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HomeMy WebLinkAbout0592 SKUNKNET ROAD - Health 592 Skunknet Road Centerville F/R A = 169 .015013 owf1ford, NO. 1521/ RA 30 10% s � c� 0 CARMEN E. SHAY (508)-548-0796 ENVIRONMENTAL SERVICES,INC. P.O. Box 627,East Falmouth,MA 02536 December 31, 2002 RE: Certification of Title V Septic System Installation: Residential Property—592 Skunknet Road, Centerville, MA Dear Sir or Madam: On December 30, 2002, Roger Roberts, Inc. was issued a permit to install a Title V Septic System at 592 Skunknet Road, Centerville, MA, based on a design drawn by Shay Environmental Services, dated, December 28, 2002. XX I Certify That The Septic System Referenced Was Installed Substantially According to the Plan I Certify That the Referenced Above Septic System Was Installed With Changes but in Accordance With State and Local Regulations, Revisions or As-Built Plans/Sketch will Follow. The Septic System Was Not Installed Per State and Local Regulations and Corrective Action is Required. If you have any questions, please do not hesitate to call the undersigned at(508)-548-0796. Sincerely, CARMEN E. SHAY ENVIRONMENTAL SERVICES,INC. 0 M�SS�i 1 c o CARMEN y�N Cn Y Cn Carmen E. Shay, R.S., C.S. 11810 President /S T f' `' SA IAVI I W Pa . V TOWN OFBARNSTABLE � CATION Y-0iik-W—T-- f�//��d1RO SEWAGE # ��—Z07 ,"t!I ,�1>G C E�1 I 12 V i LL.L ASSESSOR'S MAP & LOT �. tLINSTALLER'S NAME&PHONE NO D114-2�GN4—: ,>;d SEPTIC TANK CAPACITY f5 1 S T 7 N�. IOOd 5,4-kV^J LEACHING FACILITY: (type) (size) le' KA�?�/ NO.OF BEDROOMS BUILDER OR OWNER IL NN PERMIT DATE: 3 D tea-- 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) Feet Furnished by r I coo 57 o t A O,7 NEW Nu. ! FEE COMMONWEALTH Or MASSAC14USETTS Board of Health, `¢�(1 �n�2 MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct( ) RepairX Upgrade( ) Abandon( ) - ❑Complete System J ndividual Components Location �1n �l) Owner's Name Map/Parcel# M;�Q q Fwc,�A —, Address 5Ct2 N V� Lot# Ar Telephone# Installer's Name S ; V Designer's Name Address Mfl Address ' Telephone# — S �� Telephone# 54 9 Type of Building � �( Q,(]�t14\ Lot Size 15 1 1 LO d sq.ft. Dwelling-No.of Bedrooms ^� "Q� �?� ) Garbage grinder (/ 1A Other-Type of Building Noce No.of persons Showers ( )rCafeteria (LK Other Fixtures Li#1 AMoU tCts% S�nk Design Flow (min.required) 33 O gpd Calculated design flow 33o Design flow provided 2 4.4A gpd Plan: Date � '���0 vZ Number of sheets Revision Date •- Title Description of Soil(s) a C� Soil Evaluator Form No. Name of Soil Evaluator 6AAMIJ I &A9 Date of Evaluation Ina DESCRIPTION OF REPAIRS OR ALTERATIONS Am The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further ees to of to plac tem' operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date -4pp�o�eG@ 6y -3n-o2 Inspections 2^ D n . . FEE v Board of Health, s- C,�\,e MA. APPLICATION FOP DISPOSAL SYSTEM CONSTRUCTION PERMIT ti Application for a Permit to Construct( ) RepairX Upgrade( ) Abandon( ) - ❑Complete System di Individual Components LocationvrA-)PA-R6• Ci Jt Owner's Name 1 C�i� Jte�C`\C`rG Map/Parcel# �� ,(,C1 7�c� Address;.�t- f� I.T� _ � � ��_ Lot# t 7 Telephone# j Installer's Name. Cif (A S SP_C>A�t C c P.eU1 C Designer's Name ��G f`.��� � S v(5. Address Address -� _ -�� . M�1 ti_,�.x c�,��- . �• �c;1��',e,���,, 1�1 GAS ;.. Telephone# (�� Telephone# y © 9L L 1 ls, sq.ft. � ll Type of Building K0���("�S1S`� C>\ Lot Size Dwelling-No.of Bedrooms �'�r-,� Garbage grinder N/A Other-Type,of Building I V<w) e. OF No.of persons Showers ( ),,,Cafeteria Other Fixtures L c)\,1 ;N-ei�2�? �1 <� B c1 Sink LAUi.►i�R`1 t Design Flow (min.required) -a)---is O gpd Calculated design flow Design flow provided 311;\'A•u 8 gpd Plan: Date � ,� L Q Number of sheets , `Revision Date Title Description of Soil(s) G Soil Evaluator Form No. \\\4 \ Name of Soil Evaluator eo M t4 ` l Ay Date of Evaluation O DESCRIPTION OF REPAIRS OR ALTERATIONS c A� U' c c oA D\m , The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees to not to place-th i e-system in operation until a Certificate of Compliance has been issued by the Board of Health. { Signed t A)t1 f.�1. � �!U 114/1 ks Date 1�`36 t ���Pro�ed �y: iio -3c;-U2 Inspections No. ZC2V Z -(GCi'7 FEED COMMONWEALTH Of MASSACRUS ETTS Board of Health, , MA. CERTIFICATE Of COMPLIANCE Description of Work: b6ndividual Component(s) ❑Complete System' "' The 4ndersigned here�py cef rtiif/y that the Sewyagte,Disposial System; (Constructed ( ),Repaired�(�,Upgraded ( ),Abandoned ( ) at has been installed in accordance with the provisiogs of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. 4002--(007T ,-dated 11 30102 . Approved Design Flow (gpd) Installer t h) .1 I[.