes No
X the system is within 400 feet of a surface drinking water supply
_ X the system is within 200 feet of a tributary to a surface drinking water supply
_ . X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well)
The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the
Department for further information.
revised 9/2/98 ' '
.� Page 4 of 11
kt
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner: ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7/21/00
Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following:
Yes No
X - Pumping information was provided by the owner,occupant,or Board of Health.
X _ None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period.
Large volumes of water have not been introduced into the system recently or as part of this inspection.
X _ As built plans have been obtained and examined.Note if they are not available with N/A.
X - The facility or dwelling was inspected for signs of sewage back-up.
X - The system does not receive non-sanitary or industrial waste flow.
X - The site was inspected for signs of breakout.
X _ All system components,excluding the Soil Absorption System,have been located on the site.
X - The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of
construction,dimensions,dept�-of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been
determined based on:
X _ Existing information,For example,Plan at B4O,H,
X - Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)1 5.302(3)(b))
X - The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal
Systems.
revised 9/2/98 Page 5 of 11
Ur
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7/21100
FLOW CONDITIONS
RESIDENTIAL:
Design flow: 110 g.p.d./bedroom
Number of bedrooms(design): 4 Number of bedrooms(actual):
Total DESIGN flow: 440 gpd
Number of current residents:0
Garbage grinder(yes or no):NO
Laundry(separate system)(yes or no): NO If yes,separate inspection required
Laundry system inspected(yes or no): NO
Seasonal use(yes or no): NO
Water meter readings,if available(last two.year's usage): n/a gpd
Sump Pump(yes or no): NO
Last date of occupancy: 5/1/00
COM MERCIALIINDUSTRIAL
Type of establishment: n/a
Design flow: n/a gpd(Based on 15.203)
Basis of design flow:n/a
Grease trap present:(yes or no): NO
Industrial Waste Holding Tank present:(yes or no): NO
Non-sanitary waste discharged to the Title 5 system:(yes or no):NO
Water meter readings.if available: n/a
Last date of occupancy:n/a
OTHER: (Describe)
n/a
GENERAL INFORMATION
PUMPING RECORDS and source of information:
n/a
System pumped as part of inspection:(yes or no):NO
If yes,volume pumped n/a gallons
Reason for pumping:n/a
TYPE OF SYSTEM
X Septic tank/distribution box/soil absorption system
_ Single cesspool
_ Overflow cesspool
_ Privy
_ Shared system(yes or no)(if yes.attach previous inspection records,if any)
_ I/A Technology etc.Attach copy of up to date operation and maintenance contract
_ Tight Tank Copy of DEP Approval
Other:n/a
APPROXIMATE AGE of all components,date installed(if known)and source of information:
1995 PERMIT 95-1667
Sewage odors detected when arriving at the site:(yea or no) NO
revised 9/2/98 Page 6 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OFERICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7/21/00
BUILDING SEWER:X
(Locate on site plan)
Depth below grade: 12"
Material of construction: _ cast iron _ 40 Pvc X other(explain)
Distance from private water supply well or suction line: n/a
Diameter: n/a
Comments: (condition of joints,venting,evidence of leakage,etc.)
THERE IS TOWN WATER
SEPTIC TANK: X
(locate on site plan)
Depth below grade: 4"
Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other
explain: n/a
If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO
Age: n/a
Dimensions: 1600G L 10'6"H 6'6"W 6'8
Sludge depth: 1"
Distance from top of sludge to bottom of outlet tee or baffle: 33"
Scum thickness: 1" f �*
Distance from top of scum to top of outlet tee or baffle: 6"
Distance from bottom of scum to bottom of outlet tee or baffle: n/a
How dimensions were determined: MEASURED
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,
etc.)
THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE
SYSTEM'S USEFULL LIFE.
