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0562 SOUTH MAIN STREET - Health
.._.._.._.. ...._____ :__...__ 5S2'South Main Street Centerville F/R r+ A 186 047 IN UPC 12534 i No.2-153LOR 0ftr, NASTINOi.UN r ' r Health Master Detail Page 1 of 1 9, �au is d/" .w _ �„ �,� ,!�, � "�,,. �•�.,x5s•„g:� ^`,� a.'�"„# "�.^` 'a i�g• Logged in As: TOWN\rnalkusk Health Master Detail Wednesday,November 7 2018 Application Center Parcel Lookup Selection Items Parcel Septic Perc Well Fuel Tank Parcel: 186-047 Location: 562 SOUTH MAIN STREET,Centerville Owner: EFTIMIADES, MARIA Septic 1, 8/21/2003 New Septic... Permit number: I 2003403 i Permit type: ISelect type V! Complete system: El Issue date ; 8/21/2003 711H Complete date : 9/15/2003 p Type/Size _.. infiltrators I Septic tank size: T e/Size of SAS: 24 standard infiltr Installer: J§elect Installer j Card on file: I/A service type: 1,Select service V Innovative/Alternative Technology type: Singulair. V Variance date : F I Abandon complete date : Abandon permit number: Repair deadline date : F- Repair notification date : Keyword: I Comments: A ............................. ......... variance granted 5 bedrooms - I/A monitoring w/ ;�--� � Delete Septic Winston Steadman (May2014) AI V! i Inspection 1/4/2003 1 New Inspection... Number Inspection Date Inspector Result 1M 1/4/2003 Ford,James M. , Ford Septic Services V" F/R(Fail/Repaired) V 1 � The following condition(s) are occurring: ❑ discharge or ponding of effluent to the surface of the ground ❑ pumping more than 4 times during the last year NOT due to clogged or obstructed pipe ❑ backup of sewage into facility or system component 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 ❑ any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ any portion of the cesspool within a Zone 1 to a public well ❑ any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis Received Date Comments 79 ._ j Delete Inspection Save Septic Changes I I Return to Lookup http://issgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID=186047 11/7/2018 Page 1 of 1 LOP- i'C�i4C 5Iv https((septic.barnstablemuntyheakh.orgjregipermits(edit/32481new:1 Q�i�®s� PerMts X LOP- o I File Edit View Fannies Took Help rT2 Reference Cards Harmful Al... $Cyanobacterial Harmful Alg... #5ecd-d Recertification ®http--wwwdearrtide5.org-... Massachusetts Department... t }Algae information Mass w Research and News Nutrie...Edit Permit am I Nlain PC,[ --T T _ Town Permit# 2003-403 Address 1 562 South Main Dep Approval Remedial v Address 2 r - _ . -- r �s Groundwater No v Zip Code 02632 i 4 Discharge —- - ___ ---- - -- - Village-fFTi Centerville ' Assessor Map 186 x _ . . i Property Type '(Multi-Family Residential v Assessor Parcel 047 _... ___. Occupancy Seasonal v _ #Occupants --- ------ Bon Approval Date ±2003-06_18 #Bedrooms 5 ----- - --_ --__ - ---__._------_._ Install Date 2003-09-17 #Bathrooms 4 2.5 _ _ _ __---.---- _ CDC Date [2003-08-21 ] t Startup Date 2003-09-21 MA Design Flow i 550 , Sas Size i 754 —] i ------ ---- ? 'Designer ;Sweetser Engineering v Parcel Size .16 ]acres v I - --- — - -- 1 .Installer Bortolotti Construction v Convert to Acres 3 Nitrogen h 'Zone II Interim Wellhead Protection Area No " Other Nitrogen Sensitive Area (No v ` • � � Q I Save Cancel j y ini :"de`17Wa9 Prat area nb,c-. © `! IS " hert�e.'Sersi tirc.L.rca.' Ro' v ....-.-- •--�-- _ .�;.,.-_- ..._.__ Customize.., 1lEsxx fn,@� ,/� 10 95 AM I' it 'Start 1 7- Alt T- lv� Ir'" I Y'V1 11(7(2018 Kit; file:///C:/Users/malkusk/Desktop/bc.gif 11/1/2018 YOU;WISHTO OPEN A BUSINESS? .. For Your inform anon. 8usines .c rt icaties(co t$ 1abb for ears);:;A bus111ess er ifcate JNLY REGISTERS YOUR NAME inaown (which ou ust o:b M G L it:tities nod. ova you petrnrsslon tc►operate.] You must first iabtaxn th.e rie.Cessary,:signatures on;this form at 200 Maui St,.Hyannis: I m. d..: y ,. 9 r ll an et:ahe Business Certifieate'that is Take the'compf:efed:farm to tl�e:Tnwi�srlerk s tDfi%:ce,.1<st FI , 367 Maln St, Hyannis;lY)A C�2,60 f (To.wn H.a ) d g. requ lied by law;. ....... _. _.. . .... DATE L Fill to please: APPUCANTS> YOUFi'NAME/S w l ,�,�` ( f BUSINESS YD.UA:HDNIE'ADORESS 1 .z �a,,�ri'iila TELEPHONE #' Horne Telephone Number ? OR EIN #.. =MAIL. I ark r:. NAME OF CORPORATION :5 7 e a NAME OF'NEW BUSINESS• TYRE OFBUSINESS IS:THIS A HOME OCCUPATIONS YES NO ADDRESS DF:BUSINESS..r " - S"r1Qa�� C a✓� e f.y, l l MAP/PARCELMIVIBER [Assessing) x; ew,'busiriess thsrearta sevara.I tF`In s:yi w rrJu's dfl 1 ord rta 6e In Mplii nee with tha rules and'regufations oft s T wr'. n : When star6ing e n 9 .. Lai to:This fdrrn:Is Intandsd taassist. ou tn;:gb alr�In.g the it#forrna..t orb y> u<rr�ay eed Yu r IVtI ST GD TO 200 Marn,St (cprner of Yarmouth` Barns...... Y Rd &I1Ia�n 5treetj td malts sure ypu have the apropciate perrrtlts a'rtd liberlses requErd to legally agerate your business In t is town MUST COMPLY WITH rHOMEr OCCUPATION 'I. UILIING GOM1Vt1SSIQAIE RULES AND REGULATIONS FAILURE TO This. diuldualol'any p � uirernents that pertain ta. is type i f business: CON1F4`P MAY RtFs_Q�,r IN FIN uthor►zed Signa urGO Ar . _.... 