�', 14W ..ram"7 . /z I Designer: Inspector: Date: The issuance of this permit shall not be construed as a guarantee that the system will function as designed. No. 700 2 0 7 FEE Board of Health,A l' rA f&b 1,L MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to; Construct( ) R -pair( )' Upgrade( ) Abandon( ) an individual sewage disposal system at ^l���.- _..3►/,u nl/ n .f"t/,, I n J as described in the application for Disposal SystemConstruction Permit No. 2GO2_G67 , dated 1Z'T Z Provided: Construction shall be completed within three years of the date of this perm' . All`c 1-c ditions must be met. Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date 12 6 02 Board of Health TOWN OFBA,RNSTABLE LOCATION 69a SY—u k-w-x- eV'AiJ SEWAGE # �otl�-•-&"07 VILLAGE G Fry i2 V i L(.L ASSESSOR'S MAP & LOT 6&7t INSTALLER'S NAME&PHONE NO SEPTIC TANK CAPACITY � 15TiN L000��A-�1�^J LEACHING FACILrI Y: (type) (size) /D K,34 NO.OF BEDROOMS BUILDER OR OWNER 0JN45- Sl� pQ - '1 21 7n� PERMIT DATE: Q 30-�6a-- COMPLIANCE DATE: Z 3l G 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 r 1 /i 0 �� tcoo517 o fi NEW S,A$,3"HF;LTRaToRS 409"3� FORM 11 - SOIL EVALUATOR FORN Page 1 of No.: Date: 12/27/02 COMMONWEALTH OF MASSACHUSETTS Barnstable , Massachusetts Performed By: Carmen E. Shay Date: 12/27/02 Witnessed By: Waiver Location Address or#592 Skunknet Road Owners Name: Donna Steiding Centervills,MA Address and #592 Skunknet Road, Centerville,MA Lot# (Map— 169,Parcel 15-13) Telephone Number: New Construction : X Repair : OFFICE REVIEW: Published Soil Survey Available: No ❑ Yes ❑ Year Published: Publication Scale: Soil.Map Unit: Drainage Class: Soil Limitations: Surficial Geologic Report Available: No❑ Yes❑ Year Published: Publication Scale: Geologic Material: (Map Unit): Landform: Glacial Outwash Flood Insurance Rate Map: Above 600 Year Flood Boundary: No ❑ Yes a Within 500 Year Flood Boundary: No 57 Yes ❑ Within 100 Year Flood Boundary: No ❑ Yes ❑ Wetland Area: None National Wetland Inventory Map (map Unit): Wetlands Conservancy Program Map (map unit): Current Water Resource Conditions (USGS): Month Range: Above Normal ❑ Normal [�:] Below Normal ❑ Other References Reviewed: USGS Topocraphic Map 1DEP APPROVED FORM 12/7/95 i FORM 11 — SOIL EVALUATOR FORM Page 2 of 3 Location Address or Lot No.: #592 Skunknet Road, Centerville, MA On -Site Review Deep Hole Number: #1 Date: 12/27/02 Time: 10:00 AM Weather: Sunny. Cool Location (identify on site plan): Refer to Sketch Landform: Outwash Plane Position on Landscape (sketch on back): Refer to Sketch Distances From: Open Water Body N/A feet Drainage Way N/A feet Possible Wet Area N/A feet Property Line 25' feet Drinking Water Well N/A feet Other DEEP OBSERVATION HOLE LOG Depth From soil Soil Soil Soil Other Surface Horizon Texture Color Mottling Structure, Stones, (inches) (USDA) (Munsel) Boulders, Consistency, % Gravel oil — 10" AP Sandy 10 YR 3/2 None <5% Gravel, Friable Loam Friable 10" — 30" Bw Sandy 10 YR 5/6 None <5% Gravel, Friable Loam Friable 30" — 42" C' Fine Silty 2.5 Y 7/4 None Fine Sand, 15% gravel, Sand Friable 42" — 120" Cz �_�ne�. 2.5 Y 6/6 None Mec4-Fn.�_Sand, <5% Sand gravel, Loose Parent Material (Geologic): Glacial Outwash Depth to Bedrock:None encountered Depth to Groundwater: Standing Water in the Hole: None Weeping From Face: None F +i^rated Seasonal High Water Table 120" Assumed — No groundwater Observed DEP APPROVED FORM 12/7/95 FORM 11 - SOIL EVALUATOR FORM Page 3 of 3 Location Address or Lot No.: #592 Skunknet Road, Centerville, MA Determination of Seasonal High Water Table Method Used: ❑ Depth observed standing in Observation Hole: N/A inches ❑ Depth weeping from side of Observation Hole: 120 inches (assumed) ❑ Depth to Soil Mottles: None inches ❑ Groundwater Adjustment: None feet Index Well Number: Reading Date: Index Well Level: Adjustment Factor: Adjusted Groundwater Level: N/A DEPTH OF NATURALLY OCCURING PERVIOUS MATERIAL: Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system: Yes CERTIFICATION: I Certify That on September 17, 2000, (date), I have passed the soil evaluators examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Signature: Date: 02 C�a• FORM 12 - PERCOLATION TEST Location Address or Lot No.: #592 Skunknet Road COMMONWEALTH OF MASSACHUSETTS Centerville , Massachusetts Percolation Test Date: 12/27/02 Time: 10:30 AM Observation Hole #: #1 Depth of Perc 1 — 40" "VOAk4D '1 Start Pre-soak 10:30 AM End Pre-soak 10:45 AM Time at 12" 10:59 AM Time at 9 11 :13 AM Time at 6" Time (9-6") Rate Min./inch 5, s .