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Home My WebLink About0385 SKUNKNET ROAD - Health 385.Skunknet Road Centerville A = 170 117 F 1 i I Commonwealth of Massachusetts Y W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 385 Skunknet Road M �+� Property Address P,a James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 e� page. City/Town State Zip Code Date of Inspection I� 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. filling n A. General Information fillin out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Brett Hickey use the return Name of Inspector key. B&B Excavation rab Company Name 374 Route 130 Company Address Sandwich Ma 02563 City/Town State Zip Code (508)477-0653 S113747 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 4-20-18 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 ��y� 6 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments cM 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 page. CityFrown 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: The system was in working order at time of inspection. 13) 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 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 page. City/Town 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 i r❑ s m v removed ed Y 0 NEI 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 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 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 '/z day flow t5ins•3113 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 GSM 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 page. Citylrown 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 CM 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 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 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? ® ❑ 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): 3-Number of bedrooms (Actual) 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 331/GPD t5ins-3113 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 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information required for every Centerville is Centerville Ma 02632 4-20-18 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usa e d See below 9 ( Y 9 (9P ))� Detail: 2017-95,000gallons 2016-27,000gallons Sump pump? ❑ Yes ® No Last date of occupancy: Current Date Commercial/Industrial Flow Conditions: Type of Establishment: NA 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 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 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: Owner- pumped last year 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: ® I 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 385 Skunknet Road Property Address James Nye Jr. 'Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: New SAS added to existing tank in 2005 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 2'feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal list age'.' g years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000gallons Sludge depth: 4 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - 9 p Y Y M 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 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 32 Scum thickness 2 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 14" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank was in working order at time of inspection with liquid level equal to outlet invert. Tank is not in need of pumping at this time but should be pumped every two years for maintenance. Grease Trap (locate on site plan): Depth below grade: NAfeet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•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 Voluntary Assessments 0 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 page. City/Town 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: NA Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: r 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° M 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 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 11 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box is in working order at time of inspection with liquid level equal to outlet invert. D-box did not show signs of back up. 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.): NA 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 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: (5) Hi capinfiltrators ❑ 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.): Leaching was in working order at time of inspection with no sign of hydraulic failure. Leaching was dry when viewed. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•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 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 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: NA 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 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is Centerville Ma 02632 4-20-18 required for every page. City/Town 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 vent C i insp. port Rear 4 B A Al-20' A2-22' �--�, B'I-25' { ) 132-27' �-/ 133-27' *� 134-25' +r 2 C3-45' C4-43' t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 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: No GW @ 132" 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: 4-1-05 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: Plan on file with BOH. 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 m' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 385 Skunknet Road Property Address James Nye Jr. Owner Owner's Name information is required for every Centerville Ma 02632 4-20-18 page. City/Town 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Certified Mail#7005 2150 002 1041 8351 IKE Town of Barnstable Regulatory Services BARNb CAB14 nnss. g Thomas F. Geiler, Director t6sg �� Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 December 4, 2008 Edgar Narvaez 385 Skunknet Road Centerville, MA 02632 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION. The owned b you located at 385 Skunknet Road Centerville was inspected property YY p on December 3, 2008 by Timothy O'Connell, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.450—Means of Egress. A room was observed being used as a bedroom within basement of home without proper second means of egress as required by 780 CMR 3603.10.4.1of the Mass State Building Code. 105 CMR 410.300 and 310 CMR 15.00: There were a total of four (4) bedrooms observed in this dwelling. However, the existing septic system (permit # 2005-121) was not designed for(4) four bedrooms. It was designed for three (3)bedrooms. The following violation of the Town of Barnstable Code was observed: s& 59-3 (a) (b) of the Town of Barnstable Code: (a) Owner stated that six (6) adults reside at the dwelling when only five (5) are allowed due to number of bedrooms. (b) Owner also stated that six cars a parked at home over night. (a) The maximum number of occupants in a residential dwelling shall be determined by the number of bedrooms contained therein. A maximum number of two occupants are permitted for each of the first two bedrooms; for each additional bedroom a maximum number of one occupant is permitted.It shall be a violation of this chapter for any person in excess of that provided herein to occupy any residential dwelling. QAOrder letters\Housing violations\385 skunknet.doc (b)The maximum number of motor vehicles that are permitted to be parked overnight, other than in a building, at any residential dwelling shall be equal to two motor vehicles for the first bedroom in a residential dwelling and one motor vehicle per bedroom thereafter. You are directed to correct the violations listed above within twenty-four (24) hours of your receipt of this notice by ceasing and desisting the use of said room within the basement as a bedroom. You are also ordered to remove beds from said room. You are ordered to remove the bedroom from the basement by removing entrance door and by opening the door-way entrance to a minimum of five feet wide opening this must be complete with thirty (30) days of your receipt of this notice. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. aPERRDER OF T E BOARD OF HEALTH A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Timothy O'Connell, Health Inspector Q:\Orderletters\Housingviolations\385skunknet.doc 1 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 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:When filling out forms A. General Information on the computer, /J use only the tab 1. Inspector: key to move your cursor-do not Carmen E Shay use the return key. Name of Inspector Shay Environmental Services, Inc. , Company Name 185 Ashumet Road a, ' Company Address erNn Mashpee MA 02649 City/Town State ' Zip Code" 508-539-7966 3080 Telephone Number License Number hJ i t1 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 ,fi ❑ Needs Further Evaluation by the Local Approving Authority C:ARPT I SHAY 9/12/096 ��FfiTtF��4� Inspector's Sign 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. Lb YeDi 385 Skunknet Road,Centerville•03/08 Title 5 Official Inspection Form:Subsu ce Sewa os System•Page 1 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. City/Town 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: No liquid in SAS @ time of inspection. System passes. 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 385 Skunknel Road,Centerville•03/08 Title 5 Official Inspection Form;Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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. 