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Home My WebLink About0035 SHORT BEACH ROAD - Health 35 Short Beach Road 206-030/031 /032 Centervill 11l ® °4N" lllt UPC 12543 No. 53LOE HASTINGS,MN - 1 I ti � ao� -o30 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c4 ,M 35 Short Beach Road rr+ Property Address David Pontius c Owner Owner's Name v information is —j required for every Centerville Ma. 02632 01/03/2017 page. City/Town State Zip Code Date of Inspection PU GF1 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 filling out forms A. General Information SIB on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael T Bisienere use the return Name of Inspector key. Cape Septic Inspections r� Company Name 624 Old Barnstable Road Company Address ICI Mashpee Ma. 02649 Cityrrown State Zip Code 508-280-3356 S13938 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 01/07/2017 Inspector'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 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. ****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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Boa VS Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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: This home has a H-10 1500 gallon septic tank an H-10 D-Box and a leching trench with infiltrators.At the time of the inspection the leaching was dry and there were no visible signs of past hydraulic failure 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. Cityrrown 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 r 1 � Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 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 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 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 cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. City/Town 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. ❑ 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. City/Town State Zip Code Date of Inspection 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? ❑ Z. 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: ® ❑ 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 gpd x#of bedrooms): >440 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is Centerville Ma. 02632 01/03/2017 required for every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage Fall 2016 9 ( Y 9 (gpd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date 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: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. City/Town 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: 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 I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 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: 05/22/2008 Were sewage odors etected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 18"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.): Septic Tank (locate on site plan): Depth below grade: 12"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: Standard H-10 1500 gallon Sludge depth: 3„ t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 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 3 Scum thickness 1 Distance from top of scum to top of outlet tee or baffle 35" Distance from bottom of scum to bottom of outlet tee or baffle 5" How were dimensions determined? Sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I would recommend the new owner put the septic tank on a maint. plan with a local septic pumping co. based on the future use of the home.The Barnstable Health Dept. has a list of local septic pumping Co. 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 L 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Vol untary'Assessments M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts L v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. City/Town 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.): The H-10 D- Box was at working level and there was no visible signs of past hydraulic failure. 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: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: one with infiltrators ❑ 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 leaching was dry at the time of the inspection and there were no visible signs of past hydraulic failure. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert I Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 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.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. Cityfrown 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 V/ t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 /I TOWN OF BARNSTABLE LOCATION -7r 'are SEWAGE#.,?ee VILLAGE 6yV,v X ASSESSOR'S MAP&PARCEL ,qQ f, 310 INSTALLERS NAME&PHONE NO.� ��f� �ewJ�igGfiPo•� ya P 99��_ SEPTIC TANK CAPACITY /SbA eq /,/-/4 LEACHING FACILITY:(typ/e/)J';Abrr.4, 3asd (size) 9 X PJ x' NO.OF BEDROOMS 7 OWNER PERMIT DATE: 6--/3—QI COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility). /00!