2. B0ARD OF HEALTH M This in..dtvidual has been anforme ermit requirements that pertain to this type of business: US' 071APLYWITH ALL kIAZARDQU MATERIALS RE0l�1rA`ti"10VS Authorized 81gifature** C0.MMENTS GC GCiS �S 1— - 3. CONSUMER AFFAIRS[LICENSING AUTHORITY) Ehls tnc}ividuel..has been informed:gftheaicensing>requ�remants;tl at pertain to:this type of tiuslness::: Author lzed Signature*'* CDMIUIENTS: Fi f «. r= I R h Town of Barnstable Barnstable Regulatory Services Department MASSPublic Health Division I I 1639 1� A 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO I CERTIFIED MAIL # 7012 1010 0000 2851 2811 March 19, 2014 Maria Eftimiades 1623 3RD Avenue Apt. #14F New York, New York 10128 RE: Massachusetts Department of Environment Protection (MA DEP) ID and Operation and Maintenance Contract for the Innovative Septic System installed at 562 South Main Street, Centerville in the Town of Barnstable. As of today's date, the Massachusetts Department of Environment Protection ID for your Singular innovative/alternative wastewater treatment system has not been registered with the Barnstable County Department of Health and Environment, or the Town of Barnstable Health Division. Also, there is no evidence in our files of an operation and maintenance contract for your system. Therefore we are writing to instruct you that the Massachusetts Department of Environment Protection (MA DEP) and the Town of Barnstable require you to keep an Operation and Maintenance (O&M) contract in effect at all times for your system. Information about these requirements-may be found at http://www.barnstablecountyhealth.org/ia-systems/ia-owners-guide. The Public Health Division is hereby contacting you to inform you of the above requirement and to order you to comply. Accordingly please forward a copy of a signed contract via mail, fax or e-mail within thirty (30) days of receipt of this letter. Please be advised that if you do not respond within thirty (30) days of your receipt of this letter by forwarding a copy of an assigned contract, you will be scheduled to appear before the Board of Health at a show cause hearing on May 13, 2014 to provide information relative to the required contract. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S. CHO Agent of the Board of Health Health Master Detail Page 1 of 1 } d sr Ls ,� ���j���er rr G��•..�. N ��' „".a,t� r" s"Y, �- �� � �,�mr� �a v� �� Logged In As: TOWN\malkusk Health Master Detail Wednesday, March 19 2014 Application Center Parcel Lookup Selection Items Parcel Septic Perc Well Fuel Tank Parcel: 207-005 Location: 446 SOUTH MAIN STREET, CENTERVILLE Owner: EFTIMIADES, MARIA Business name: Business phone:�— Rental property: Ci Deed restricted: r Number of bedrooms : 0! Contaminant released: r' Fuel storage tank permit: Save Parcel ChangesLookup—� Parcel Info Parcel ID: 207-005 Developer lot: Location:446 SOUTH MAIN STREET Primary frontage: 138 Secondary road: Secondary frontage: Village:CENTERVILLE Fire district:C-O-MM Town sewer exists at this address: No Road Index: 1507 Interactive map Town zone of contribution:AP (Aquifer Protection Overlay District) State zone of contribution:OUT Owner Info Owner: EFTIMIADES, MARIA Co-Owner: Streetl: 1623 3RD AVENUE, APT #14F Street2: City:NEW YORK State:NY Zip: 10128 Country: Deed date:2/1/2008 Deed reference:22643/179 Land Info Acres: 0.60 Use: Single Fam MDL-01 Zoning:RD-1 Neighborhood: 0109 Topography:Level Road:Paved Utilities:Public Water,Gas,Septic Location:Rear Location Construction Info Building No ear Bull Gross Area Living Area Bedrooms Bathrooms 1 1900 2296 1313 3 Bedroom 1 Full + 1H Buildings value:$99,200.00 Extra features: $21,000.00 Land value: $267,000.00 http://issgl2/i,tranet/healthMaster/HealthMasterDetail.aspx?ID=207005 3/19/2014 Postal (DomesticC3 CERTIFIED�MAIL. RECEIPT Only;-No Insurance Coverage Provided) �- fU For delivery information visit our website at www.usps.come coLrf Postage $ __ pk S f M Certified Fee /�- p Postmark ReturnReceipt Fee 6 p (Endorsement Required) � Fw i ere a p Restricted Delivery Fee p (Endorsement Required) rq MTotal Postage&Fees (�s P S r� ru Sent To _1= �- '� -- --------- p Street Apt No.; c/ Cam/ (� or PO Box No.--- _-d_------ -CJO r�--L�(� �----------------- City State,Z/P ((14D t� 7 _PS ForT_:��00-,Au%u-st.2006 See Reverse for Instructions Certified Mail Provides: ■ Amailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mailcei..' ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when.making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 Please note, we've moved!! - tAean s 8�Wheler, LLC 1545 lyannough Road Hyannis,MA 02601 (508)362-5680(p)•(508)362-5684(f) i800.229.5629 www.stearnswheler.com U.S.POSTAGE»PITNEY BOWES p THE F +- �Po Iwo Town of Barnstable Public Health Division MR MASS. .200 Main.Street _ € ZIP 02601 $ 006.9'80 Hyannis,MA 02601 { 02 1YV 0001.383424FEB. 18. 