GREASE TRAP: _
(locate on site plan)
Depth below grade: n/a
Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other
Explain: n/a
Dimensions:n/a
Scum thickness: n/a
Distance from top of scum to top of outlet tee or baffle: n/a
Distance from bottom of scum to bottom of outlet tee or baffle n/a
Date of last pumping: nla
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,
etc.) A:,. i
n/a
^ 4n:
revised 9/2198 Page 7 of 11
Ir '
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SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7/21/00
TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection)
(locate on site plan)
Depth below grade: n/a
Material of construction: _concrete_ metal_Fiberglass _Polyethylene _other
Explain: n/a
Dimensions: n/a
Capacity: n/a gallons
Design flow: n/a gallonstday
Alarm present: NO
Alarm level:N/A Alarm in working order:NO
Date of previous pumping: n/a
Comments:
(condition of inlet tee,condition of alarm and float switches,etc.)
n/a
DISTRIBUTION BOX:X
(locate on site plan)
Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)
THE DISTRIBUTION BOX IS STRUCTURALLY SOUND.
PUMP CHAMBER: _
(locate on site plan)
Pumps in working order:(Yes or No): NO
Alarms in working order(Yes or No): NO
Comments:
(note condition of pump chamber,condition of pumps and appurtenances.etc.)
n/a
is
revised 9/2198 Page 8 of 11
i
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7121/00
SOIL ABSORPTION SYSTEM(SAS): X.
(locate on site.plan,if possible;excavation not required,location may be approximated by non-intrusive methods)
If not located,explain:
n/a
Type:
leaching pits,number:(n/a)n/a
leaching chambers,number: (8)INFULTRATORS
leaching galleries,number: (n/a)n/a
leaching trenches,number,length: (n/a)n/a
leaching fields,number,dimensions: (n/a)n/a
overflow cesspool,number: (n/a)n/a
Alternative system: n/a
Name of Technology: n/a
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)
THE LEACH FIELD IS FUNCTIONING PROPERLY.THE SOIL PROBED DRY IN LEACH FIELD,SYSTEM SHOWS NO SIGNS OF FAILURE.
CESSPOOLS: _
(locate on site plan)
Number and configuration: n/a
Depth-top of liquid to inlet invert: n/a
Depth of solids layer: n/a x
Depth of scum layer. n/a
Dimensions of cesspool: n/a
Materials of construction: n/a
Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)NO
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
nla
PRIVY:
(locate on site plan)
Materials of construction: n/a Dimensions: n/a
Depth of solids: n/a
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
nla
- I
revised 912/98 Page 9 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7/21/00
SOIL ABSORPTION SYSTEM(SAS): X
(locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods)
If not located,explain:
n/a
Type:
leaching pits,number:(n/a)n/a
leaching chambers,number: (8)INFULTRATORS
leaching galleries,number: (n/a)n/a
leaching trenches,number,length: (n/a)n/a
leaching fields,number,dimensions: (n/a)n/a
overflow cesspool,number: (n/a)n/a
Alternative system: n/a
Name of Technology: n/a
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.)
THE LEACH FIELD IS FUNCTIONING PROPERLY.THE SOIL PROBED DRY IN LEACH FIELD,SYSTEM SHOWS NO SIGNS OF FAILURE.
CESSPOOLS: _
(locate on site plan)
Number and configuration: n/a
Depth-top of liquid to inlet invert: n/a
Depth of solids layer: n/a
Depth of scum layer. n/a
Dimensions of cesspool: n/a
Materials of construction: n/a
Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)NO
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
n/a
PRIVY:
(locate on site plan)
Materials of construction: n/a Dimensions: n/a
Depth of solids: n/a
Comments:
(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)
n/a
revised 9/2/98 Page 9 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7121/00
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent reference landmarks or benchmarks
locate all wells within 100'(Locate where public water supply comes into house)
a
U G TA V 1
AA a�
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P� 23
revised 9/2/98 Page 10 of 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 22 RIVER VIEW DR CENTERVILLE, MA 02632 M228 P1092
Name of Owner ESTATE OF RICHARD ROUNDS C/O REALTY EXECUTIVES
Date of Inspection: 7/21/00
NRCS Report name: n/a
Soil Type: n/a
Typical depth to groundwater: n/a
USGS Date website visited: n/a
Observation Wells checked: NO
Groundwater depth: Shallow_ Moderate_ Deep_
SITE EXAM _ Slope
_ Surface water
_ Check Cellar
Shallow wells
Estimated Depth to Groundwater 12 Feet+
Please indicate all the methods used to determine High Groundwater Elevation:
_ Obtained from Design Plans on record
Observed Site(Abutting property,observation hole,basement sump etc.)