�MPI * Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Performed By: Carmen E. Shay Witnessed By: Waiver Comments: Would Not Hold 24 Gallon Presoak - 5 MPI Site Passed X Site Failed DEP APPROVED FORM 12/7/95 Sege- 20-01 13 : 52 BARNSTABLE HEALTH DEPT 5087906304 P • 02 i sr2S;o, .NOTICE: This Form Is To Be Used For the Repair Of Failed , Septic Systems Only, PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM -, hereby certify that the engineered plan sip ed by Me deteC 1�. �Oo"1 , concern.ing the property located at �_ 51Fvelre � Q_ meets all of the tcl,owlncy nte(ia • Th,s failed system is connected to a residential dwelling only. There are no _oruntrzia! or business uses associated with the dwelling. • T'.e soil is cuss:;ed as CLASS l and the percolation rate is less than or equai to j n_nutes per inch. The applicant may use histoncal data (o conclude this fac' or may :onduct are:,m,nar% tests ac the si;e without a health agent present. • There :s no increase ,n Flow and/or change in use proposed • There are no variances requested or needed. • The bottom Df the proposed leaching facility will not be located less than fourteen I,,) ;ee; aoove the maximum adjusted groundwater table elevation. ,Adjust the ;:-oundwater table using the Frimp(or method when applicable) Piease complete the following: ra.1 "fnp ,,t Grow)(] Surface Elevation (using GIS information) B G.W E;cva(:on O_ .F d;ustmen `�t for high G.W. t16 r� ,_)'F TRHNCF BETWEEN A and B 1 S D — DATE: NOTICE 3asec .j,:on tie above sr.formation, a repair permit wil! be issued for -)edroorn.s Ta�,r:-.um `�r, ,ddiuonat bedrooms are authorized in the future without engineered ep( c syste n plans. _ _ __—•-- �ruh:C'Ac �uccamp f N Permit Number: Date: Completed by: I HIGH GROUNDWATER LEVEL COMPUTATION I i Site Location: ��� S�C15'(l,kru�y RnAo Lot No. Owner: pprtc Q _Address: ut�G+ A� Contractor: fhaq Cn%JtfOt1Qf1C(kdAddress:_��`1D X( � G• �Gt�t�O �.�aS-J(,o I Notes: STEP 1 Measure depth to water table tonearest 1/10 h. .............................................................................. Date month/aav/v .r ' I STEP 2 Using Water-Level Range Zone and Index Well Map locate I site and determine: ! M OA Appropriate index well.................................................... IW OBWater level range zone..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well .................... �l ....... moAt yoar l 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 levelat site (STEP 1) ............................................................................................................. J�.g I � I i i Cape Cod Commission: USGS Well Data -November 2002 Pagel of 2 United States Geological Survey Observation Wells As a service to Cape officials, engineers and other interested parties, the Cape Cod Commission publishes monthly groundwater data gathered by its Water Resources Office. The water level measurements shown below are taken monthly from United States Geological Survey (USGS) observation wells and compiled during the last week of each month. They are published as soon as possible thereafter. Listed below are nine out of the 61 wells measured across Cape Cod by the Commission's Water Resources Office. These nine are employed as index wells to be used with Technical Bulletin 92-001 to predict high groundwater levels. For your convenience, we've also provided links to USGS national and state data. See the last column in the table and the footnotes below. For further information, please contact Hydrologist Gabrielle_Belft at the Commission offices (508-362- 3828). November 2002 USGS Site Water Record Record Departure from Number*I-`I Location Well No. Level* High* Low* Average** (links to US(''S Monthly Overall national water-level database) Barnstable 230 25.6 20.5 26.6 -1.1 -1.9 413956070164301 Barnstable 24W 27.4 20.5 28.6 -2.2 -2.9 414154070165001 Brewster BMW 21 13.4*** 6.9 13.6 -2.6 -3.2 414518070020301. Chatham CGW 138 25.4 20.9 26.6 -0.8 -1.4 414100070011101 Mashpee MIW 29 9.2 5.6 10.0 0.0 -0.6 4_13525070291904 Sandwich 2D52 47.8 45.9 48.2 -0.2 -0.5 414418070241601_ Sandwich ZD3 54.6 45.8 55.1 -3.8 -4.5 414124070265901 Truro TSW 89 12.1 10.2 13.0 0.1 -0.1 420206070045901 Wellfleet W?W 12.2 7.3 12.8 -1.1 -1,7 415353069585401 http://www.capecodcommission.org/wells,htm 12/1 1/2002 Commonwealth of Massachusetts Title 5 Official- Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 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. Please see completeness checklist at the end of the form. Important:when filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your f� �0 cursor-do not Robert Paolini (/ use the return key. Name of Inspector Robert Paolini Se tic,Service Company Name. 17 Playground Lanet. - - Company Address Yarmouthport -�~ MA 02675 City/Town \ State Zip Code 508 362-3555 S14454 