2014 7012 1010 o020 2851 246J- t- -� -�- j r-Y-, lvw Y'---) l—o-r' e �JM R E TURN TO S E bl D-E UNABLE TO FORWARD I { BC: 32601400200 *0822-22388-18-43 _ is •. _, _ C 4'002 I di'll-flifl1mli ot0l�Doi11 14a fS �i�s3+:1'1 i'�ll��ll s � . ' s � �- SENDER: • •N COMPLETE THIS.SECTIONON DELIVERY i ■ Complete items 1,2,and 3.Also complete A. Signature j tN I i em 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee C -O that we can return the card to you.■ ttach this card to the back of the.mailpiece, B. Received by(Printed Name) C, Date of Delivery h I on the front if space permits. 3 I D. Is delivery address different from item 0 ❑Yes p�. I 1 Addressed to: If YES,enter delivery address below ❑ No r I S u c E r N L—a rN z S CL_03 1 3. Service Type ,� t 2Lertified Mail ❑Express Mail I \ d ❑ Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. i 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number -��-- � --'"`-- ---��-- I / 7 012 1 10 0000 2851 2460 (Transfer from service label) I PS'Form 381 1.Februarv.2004 Domestic Return Recei t P +��. 102595-02-FA-1540,- ..��._. . i i Town of Barnstable Barn Regulatory Services. Department ` BA MAS& Public Health Division o 39. a`0 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Interim Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0000 2851 2460 02/14/2014 Maria Eftimiades 8 Sylvan Lane - - Sag Harbor, NY 11903 RE: Massachusetts Department of Environment Protection (MA DEP) ID and Operation and Maintenance Contract for the Innovative Septic System installed at 562 South Main Street, Centerville in the Town of Barnstable. As of today's date, the Massachusetts Department of Environment Protection ID for your Singular innovative/alternative wastewater treatment system has not been registered with the Barnstable County Department of Health and Environment, or the Town of Barnstable Health Division. Also, there is no evidence in our files of an operation and maintenance contract for your system. Therefore we are writing to instruct you that the Massachusetts Department of Environment Protection (MA DEP) and the Town of Barnstable require you to keep an Operation and Maintenance (O&M) contract in effect at all times for your system. Information about these requirements may be found at http://www.barnstablecountyheaIth.org/ia-systems/ia-owners-guide. The Public Health Division is hereby contacting you to inform you of the above requirement and to order you to comply. Accordingly please forward a copy of a signed contract via mail, fax or e-mail within thirty (30) days of receipt of this letter. Please be advised that if you do not respond within thirty (30) days of your receipt of this letter by forwarding a copy of an assigned contract, you will be scheduled to appear before the Board of Health at a show cause hearing on March 11, 2014 to provide information relative to the required contract. PER ORDER OF THE BOARD OF HEALTH o cKean, R.S. CHO Agent of the Board of Health SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Si ure item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to.you. c ed by rint a gat of Delivery ■ Attach this.card to the back.of the mailpiece, ,� t�t �(/� , or on the front if space permits. i Article Addressed to: . Is delivery address different from item Yes , If YES,,enter delivery address b/elow: O P10?6;dde 1 N C W yO e C 3. Service Type t (,Certified Mail ❑Express Mail (� i �� ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑.Yes 2, Article Number( 7 012 �010 0 0 0 0 2 8 51 2 811 v' IFansfer from service label) � PS Form 3811. February 2004 Domestic Return Receipt 102595-02-M4546 r UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid I To s R OF Permit No.G-10. . I ` Send.: • er: Please print yes PRie$ VddA s and ZIP+4 in this box I fo�wrr` f Barns b I y Health`Dvison 200 Main Street I I l Hyannis,MA 02601 I J I I I I 1+I)II'l► lls111111'Iil1iI)i„Mill iIi»il IIIlliqrr11i►111+11111 . I Postal .CERTIFIED MAILTMRECEIPT (Domestic Mail Only;No Insurance Coverage Provided) For delivery information visit our website at www.usps.come rR OFFICIAL USPE �O Postage $nj �Pr�N 0 S Iv1� Certified Fee 0 O Postmark C, a Return Receipt Fee q 1 0 p p (Endorsement Required) ?