385 Skunknet Road,Centerville•03108 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 3 of 15 I v Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. CityrFown 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 '/z day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 385 Skunknel Road,Centerville•03/08 Title 5 Official Inspection Form,Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): 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 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. 385 Skunknet Road,Centerville•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 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? ® ❑ 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)] 385 Skunknet Road,Centerville-03/08 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 6 of 15 X Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 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: Unknown 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: Last date of occupancy/use: Date Other(describe): 385 Skunknet Road,Centerville•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Board of Health 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): Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No 385 Skunknet Road,Centerville•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 2.5 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.): No evidence of leaks, plumbing properly vented 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: U x 8' - 1000 gallon Sludge depth: 30" Distance from top of sludge to bottom of outlet tee or baffle 15" Scum thickness 0 11 Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Measured 385 Skunknet Road,Centerville•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. City/Town 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.): Tank in good condition,lnlet Tee in good condition, outlet Tee in good condition 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): 385 Skunknet Road.Centerville•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 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 D-Box Present 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.): Liquid equal with outlet invert. One outlet present. No significant solids carry-over noted Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 385 Skunknet Road,Centerville-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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: ❑ leaching galleries number: ® leaching trenches number, length: 1 - 37' x 10' x 1' ❑ 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.).- No Liquid in SAS - 12" effective depth availavble 385 Skunknet Road,Centerville•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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.): 385 Skunknet Road,Centerville•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 5 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 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. X j7S 1 L385unknet Road,Centerville•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 385 Skunknet Road Property Address Edgar Navareaz Owner Owner's Name information is required for every Centerville MA 02532 November 12, 2009 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: No groundwater at 10' feet per soil log 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: refer to plans on file 385 Skunknet Road,Centerville•03/08 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System•Page 15 of 15 f TOWN OF BARNSTABLE Lnt;AT1;ON c C7�uC1 SEWAGE# o9b6..S— a VILLAGE ASSESSOR'S MAP&PARCEL I—+r3 INSTALLERS NAME&PHONE NO. 1�c�k3� S SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) 3 XI 0 XI NO.OF BEDROOMS OWNER PERMIT DATE: 411 J©S COMPLIANCE DATE: Separation Distance Between the: 5 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) A) A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) A)JA— Feet FURNISHED BY F(IJ &Ip,Y. r r TO alo a s O �4 �} 45 075 3 p t� C. W I - TOWN OF B STABLE LOCATION � � � SEWAGE # VILLAGE Cei�'C"�/�J� ��. ASSESSOR'S MAP & LOTS INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY � c4--' LEACHING FACILITY: (type) 6. =�`�'rwwc (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: 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 �6 - - 61 , Lj No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: .111' Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for 30igpooal bpf�tem Con6truction 3permit Application for a Permit to Construct( . j Repair( /upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.3Jr �� Owner's Name,Address and Tel.No. Assessor's Map/Parcel '7o I I� � ra,Lti s Installer's Name,Address,and Tel.No. _Designer's Name,Address and Tel.No. ®, t oy tg-2-? a -< h oA Type of Building: Dwelling No.of Bedrooms —7-1 Lot Size sq.ft. Garbage Grinder( ) Other 7 pe of Building_ c v` o. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow er gallons per day. Calculated daily flow 7:3 c d gallons. Plan Date PIDo i Number of sheets Revision Date Title Size of Septic Tank �`' " ts-r SU2� Type of S.A.S. vc- Cr t _-i I l'tl j tl Description of Soil 4,_0_ Nature of Repairs or Alterations(Answer when applicable) r l�CTAc��L.U�4--� . Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with.the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance hasbaeniszued by th' oard of tttl . Signed 'Date `d6 Application Approved by Date Application Disapproved fo the following reasons Permit No. 2 u 18 %a / Date Issued "`r U � E •'fits � i �B/, d/, �� .. .. • � �: ~ No. o - # x s - ; '?� Fee 14 0 HE C`OMMONyW ALTH OF MASSACHUSETT Entered in computer:. Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 1 -. 01pplication for Mig ont mem -Cott!5tructiott Permit � f Application for a Permit to Construct( )Repair(/Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. 4—viLJ� _ () Owner's Name,Address and Tel.No. Assessor's Map/Parcel "'7 C ' 4� �\ / MA,4 t c— Insta'ller's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 12 . srd it:,No.of Persons -Showers( ) Cafeteria( ) l Other Fixtures Design Flow "?. .h' gallons per day. Calculated daily flow 1 , gallons. Plan Date A(lr t 1.. 1` ' ?7>Number of sheets Revision Date Title Size of Septic Tank_ Type of S.A.S. r�1.' i ' sue, L�1," Description of Soil �F il�t.r , "r� . f? ti w f C _I✓ ��1 I y,Z 2 Nature of Repairs or Alterations(Answer when applicable) � r V\CZ r"' k.)__.. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has heendssued by th's�Board of �ealth. Signed �� -� d Date t Application Approved by Date Application Disapproved 67the following reasons Permit No. 2 U u C J D ! Date Issued S THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(✓ ) Abandoned( )by , t t at l Wit! ,. 1� w. " 'o—,0 Cc'►4 r A��2has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated t— Installer 'ZI_) ram. -A-c. Designer Ca , S A A-/ The issuance o i this permit shall not be construed as a guarantee that the S`y'stern will function as d signed. Da Inspector `h 1 iV 4 No. U t) — l.? / Fee a THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS 0i5pozar *pgtem Congtruction permit Permission is hereby granted to Construct( )Repair*---j'Vpgrade )Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this(permit. Date: Approved by -...J � 7 / t� 1 V Town of Barnstable °Ft"E'° Regulatory Services Thomas F. Geiler,Director • anxxsrnsr.E. « Public Health Division iOrEO .�A Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 4/05/05 Designer: Shay Environmental Services, Inc. Installer: Robert Septic Services. Address: P.O. Box 627 East Falmouth Address: 5 Trenton Street MA 02536 Yarmouth, MA On 4/01/05 Robert Septic Service was issued a permit to install a (date) (installer) septic system at 385 SKUNKNET ROAD, CENTERVILLE, MA based on a design drawn by (address) Shay Environmental Services, Inc. dated 04/01/05 (designer) . p certify that the septic system referenced above was installed substantially according tohe design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. 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 certified as-built by designer to follow. r :i �F ti'S,SS�c �o CARMEN (Installer's Signature) 0 E. SHAY Cn No. 1181 i �FGf STE�� J�1 s4NITAR\NN (Designer's Signature) 0 (Affix Des tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form f 9/16/03 Notice: This Form Is To Be Used For the Repair Of Failed Septic Systems. Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, C 8:S t, VA Y ,hereby certify that the engineered plan signed by me dated 411 b S concerning the property located at 395 un lst��z �� . ��e c� Q� meets all of the. following criteria: • This failed system is connected to a residential dwelling only. There.are.no commercial or business.uses associated with the.dwelling. .• The,soil is classified as.CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct deep . test holes and percolation tests.at the site without a health agent present. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The.bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the. Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation +adjustment for high G.W. _ DIFFERENCE BETWEEN A and B p ti SIGNED : DATE: 1 NOTICE Based upon the above information;a repair permit will be issued for bedrooms maximum.. No additional bedrooms are authorized in the future without engineered septic system plans. gASeptic\percexemp.doc 11 r Permit Number:,,Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location:_ _ 2)B5 UT_ � o��e Lot No. (e i Owner:__L ja ,,r+ Address: ��t✓p� Contractor: swpvy 9nu . -6-jcc, Address: ti )D)cY�ldaa9��n A Notes: ®y STEP i Measure depth to water table tonearest 1/10 ft. .............................................................................. .Oats , 3 Ot month/day/year STEP 2 Using Water-Level Range Zone and Index Well Map locate site:and determine: OAppropriate index well.................................................... OWater-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... 