e
Determined from local conditions
_ Checked with local Board of health
Checked FEMA Maps
Checked pumping records
Checked local excavators,installers
X Used USGS Data
Describe how you established the High Groundwater Elevation.(Must be completed)
USGS MAPS AND CHARTS-12+FEET
r'
revised 9/2198 Page 11 of 11
I .�
�X
FLOORPLAN
vier: John/Pamela Vecchione File No.: 08080238
deity Address:346 Riverview Lane Case No.:
t Centerville State: MA Zip: 02632
ender:Middlesex Savings Bank
i
34.0'
f
Bah Office
Finished Basement
34.0' Galley 24.0'
Kitchen Area(no stove)
2'
9
Bath 7
SFr ;r Play Roam
Bedroom Bedroom Family Room
F,
24.0'.
34.0'
34.0'
34.0'
Second Floor
Deck
200 18.0' Bath
Bedroom '
Bedroom
r
.5 Bath 24.0'
9
Foyer eP
Garage
18.0' Family Room
Kitchen Dining Room
Porch
24.0'
20.0' 34.0' .
First Floor r
Interior Not to Scale -
Sketch by Apex IV WindowsTM
AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN
Code Description Size Totals Breakdown Subtotals
GLAl First Floor 1466.00 1466.00 First Floor
GLA2 Second Floor 748.00 748.00 4 11.0 x 18.0 198.00
BSMT Basement 1268.00 1268.00 = 16.0 x 24.0 384.00
GAR Garage 420.00 420.00 - 26.0 x 34.0 884.00
Second Floor
22.0 x 34.0 748.00
a,
TOTAL LIVABLE (rounded) 2214 4 Areas Total(rounded) 2214
office@grassoappraisal.com
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ro n s�c�
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FLOORPLAN
der: John/Pamela Vecchione File No.: 08080238
deny Address:346 Riverview Lane Case No.:
_ry Centerville State: MA Zip: 02632
i-ender:Middlesex Savings Bank
aF' _
A�
ef�r
1
34.0'
Bath Office
Finished Basement
34.0' Galley 24.0'
Kitchen Area(no stove)
I
i^
Bath '
1 Play Room
c
ei Bedroom Bedroom
Family Room
24.0'
34.0'
34.0'
34.0'
Second Floor
Deck
200 m Beth edroom '
18.0' FN Bedroom
c
.5 Bath 24.0'
'i 1
Foyer
Garage
Family Room
18.0'
Kitchen Dining Room
Parch
24.0'
34.0'
20.0'
Patio -._- .....
First Floor
Interior Not to Scale
Sketch by Apex IV Windows'
AREA CALCULATIONS SUMMARY i LIVING AREA BREAKDOWN
Code Description Size Totals f Breakdown Subtotals r
GLAl First Floor 1466.00 1466.00 First Floor
GLA2 Second Floor 748.00 748.00 11.0 x 18.0 198.00
BSMT Basement 1268.00 1268.00 16.0 x 24.0 384.00
GAR Garage 420.00 420.00 26.0 x 34.0 884.00
Second Floor
22.0 x 34.0 748.00
f
TOTAL LIVABLE (rounded) 2214 4 Areas Total(rounded) 2214
office@grassoappraisal.com
ow1v OF B RNSTABLE
LOCATION � .�'�1��ra /' � SEWAGE
VILLAGE CeA°6.(`V t I e , ASSESSOR'S MAP & LOT <
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) S' (size)
NO.OF BEDROOMS
OR OWNER
PERMITDATE: J4, COMPLIANCE DATEd""---7'�;?
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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S � �`'�``
S
\b� _ � _'
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ASSESSORS MAP N0'
PARCELNO• �� � .
No. ...... Fizi& $.....3 0...........
LTH
THEBOARD^ �® I—AO FUAS^CHUSETTS
f HEALTH
TOWN OF BARNSTABLE
Appliratiou for Mt 5p ml Wurk.6 Tomitrurttun ramit
Application is hereby made for a Permit to Construct ( ) or Repair ¢{X) an Individual Sewage Disposal
System at:
................22•••Rimer-miem..Lane---Centeruilla ..................................................................................................