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: n Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Ev uation by the Local Approving Authority 1/28114 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•3113 Title 5 ial pection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 page. City/Town State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑x 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: 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): j t5ins•3/13 Title 5 Official Insp ection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 592 Skunknet Rd. Properly Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 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 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 Commonwealth of Massachusetts - Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments "- 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 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 ❑ 0 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 ❑ 0 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ 0 Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner owner's Name information is required for every Centerville MA 02632 1/28/14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ FX1 Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ 0 Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ 0 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ❑x Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ❑x Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ 0 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.] ❑ 0 The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ 0 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 5of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 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 0 ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ 0 Were any of the system components pumped out in the previous two weeks? ❑ 0 Has the system received normal flows in the previous two week period? ❑ 0 Have large volumes of water been introduced to the system recently or as part of this inspection? 0 ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) 0 ❑ Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? 0 ❑ Were all system components, excluding the SAS, located on site? 0 ❑ 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? 0 ❑ 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. ❑ 0 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): 330 t5im•W3 Title 5 Official lmpection Form:Subsurface Sewage Disposal System•Page 6 of V Commonwealth of Massachusetts - Title 5 official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 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 0 No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes 0 No information in this report.) Laundry system inspected? 0 Yes ❑ No Seasonal use? ❑ Yes 0 No Water meter readings, if available last 2 ears usage d na 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes 0 No Last date of occupancy: Date na 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 Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 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 0 No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: 0 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 - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner owner's Name information is required for every Centerville MA 02632 1/28/14 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: Were sewage odors detected when arriving at the site? ❑ Yes ❑x No Building Sewer(locate on site plan): Depth below grade: 2'feet Material of construction: ❑ cast iron ❑x 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of leaka e.System vented through house vents. Septic Tank(locate on site plan): Depth below grade: 18'i feet Material of construction: O 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: 1000 gl. Sludge depth: 4" t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 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 33" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle 12" 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.): Pump tank every 2 years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form R Subsurface Sewage Disposal System Form - Not for Voluntary Assessments " 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 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: 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•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 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 No 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.): Box is Ievel.Box has three outlet Iateral.No evidence of solids carryover.No evidence of leakage. 