�e� 0 Restricted Delivery Fee i Q (Endorsement Required) , p Total Postage&Fees $ GSPs 1'9 _. Sent To M IU 1 0 1 C1_-, to�_S rq �lYJ Street,Apt No., or PO Box No. 2 3 Qom( � �,ry s�ie:ziP� y 3 �y� 11 Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of. delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For.an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it'when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 THE 'Town of Barnstable Barn r Regulatory Services Department ftaft `"ter Public Health DivisionSTA I �FD MId°�� 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard Scali,Interim Director ` FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7012 1010 0000 2851 2460 02/14/2014 Maria Eftimiades 18 Sylvan Lane Sag Harbor, NY 11903 RE: Massachusetts Department of Environment Protection (MA DEP) ID and Operation and Maintenance Contract for the Innovative Septic System installed at 562 South Main Street, Centerville in the Town of Barnstable. As of today's date, the Massachusetts Department of Environment Protection ID for your Singular innovative/alternative wastewater treatment system has not been registered with the Barnstable County Department of Health and Environment, or the Town of Barnstable Health Division. Also, there is no evidence in our files of an operation and maintenance contract for your system. Therefore we are writing to instruct you that the Massachusetts Department of Environment Protection (MA DEP) and the Town of Barnstable require you to keep an Operation and Maintenance (O&M) contract in effect at all times for your system. Information about these requirements may be found at http://www.barnstablecountVhealth.orq/ia-systems/ia-owners-guide. The Public Health Division is hereby contacting you to inform you of the above requirement and to order you to comply. Accordingly please forward a copy of a signed contract via mail, fax or e-mail within thirty (30) days of receipt of this letter. Please be advised that if you do not respond within thirty (30) days of your receipt of this letter by forwarding a copy of an assigned contract, you will be scheduled to appear before the Board of Health at a show cause hearing on March 11, 2014 to provide information relative to the required contract. PER ORDER OF THE BOARD OF HEALTH f o cKean, R.S. CHO Agent of the Board of Health March 1, 2004 Siegmund ENVIRONMENTAL SERVICES,iNC. Dr. Dale Saad 49 PAVILION AVENUE Health Department PROVIDENCE, RI 02905 Barnstable Board of Health 200 Main Street P/401/785/01 30 Hyannis, MA 02601 F/401/785/3110 www.siegmundgroup.com Dear Dr. Saad, HUNGARY Enclosed, please find copies of the MA DEP Inspection reports for the following Marlett Kft. Singulair®Wastewater Treatment Systems currently in operation in Barnstable: and Profes-Aqua,Kft, Budapest Address MA DEP ID 55 Tonela Road, Barnstable SING5.7_ RUSSIA 562 Main Street, Centerville Not Yet Assigned Sesi-Krasnodar Krasnodar If you have any questions regarding the enclosed information, please do not hesitate to contact me directly. SLOVAK REPUBLIC Ekostor/usa spot.sr.o. Tomasov i WEST INDIES 1 Rosewater system Reardss, g , St.Maarten I McAlastair,Ltd. O ister . Sieg d M n Nevis enc. cc:file PLUM THOMM0091 (EL RAM AM gMM &N, I assachusett� Department of Env r Onmsntaf PrO ticn Bur—au at Resource PMteCdcn-i e 5 DEP Approved nspGC jo and O&M Foams for Tide 5 11 Treatment and Dis � ���� A. Installa ' lt -�--- fotcrss cer the ase =1y ft tM6 key FacRy Street Ad*e s to move your cursor-do i^t city Zip key, Mailing address of owner if different city stagy T phene Mu bef . f B. Authorized Service Provider _cam F� -i state j �1)74rs _0130erL I T � Gertdted Opwatan certiriezticr:�er i i C.-FacMVjSyztem Information 96 0 1 DEP 1D Mam.ftCurer ID tip &rcr:f Installation tt to Start of peration Approval Type:'General Q PMVisio tal[l PHO ing Q Remedial �Seascnai Residence-used less than 6 ma.lyear ' es❑Na j - i D. opera i Or an irxstse�san bate �reviaus!ns n r Stnclge Depth go be checked yearly} Pumping Racotrmended El�! No r+tttu ,IIsscipHnts T51AOMI-3t2W= Page t of_ Massachusetts Department ef Env€roa er-tat Protection Sureau of R Urce Prot icn-Tte� fDEP p s € n and Foy for hfie I./ Trent and Dispo" Sal Sys tat E. Sampling Informant* n Samples Talon: El influent Q Effluent Parameters sampled:❑pH F-I 80D TSS Q TN[j Other(list below) `j Other 1 Dthe:2 other 0ees__c r4%cn of any maintenance perfarmed since prc-,Aotss ir_ispedtion&during this inspection. f ltilates and Cctrtrnent�: i F. Certfic2tion I t ert fy_I have Inspected the sewace treaunent and disposal sy5d m at the address above,have carnple this rt pw and the ate^ tedincloay operation and mair,2ncs Checklist and the inf on.