3 � month/year STEP 4 Using Table of Water-level Adjustments for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment ..............................................:........................................... STEP 5 Estimate depth to high water by subtracting the water• level adjustment (STEP 4) from measured depth to water level at site (STEP 1) ......•......•............ . Figure 13.--Reproducible computation form, 15 TOWN OF BWSTABLE LOCATION � ��'�'�"� i` ; SEWAGE # VILLAGE ��io�-T�'�/�\ ASSESSOR'S MAP &LOT INSTALLER'S.NAME&PHONE NO. — SEPTIC TANK CAPACITY `T �'�✓ LEACHING FACILITY: ti ('typ�J 1� �. S�LP—y�-Td `��V�°.S (size) �/� f NO.OF BEDROOMS BUILDER OR OWNER �u . PgRMITDATE: "—�s, . . COMPLIANCE DATE: 0� 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 i G � A li ! ` � eS 3� c�4�� ION SEWAGE PE RMiT NO. VILLAGE Cen` evt_0\We- INSTALLER'S NAME i ADDRESS k ��k�y BUILDER OR OWNER DATE PERMIT ISSUED <3s DATE COMPLIANCE ISSUED � _ 4 _g5 Al cot 6 CIS" b'fJc k ® t Gc r�� I No... .A...... Fizz...Sb............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...........................................O F................._-_Q ( ApplirFation for Ut6pasal Workii Tomitrurtion thrmit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: 3 oc tion•Addr s or t No. O Address Installer Address dType of Building Size Lot.I D ......Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '04 4 Other—T e of Building No. of persons............................ Showers — Cafeteria WOt r xtures .----------•--------------•----•-•--•--••••......•-•-- wDesign Flow..:.. ... ...............................gallons per person per day. Total daily flow------�.��.............................gallons. WSeptic Tank—Liquid'capacity Doflgallons Length-_:�P Width................ Diameter________-____- Depth................ x Disposal Trench—N . .................... Width•..._............... Total Length_----__..._.__..... Total leaching area_._.._._ _•_... sq. ft. Seepage Pit No.____..__.f_.._.__ Diameter---- Depth below inlet......A .._ Total leaching area. �...sq. ft. Z Other Distribution box (✓) Dosing tank ( ) Y G QSSoG. Percolation Test Results Performed b �1�w�...�............ .......................... Date........................................ Test Pit No. I...!�...minutes per inch Depth of Test Pit.....2- ....... Depth to ground water-- -'_____________ ri Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... O t � r --- � <-• � r -r• l-- ............. ODescription of Soil.. . - --- --- v ''. w ------------------- ..............t �...... ----•---------------------•--•------•---------..----------------•••---------- UNature of Repairs or A erations—Answer when applicable- Agree ent: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary C e— Th nde signed further agrees not to place the system in operation until a Certificate of Compliance has Wse h and of health. �Signed ---•-----------------•-- -- � Date Application Approved By------------ - ..._-�!�"`�.. .. .. ........ Date Application Disapproved for the following reasons-------------••-------------•---•••---•••-•------------••--••---•------------•--•---•---•......•-••._.........•-- .................•--•-••••--••-•---•-----••-•--•......--••----------•...•--•••••-•------•-....•----•-------••••--•-•---••-------•-----------•---------•---•••-•-••---•---•-----•----••••-------••••••--- Date Permit No......................................................... Issued................................ ....................... . 1 y No. : ...:.... FEB ............. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ...................OF..................:, "'� y� - '�A tir. i fi Lj Annlirattion for Disposal Works Tonstrurtion Prrutit Application is hereby made for a Permit to Construct (1,/4 or Repair ( ) an Individual Sewage Disposal System at: C..... :.... '...........------ ' izwlt v,� ............................... Location-Addres _ or Lot No. ^.. --` ••- ................................................ ......... `� .__ _... ....... - ....................... ow Address Installer Address Type of Building F Size ......Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) alOther,,fixtures -----------------------------------------------------•--••••-•-•- •. 11 W Design Flow......%`............................gallons per person per day. Total daily flow..._.%''.-''.....................gallons. 9 Septic Tank—Liquid*capacity,-!j�.12gallons Length...�� Width................ Diameter..._.........._. Depth................ Disposal Trench—No. .................... Width.................... Total Length................A.. Total leaching area....................sq. ft. o Seepage Pit N ..._..