Location-Address or Lot No.
R.T. Rounds
-----•....... ----------------------------------•--•................ -•-----------------•-•-•--•--------••....•----•-•----•--•-----••---••...-•---••--•-------.........
Owner Address
W J.P.Macomber Jr.
................................................-...i-----•••----•---••-•---------•---•••-••---- ----------------------------•----•••--•••---•--•---••-----•------•--•---••-•••----...........----
Installer Address
UType of Building Size Lot............................Sq. feet
.� Dwelling—XNo. of Bedrooms------------a-----------------------------Expansion Attic ( ) Garbage Grinder` ( )
aOther—Type of Building -------------_---..------- No. of persons--------------.---..----... Showers ( ) — Cafeteria ( )
dOther fixtures -------------------------------------------------------------------------
W Design Flow--------------------------------------------gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity.---------.gallons Length---------------- Width.........------- Diameter...---..-._---- Depth................
x Disposal Trench—No. .................... Width.................... Total Length....-----------.-.:- Total leaching area....--.-.---------_sq. ft.
Seepage Pit No...----- ..._ -.... Diameter-------------------- Depth below inlet..--.....--......... Total leaching area:.................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
1.4
Test Pit No. I................minutes per inch Depth of Test Pit---------.---------- Depth to ground water...-:...................
(3� Test Pit No. 2................minutes per inch Depth of Test Pit.-.----_----------- Depth to ground water....--..................
C4 --------------------------- ----------------------------------------------------------•...•-•-•---•---•------------•---•-------•--••-•-•-----•-....••--.--..
ODescription of Soil...................................................................................... -----------------------------------------------------------------...........--•--
v ....-•••--•.............•••••••••••---•--•-••-•---•--•----------•--•--------•-S.ani3---&---Gra-v.el--------------------------------.....-------------------•--•-•----....-----------•----
W
---------------------------•-- ---------------------------- ------------------------------------------------ -----------------------••--------•-------------••...••••----••-•-••--•-•-•-•--•-••......•-
U Nature of Repairs or Alterations—Answer when applicable-------Caved----In--casspoo-1,-- In-s-tal-1--------•-••----
1_�1500 gallon.--tank__.1-_-di_stribution-•-box-_8---inf l ratQr- ... gel......,•..........
Agreement: in 2 ' of stone.
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Complia,ce has be is ed y the bo rdjohealth.
Signed ..... .... --- ----- -- '-------------------- -----6./
Dare
Application,Approved By ..... ......
Date
Application Disapproved for the following reasons- --------------------------------------------------------------------------------------------------------------------- -------
ij Dare
Permit No. ........................ Issued
Dare
No:. ......._._...._.. - Fil s.... ..... o...........
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
^ TOWN OF BARNSTABLE
iiration for Dig n�� � �ttl Vvrlw Tnmitrurftlan Vamit
wApplication is hereby made for a Permit to Construct ( ) or Repair (KX) an Individual Sewage Disposal
System at:
Riv-_armie l..T:ane C'euxtexai_1p..
Location-Address or Lot No.
R.T. Rounds;
-------------------------------•-----------------------•------------------------------------------ ----------------------------------------------------
•------------------------
..._................
Owner Address
W J.P.Macomber Jr.
-------------------------------------------
Installer Address
UType of Building Size Lot............................Sq. feet
Dwelling KNo. of Bedrooms------------s-----------------------------Expansion Attic ( ) Garbage Grinder ( )
a Other—Type of Building ____________________________ No. of persons-...__._______________.__-__ Showers ( ) — Cafeteria ( )
Other fixtures
WDesign Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons:
04 W Septic Tank—Liquid capacity............gallons Length________________ Width---------------- Diameter---............. Depth................
x Disposal Trench— No. .................... Width.............. Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No_____________________ Diameter-------------------- Depthl..below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank (,.')
Percolation Test Results Performed by.................. -----------------•------------------------------------ Date........................................
Test Pit No. I----------------minutes per inch Depth/of Test Pit-------------------- Depth to ground water........................
f=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4
0 Description of Soil........................................................................................................................................................................