-tor repo Q te,artdl Comp€efe as of the ttr=3e o€ e i sly on. lama A ^r LS t GI►t7R" a i ' t Sie_naiu[e �-ze System owner must submit this report technology O&M checklist,and arty requiree s2mG�ing suits to the local board of health and DEP aS follows for each inspection performed: Remedial Use by January Piloting&Provisional Use- General Use-by September 31"of each year for the within 30 days of inspection 30'h of each year for the previous calendar year date previous 12 months Department of Envirorimeritaf Protection won: ' tee 5 Program i One Winter Street,e Floor f i Boston-MA 021 3 Page Z of 2 T51ROM1 •3128/i)z f i SINGUL SERVICE .; : ruler - t in _run {with same Alter) tie=inter irAO A, 11 the aute�fthelicsle in _ '%21 PEu ff—£3R -- air hose and agilate with air. t ;Tr tiffs? �eYu�aitatirrg vritsi L-iean wnersiomy flowing uaW the Location Work t Ire taexiormett Done exitim tvaro.is c€ear First Re"concrete caves cbe� ��3rosing down niter chamber for normal water level Scrape hopper Ock studge depth after scud year of ape<do¢ fly labitc2nt to filter f an=e Second Remove concrete cover chamber Place der in ph=,.all with clean water and sink it Cautmt Open and set to"CON-r , position Tmm ntmt locking tabs,replace center f lt=c-over Secanal Check sir c i9r aexasczj climber ��J�"� Replace toricretecover Vnplug aerator and lift out First Replace concMW cover Check ffm wom-rubber pads 5gcoavd F4tt in aeritx' Ch=k for wear csiproblent-v �tan3ber : Check wire in wiser fiii.-taf ing, Cca 6 a so it is rat in contact : tape if nerdeeirctr aiiyrhiaL ' wash,off aetatarl put it back Replace cm=em covez Hook up arzraese,cheek Call-k-Nd Pui swi£ch-an"AUTO' CirIrCn1'§ARU=Wor ruminwg, IytrrOV�lt�rl. lti&Laver - . Thh-d ter, Ve concrete cover arid•.' amber re&ove fter top- Beau and recoudti=tr.64Er Paper heave notice of Service with work O-A= Turn in black locking tails P Install pinup and start pumpin. from filter to fuse chamber. tote in company file any ; ' Lift filter with rope as'etiiarity or problem Indite if any fallow-am s Lift out filter,out it in rtib necessary Cieasi the outside of filter witls l rase t4 complete file an watt};drain bad.to ftasi Sezvit~,retu�n itts3 take l chamber dK 4yiE b1O-, J�," C V4"-t .5- Sr , eo_ c� () r CRAIG R. SHORT, P.E. 235 Great Western Road P.O. Box 1044 Telephone(508)398-8311 South Dennis,MA 02660 Fax (508)398-3063 PROFESSIONAL CIVIL ENGINEER, SOIL EVALUATOR, SEPTIC INSPECTOR SEPTIC SYSTEM DESIGNS, COASTAL&BUILDING DESIGNS TO: Thomas McKean Health Director Barnstable Board of Health 200 Main Street Hyannis, MA 02601 RE: CERTIFICATION OF SUBSURFACE SEWAGE DISPOSAL SYSTEM LOCATION OF SYSTEM: 562 South Main Street,Centerville,MA AM 186/047 CLIENT: M. Timothy Friend PLAN DATE: 03/36/03 FILE#: Sweetser Engineering Job#5604-00 Craig R. Short,P.E. File#1-962 DEP#SE3-4126 DATE(S)OF/TYPE OF INSPECTIONS: 09/09/03 Photograph&Inspect pump chamber and singular installation 09/10/03 Photograph&Inspect partial overdig 09/11/03 -Photograph&Inspect remainder of overdig - - 09/15/03 Photograph&Inspect S.A.S. with pump test of pressure dosing 09/16/03 Photograph&Inspect Infiltrator and vent 09/18/03 Photograph,Inspect,measure for as-built, check pump float Also included is a notarized letter from M. Timothy Friend that states that he had already changed all of the plumbing to low-flow water use fixtures, as required by the Conservation Commission, 1, Craig R. Short, Civil Engineer, duly licensed as such in the Commonwealth of Massachusetts, do hereby certify that this firm has visually inspected the constructed subsurface sewage disposal system shown on the referenced approved plan, and further certify that the system, as constructed and shown on the attached As-Built, generally conforms within acceptable tolerance to the regulations, as varied, set forth in 310 CMR 15.000 and the Town of Barnstable Board of Health Regulations. .j Craig R Sh rt,P.E.,Engineer Date cc: ^File: 1-962 Client: M.Timothy.Friend Contractor. Bortolotti Construction Barnstable Conservation Commission Sweetser Engineering f CRIPTION: �� ,S �t� r-j e s YS Tim >� S � v/< T� top DES a V, PUMP c0 /c C 1-4a Evart JENr c q 32 ` G x 2 9 4FRS A3ZZD oFFSEr r/E o t2-2" 28� 28 4/4 ,cis 34'-/a'' A7_3S'G'' _r37 2.9'.811 r'S 7-�oA A-/3--33 0 Q 13. 7=0'' Ago Member ASCE CRAIG R. SHORT, P.E. P.O.BOX DENNIS, GQ IO LOCHS:� ' SOUTH DENNIS,MA 02660 SHORT �,� ' r Professional Civil Engineer Soil Evaluator 1 ' CIVIL �. P Septic Inspector TOWN: C�/V rtae ��L Lam_ �1?A Licensed Construction Supervisor o p ��' No. 2'4�3 Septic«Site Piers-Structures•House Designs - np�� �7 h+z' ;' 1)A'f /o rll.l. tf /- 9LZ Office.(508)398-8311 Fax:(508)398-3063 i To: Mr. Craig Short Sweetser Engineering 235-Great:Western Road. South Dennis; Ma. 02660 From:. Timothy Friend 887 Ellington Road South Windsor, Ct. 06074 Date: September 25, 2003 Re: 562 South Main Street, Centerville, Ma. Low-Flow fixtures Dear Mr. Short: Regarding the plumbing fixtures at our house at 5.62 South Main Street, Centerville, Mass. When we purchased the house all the fixtures were old style, some in need of immediate replacement. When we replaced the valves and fixtures, we replaced them with low flow units. This includes replacing the upstairs and downstairs toilets and supply valves in approximately 1993, the upstairs bathroom sink fixtures and the downstairs shower and sink fixtures and showerhead at about the same time. Both sets of_ kitchen fixtures were replaced approximately four years ago, in about .1.999. The: upstairs bath/shower fixtures and showerhead were replaced about 2 years ago,. in 