___.�..__ Diameter...J-_-t..__.__...._ Depth below inlet.... . Total leaching areac�'-__/...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '—' Percolation Test Results Performed by--'-ll--''_:__dA.Iz :4li...`. .......................................... Date Test Pit No. I...l_ Z'...minutes per inch Depth of Test Pit.....it� ......... Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P1 -••••••.••••----•------•----•-••-••-••-•---••-••••......-•--••••-••--•--••-•••-••-••••--------------......................................................... O t \ , Description of Soil ........................................................... - .r...--••-.....6......... .............................. W ...................-..................................................................................................................................................................................... UNature of Repairs or Al erations—Answer when applicable................................................................................................ Agree ent: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TTTL2 5 of the State Sanitary Code— The ndersigned further agrees not to place the system in operation until a Certificate of Compliance has been s e " heA and of health. Signed._. �` l._,_ " � � `Dae Application Approved BY ............................ ............•. ---------- L Date Application Disapproved for the following reasons----------------------------------------------------------------------------------------------------------------- ----------•....................................•-------------------------•-------.....•---••-••••..._....._ ------------------ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOAR OF HEALTH ..........................................OF ........................... Trrtifiratr of ToutnliFanre THE ,IS TO CERTIFY,,T-hat the Individual Sewage Disposal System constructed ,. or Repaired ( ) by ...._ ��'' .�,.- ' = 'V/----------------------------------------------------------------------------------------- == ^. `�` • t has been installed in accordance with the provisions of TITLE; 5 of The State Sanitary Co e as described in the application for Disposal Works Construction Permit No...... ................................. dated._-..:-_.!.................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT Bk�COI_tTRIIED AS A G,6AWAAUE'Thk THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............. ........................................... Inspector---- THE COMMONWEALTH OF MASSACHUSETTS, BOAR OF HEALTH ........................................ OF :. lte ?: .-A-........................................ _ FEE............ Disposal Works Tonotr on rrutit to Coer ct or epa ( Indi -•-• .� �'/ ;/ Pmisston is hereby anted.�_" ..1...., J vidual wage Disposal System at No...... = s1 1:! r -------------------- ..--------------..._.......----•- �; r ~ - treet ----••- as shown on the application for Disposal Works Construction Permit No..................... Dated.....................:.......am................ — ... f-• `f l Board of health DATE---•--------------r--='�•^-....1.17._/7,:�_..�.. FORM 4F55 HOBBS & WARREN. INC., PUBLISHERS y �C SITE PLAN SHEEr I OF 2 SCALE: I = ZO' 3 3 1' Z� ' o�" h/ � :4LL A�Pouvp. _- � 5zx5 O �Z . 0 o r-v�,c3 F4. /9 I Q ® I I P 3 log Ch E[. 5/.5 i I i NN I I � I � � I ox� 9,3o N Of P I I I a� WILL16AM _ �. WARWICK _. � ` ✓ 1.1�/KA1 7" BOA l) /ST i. p FOR LESEL - �DLLO WS REGISTERED LAND SURVEYOR LOT ZONE PLAN REF. DATE ��SfB✓� BENCH MARK DATUM L 2 -5U WM. M. WARWICK 8 ASSOC., INC. DOMESTIC WATER SOURCE fir�`�c.JA� `�-�� fi` BOX 80/ , - NOR rH FA MOUTH FLOOD ZONE. N D�- �-1 A. t�D��--, MASS. 02556 - (6/7J 563 -26 38 LEACHING BASIN SECTION NOT TO SCALE spec 2 f Z 24 C.I.MH COVER EARTH F/IL BRICK AND MORTAR COURSES AS RE00• TO BRING 4 4 COVER TO GRADE ' .. B'FLOW LINE INLET 1_ _ __ ___:,s �' 2`�- "TO%" WASHED PEAS TONE FREE OF IRONS, PIPE T FINES AND DUST /N PLACE i1 OPENING WITH 4%8" 14" To I%2 WASHED CRUSHED STONE FREE OF OUTER DIAMETER IRONS, FINES AND DUST /N PLACE ANO I•'14"INS/DE DIAMETER I. CONCRETE TO BE 4• . : . 000 PSI 28 DAYS 2. REINFORCED WITH 6 x 6 NO. 6 GA. W.W.M. 3. 2'AND 4' SECTIONS ARE AVAILABLE FOR •�-- GREATER DEPTH REQUIREMENTS 40 4. NUMBER OF PITS REQUIRED E FFECT/VE DIAMETER I--�� MIN. IZ ; NOTE: EXCAVATE TO ELEVATION 3-)'S0R (NOT ro ExcEED 3 TIMES EFFECTIVE DEPTH) LOWER AS REQUIRED TO .REMOVE ALL WArER TABLE - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL PROFILE GRAVEL TO DESIGNED GRADE. 5A' p I8"STD. LT. War. C./.MN COVER �o '•. Z' �72• Z-5 .1 •I 4"C.ItP/PE 4"B/T.FIBER PIPE TIGHT JOINT OUTLET LEVEL DWELLING FLOW LINE TO FIRST JOINT —— •,-. �;—• �7 G OO + 110(�00 1 c.I. TEE / Lt7 Z 11 o 00 1 1 ,. 