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 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑x leaching chambers number: 5 HC Infiltrators ❑ 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.): Sandy soil.No signs of hydraulic failure.Leaching chambers were dry at time of inspection Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 X, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cons.) 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 592 Skunknet Rd. Property Address LAUGHTON NATHAN F Owner Owner's Name information is MA 02632 1/28/14 required for every Centerville page. Cityrrown State Zip Code Date of inspection D. System Information (cunt.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent referenoe 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 vk icta�5.� 1 �'JCi NEW S,p.S,TivF;cTRaroPS J , �2,3 Qa�' rdie 5 official Inspection Form:subsurface Sewage Disposal System-page 15 of 17 t5ns-3113 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: t] Check Slope ❑x Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of leaching 12' 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) 0 Checked with local Board of Health-explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS observation well data.USED:Technical bulletin 92-0001 annual ranges of groundwater elevations. 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 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments "r 592 Skunknet Rd. Property Address LAUGHTON, NATHAN F Owner Owner's Name information is required for every Centerville MA 02632 1/28/14 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist M Inspection Summary: A, B, C, D, or E checked 0 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 Forth:Subsurface Sewage Disposal System•Page 17 of 17 LOCATri N SEWAGE PERMIT NO• VILLAGE INSTA LLER'S NAME i ADDRESS d U I L D E R OR OWNER DA T E PERMIT ISSUED _do V DATE COMPLIANCE ISSUED ^ � 9-8� f Lioi-4 � � x . OV 37'te L/ ,No._. 1..J�.. _ Fps........... ............... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH• ��------ -- .......OF.............. `@�' Appfiraation for Disposal Works Tonvtrnrtion Frrmit Application is hereby made for a Permit to Construct ( V1 or Repair ( ) an Individual Sewage Disposal System at \ ... `� = ......- ��. ...�.............•----------.... ............ ---........------.....----- - T` f Location-Address � or�Lo�n^N ......... .J. 1 .. ..............I......... .��\............. .............."J. ..�� .vY!�1......._.........---------.............--- owner Addre s .......L.(.............................. ................ �'�r�1 S= �- -............................---- Installer Address Type of Building Size Lot..\. .....Sq,. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder gym) aOther—Type of Building ............................ No. of persons............_............... Showers ( ) — Cafeteria ( ) PaOther fixtures ...................................................... W Design Flow.................lAQ...................gallons per person per day. Total daily flow_-__-___...33®_____.._....._._._._gallons. WSeptic Tank—Liquid*capacityX-O oOgallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Q Percolation Test Results Performed by........�.C. ? �1.... 0...._��jIf ........ Date__..3:' 1...•• ...... ,.� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------•--•-----•. .................. ... --........-------...-.......---...._..--------------- ----------------.-- 0 Description of Soil...........fJ -• 0 0.M....... �� :S v�..�.L'..� W ---...•••-••------•------------------• ............---mom -----... -------•-- ......--....---•-•--------•------ --•------------------------- -----------------------------------------•--------------....--------------------------------------------•---------------------••----••-------------------..............._ U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------------------------•-------•-•••-----------..... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of IT', . 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed. , - ° �`. ..... ��:5" Date Application Approved By........ ,.. � ` Date Application Disapproved for the following reasons___________________________________________________________________________ ................ --••••---...— ....-•-•-•-----------•-------------•----......__...--------------•--------...---------.......------....--••-----------•--••••----•-•---------------------------......•----•-••-•----•-••••--•--...•----- Date PermitNo......................................................... Issued....................................................... — -- — --- --- Date -- -- S yNo .