^ Feet FURNISHED BY fr 1 � / ///- 3`7'3 y 3 Aa-ry'$" z 3- y16 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 9 plus feet 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: Date ❑ Observed site (abutting property/observation 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: augered a hole at a lower elevation and shot it with a transit to show five plus feet of seperation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Short Beach Road Property Address David Pontius Owner Owner's Name information is required for every Centerville Ma. 02632 01/03/2017 page. Cityrrown 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 n V s v t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 to Commonwealth of Massachusetts Title 5 Official Inspection Form ` ; �a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. City/Town state Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way. Important: A. General Information When filling out forms on the computer,use 1. Inspector•: C only the tab key to move your Michael Kellett cursor-do not Name of Inspector use the return key. Aardvark Environmental Inspection Company.Name P.O. Box 896 Company Address East Dennis MA 02641 City/Town State Zip Code 508-385-7608 S13742 Telephone Number License Number B. Certification 1 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. 1 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 06/25/10 Inspector'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 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. 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. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. Cityrrown state Zip Code Date of Inspection B. Certification (cont.) 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cunt.) B) System Conditionally Passes (cont): ❑ 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: 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. r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ 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 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 cesspool is less than 6'below invert or available volume is less than Y2 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. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is sequined for Centerville MA 02632 06/24/10 every page. City/Town State Zip Code Date of Inspection B. Certification (cunt.) D) System Failure Criteria Applicable to All Systems(cunt.): Yes No ❑ ® 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. ❑ ® 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 11 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. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. Cityrrown state Zip Code Date of Inspection 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 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: ® ❑ 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)] Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. Cityrrown state Zip Code Date of Inspection 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 gpd x#of bedrooms): 440 Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: never Date 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-sanitarywaste discharged to the Title 5 system? Yes No 9 y ❑ ❑ Water meter readings, if available: Last date of occupancy/use: Date Other(describe): Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cunt.) General Information Pumping Records: Source of information: 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) ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (f known) and source of information: 12/12/07 Were sewage odors detected when arriving at the site? ❑ Yes 0 No Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 1.6feet 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.): Septic Tank(locate on site plan): Depth below grade: 0.7 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 Sludge depth: 0" " Distance from top of sludge to bottom iof outlet tee or baffle 31 Scum thickness 0" Distance from top of scum to top of outlet tee or baffle 26" Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? measured Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. Cityrrown State Zip Code Date of Inspection 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.): The tank was sound and tight with tees in place and liquid two inches below tee.this system appears to have never been used. There is about 500 gallons of Gear liquid with no visible solids present. the house has no toilets or sinks installed 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 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): Commonwealth of Massachusetts Title 5 Official Inspection Form Mum- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) 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 Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert dry 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 box was level and tight.There was nothing in the box. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order. ❑ Yes ❑ No Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. Citylrown State Zip Code Date of Inspection D. System Information (cunt.) Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 5 ❑ 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.): This system has five chambers set in anine foot by forty-three foot field of stone. The chambers were dry. f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. Citylrown state Zip Code Date of Inspection D. System Information (cunt.) 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 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.): Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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. T!r-0 Xk yy 30 Ss Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M 35 Short Beach Road Property Address Celestino Digiovanni Owner Owner's Name information is required for Centerville MA 02632 06/24/10 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 7.3 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: Date ® Observed site(abutting property/observation 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: I augered to 8.0 feet and found no water. I adjusted to 7.3 feet Bottom of leaching is at 4.1 feet. Notes: STEP pure iie °to Wee-, = ® o (depth is an feet below land ffa-00) = srtrn w Is STEP 2 Using Water-Level Range ZOM and llrldOx 8 �� A) a'tPP-M€'J m-te !rKjeX wig: � 4 -s) wester-v4ei mn_ 3 s a ..ss rsoexsraaesr s.us s ti ` t'l1ti��9t3� � 5-.➢.➢etd:`�i3ii�'se — level or index weti. STEP 4 t m`i4,-:or�o� ' �degth -ter i 'C g::€ a is P j}, aes leve➢for= �! -��_ > .gin f�� cl� s��➢E water--level adjustalteOt. _ 7, 3 eoth to high w-tom by su�—� � �• stir�tate ai _ sysiaac"reA dep-th to water level at Site "worm-IMMOV-0110 ' Ems. 5 iS5®as �.�iMY9RIf7SGtiEiJi Fi.vtal,{(:�••--_ yeas monthly index _mom s_ TOWN OF BARNSTABLE LOCATION�.^77"/ 4 AJ SEWAGE#��0� VILLAGE `�7`y% T ASSESSOR'S MAP&PARCEL ! INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY H-/® LEACHING FACILITY:(type).Z—„/1/.,/n 3as d (size) 9 x 413 X? ' NO.OF BEDROOMS 7 OWNER ra5i�r �ct�o� PERMIT DATE: COMPLIANCE DATE: e- Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility.(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 1_3S4C G, �� r /3 �9 )3a-a9 6 A*mo✓a Fee i v V THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye pplicatiou for ;Otopoal &_ potem Con0tructiou Permit Application for a Permit to Construct( ) Repair(W/Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. d s 5�9� �/,(� /� Owner's Name,Address,and Tel.No. Ccl�ft/l vi v�� PO /"/4-0 0/ G Assessor's Map/Parcel 3 �' tl�rj v l��/L — ,,,— IV. 67 L� Installer's Name,Addr ss,and Tel.N Designer's Name,Address and Tel.No. U &11*1e � � a S G eLv��✓ //Ye Type of Building: 7 -71 Dwelling No.of Bedrooms Lot Size �?, 2 �'� sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) Lf 61 gpd Design flow provided �/ gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in a cordance with the provisions of Title 5 of the Envir nment ode and not to place the system in operation until a Certificate of ompliance has been issued by this Boar H I _ Signe Date «�D Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. �• Date Issued iTT �1 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: h Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS pplitatiou for 0�igpo5al *pgtem Cora.5tructiou Permit •,.Application for a Permit to Construct( ) Repair(►,'Upgrade O Abandon O ❑ Complete System ❑Individual Components Location Address or Lot No. 3 f sLi R L Owner's Name,Address,and Tel.No. �CtirC/1v�6.4.E- �/�I .yp .oi Gi C� Z .r i Assessor's Map/Parcel o ? 27 7Z, Installer's Name,Addr ss,and Tel.No. Designer's Name,Address and Tel.No. 13 3 r-Imr 4, 6- Type of Building: Dwelling No.of Bedrooms Lot Size Z 74 Z 7,'2— sq.ft. Garbage Grinder ( 4<4�7 Other ` Type of Building No.of Persons Showers( ) Cafeteria( ) i.."" Other Fixtures Design Flow(min.required) y410 gpd Design flow provided �a/ a gpd i Plan Date S 1, �' Number of sheets / Revision Date —�— 'title Size of Septic Tank Type of S.A.S. J r Description of Soil it Nature of Repairs or Alterations(Answer when applicable) last inspected: 1 r 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 Envir nment 1�Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar .6f H 1 --- Signed—, Date `Application Approved by � j. ) /j Date Application Disapproved b r PP PP roved Y� / Date for the following reasons Per No. Date Issued ——————————————————————— —————-- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS r Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( f/KUpgraded ( ) Abandoned( )by` at 35— t.7 4 has been constructed in accordance with the provisions of Title 5 and th for Disp s System Construction Permit No. 7/ —5�Pdated 4 Installer T• d / Designer #bedrooms L' Approved design flow L gpd The issuance of this permit shall n t be co trued as a guarantee that the syste vt"li 1'ft ', s"d signed. Date �� o Inspector ------------------------------------------- No / j . Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS t 1=igpogal *pgtem Congtruction Permit Permission is hereby granted to Co truct ( Z Repair ( ) Upgr de ( ) Abandon ( ) System located at �7 �/' � 9 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 st be 4cm leted within three years of the date of this per Date Approved b.\ —__ MAY-27-2008 TUE 11 :06 AM BSC GROUP YARMOUTH FAX NO, 5OB7788966 P. 01 Town of Barnstable Regulatory Services Thomas F.Geiler,Director n 9 i�l I I p PLtbliic Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Desicner Certification Form Date: Sewage Permit# ao0`7 -5(d_; Assessor's MaplParcel a0 k. 30�3t f U Designer: 95 G G P-oof. t td G . Installer: 6 jZ0Lo:jZ j C6MSTf,JG� tON t Nc Address: 341 goufl� agt Ura CT D Address: 4S talp_Os-TQL� &08r) W. y&gr%6uTtA, KA W613 hAy's rblis MI 5_ KA da448 On . —13 —0$ L")Zj�a/j' �y,Sf r�,�� was issued a permit to install a (date) (installer) septic system at 3� 5"pga GE6 CH KCQA D based on a design drawn by (address) 55L 6Flouf 1PlC, . dated i - ab --6q (designer) X 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 the distribution box and/or septic tank. C� 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 Regulations. Plan revision or l ed as-Wilt by designer to follow. (Installer's Signature) YBOATIAN CIVIL 9 go.48M � AL "esi nat ) (AMX Lxsigne p Here) PLEASE RETURN TO ]SAWNSTASLE PUBLIC HEALTH DIVISION. CERTMCATE OF COMPLIA-NC'E WILL NOT BE ISSUED UNTIL. 111,0TH THIS FORM AND AS-BUILT CARD ARE RECEIVED AV THE BARNSTABLE PUBLIC HEALTH DIVtiWN. THANK YOU. Q:Hel a tigSepncJDesietor Ccrhfioxtion Forrtc 3-26-04.doc 1 BED LIVINGROOM BED#2 N CL CL. CL. 0 0 N M N co co ca BED#3 0. cc 0 in KITCHEN in r D ECK cc Y Q 0 co BATH CD CD CD a CL. CD O m 3 O Z o BED#4 CD co co r t!e �4�f^., 1 / ,. Fee /00 P� ` THff COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitation for Migool *pgtem Cunmruction Permit Application for a Permit to Construct(x)Repair( )Upgrade( )Abandon o� ) 0 Complete System ❑Individual Components Location Address or Lot No. 35 9NoKT &£flcN J14 0i n Owner's Name,Address and Tel.No. (jF �}LTY T2JST� CENTERt/aLE,MA Uo -eo/3w gR14acy Assessor'sMap/Parcel pqp :Z06 12$7 OL4 AOSr?oAO (kctr_:50 5r SZ -4120-.269 2STWS «S MA or&Y6 Installer's Name,Address,and Tel.No. e)5R a 10?T1 C4d5T 2JcTtor l Designer's Name,Address and Tel.No. 6SC Ckao p t o•36 x 704 �S7 N1cr„St.(Rfi z8)d n:t 6 Sob^y28-939y MARsTo+JS w(lus, M►4 oy�Y8 77�'89tq .��7'0-ytrftooA,001 a23 509- Type of Building: . Dwelling No.of Bedrooms Lot Size ZZ,Z.5 2- sq.ft. Garbage Grinder( ) Other Type of Building /f ,10E zn -L No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow y%Q gallons per day. Calculated daily flow gallons. Plan Date MA&W 31 z003 Number of sheets / Revision Date I - 2 6 -D Title 1-5EWF.M66 P1511o5r4L SY57E� t�Sl6N Size of Septic Tank I Sri ca,1615 Type of S.A.S. L&QC ING C46!fM49 Description of Soil, 5rs P14A) Nature of Repairs or Alterations(Answer when applicable) CDm Olaf lCb4oll&L-4'Nf-&)1A4rdLZJf_/DAJ� !t APM J40 PL.4IJ S Date last inspected: Agreement: Ft r-7M- m w� i on^e 4 We r ' DESIGNING ENGINEER MUST SUPERVISE The undersigned agrees to ensure the construction and maintenan4NST ysK sal system in accordance with the provisions of Title 5 of the Environmental Code tSf`�S1tT1 a Certifi- cate of Compliance has been issued by s oard of Heal ACCORDANCE TO PLAN. Signed Date I—&-O Y Application Approved by Date Application Disapproved for the fol ing reasons Permit No. ` fl O V-0 7 V Date Issued - NV12� �e.r. TM, nuu-Y (.,jje j THE COMMONWEALTH OF MASSACHUSETTS e 111,41. BARNSTABLE, MASSAC�Y§W@ENGINEER MUST SUPERVISE ION AND CERTIFY IN WRITING QCertif irate of ComNXEM WAS INSTALLED IN STRICT THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constru0=11O UPPLArJpgraded( ) Abandoned( )by at 3 - has ben constru ted i accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. oYY dated a- - a Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector No. zoo d-7 q — DESIGNING ENGINEER MUSEee , (1� THE COMMONWEALTHION S PEA RVISE OF MASSAC AND CERTIFY IN WRITING PUBLIC HEALTH DIVISION - BARNSTABLES MAS LED INSTRt TO PLgN, Mi5polal *p5tem �tCon5truction Permit Permission is hereby granted to onst�uct(�Q)�pair(gQ)Upgrade�/ )Abandon( ) System located at �_S S��r C- d , �M' i 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 th' ermit. Date: �' Approved by �f L' � � ,�� tl+ �. r i ! ', --' •-- '- _ :... «•-' '.;r-y...,.- .. - - .. --. .-.-"._- _ No. U.`.:�: _ � e :t �u 2 i ��S' FeeEntered in computer:T ECOMMONWEALTH OF MASACHUSETTS Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS �...q , apPrication.f1df Mf000l *pgtem conztructfon Pefnttt � Applica�tion for a Permit to Construct OORepair( '.fi),,Upgrade( - )Abandon( EJ Complete System •O Individual Components Location Address or Lot No. 35 yNO(ZT a£ICH T7�6 0 Owner's Name,Address and Tel.No. fj�IZC�94TY �Sr t e-ENTEkVIL.L6, MW 46 I�or3E4T 9KA0-E Y Assessor's Map/Parcel MAP ;Zo b I Z 617 01-4 POST R641) AnC£c.