2001. These are all the fixtures that are tied into the sanitary system. t Timothy Friend Date SUBSCRIBED AND SWORN TO BEFORE NE yt IS.2 5:»..DAY 0IF 20 L3 NOTARY PUBLIC CVY1YVl i S.S-on GX� 1��3i � Olp s-c d u4 ��u -L��.ad�o,,C I eD AsBuilt Page 1 of 1 1V� ��`Jt •Jtlt�.. A•WYL ►. ')N 562- SctA Neav, S-F'_ SEWAGE# CO3-'/03 VILLAGE C94141yt I L ASSESSOR'S MAP&LOT_/8G,-OHl INSfALLER'S NAME&PHONE NO. r�'OIO i ContS�rucTiah SEVIC TANK CAPACIT -'-J-/- - --gA w-,J7' {�+� L ,\ rr 11 , � +,P LEACHING FACILITY: (type)�Zt 4� 4A 1+ tdrt(size) VC x_Zq x NO.OF BEDROOMS S BUILDER O T `n,.A -e.nd PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Priva a Water Supply Well and Leaching Facility (If any wells exist o5site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist Mn 300 feet of leaching facility) Feet Furnished by f --��•T°��o"', SEPTjG •S YS rim ;QJ aSWAr-- � •_., -=--_ •' z.�ear ��.. ,z,« . Pt+mP <Ne MaI,P 29i =1 TA:C9rMGNY OFFSET ric �` ti 2G3r29 d9S,Lath f- AS ua eM- ' aG^aynT ec 3i•I' %8� � � , drys RLA.33 0_�.a'hl�'s'o° B14/ca d' S . Acf.3U-9 0/.f 404 A^ _ /I WeW•tCE CRQQ R.SHORT,PE POtt M T/M o rNY F-,y,,e zV . PA tm[1W tanxaB«Swt,u° y q was• 1 . M / or. M . Pa/,san/OI6�Py�•teiGWm °�ViL '[WN; N G A YaeCWrumm S9K+.l,�chpnor 4a UNI O fs r.c:. ...._ ... http://issgl2/intranet/propdata/prebuilt.aspx?mappar=186047&seq=1 2/12/2014 Massachusetts Department of Environmental Protection f Bureau of Resource Protection -Title 5 DEP Approved Inspection and O&M Form for Title 5 I/A L I Treatment and Disposal Systems ' A. Installation Important �K t' ✓j C%� r �/ , When Ming out Owner �, / j forms u e J�(110� / "/ /9� � y only the tab key Fa dlity Street Addfpss to move your �' J//(7 m� cursor-do.. Cry Zip the return I key. Mailing address of owner, if different: s A04dr 14 ZU B7-Sd � C � I city J State Zip -6 1 0 ext_ Telephone Number B. Authorized'Service Provider _ S/P ,r"rlv/t �f SPr�VdCPS .l..o�C os�ne F� S Address ra r/ia1,efic'-e_ OL C4 State Tap ( 61)7,fs" - ©l3dext i Telep Number. I zl e, A4,gr !/1S �QS�� i Cer ified Operator Name Certification Number i C.-Facility/System Information h' /1loxwec 0 1?6 0 I D ID ManufaCurer tD o� Mc"Nuni ser v s ) J / 03 ! t� Installati Date Start of O radon Approval Type-[] General Q Provisional Q Piloting Q Remedial Seasonal Residence—used less than 6 mo./year: Yes FINo D. Operating Information � J Inspection Date Previous Inspection Date Sludge Depth(to be checked yearty) Pumping Recommended Yes No .� r Effluent Description i T51AOMJ •3r2w2 Page t of z . i r -V) ' Massachusetts Department of Environmental Protection Bureau of Resource Protection -Ttle 5 DEF Approved Inspection and O&M Form for Title 5 11A Treatment and Disposal System E. Sampling Information - Samples Taken: [I Influent❑ Effluent Parametefs sampled: ❑ B0O[]TSS [j TN❑Other gist below) Other 1 Other 2 Other 3 Description of any maintenance performed since previous inspection&during this inspection: Notes and Comments: F. Certification � ���G�� -- I certify: I have inspected the sewage treatment and disposal system at the address above. have completed this report and the attached technology operation and maintenance checklist and the information reported is true,accurate and complete as of the time of the inspection. 1 am a s ratan' �rdartce with 257 CMR 2.00. ratan ianature System owner must submit this report,technoiogy O&M checklist,and any required samciing resuas to the local board of health and DEP as follows for each inspection performed. Remedial Use—by January Piloting&Provisional Use- General Use—by September 31a of each year for the within 30 days of inspection 30"'of each year for the previous calendar year date previous 12 months i Department of Environmental Protection Attention: Title 5 Program i One Winter Street, e Floor Boston_ MA 02108 - I , page 2 of 2 TSIAOMI -=8102 r Ile IN SINGLZAIR SERVICE CHECK LIST (with same Sher) Jet filter upright in tub.run SESI NO. A f!y clean water into it until the DATE OF SERVIE 3l� �� wrier flows out of the hole in - the flange.insert compressed SERVICE PERFORMED ) = __ air hose and agitate with air. ;initials) Keep agitating with clean + water slowly flowing until the Location Work to be cerformed Done I exiting water is clear. First Remove concrete cover,check Finish hosing down Filter chamber for normal water level Check sludge depth after Scrape hopper second year of operation Apply lubricant to filter flange Second Remove concrete cover chamber Place filter in place,fill with clean water and sink it Control Open and set to"CONT, i center position Tian out locking tabs,replace filter cover Second Check air flow through aerator Chamber Revlace concrete cover Unplug aerator and lift out First Replace concrete cover chamber Check for worn rubber pads Second Plug in aerator Check for wear or probiemv chamber Check wire in riser fbr Aiafing, Cnrl wire so it is net in contact l tape if needed ynch anything Wash off aerato-put it back Replace concrete cover Hook up aricaeter,check Conr'_-ol Put switch on"AUTO- current Wqh aerator running, ce ter position remov+s!