1 11 aoo 00 1 1 1.1 STD: PRECAST CONC. : 9 i T. BOX TO BE 11 000 00 1 1 1 1 Wa GAL.SEPTIC TANK D/S �•I O 1 000 0 0 0 1 1 1 INSTALLED ON LEVEL, I 11 000 00 63 1 i STABLE BASE 11 100 00 1 1 \SEPT/C rANK TO BE '1 000 00 1 1 I /NST LLED 0 LEVEL, I It 100100 1 1 ' ' ; STABLE BASE. 11.1 40 0 0 0 0 1 , LEACHING BASIN ' 1 1 100 0 O 1 1 , , '• � iit O 0001 „ BASE TO BE LEVEL I S p p 1 1 , , iL g3.5 SOIL AND P£RC. DATA PERC.RATE 2 MIN. /IN. 0„ TEST PIT NO. P 37aS 0„ TEST PIT NO. 2 I �I'oP/�V V3So 1 � TEST BY: -I} l'p �3�, WITNESSED. BY: �� `'F r-p TEST PIT GR. EL. gyp, DATE IZli.s DESIGN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM, DISPOSAL SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EFFL.f��GPD. PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK o0o GAL ALL .SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE SIDEWALL AREA12GAL./SQ.FT. TO REVISED TITLE 5 OF THE STATE ENVIRONMENTAL CODE, MINIMUM REQUIREMENTS FOR THE SUBSURFACE DISPOSAL OF BOTTOM AREA.�LD..GAL./SQ.FT. SANITARY SEWAGE EFFECTIVE ON JULY It 1977. LEACHING. REQUIRED I SQ.FT. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. Z �-SQ.FT. - AT COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE *. d BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES I/4" / FT. UNLESS INDICATED OTHERWISE. ° SEWAGE D/SPOSA L SYSTEM ARTIN gcyN FOR' L L -�v•�L L c::)\ S w MORAN v L 1 3417 y �o G/sT�Q �a`�` Gam1 V l l l.F A4 A�.S,1j . �e'ss O/SAL EN SCALE AS /ND/GATED A 7 °o S t D TE • WM. M. WARWICK 8 ASSOC., INC. 8OX 801 - NORTH FAL MOUTH ` MASS. OZ556 (617) 563-2638 PROFESSIONAL ENGINEER i } 1 / 1 -301 r -206 �. Interior ArchitecturE 7r_6" 234 Lyman Rd. Milton, MA 02186 Lin. p. 617.869.8566 f.617.249.1978 www.b2arch.col BATH CONSULTANTS CIO. C F.F. To = BEEROQM #2_= Ceiling= _ Molly H. Boudreau F.F.To Ceiling,T 8 T-8" `_° y Interior Architect t � - PROJECT - - EXPANDED N a N Nye Residence MASTER 385 Skunknet Road BEDROOM Centerville, A 02639 N w, .. �" __. .- - F.F.To Ceiling O T-8" C e M -� ,r -1 7 y ate D Balcony_ F.P. t .77. - - OPEN TO BELOW _ L — ICI z I l - ri UP ._ N w Y 301 NOTES' For design purposes only. Not intended for construction. Verity all dimentions in the field. This document,as an instrument of service,is t _ - sole property of b.2 Interior Architecture.Its use _ - the owner for other projects or for completion o - - _ - this project by another party is strictly forbidden. a - - - - Distribution in connection with this project shall i } Re-Used Window from BR#1 be construed as. be construed as publication in derogation of the 1 P R01POS E D 2 N D FLOOR PLANN . ,. 2t-4„ x 4'-4" Double Hung, 12/12 Lite New Walls -10 SCALE 1/4"< 1 -o ��"— Re-Used Window from Master Bedrm. 2 2'-4" x 4'-4" Double Hung, 12/12 Lite .c _ Skylingt (Optional) A- 103 k `` 4 Velux, Model: M06-2 SHFFT 3 nF 11 - - ._ *NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. SECTION A -A y11iAtiUliOirV a ALL OUTLET PIPES FAQY THE 10' min. from OWRMTM Box SHALLK Existing Foundation house to septic tank PROFILE VIEW OF ADDITION TO LEACHING SYSTEM SET tEVU FOR AT LEAST 2 FT. 1Y _ coNcatETE COVER Lc took coven must he D-BOX cover must be I TOP OF FOUNDATION = ELEV. 100.00 (Assumed) within 6 in. of finished grade r I 1 within 6 in. of finished grade Grade over Septic Tank - 98.00 ,-(rode over D-Box - 98.00 over SAS - 98.00 3" of 1/8" - 1/2" Washed Peastone ^� J- 6.OUTLET '•..�.'. 2 1�. ;e KNOdI0U15 ^ . � 3/4" to 1 1/2 " Washed Crushed Stone % �� S.5' OUTLET I ��) I 12' *RIFT A\ 10 10iMIN s - 0.02 ! 4• PVC(CAPPED) INSPEcnoN PORT ro BE `•\ 6- 3 Har H-10 INSTALLED AND ro BE W1t1teH s• of GRADE -r ST. BOX 3' um,,, r. r• ( \�e Top OF System- Oev. -94.75 :� 2 385 Skunkri Rd _ EXiST. _ s=o.o1 or Greater 0 1s' \ ��P� o In 1,000 GAL. s- 0.01" per root 10"En«hVe Depth -1s.s•- 4" - SCR. 40 Te FROM EXIST rWNDATIDN poi N SEPTIC TANK g f- m H-10 PLAN SECTION CROSS-SECTION M 20' CoNcRE-E FULL FouNDA u u n v 0.83' (10 inches) 5 Units 2 6.25' = 30' r o " rn J 4 -313 3 HOLE H-10 DISTRIBUTION BOX y SYSTEM PROFILE 6 inol 3/4•-1 1/2' v M + _ f " "6 NOT TO SCALE = A compacted stone � O U � �-J � - 37,z5' Not to Scale - c u 4' 4' II Effective Length ® eas awl>r err s ceaw r�?�o+t1i.TE� __ c -ij 3 SOIL ABSORPTION SYSTEM (SAS) GENERAL NOTES 6 in.of 3/4'-1 1/2 p 11 0 compacted stone s Effective Width INFILTATROR HIGH CAPACITY (H-20 LOADING)/ GEORGE O'BRIEN 1 NOTE ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE 0 . Contractor i3 responsible for Digsafe notification m (OR EQUIVALENT) Not to Scale and protection of all underground utilities and pipes. 