•.30,31,S2 • 20-.266 R ioNS iuS,rv1/9ozGy� •. Installer's Name,Ad(ress,.rd Tel.No. (6(t-rd 01'TI Co►.ST2\)C�Tk ot,1 Designer's Name,Address and Tel.No. 6SC G2ou P r 7q 4 "`'�" ,�'�� .¢ 6 57 4:,.St.(At.Z$)d n:t 6 5G$-yig-E399 �171(lSTUIJsr ;VUf�'MJ`1oxe, '-';08'77$'6911 W•yarhaoth,M�`I aZG73. Type of Building: Dwelling No.of Bedrooms Size 1 Z,L3 Z sq.ft. Garbage Grinder( ) Other Type of Building a510F,vTiA-t. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow y _gallons per day. Calculated daily flow gallons. Plan Date M A► W S1 ZW 3 Number of sheets / Revision Date I - 2 6 - O y � Title SEWE/U96t /SPo9L ZyST£rYI l�rSt6N `� Size of Septic-Tank I xx ca 1(6✓5 Type of S.A.S. Gf�Cf/i /(; f Description of Soil, Sfs.&4A) Nature of Repairs or Alterations(Answer when applicable) CoY►4 PLFTf RF-KotlHt.4 N a) IAA r4LL1I7_1oAl/fS I!EK.AP oYZ Q PLArt1S Date last inspected: �jpCuMOJ �v�' � I I� Agree ment:' -�F c�� M�1 t�^�c c �P i.K' .� 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 Certifi- cate of Compliance has been issued by s oard of�Heal Signed F .� X "" ` ``" '' Date` 11�`.�1 r Application Approved by �4 r. `, f/ Da' d -�4 tba Application Disapproved for the following reasons ., Ys y. k Permit No t1 fl��=1j 7 _. .., r.. -- Date Issued 0 -Z T h t/ i _a J /� Nt1 (l e T r✓>', M�s� (onRPCT THE COMMONWEALTH OF MASSACHUSETTS S.Pofe r ,f',I �eome)Avr,')h4 BAR�NSTABLE, MASSACHUSETTS R., Certificate of. empliance THIS IS TO CERTIFY,that the On-site SewageDisposal System Constructed r .•a � P Y ( )Repaired( )Upgraded( ) Abandoned( )by ate • � � `w�r,gip4 has b��e��e��n constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No' ;,, -l1 ? da'ted DLJ�s/It+ *1 Installer J, v ~~ t ,r .�.` ,- Designer' The issuance of this permit shall not be construed as a guarantee that the system will'ftinctip'as designed. r - Date Inspector No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mizpooaf bpztern Con6tructiori Permit le` Permission is hereby,granted so Construct(VI)Rep7''r(,. ).;Upgrade, )Abandon(» ) System located..at`"� S Uf �FQ U '" p /1:), w ` 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.y � Provided:Construction must be eom leted within three ears of the ,o r p y e date of thl ertnit. // 1, Date: 7 f�-57JII � ti` Approved by V 1 . �OF1NE 1pw Town of Barnstable • BARNSTABLE, Ass. i639• Board of Health ♦0 Argo �a P.O.Box 534,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. February 27, 2003 Mr. Craig Field and Mr. Kieran Healy BSC Group, Inc. 657 Main Street Unit #6 West Yarmouth, MA 02673 RE: Septic,System 'Replacement, 35 Short Beach`Road, Centerville A=206 - 030, 031`, 032 Dear Mr. Field and Mr. Healy: You are granted permission, on behalf of your client, BF Realty Trust c/o Robert Bradley, to install a replacement onsite sewage disposal system at 35 Short Beach Road, Centerville, Massachusetts. The permission is granted with the following conditions: (1) No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The septic system shall be installed in strict accordance with the revised engineered plans dated May 21, 2003, revised January 26, 2004. (3) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the plans dated May 21, 2003, revised January 26, 2004. FieldBradley f (4) The dwelling must be connected to public sewer when/if it becomes available. There is an existing four bedroom home on this property. The physical constraints at the site severely restricts the location of a soil absorption system due to high groundwater table elevation and close proximity to the salt marsh. The proposed design plan appears to meet all of the State Environmental Code provisions and local Board of Health Regulations. Sincerely yours, Wayne Miller, M.D. Chairman Board of Health Town of Barnstable FieldBradley 1 i ALL W tDRx S NOTE ALL 1 - ...:.•:• B T. ro COMPLY rant aRtitENr TOTES: wQACHUSETTS WALOAG COOS.ALL 27-0• ls-4• APPLICABLE RUES NO RECILATONS. 1.ALL DaERIDR WADS ARE AND BE PERFORMED I4 SUCH A MANNER AS TO 6lSTARE WAIN SAFETY. 2di 016'OC MAIN,MTH 1/2'GVE 5-Z 11•-6' S-2' 2. CLUE WADES TOGETHER SEE�1NSUAIION AND 6 ML VAPOR BARTIBt. W/CmaIRLICINM ADHESIVE AND MIL TOW ER W/2 ROWS 12'OC 10D NAILS I ALL 016*OR PARTITIONS S ARE . 2.4 01G OC FRAMING MIN 1/2•GWB i 3. ALL READERS ARE 3-200 W/2-1/2'PLYWD FACT SIDE CLUED AND WAED TOGETHER.UNO 4. PROVIDE 6 MIL VAPOR BARRIER ON THE WNW SIDE OF THE WEAL,IYP. 1 ALL FACEINTER GIRT OR ONS ARE TO . TIE FACE OF WB S PROVIDE 1 MR UL RATED SEPARATION BETWEEN THE GARAGE AND REST OF EULDBIC 6 GC.TO COORDINATE REOIARELENTS AND LOCATIONS OF ELECTRICAL DEVICES AND _gWMY ABOVE MAHOGANY RNd1G MEOHAMMM SYSTEMS AS REQUIRED. . . -i No POSTS TIP. . 