�...J�.9 .��» :; Fes$.... ©.." A) .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH LG. .................OF............ C,li...... ApplirFation for Disposal Works Toustrurtion rumit Application is hereby made for 'a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: ............`:»........». .....- - -_ ............................... ..•-•---•--................-=......•. ......................................... --- Location-Address _ or, Lot No. :._....__.»............ .......................................... ---•--••-•---•--••----•---••---- Owner Address t -� t -- e-... ............................................................. -- ._ .:. Installer � Address Type of Building Size Lot.. ..,t ......Sq. feet Dwelling—No. of Bedrooms...........................................Expansion Attic ( ) Garbage Grinder (U J) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ............................................................ •-•----------•--------------------------••----------------•-----•-.---------- WDesign Flow................. ......................gallons per person per day. Total daily flow.........._ .`"_______._._._____.._gallons. WSeptic Tank—Liquid capacit0.v°9.gallons Length................ Width................ Diameter .... Depth................ x Disposal Trench—No..................... Vidth.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter..................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by....... _�_� ._�'A___ �` �'�-'_V-'--..-.--- Date._..�` ........... ` c' � .... �,,_.......... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 0:4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ••---•-•---•------------•----••••................ ......•-•••-.....-- .....---•----------........•....................................................... U Description of Soil...........`.:.. e Z............... --`-=--ct..�....------'. ................J\) •-u-k3._"A............................................ ---------------------r..... .........-.....�:.-----•---•_.. °_ '. ............................. .............. _ ................................. UNature of Repairs or Alterations—Answer when applicable................................................................................................ ----------------------------------•-•--------------------------•----------------------------.........---•----------------------------------------------•-••--------••-•-•-•-•--..........._.........--•' Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TTTT-2 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed.-•-----•--- t«^^^^ g .......................... ........... ....,�0 � ..- S - C • •......--•--•...... ad Application Approved B ,,ems De Date Application Disapproved for the following reasons-----------------------•------------------------------------................................................. -------------------------------•-----•----•--------------••---------------...---------.......•-•---------••---.••••••-•-•-••---- ....................................... ............................... Date PermitNo......................................................... Issued------------------------...--•--•--•---•-••----------. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .:: ?...................OF.............�..C.. ...` ......... ......................... TrrtifirFatr of TompliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by.................... ==' '= ' r ................` ...... �..-- ------------------------------ ;.: Installer �7 ` 7 .. t.) -'"`��i C' \_L l L � `.^•'�..n �.�. \ i \�---- at .... ----..•---------------- ------------------...----------•-------------._........-----•-•••••--•--•. has been installed in accordance with the provisions of T v' c f,The State Sanitary Code as described in the application for Disposal Works Construction Permit No. ...................... dated----------- ---------------_..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE---••---------•---••-•--.-•-•-- L=... .n e---------------------------•. Inspector-•-•--. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `rdo N6......................... Disposal Works TDono#rurtion rrmi# Permission is hereby granted..............L!.._. ............ =`S-�•...--•--•-•-----••-•-••••••••-••-•••--....---•-...........--•-- to Construct ( 01-l'or Repair ( ) an Individual Sewage Disposal System at No. =' ---•-•................. ---� ..................... ..................... .. « C �...._T. ..i.� v.�.1 .L Street as shown on the application for Disposal Works Constructio t No..................... Date ........____...................._......... / oard of Health DATE...... --......