0 w Bottom or rest Hole r-ve 1 EIev E C)RS NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18" /EFFECTIVE HEIGHT IS 10" 2. The Septic tank and distribution box shall a se Groundwater Observed -- NONE OB5I:RVE.D level On 6" of 3/4"-1 1/2" stone. � 3. Backfill should be clean sand or gravel with no stones over 3" in size. --- - -- - -- -- 4. This system is subject to inspection during installation PERCOLATION TEST 5 by Carmen E. Shay - Environmental Services, Inc. . The contractor shall install this system in accordance with Title V of the Massachusetts state code, the approved plan Date of Percolation Test: MARCH 31, 2005 and Local Regulations. Test Performed By. CARMEN E. SHAY, R.S., C.S.E. 6. If, during installation the contractor encounters any Results Witnessed By. WAIVER(per Barnstable B.O.H.) soil conditions or site conditions that are different EXCAVATOR: Shay Environmental Services, Inc. from those shown on the soil log or in our design Percolation Rate: Less Than 2 MPII 0 48" installation must halt & immediate notification be made to Carmen E. Shay - Environmental Services, Inc. Test Hole 7. No vehicle or heavy machinery shall drive over the No. 1 - - - �� -- PL j septic system unless noted as H-20 septic components.DEPTH SOILS ELEV. 105.00 8. Install Tuf-Tit* gas baffles or equals on all outlet tee ends. 0 98.00, 9. All Distribution Lines shall be 4' diameter Schedule 40 NSF PVC pipes. Sandy 10. All solid piping, tees & fittings shall be 4" diameter 10 YR J/2 � Schedule 40 NSF PVC pipes with water tight joints. 97.001 11. Municipal Water is Connected to ALL OF The Residence and Abutting 0"-12" A Loamy I �� Properties Within 150 Feet. Sand 10 YR 5/6 �� Failed THE PROPERTY LINES ARE APPROXIMATE AND 12"-27" Be 95.75 �� Leach Pit COMPILED FROM THE SURVEY PLAN GENERATED BY y `� EXISTING WILLIAM WARWICK & ASSOC.., ENTITLED oomy Sand 1000 GALLON SITE PLAN OF LOT 645 SKUNKNET ROAD, CENTERVILLE, MA" -Box 2.5 Y 8/6 x\ SEPTIC TANK DATED DATED JULY 8, 1985 27"-48' G 94.00 a _ AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN O 0 IT SHOULD BE USED FOR NO PURPOSE OTHER THAN Sand Medium x\ THE SEPTIC SYSTEM INSTALLATION. 2.3 48"-132" C, 8700 PROJECT BENCH MARK -- I TOP OF FOUNDATION _ EXISTING LEACH PIT TO BE PUMPED OUT AND FILLED IN PLACE TOP F FOUNDATION (Assumed) DECK \x� TEST HOLE #1 NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE ELE `x 37.25. . ! ELEV 98.00 FROM THE EXISTING LEACH PIT TO BE DISPOSED r OF AS PER BOARD OF HEALTH SPECIFICATIONS. �� • �' WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY EXISTING Perc #1 3 BEDROOM I BUT, Ar;i OVER }v('i' FROM THE PROPOSED SAS. - Depth to Perc: 42" to 60" F� � - Perc Rate= Less Than 2 MPI ROUSE n1 D ASSESSORS MAP 'i 70 PARCEL 1 17 \` Observed Groundwater = None Obs. #385 ZAl 0' 11 LEGEND - � i I F104X 11 DENOTES PROPOSED I SPOT GRADE 2-18' DIAM. ACCESS MANHOLES I I - 8' 1 1 9B X 104.46 DENOTES EXISTING 4. I SPOT GRADE I I 97 i PL PROPERTY LINE 1 WLET ) --- -_ i i r6 DL PROPOSED CONTOUR / T I 73 5' ----t_-� THE AccEss covEus FOR THE SEPTIC TANK. -- ---- --- -- --- -- -T------T-- ----- ---- 97 - - - - - -97 EXISTING CONTOUR DISTRIBunON Box AND LEACHING COMPONENT 3 I ASPHALT •� -�,-- - �,_ SET DEEPER THAN 6 INCHES BELOW FINISHED ry I I '.'- t-r.�'�.•_. GRADE SHALL BE RAISED TO WITHIN 6' OF I I DRIVEWAY I _ -.. .• - FINISHED GRADE- I 'STEEL"REINFORCED PRECAST CONCRETE DEEP TEST HOLE & PLAN VIEW INSTALL TUF-nTE GAS BAFFLES OR EQUALS LOT #645 I PERCOLATION TEST LOCATION 3-24' REMOVABLE COVERS 16,050 Square Feet +/- I I .---------� 6 FOOT STOCKADE FENCE _ - -- --------------- - _ c 3' min!clearance j t3' IaFt y I I I I I INLET 8_min.T_l2" min. fnNt to wUel 8•min. `; 1f ram- I OUTLET "TT- __. 5' 7• ___� L i L��t t - IIIILLJJJIII 5 - - ________ - ___-_ L _ 65.70' _ _ _ __- ___ ___ PLOT P LAN - - 39 30' - --- -- - -- - --------- -- -!- - I R 3101.02' tI ---- -----------------96 2 Eo °°°. •T OF- PROPOSED SEPTIC SYSTEM UPGRADE 1 - - - -- - -- -- - ---- ---------------------------- ----------------------------- - - E PREPAR D FOR '` "• o- -1 Or"- - MARIA G . KARALIS CROSS SECTION END-SECTION ,S'KUNKN-jE7 T R OA D AT ' TYPICAL 1000 GALLON SEPTIC TANK #385 SKUNKNET ROAD NOT TO SCALE (40 FOOT RIGHT OF WAY) CENTERVILLE, MA Design Calculationsi.,�'�tjoS PREPARED BY: Number of Bedrooms: 3 Equivalent to 330 Gol./Day (330 Gal./Day Min. per Title V)- r I G CARME11r E. ,S'HA Y Garbage Grinder: No Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V) Septic Tank - 2 x 330 Gol./Day = 660 USE EXIST. 1,000 GAL. Septic Tank. No. 1 ENVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch Bottom Area: 0.74 gal/sq. ft. x 370 sq. ft. = 273.8 gallons GrST P.O. BOX 627 1 R� Sidewall Area: 0.74 gal./sq. ft. x 78 sq. ft. = 58 gallons 0 20 40 50 `' S4NITAR\F� EAST FALMOUTH, MA 02536 Providing: = 331.80 gallons _--.__ TEL/FAX : 508-539-7966 Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS, HAVING A 0.83' (10 INCHES) EFFECTIVE DEPTH, ( SCALE: 1 =20' DRAWN BY: CES DATE: APRIL 1 , 2005 TO BE USED NTH 4.0' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE PROJECT SD715 FILENAME: SD715PP.DWG SHEET 1 OF 1 ON THE ENDS. NO STONE UNDER. SCALE: 1"=20