7. ALL FLOOR P1;NETWOIONS TO BE RRESNm SUCH AS TO MAINTAIN THE FIRE RATING. I ti 8. ALL CLAPBOARD AND WO TRW To BE PRIMED ON ALL SIDES,IYP. S. ALL DaIERIOR WHOM AND PATIO DOORS ARE BASED ON ANDERSEN MNDOWS C STEP ON I PROVIDE INSECT SCREENS At ALL OPERAME MN DOHS --- -- ® 10.PROVIDE E70WlST fAtLS IN ALL BATHROOMS. LIVING TYPICAL ROOM FINISH SCHEDULE no Room Nome Floor Base Walls Ceiling Remarks --- rE Unfinished Basement Cons Slab --- Coro. Con. BEAM ASM i _-_-__--_------_ .' -. --- - I s" 1F-d Entry Hardwood Wood Ptd.GYM. Ptd.GWB is IUWng Room Hardwood Wood Ptd.GW8. Ptd.GWB g n C STEP DNI 5d 1 Coots orCer.noodw Wood Ptd.OVAL Pid.GINS Kitchen Hardwood Wood Ptd.GWEL Pttl.GW8 —'-- FBA14P)ECL. Breezeway Cer.Tile VA-d Ptd.GVA3. Ptd.GWB. ':® I Powder Cer.Tile Wood Ptd.GWB. Ptd.GVAd. Both Car.TRe Cer. the 'TILE/GWI3. Ptd.GVAB. D3 l_J Garage Canvete Wood Ptd.GN7i Ptd.GW8 Bedroom Carpet Wood Ptd.GM. Ptd.GMAT s-3 9-6• § KITCHEN rir DECK Capet Carpet Wood Ptd.GM. Ptd.GV8 g� I >b E STEP ON L CL1 BEDROOM'= O I ® $'d Provide rod and shalt in aft closets. I O r 6• p 1 77 02 O E EWAY s- �� . DOOR SCHEDULE 114- ® PO \ �� mt Door Door Frame .Lock Remarks C\ No. I mat. size t e mat TNRESNao L`�1) 1 fi STEP ON 01 wood 3'-0'x 6'-6'%1 J/4' EXTERIOR WOOD eek Tres Note 2 4 SIDELIGHTS ,e ) �STEP ON wee 02 d 3'-0'%8•-8'x 1 1/8' (R-FOLD HOOD OJ woad 2'-B'x 6-8'a 13/8' fi PANEL poop yea S Dd Mood HF-0'z 8'-8'x 1 1/e' Ell-FOLD wood 1 1 .p "ttO D5 road 2•-6•'x 6'-B•x 1 J WF RM OF STEPS I J• p 010 0. /8' 6 PANEL wood MARBLE yesNote 3 1 N THE FIELD.TIP. 0• 3 1 D6 wood W-O'x 6•-0' FVM6068APLR EXTERIOR WOOD Note 1.2.4.5 07 Wood 2'-8"x 6•-6'X t 3/6' 6 PANEL wood GARAGE woo R%T DB ateet 3'-0'x 8'-tY x 1]/� � EXTFJa012 wood OAK Y. Note 2.4.SIDELIGHTS W r GONG CURB TYP AROUND 09 Woad- 2'-8"x 8•-8'%1 3/8' 8 PANEL woad 1O8 GARAGE DOOR 5'ODNC SAS REW.W/WWF 6x6-10/10 010 STEEL 2'-8"x W-B'R 1 3/w a PANEL STEELM OVER 6 MIL VAPOR BARtiIER FIRST FLOOR PLAN OVER CUM COMPACTED CRAVEl 011 Wand 6 PANEL VAM 6'-O'x 8'-e'x 1 I/6' pt�FRIHE LAP VAPOR BARRIER BEETS 6'LAN AND TAPE JOINTS \ 012 STEEL, le-0'x Y-0' 6ARACE� WOOOAIED �� PROVIDE 1 IW SEPARATION B£1L1EE11 D13 .Cad ]'-o'x s'-Mr FYMI]taeLR EXTERIOR WaaD GARAGE AND THE HOUSE 5 . i. ® Fi0ht 'V�►iL"F t,�Yi' Cc Y��2u2 uz G 1cu m �i�rt�( j,Llr✓�fC LZ A )UZL�r+'?ZC':Lt.�L� i Ct k9 I'm`J.Lt7 E[i t7,t?I 1 C?• G�C c��.� � pe�firx,� a, Not. -,jLuCL11Cn:5. Note I-Wnyl-dad F-Invood Widhg PaUo dam.by A der.eo Hobe 21-Pm"o:ovmpfete-athe tripptng poekoge of all e rs xterlor doom. Note 3'-ProMd marble thr."d O all both doors Note 4-Provide deodb.lt. Note 5.-Provide Insect Careen . A 6.Q F REVISED BUILDING PERMIT DRAWING 1-26-2004 S U TP H I N ARCHITECTS - NEW RESIDENCE FIRST FLOOR PLAN raving xa oaa A 1 35 MEDFORD STREET PHONE: 677-7t8-2001 ,t 6` "4 8ae1e O SCHEDULES _ swT>:301 Fie �7_7,E3-ama � " _ 35 SHORT BEACH ROAD As xorrsn e' SOMERMLLE, MA 02143 yy®g•TE j WW.ECM-WID- y CENTERVILLE, MA r 6oc xo -_ 7!_D- • 5'-2• tt'-D' S'-2• . CL.i of a sdv_co ac�wc O s�aco area LCONY 24I0 6•0c. 20044CM BEDROOM 2 D6 6'.ntP C L. I --- BAT FQO �j e'S p 1 ElO DMtl DI j (, i 4 o la to BAT D ® uraauNy auimc 5• ROOF PLAN i FAMILY ROOM MD POSTS*� EDROOM 3 6,STEP '' DECK CLI 1`1 I I� DD I I � MTL FLASHING - \ 2x6 PT DECKING 1/2" SPACERS ATTCHED W/ ] 2x10 PT.LEDCER \ i' A \\CL\. 1/2" DIA GALV • LAG BOLTS. 12" DC w o 2x10 PT. BEDROOMa a r 4 SECOND FLOOR PLAN ti•,: \\ DECK TO BUILDING D TAIL TMp• FLASH. AT DECK JOISTS DS ® a SCALE 1 1 2"=1'-0" NTS. 9"1 sne/ No. 2723 5 :1an^ ti o a1Dy�, y MA BUILDING PERMIT DRAWINGS 6-1 — 03 TYP. FLASHING AT DOOR SILL TYP. FLASH. AT WINDOWS N TS. N TS. S U T P H I N ARCHITECTS Project 6!8.03 Revisions Title Drawing No J5 MEDFORD STREET PHONE: 617-71B-iaot NEW RESIDENCEe O SECOND FLOOR PLAN 35 M FAl en-7le-zaa3 35 SHORT BEACH ROAD AS NOTED SOMERVILLE, MA 02143 E-MAILWEBASITE.. WWW.OESGNN--VAI)E.60M CENTERVILLE, MA a----- -- ROOF PLAN, DETAILS North ad 6-W Yam' Pf{s{POST.T1P. s•-r rc-e� s_r ' 2-2d0 BEAM,TV. r--� -I -', L--�---- /• •\ 117 TJ Sm a ir oa ----------------------- i I 12'DIA SONOTUBE 2-11 7 ME BEAU a ,O. I = To r_o"BELOW GRADE.IYP. _ CRAWL SPACE b 1 PT 2A0 IEDGM TIP. I 5 CONG SLAB REI F.W/BRF 6X6 10/10 I 1 , PE1 1 I OVER 61BN COMPACBTtD I�RAVEL 1 I _-_ r 11 LAP VAPOR BARRIER SIfE'M V MIN MUD TAPE JOINTS i _-_ HIILLL ' I I1 b i 1 GONG STOOP AT 8OTTOM.OF STAIR (. 1 ` 1 i --- NEAOERS ARE 2-21W,IR0. - I 1 I � � I 1 -- \ -------_----- --- — ------ -------- ------- „ \\ \\ A \\ 2da TV. \ \ OG i' S'CMSUB ON fIiAOE REI1F.W/WAT 6O6-10/10 \ \ 11 7 TAO SW 0 19- t t < OVER 8 N0.VAPOR BARRIER \ \ 2,t0 O 18'OC.T1P. OVER B'MIE COMPAGTEO(RAVEL \ \ CANBIEVFR 22-Y �b \\ \\ \\ \\ YIl7 ISE bNt . 7w-w \\ \\ \\ \\ \ \ \ \ La BASEMENT PLAN \\ \\ n 7/r TJVPRO 550 O Ir OC AFL MOM ARE 2-m0.Uxa i SECOND FLOOR FRAMING PLAN REVISED BUILDING PERMIT DRAWING 1-26-2004 �°��`S U T P H I N ARCHITECTS - e e.os Revisions )��e ]hawing Na 35 MEOFORD STREET P o E' st7-7+B-som NEW RESIDENCE SUITE Mot fAx 8T7-7T8-2D03 '35 SHORT BEACH ROAD AS Nam BASEMENT PLAN E-MAIL:* SUTPwaa-ApCHlpQtoE.B.c01A FRAMING PLANS SOMERVILLE. MA 02143 WEB SITE. WWW.DESIGN-W®E1Y7M v CENTERVILLE, MA ��. �� - North SEPTIC TANK DETAIL: 150o GALLON DISTRIBUTION BOX DETAIL: NOT TO SCALE LEACHING DETAIL: NOT TO SCALE REVISIONS , SOIL TEST PIT DATA: MARCH 28, 2003 NO. DATE DESCRIPTION P-10454 NOT TO SCALE NO. OF OUTLETS cJ 37.5' 5 1. 