_...�° � .............. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS - t>wL-,( FL�Ow c t10 4 3 33o 4-P•T7. Q ISo• t o' I Z. d..£�T I C "TAt`J K ¢ 330 r IS O % + 49 5 i ROSAL. t?IT USE loon tsAL. _ too,4 STCU)AL-i- Amy. - (so S.P. , S coo f ISo S;; " 2.S + 3 7$ G.P.O. BOT-rOAA &Or-- Q So Sr--. r �Nc , °•z D,Box P+I T �. 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NAMES I i Barnstable Assessing Search results Page 1 of 2 ip m„ s 2-1 63 , a ` `: ✓ Home: Departments:Assessors Division: Property Assessment Search Results —back to search 592 S'KUNKNET ROAD Owner: Property Sketch Legend STEIDING, DONNA L Map/Parcel/Parcel Extension = 169 /015/013 Mailing Address ' STEIDING, DONNA L 6. ��33 1113�II��'33�11333..A 592 SKUNKNET RD l CENTERVILLE, MA. 02632 Assessed Values: 93, 33 Appraised Value Assessed Value Building Value: $80,000 $80,000 Extra Features: $2,600 $2,600 Outbuildings: $600 $600 Land Value: $44,900 $44,900 Interactive Property Map: ap requires Plug in: Totals:$ 128,100 $ 128,100 1 have visited the maps before . Show Me The Map Sales History: Owner: Sale Date Book/Page: Sale,Price: STEIDING, DONNA L 3412/105 $0 Tax.Information: Tax Rates: (per$1,000 of valuation) Town Tax $ 1,186.21 Town Fire District Rates Other Rates 9.26 Barnstable 2.61 Land Bank 3%of Town Tax C.O.M.M. FD Tax $ 176.78 C.O.M.M. 1.38 Cotuit 1.69 Land Bank Tax $ 1,398.58 Hyannis 2.54 West Barnstable 1.54 Total: $ 1,398.58 Due to rounding differences these values may vary Land and Building Information http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/... 11/8/2002 Barnstable Assessing Searchrkesults Page 2 of 2 Land Building Lot Size(Acres) 0.35 Year Built 1981 Appraised Value $44,900 Living Area 816 Assessed Value $44,900 Replacement Cost$90,943 Depreciation 12 Building Value 80,000 Construction Details Style Cape Cod Interior Floors Hardwood Model Residential Interior Walls Drywall Grade Average Grade Heat Fuel Gas Stories 1 314 Stories Heat Type Hot Water Exterior Walls Wood Shingle AC Type None Roof Structure Gambrel Bedrooms 2 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 1 Bathroom Total Rooms 5 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value SHED Shed 80 $600 $600 FPL2 Fireplace 1 $2,600 $2,600 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) i CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area (Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/`... 11/8/2002 I I 1 I 1 I 1 _ r , ll/ i. i _ I � i { I ; 1 , 1 I 4 I I I. : { r : i : : _ I _ f 1 , , , 1 ` i _ I ' I I : i. 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I III Mach ai x k-i Vv 77 U-0 6 Sub r —W-At ((0 I i.. .'.. _. _ I i ' I ! ..- {t if Ir • JL_ L 4, t 7 L j , I f_ I i -I �5.,,_. ».f_ `,. i,. � ry �� ') I � -! i t I I- i _� I_. .� - I I i � � � ' I i I I i -A SECTION A A 1' = 2000' +/- 10' mina from ALL OUTLET PIPES FROM THE O house to septic tank NOTE: ALL PIPES ARE TO BE 4" SCHEDULE 40 P.V.C. PROFILE VIEW OF ADDITION TO-LEACHING SYSTEM DISTRIBUTION sox SHALL BE Antes Wa q Existing Foundation SET LEVEL FOR AT LEAST 2 FT. 12" CONCRETE COVER Septic tone covert mutt De 3" of 1/8" - 1/2" Woshed Peoslone q within E in. of finished grode )_ //NGrode over Septic Tank - 99.00 Geode over D-Bo. - 99.00 -Geode over SAS-9900 3/4' to 1 1/2 " Washed Crushed Stone 3 - 5'OUTLET ^"' ='-s•.'. 2 - "'�, KNOCKOUT$ - -,55' Li 5 . 0.02 /. OUTLET 12 INLET 3 HOLE M-10 {' N 25' EXIST. S.O Ot DIST. BOX 3' Maximum Cover - 6' E 2- Z Y p�pC SITE R Top of SAS Elev. _96,00 .` T o E 1 2$ ExIST, PIPE 1,000 GAL. S- 0.080' per foot ~,SS' Y 4" - SCH. 40 7e ZH RIJ ' FROM EXIST. FDUNDATIDN w SEPTIC TANK n 25' 2' Effective Depth r 1.75' F Af<M�11 n ch H-10 Io "> 0 6 units I? 6' 30' o-s.a 0 1' .STONE UNDER CHAMBERS PLAN SECTION CROSS-SECTION CONCRETE FULL FOUNt7Ai10 > II to p Q 1' 3' 3` u v 0) n 30, SYSTEM PROFILE " 6 in.o1 3/4"-, ,/r n L 36 3 HOLE H-10 DISTRIBUTION BOX MAP [� compocied stone > y y n Effective Length NOT TO SCALE LOCUS I"t f 1 f Not to Stole c > 9 9 - 0 4 4 > c _2-5' SOIL ABSORPTION SYSTEM (SAS) 6 in.of 3/4'-1 1/2' c t0 . compacted stone Effective vlath m CULTEC MODEL 125 (H-10 LOADING)/ SHOREY PRECASTS Q9Ltsrr_9t_i�>ELr�+s_s_et�.- ------- (OR EOUIVALENT)Not to Scale GENERAL NOTES NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18' /EFFECTIVE HEIGHT IS 12" 1. Contractor is responsible for Digsofe notification and protection of oil underground utilities and pipes. 2. The septic tank and distribution box shall be set level on 6" of 3/4"-1 1/2" stone. 