U ---•--------------------------------•----•------•----------------------5_6Dd &...G aviaZ...-----------------------------------------------------•---•---••--------------•----
�- W •
x ----- ------------------------------------------------------------------------------------------------------------ ....................................................................................
U Nature of Repairs or Alterations—Answer when applicable-------a3l!ecl...i_____ �s ................
11_S00 gallon tank 1 -distribution box---8-._intilt_ rators...packed..................
Agreement: in 2 of stone.
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has be -n issued by the board of�health.
Signed .-.. .. ....-.
t% -6�2-1 �95...:......
Date
Application.Approved By -----' ._..-
. ---- .....:....................................... ................Dace..................
Application Disapproved for the following reasons: . ................................................................. . . ....... .......................
�' ....- ... - _...----- _----------------------_:..-- -
.�. f�
Date
Permit No. ---------- Issued
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Q.TPrtifi ate of (gampliance
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (XXX )
by ------J.P...Maco. ---------------------- -mber... ------
Jrr- ----------- ---------- --- ----- ---- - - _ - ------------ --------------- -... ......------------- --- ------------
h,tau-et
- -
at ...........22 Riverview Lane. Centerville. -----------._..-------------------.-----------------------_--------------------------------....----
------..---------------------
has been installed in accordance with the provisions of TITI.E,S pyre State7onmental 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:- .
11 L
�/ 9_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF OF HEALTH
TOWN OF BARNSTABLE
No..r / FEE..$.... 0-•---......
Displisal Workii Tanotrurtivit "permit
J P.Macomber Jr.
Permissionis hereby granted..............................................................................................................................................
to Construct ( ) or Repair aX an Individual Sewage Disposal System
CL Riverview Lgno Centerville
atNo.............................•-------------------------------------- -----------•-------•------------------------------------------y ---------------••------------
treet (��''�/
as shown on the applicatio for Disposal Works Construction rmi.t No .__/ .___ ated___L'_._._______.__..�. ._......_.
/ Board e lth
DATE---------- - -� ...� .....................................
FORM 36508 HOBBS&�WARREN.INC..PUBLISHERS
R� V� vleul �- A,ve
TOWN OF BARNSTABLE
LOCATION SEWAGE #
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS)
I� J.P.Macomber Jr. , hereby certify that the application for disposal works
construction permit signed by me dated 6/21 /9 5 , concerning the
property located at 22 River view T.anP meets all of the
following criteria:
• There are no wetlands within 300 feet of the proposed septic system
• There are no private wells within 150 feet of the proposed septic system
• The observed groundwater table is 14 feet or greater below the bottom of the leaching facility
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
SIGNED : DATE:
LICENSE EPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER
[Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan,
this plan should be submitted].
I
EXISTING SEPTIC SYSTEM COMPONETS
SHOWN ACCORDING TO AS-BUILT ON FILE
WITH BARNSTABLE BOARD OF HEALTH.
SG 173650"E
203.27' N
N
AN-
- -2 28- 102
rn 1...,878''+-5F (CALL)
m\ PROPOSED �' I
C REMODEL 1-
\ ��Q
Z I FROPOSED
p ADDITION
— N /No.346
I I/257Y.WD.FR
3�
EXIS
0 2a' ATIOIT
� o v
�� oo
BENCHMARK: MAG. NAIL SET.
ELEV. = 100.00 i00
(ASSUMED DATUM) / BIT. CONC. �Q
/pr3 `98 DRIVE
Ocl
10\1
s� 6s=�
ti
DWELLING 15 LOCATED IN THE KC ZONE
20' F.Y
10' 5.Y. / R.Y.
z
5
6
W
a
51TE PLAN JOB No.: 131 14 ,
3
I N DATE: 09AUG 13
SCALE: 1" = 40'
13ARN5TABLE (CENTERVILLE) MA
PREPARED FOR
M
JOHN PAMELA VECCHIONE
M
O
i
Q richard j. hood, p15
M land surveyors - engineer5
35 timberline drive - ma5hpee - ma 02G49
a
Ph / Fax: 508.833.7100
•