1/26/04 ADD. TOPO TEST PIT _ 1_ NOTES: 1. SEPTIC TANK SHALL BE STEEL 5. INLET AND OUTLET TEES TO BE CAST IRON, FINISHED GRADE GRD. EL. 7.43 REINFORCED CONCRETE. o0 0 0 00 0 0 0 000 o 0 0 000000000 0 o c> 0 0 0 SCHED. 40 PVC OR CAST-IN-PLACE CONCRETE. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 EST. HIGH GW. 2.2 2. SEPTIC TANK TO WITHSTAND H-10 LOADING TEES TO BE CENTERED UNDER MANHOLE COVER. IMMOVABLE 2" WALLS NOTES: 0 5 UNITS o r------ UNLESS UNDER PAVEMENT, DRIVES OR 0 WITHSTAND H-10 LOADING HIGH DENSITY 0 50" g' TRAVELED WAYS, WHEREIN H-20 LOADING 1. DIST. BOX TO WI00 SHALL APPLY. n:a.. ,o:.v.. ,o:�....,:p.:: pw"" o UNLESS UNDER PAVEMENT, DRIVES OR 4" PVC oa POLYETHYLENE INFILTRATOR 3050 o I 1 A I 3. ALL PIPE CONNECTIONS AND CONCRETE 2-24" DIA CONCRETE MANHOLES T TRAVELED WAYS WHEREIN H-20 LOADING PIPE o00o o 0 00 0 0 0 o o 0 0 0 0 0 0 0 0 0 0-6-0-0 o 0 0 0 oo I LOAMY SAD I CONSTRUCTION SHALL BE WATERTIGHT. I W� METAL HANDLES BROUGHT � � � 15" SHALL APPLY. o 0 0 0 0 0 0 0 0 0 0 0 0 0 7.5YR 5 4 I HIGH GROUNDWATER COMPUTATION 4. FILL ALL UNUSED KNOCKOUTS WITH T 8 OF FINISH GRADE 8 2. PROVIDE INLET TEE OR BAFFLE WHERE 43.2' GENERAL NOTES: _____ MORTAR. (is •. 5,5" OUTLETS � � SLOPE OF PIPE EXCEEDS 0.08 FT./FT OR 1. THIS PLAN IS FOR DESIGN AND EL = 6.26 14 BASED ON TIDE & NEARBY WELL) TEE TO BE UNDER 120 MIN. PLAN VIEW - LEACHING CHAMBERS TOP-OF WALL EL = 9.7 CONSTRUCTION OF THE SEWAGE M.H. OPENING 3" �� IN PUMPED SYSTEM. DISPOSAL FACILITY ONLY. OBSERVED HIGH TIDE 2.2 `" 1- 2" 3. FIRST TWO FEET OF PIPE OUT OF DIST. LOAM & SEED DISTURBED AREAS VERSA-LOK MODULAR 2. ALL CONSTRUCTION METHODS AND 4" BOTTOM ON LEA' BOX TO BE LAID LEVEL CONCRETE WALL AS MATERIALS SHALL CONFORM TO MASS. OBSERVED WATER IN WELL 2.2 RAISE M.H W/�•- 8' MIN. 3 4" TO STABLE BASE HOWN ON PLAN D.E.P TITLE 5 AND LOCAL BOARD SEWER BRICK . . •e. . . . .; 1 1/2' USHER 4. ALL PIPE CONNECTIONS AND CONCRETE 48" WELL SET AT 1010 CRAIGVILLE BEACH ROAD 10'-0" & MORTAR - " ! CROSS-SECTION STONE BASE 3' MAX. C MPACTED FILL 36" MAXIMUM 12"MINIM M 3" LAYER HEIGHT 0. WALL OF HEALTH REGULATIONS. NORM WA 12 CONSTRUCTION SHALL BE WATERTIGHT. EL = 2.2 - 60" AND ELEVATIONS APPROVED BY THE B.O.H. 0 0 o 0 0 0 000 0 0 0 0 0 PEASTONE VARIES 0. TOWN OR 3. ALL PIPES LOCATED UNDER PAVEMENT IN APRIL OF 2002. BASED ON THE HIGHEST �• 3" _ 5. FILL ALL UNUSED KNOCKOUTS WITH MORTAR. o 0 0 0 000 0 0 0 00 0 o MAXIMUM. TOWN 10" 14" T Q � HEIGHT RESTRICT. � TRAVELED WAY SHALL BE SCHEDULE OBSERVED READINGS IN A MONTHLY CYCLE. PRECAST SEPTIC TANK a HIGH O 00 O 40 OR EQUAL 30" Q O DENSITY O O O 4. THERE ARE NO KNOWN PRIVATE WELLS EL = 1.43 72" INLET TEE 5'-1" 30 1/2' 24" O POLYETHYLENE O Q LOCATED WITHIN 150 FT. OF THE 5'-2" 4'-8" •_ 51-8. DEPTH O INFlLTRACH N ATOR 3050 $ QO O O O PROPOSED LEACHING FACILITY NOR _ _ 4 0 MIN. w Mw ON 15 1/2 Q ANY KNOWN WELLS PROPOSED WITHIN MEDIUM SAND 5'-8" Z LIQUID DEPTHi�aa+�nioU PRECAST DIST. 1 O CHAMBER \ O w ' XIST GRADE 7.5 150' OF ANY KNOWN LEACHING FACILITY. 2.5Y 6/2 • - � 3/4 - 1 1/2 5. WITHIN LIMIT OF EXCAVATION REMOVE INDICATES - . ,• +,. BOX REMOVE 29" 50" 29" STOONNE IMPERVIOUS MATERIAL ALL TOPSOIL, SUBSOIL AND OTHER „ �+i..; 'e 1_:: .,•.�.: �:_ :� UNSUITABLE 120 y OBSERVED BOTTOM ON LEVEL STABLE BASE MATERIAL FOR 9 EL = (-2.6) = WELL HIGH 3 � ' GROUND WATER PLAN VIEW " �� 7 1/ 5 ALL ROUND 19 _10, 40ML POLYETHYLENE 6. REPLACE WITH CLEAN WASHED SAND MEMBRANE IMPERVIOUS � OTHER CLEAN GRANULAR SOILS DATE: s 1�1�23 STONE* TOCROSS-SECTION VIEW PLAN VIEW CROSS-SECTION OF CHAMB.E@ BREAKOUT BARRIER (TYP) SIEVE CONFORMING V OBSERVED THE FOLLOWING 3/28/03 INDICATES TTHE BSC GROUP, INC.ST BY: - GROUND WATER ��, `\I �p 10 PASS ANo.B50 SIEVE ALL WITNESSED BY: I. �. ,,i,, \� ' �,-- \ ,... DESIGN CRITERIA: d0 S OF No. 4 SIEVE SHALL SAM WHITE INDICATES ` / �. / of <5 X OF No.04 SIEVE SHALL PERC. V Q' °b �y 1 �1 PASS No. 200 PERC. RATE: TEST FZ DESIGN FLOW: � OF ��ry c1 � N UNIFORMITY COEFFICIENT O No. 4 �2-MIN./INCH .�pP�, P NOTE. CRAIG A. _ , 1 -� INDICATES l �� \II, �! FACE OF WALL TO BE A FIELD 4 BEDROOMS AT 110 G.P.B./D 440 G.P.D. SIEVE </ s o SOIL EVALUATOR 1 �. ►, P MINIMUM OF 5' FROM No.38039 10 7. EXISTING UTILITIES WHERE SHOWN CRAIG FIELD I.---I UNSUITABLE G 1 �`Z\G ` 0 IN THE DRAWINGS ARE APPROXIMATE. M ` ' \ ' w gvER THE PROPERTY LINES. �� REQUIRED SEPTIC TANK: SIBLE THE CONTRACTORFOR PROPERLY LOCATING ALL BE SAND SOIL CLASS: v \ ON- WIF 4 r' SN Q' .3� WF�13 rn `'g"` MPR �►�.v�� 440 X 200% = 880 GAL. COORDINATING THE PROPOSED CON- 1 1 WF#12 L� STRUCTION ACTIVITY WITH DIG-SAFE 0' SP L.T.A.R. EDGE OF SALT MARSH 5 . a• AL. AND THE APPLICABLE UTILITY lay SEPTIC TANK PROVIDED: - COMPANY AND MAINTAINING THE 0.74 G.P.D./SQ.FT. 1, �l, , / C' EXISTING 4 BEDROOM ?�� EXISTING UTILITY SYSTEM IN SERVICE. • -4-- .