2-18" DIAM. ACCESS MANHOLES 3. Bockfill should be Clean sand or grovel with no stones over 3" in size. 8 4. This system is subject to inspection during installation by Carmen E. Shay -- Environmental Services, Inca x+ 5. The contractor shall install this system in accordance PROJECT BENCH MARK with Title V of the Massachusetts state code, the approved plan \ / v THE ACCESS COVERS FOR THE SEPTIC TANK, TOP OF FOUNDATION LOT #12 LOT #15 and Local Regulations, INLET 1 DISTRIBUTION BOX AND LEACHING COMPONENT 6. If, during installation the contractor encounters any OUT ET SET DEEPER THAN 6 INCHES BELOW FINISHED ELEV. 1 OO.00 (Assumed) soil conditions or site conditions that are different GRADE SHALL BE RAISED TO WITHIN 6" OF •I },( FINISHED GRADE. from those Shown On the soil log or in our design INSTALL TVF-TITE GAS BAFFLES OR EOUALS , „ installotion must halt & immediate notification be ', -•-- -.,-,�- -�`: S 12c1 06 18 W 100 mode to Carmen E. Shay - Environmental Services, Inc. �-' 101.00' 7. No vehicle or heavy machinery shall drive over the STEEL REINFORCED PRECAST CONCRETE septic system unless noted as H-20 septic components. PLAN VIEW 8, Install Tuf-Tite gas baffles or equals on all outlet tee ends. ' 3-24".REMOVABLE COVERS 9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC p;pes. � �. < 1 SHED /� 10. All solid piping, tees & fittings shall be 4" diameter LOT #13 Schedule 40 NSF PVC pipes with water tight joints. _ 11. Municipal Water is Connected to The Residence and Abutting __3' min'Neoronce �` s. INLET �' 15,160 Square Feet f�- r p INLET a" minT t2' mm. inlet to outlet 6- 11f T Propertiesth n 50 F OUTLET Within 1 Feet. Liquid level - _�` � ------------ --99 �0V� 4'-0" met THE PROPERTY LINES ARE APPROXIMATE AND o B Liquid depth , COMPILED FROM THE SURVEY PLAN GENERATED BY BAXTER & NYE, INC, SURVEYORS. OF OSTERVILLE, MA PLAN OF HOLE #1 ENTITLED LAND IN CEN ERVIL E, MA" ! W ELEV.= 98.92 W DATED OCT. 25, 1979, BOOK 339, PAGE 49 a -10 ' 36' f3.5' AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN IT SHOULD BE USED FOR NO PURPOSE OTHER THAN CROSS SECTION END-SECTION Failed Leach Pit THE SEPTIC SYSTEM INSTALLATION. � � �� s, ?;.. .;�ari.ti'�_'i;.:,. :•.�-w.,_ cl- c1-:I I I - I - �"!"l .1 ko ....<< - - _ __[ EXIST._.1000_ of USE EXISTING ,_1000__GALLON H 10 :SEPTIC TANK __ _ ____ � -- �� Septic Tank NOT TO SCALE i� �' t. LEGEND co PERCOLATION TEST 99"" o z °-Box DENOTES PROPOSED LOT 04 104X 1 SPOT GRADE Date of Percolation Test: DECEMBER 26, 2002 BECK Test Performed By. CARMEN E. SHAY, R.S., C.S-E. X 104.46 DENOTES EXISTING Results Witnessed By- WAIVER ( per Barnstable B.O.H-) SPOT GRADE Excavator: Roberts Septic Services /ZZIIZZJZ,- ......... ........... .......... Percolation Rate: Less Than 2 MPI EXISTING - '1-I PL PROPERTY LINE •0 3 BEDROOM ; 96P� PROPOSED CONTOUR HO UJE O I Test Hole o i F -1 i - - - - - -97 EXISTING CONTOUR h #592 No. 1 DEPTH SOILS ELEV- ; ® DEEP TEST HOLE & o 98,92 PERCOLATION TEST LOCATION Sandy j Loom p I Q l j 333 Q 3 I Exist. Timber 10 Y 3/z _: 1 S w I �J Retaining Wall •---• 6 FOOT STOCKADE FENCE 0"-10" A 98.00 N �� I Sandy Loon 1 I t 10 YR 5/6 s. 99- ------------------------- --- ------ ---�__-7 10"- 30" 96.42 ( I i Fine Silty Sand 9g----------------------______'D_-_ 98 P LOT PLAN ----------------- _____ I 2.5 Y 7/4 101.00' - { 30'-42' C, 95.42 S 12d 06' 18" W I V,E4-`Vr n 97---------------------- ------------------- ------------97 OF PROPOSED S E PTI 1_11 SYSTEM UPGRADE T5 Y 6/6 PREPARED FOR {42--i20- 88.92 Depth Depthto Perc: 48" t% 66" � 0-,4MS DONNA STEfDING Pert Rofote= Less That1$MPI Groundwater Not Observed AT [� No Observed ESHWT (40 FOOT R)CLh1T OF WAY} # 592 S �� U N N ET ROAD ADJUSTED H2O Elev. = None Design Calculations 0 20 40 50 CENTERV{ LLF, MA �OF Number of Bedrooms: 3 Equivalent to 330 Col./Doy (330 Gol./Day Min. per Title V) �� PREPARED BY: Garbage Grinder: No 02� R E�Cy'I L/J�` R J��////r//ITN /(7�' /U/ GAS Y .Leaching Capacity Proposed: 330 Gal./Doy Minimum (Min. Per Title V) E /`l �'. qC1 J..L Y 1/1 L.I 1 I L/ a S l.L 1 l Septic Tank : - 3 x 330 Gal./Doy = 660 USE 1,500 GAL. Septic Tank, SCALE: 1"=20' s y SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch o 81 •'ENVIRONMENTAL SERVICES, INC. Bottom Area: 0.74 gal/sq. ft. x 360 sq. ft. = 266.4 gallons Sidewall Area: 0.74 got./sq. ft. x 92 sq. ft. = 68.08 gallons �c� P.O. BOX 627 Providing: 334.48 gallons EXISTING LEACH PIT TO BE PUMPED & FILI ED IN PLACE S'9NITAP�a EAST FALMOUTH, MA 02536 Use: (5) CULTEC MODEL 135 UNITS, HAVING A 1' EFFECTIVE DEPTH, TEL/FAX 508-548-0796 TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND 3' OF WASHED STONE NOTE: ANY STRIPPED OUT SOIL CONTAINING TEACHATE SCALE: 1"=20' DRAWN BY CES DATE: DEC.. 28, 2002 ON THE ENDS. NO STONE UNDER. FROM THE EXISTING LEACH PIT TO BE DISPOSED OF AS PER BOARD OF HEALTH SPECIFICATIONS. PROJECT#SD372 FILENAME: SD372PP.DWG SHEET 1 OF 1