-tor o N/F 1 STORY DIG-SAFE SHALL BE NOTIFIED PER • �� AGNES H GLANCY & w00D HOUSE SIZE OF LEACHING FACILITY REQUIRED: THE STATE OF MASSACHUSETTS DATUM. WF 11 1 /N/F CAROLE H. & JAMES L. BOURKE #35 DESIGN PERC. RATE: <Z MIN./ INCH ATATEL 1 888344TUTE CHAPTER �7233C THETION 409 - ASSESSORS MAP 206 TOF=6.89 ENGINEER DOES NOT GUARANTEE VERTICAL DATUM: N.G.V.D. ROBERT BRADL Y PARCEL 41 TO BE DEMOLISHED LONG TERM APPL. RATE 0.74 G.P.D/S.F. THEIR ACCURACY OR THAT ALL BENCH MARK USED: RM-18 (7.19) CHISELED SQUARE A SESSORS M ' 06 UTIILITIES TY 6.01' PAR CEL 31 NEW H-10 440 GPD + 0,74 GPD/SF = 596 S.F. ARE SHOWN. LOCATIONS AND STRUCTURES BENCH MARK SET: CONCRETE BOUND AT WESTERLY SIDE OF PROPER N/F 1500 GAL. CB/DISK FER M.C. CANAVAN & M.H. FITZGERALD / f SEPTIC FND ELEVATIONS OF UNDERGROUND UTILITIES ASSESSORS MAP 206 TANK MPRSN • w\oE� CONTRATAKEN CTOR SHALL VERIFY OM RECORD SSIZE, E PROFILE: NOT TO SCALE PARCEL 40 o, SP�•� _ = ' \C 40 SIZE OF LEACHING FACILITY PROVIDED: � ..--_ _ pV8` LOCATION AND INVERTS OF UTILITIES 6� I �O _ •_ - AND STRUCTURES AS REQUIRED PRIOR \ EDGE OF= RA'VEMENT, ' ' - n USE HIGH DENSITY POLYETHYLENE TO THE START OF CONSTRUCTION. EL.=A FIRST PIPE LENGTH I - .�: • - • - - ' ' • • - / R O A Ll LEACHING CHAMBERS(5 UNITS) 9'X2'X4??' TOP FOUNDATION CONCRETE COVERS TO WITHIN TO BE SET LEVEL �F / Q AC . & THIS SYSTEM IS NOT DESIGNED FOR • FOR MIN. 2 0 - Y ' / THE USE OF A GARBAGE GRINDER. EL.=11.25 8 OF FINISHED GRADE. - RIGH1'OF WA � V _ FINISH GRADE RS PA D o 0 _ SIDEWALL - 2(9'+43.2') X 2' =20E,3 , A G,'RBAGE GRINDER IS 'RIOT =10.5 !� ._� • - N HOR'T W ❑HW UPL = - RECOMMENDED DUE TO RECOGNIZED s 4" PVC SCH 40 WALL • Q.L� - OHW ❑HW OH1 _ � B❑TTOM 9 X 43.2 ADVERSE IMPACTS TO THE LEACHING 50 S =� �� 8H� �D W-'- LNG CB/DISK 7.7 - :.I p�' PROPOSED 597S,F. FACILITY. 4" PV LEACHING CHAMBER / - e CH 4 4" PVC H - o LIMITS OF F� = EXCAVATION 59/ S.1= X 0./4 GPD/SF = 4426PD 9. EXILING INVERTS ARE TU uE c HECKE& dY THE CONTRACTOR PRIOR TO CONSTRUCTION � / / B DIS -''�'- Wp, M X - �.=75 � 0 5E� 60TES: RJR � THE ENGINEER IS TO BE NOTIFIED OF ' hE H (n / .4 1 H � =g• \\O • R\ ANY FIELD CHANGES THAT MAY BE l ,� REQUIRED. AFTER NEW FOUNDATION IS i=C L OUTLET I-F O w :/ �` �[ ~� E'D c,+ 1 I 2p0 DIST. BOA 5' SEPARATION _j� _ S 84'29'05" E\ -n p INSTALLED. SEPTIC TANK 5 w Q '•� 35.69' ' ROP SED 0 B flIS .Q 2 O a m �_ BIT. < +' F �- ` EST. HIGH GROUNDWATER 'a - - - � , DRIVE , '� "i_ --' `! 4 N/F Z PHILIP C. GATEMAN TR. ,� M �'' ASSESSORS MAP 206 N �^ �• PARCEL 45 LOCUS INFORMATION INVERT ELEVATIONS: '( t�P I ��Q N o CURRENT OWNER'S: ROBERT BRADLEY `SC GRDUP 5P\, � / nSk � \� 100 •P SEDP.OV 0 WATER �° 657 Main Street, (RT. 28) Unit 6 TOP OF FOUNDATION 12.0 A C ` 9 •\ TITLE REFERENCE: CERT. 124445, o � hl -T'rlQl �t MET•EEt� GATE BOOK 12935, PAGE 117 W.Yarmouth Massachusetts 4" INVERT AT BUILDING 100' SALT MARSH BUFFER / FND "'Y $Fr R.;iNL:tSp• f_" Z \ 02673 '� �► PLAN REFERENCE: L.C. 9288-V (PENDING) 508 778 8919 4" INVERT AT SEPTIC TANK (IN) 9.82 C fGF I ,;.:1� , '" �.,� ��, ,��g >0 SV.1 E \- 4" INVERT AT SEPTIC TANK (OUT) 9.57 D ' N88'1o'45"W 43.45 - �O. S;_p,�t ' 10.1 1� �: -�' ' - `ARE •\ ASSESSORS MAP: 206 - PROJECT TITLE: 4" INVERT AT DIST. BOX IN 9.41 E I - , \' N/F PARCELS: 30,31.32 ( ) N/F �' ROBERT BRADLEY N/F 4" INVERT AT DIST. BOX (OUT) 9.24 F ROBERT BRADLEY SHED TO BE i P M (r C��'� .-. ASSESSORS MAP 206 MARGARET A. HINE TR. ZONING DISTRICT: FRO ASSESSORS MAP 206 RELOCATED o TAB ' PARCEL 30 ASSESSORS MAP 206 SETBACKS: FRONT 30 SEWAGE DISPOSAL PARCEL 32 PARCEL 46 SIDE 10 INVERTS AT LEACHING FACILITY: �` O o , RPENCE �'.. REAR 10' SYSTEM DESIGN BENCHMARK: LuG �'' ��'25 S,q ' UPL\ MINIMUM LOT SIZE: 87,120 S.F. 4" INVERT AT BEGINNING TOP OF CONC. BOUND l6.19•30"� ��. EXIST. TOTAL LOT AREA: 22,232t S.F. OF LEACHING CHAMBER 9.2 G EL=6.01 (NGVD) I J "�7� EXISTING TANK �,q'�Sy FEMA FLOOD ELEVATION AT BOTTOM „ 43.00 �-- AND PUMP CHAMBER 6 #35 • ZONE DISTRICT: ZONE "A-13" (EL. 11) OF LEACHING CHAMBER 7.2 H 50' SALT MARSH BUFFER - N� g'30 E \ TO BE REMOVED G�,cF OVERLAY DISTRICT: ZONE II N ADJUSTED HIGH i \ (FMLY. #23) S GROUNDWATER HIGH TIDE 2.2 H ' N/F � N/F G SHORT� KERS � JANE M. WICKERS SHORT BEACH RD. OBSERVED N'( SESS I S�MAP 206 ASSESSORS MAP 206 \ LOCUS PLAN: NO SCALE -v BEACH CENTERVILLE GROUNDWATER 1.4 J R\ RO EDWARD N/F PARC L�9 / PARCEL 29 0 • E 2 z o 6 o n M ASSACH U SETTS 00 ASSESSORS MAP 206 P \ %lill o PARCEL 33 w wFs cs�. \ ROAD N in kp VARIANCES REQUESTED: o� �� PREPARED FOR: Fib�` ` r MARSH BUFFER PRE E wF#1\ °'CID ~4\ wF 7 1 � DAVID J. � O GEORGE MAUTNER N NONE: CRISPIN CNV'WF#5 \, r RIVER OCC DEVELOPMENT, INC M CIVIL \ "�-J M �I �\ J . No v�LLE 1287 OLD POST ROAD � _.. 0 WELL CENT NOR MARSTONS MILLS, MA 02648 Foy lilt LOCUS ena qcy s wF2 I�i� .\ ROP �'p DATE: MAY 21, 2003 �� JOHN J. & ANN/D. PENDERGAS COMP. DESIGN: K. HEALY N �•9 `'' ASSESSORS MAP 206 I CHECK: D. CRISPIN 00 o �Sy a �� OF SALT MARSH PARCEL 28 CH Z SALT MARSH �--ED 0 ,�,, CRA��O�LE BE DRAWN: P. HAGIST PLAN VIEW FIELD: D. GAZZOLO/R. FITZPATRICK r WF 4 Wl FILE NO. 8504-OPT.DWG � SCALE: 1 = 20 FEET ,\Il, � wF�9 WF#3 1 ,ITM IL _ DWG NO. 5423-02 SHEET 1 of 1 c 0 10 20 40 FT. 1` II' JOB N0. 4-8504.00 a a ,