�tgtaii. Close and lock cover Third RerAtive concrete cover and chamber reifrove filter top. Read and record hour meter i Turn in black Ricking tabs Paper Leave notice of service with Install pump and start pumping work owner from filter to first chamber. Note in company file any _ < Lift filter with rope as irregularity or problem vJ necessary. Indicate if any follow-up is Lift out filter,put it in tub necessary Clean the outside of filter with Be sure to complete-file on water,drain back to first service.return it to office chamber MEMO: A// (' C pto - f r - PtZQJECT DESCRIPTION: S E P 7"/ G S YS Tad /Y? '!4 S ,$ v/ v AJ n� V.E1Z T @ z Ar4 12. G4 t pump r� !< ry ;4 Sw4; �� 2� � T1t e''•9 T""M EN T �o �• F+L R n/T 2Gx2q 0,4.5 A34rL7 dFFSErriE - t t . 30'-G' f}G 32'la" Z 6 37-' 3� !q7 3SL 6O' Z7 ZQ+ 7�3" AU_._.4��:1_''_.,C3 i 7 22'-3 0,0 Member ASCE CRAIG R. SHORT, P.E. P.O.BOX 1044CR„I(, SOUTH DENNIS,MA 02660 SHCRT `.t M1_ LOCUS: C {S Professionai Civil Engineer-Soil Evaluator ! CIVILl Licensed Construction Supervisor•Septta inspector No. 274;:3 TOWN: C N T'Ee�" �//G C.�'_ MA Septic«Site-•Plem-SWctures-House Designs �' 05"T s A��F �� ``' i)ATr. 5 l2s*3 r•I t.t. 11 �- 96-Z Office:(508)398-8311 Fart(5W 398-3063 : �� J 1 SEWAGE # �C.Y). � y0 V�f AGE_ -0414r t I I�2 ASSESSOR'S MAP & LOT INS`i'AI.LER'S NAME&PHONE NO. Eo,r 1-0 10 It t` C'm S �u C 7 SEPTIC TANK CAPACITY Z. 0 jr`� � S 2(�` 29 LEACHING FACILITY: (type) AT t (stze) '� � NO.OF BEDROOMS BUILDER OR( WNEE PERMIT D COMPLIANCE DATE: w s S ` D 3 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Priva?te 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 t,. �y C p,. SO VT-H M A N ST 1 C PROJECT DESCRIPTION: SP T/ T 'lop I 1 2- 1 oc�T �L. 12. GG PUMP ( 1-4 At emel jrz 6J J eiv r a ?► S/N4 ULA�J�Tom' qL 7-A e q T--^1 EN T �a S. Jd t R�✓T Z G ZZ-10 cSFFSEr riE 1 ! AJ �2-2" R/ 28= i AZ �c=3" ryz zs 3¢ /a0/1 A!G_.a9'-3 Z/e, R2o f-c „ . 20 3t '- 3`' , 4.?3 . 49'X q 2 3 4/- R2s si=ia� 02$ 2 _0 ,� dj Member ASCE y ri 1'OR: M T�lvt T"h�Y CRAIG R. SHORT, P.E. r 4 : �-= ' s P.O.BOX 1044 C Si I t i? SOUTH DENNIS,MA 02660 "" ---' ;I,J�i LOCUS: Professional Civil Engineer Soil Evaluator v C I V i L ✓ Licensed Construction Supervisor-Septic Inspector 1 No. 274:=3 TOWN:- C E N T�� y!G��' MA epticFSite&Plem-Structures-HouseDegign s �' �' �'/aF tF�.. fir` F.A t_ tin rt: 5 Jzs 3 t 1 0Tce:(508)398-831.1 Fwc(508)398-3063. sG 20' rr' S la C3 J �;III:I:'1' / l►t� / No. - 0Q ? a. * �l k Fee J ��n �. THE C MONWEALTH OF MASS CH SETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE. MASSACHUSETTS ZIppYication for Migozar *potent Construction Vennit Application for a Permit to Construct( . Repair( )Upgrade(1/)Abandon( ) VComplete System El Individual Components Location Address or Lot No.c �p y� Owner's Name,Addres,Aand Tel. o. Assessor's Map/Parcel G,O dj �g l f'// e— Installer'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(A/0 Other Type of Building. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 5 0 gallons. Plan Date Number of sheets Revision Date Title !Q 1 � /�l_ Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) _ __ X��FM WAS INSTAI I,GD ld :, .. '=11DANCE TO PLAN, 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 been issued b s oaAof Houlth. Signed Date 7 z— 0✓7 Application Approved by - - Date -Pf Application Disapproved for the following reasons Permit No.200 3 — ya 3 Date Issued a b � 7 ! Fee S7 lip, 17 7_(�I - THE.COONWEALTH OF MASS CH SETTS Entered in computer: i.. a'. Yes ' r -TOWN OF BARNSTABLES MASSACHUSETTS PUBLIC HEALTH DIVISION Z [Ration for Mi.5poga1 *p!5tem ion!6trurtion Permit Application for a Permit to Construct( Repair( )Upgrade(V)Abandon( ) WComplete System ❑Individual Components Location Address or Lot No.c Owner's Name,Address and Tel. o. Assessor's Map/Parcel c ell A7vi//e Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. OX �/`-93 �' Sig- 39 — 392_2 Type of Building: Dwelling No.of Bedrooms % ., Lot Size X11 7 sq.ft. Garbage Grinder(A10 Other Type of Building eSl"/��P/1! No.of Persons Showers( ).Cafeteria( ) Other Fixtures t Design Flow gallons per day. Calculated daily flow j`;GS gallons. Plan Date, 3 Number of sheets ,/ Revision Date Title �0 5 Gl� 5C ��" /'4fI Aer /Y �`� ark! Size of Septic Tank 5) �9 2-leV 7`0, e7- Type of S.A.S. 7 el ✓`�Q Description of Soil �F��'�7 x I Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this .oard of Hpalth. Signed � Date 7 z- 0_-r Application Approved by S Date ail 3 Application Disapproved for the following reasons Permit No. UO 3 — !O 3 Date Issued /A I 4b ------------------------------------- f THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CER)JIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded Abandoned 2)by �/ %Z'/d ,� C©f�$ , at 5-6 ,� 5 _e,i 4 11' P has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 60.3 03 dated 03 Installer Designer The issuance of t ' e it shall not be construed as a guarantee that the system will i a (� Date Inspector �J --------------------------------------- NO. O O 3 + 7 U 3 . Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Miopooal *pftem ConMruction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(✓/)Abandon( ) System located at 2Y17/Af 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 tl s�permi . Date:_ '� I- 'Approved by � � �/_ ��� FROM : Town Of South Windsor WPCF PHONE NO. : 6602912978 Rug. 07 2003 03:30PM P2 A5d, 1. 40U3 3' :4P;u! .:1.10:UI11V �U. i45 U �RD'M '�etin of goat Windsor WP-.vmv,�v PHONE NO. E360e;912�178 Aug. 07 200.E 03-,iSPM P2 t. 52(im D 6.1 W1C16,INCH 49 Psviaori v 8S i3G A11�ari 4tnolm'T8 Blind 02505 �rnTL S tGV IR MAIKMANtd1;Cq*tTUCT M MASSACHIJIMTTI pot limppi W:rr>xd]RelwadGtf a rt�P�1n�l.adu 1 YW 4'i+artogy dk �iaosMr M, ,1e;j ►►oe FiUrid lsatrwr,aamad 0 batwea 6ia (Kgamc�7;mth 800l AV ab ,4 a 401 cno,sh!Ftuiedry ia eteo,amvaoo,,c(a 88dcet)w an d trkWea a wndltgm aadtm lot spelboor, Tetae of CnaVl" eir; 18ds 8 O0S to Maia�w),Im atarri;,ta MA Lpq>sdos oi!9i:o� im dob NWOV: The 46PA ebaWa►ctmoaooatnotIWICoadtlaFftwma�mr,"Maev1ettaatapp=11YAtalyriAMMli ;nwv4a%y t*Ud techrnlr»irme lei �p� ��oUdrtpdulkeats'ab�r�tdrlad4'rka8osaeaw�'ltplYt�tirl6iomcmuomded *sob do cqmp draw of ft spoM G aatiaa wis 4y (p�peas oaadtlloa a►'tse��;pe"'�n t,nte�'�1M' c>,rekbvetall ep laa�� la Iced'6nflia;�iw�owr�or told Soaeletele Amer ea,t<coan 6! ooaaplagl+ ttaaian+►an0w 7; ON,i 711m Is sepdtt to local atd late re 'Y Swim 46 �b id d►t�z t>�a set lY ar�iluiod as►ioa yll;ti,> ;vtsii rarpond tv swa�oltodoNd ,and in batu you +d thgo of avt�l atioa, b I $'� ma#u�o:l►tot �b ywa >r►voor. aeoo�dwsc>p w+1�lbre 6ia1N� N4 �aalmdukdamte NNE�kom rradvid up in 9 etwuatml►'traaa�a#otene wllb thv dIr®e6e� roni�►t�ed !� the CWW MW"A aeINSMA 8 of *"Utliorigad ta�aJitti+nleloaa of eQ+afgmattr*%%WIN q}E qWWWAY'to 69**to db4hop d WWII t�emlt mattm>satbau not jWbt+tbia ht ti a lbraiair gltm or oti►V*Msr qua W rauk Iu a rr►rrka��rge at�7d �apt:Ida time o�aorvsaa BbOwld y+Y'�t be cat> 1 or act mnda�t8rt USID s date Wm be 6yp3611 to Mal)4116dU144 06M41 vl", 0jDj i i%9W your sinptrdr Wiswmider VOODOO ffiyataa,piaaao re*to tha 6g1%:* MAMA The 1061dradU"ysparyrar4000 imwd.tyearaervtoe trod, Flow aafeehat MW AN m011110 o 0 Vaald Sff"COR" t 1"the 1Ve e f t(ee . ?Wdlrrr to aoip$T wiIA DIP ��iate rxey oars�.ho>ecaorwert to�!r(r�b�trter wr� ra areasetr� �aontraot to �tllr�e� Bk 17488 F°s 134 9613 0 CONFIRMATORY DEED Friend and Kathleen M Friend husband and wife as tenants b the entire in M. Timothy Fr e d a at a y entirety, consideration of THREE HUNDRED FORTY THOUSAND DOLLARS AND 001100 ($340,000.00) paid grant with QUITCLAIM COVENANTS to Maria Eftimiades, individually, whose address is 95 Phinneys Lane, Centerville, MA the land with the buildings thereon located at 562 South Main Street, Barnstable (Centerville), Barnstable County, Massachusetts. FOR DESCRIPTION SEE EXHIBIT A ATTACHED HERETO All right of homestead and other interest are also released. This confirmatory deed is given to ratify, confirm and correct a deed daked June 20, 2003 recorded with the Barnstable County Registry of Deeds on June 20, 2003 at 12:24 P.M. as instrument number 72019 in Book 17122, Page 271 in which a restriction was inadvertently omitted from said deed. Executed under seal this day of August, 2003. C jTI..moth Frie hleen M. Friend PROPERTY ADDRESS: 562 South Main Street, Barnstable (Centerville) MA STATE OF CONNECTICUT County of + (d , ss: " AL11 • • •••••,"2003 Then personally appeared before me the above-named M. Timothy Friend and ackno j., ffozegoing instrument to be his free act and deed, before me, t ='4 p d m I f.. , n i • •ere,•• ew Notary ublic •-.,, My Commission Expires: ANGELA C141RICO NOTARY PUBLIC STATE OF CONNECTICUT MY COMMISSION EXPIRES AUG.31,2003 County of �"�(�� , ss: ALL'�1'`i"0�. , 2003 .•• Then personally appeared before me the above-named Kathleen M. Friend and acknQ et-he Ang instrument to be his free act and deed, before me, � ♦ �!•.a. via3 Notary ublic '-,,J `•».••� , My Commission Expires: Return to: Maria Eftimiades ANGIc 114co 562 South Main Street NOTARY PUBLIC MY COMMISSION EXPIRES AUG.31,2003 Barnstable (Centerville), MA 02632 EXHIBIT A The land together with the buildings thereon situated in Barnstable (Centerville), Barnstable County, Massachusetts, bounded and described as follows: Beginning at the southeasterly corner of the within described premises on the northerly side of the State Highway known as South Main Street; thence NORTH 29 degrees WEST by land now or formerly of George C. Backus, one hundred eighty-two (182) feet, more or less, to a stake and stones at the edge of a swamp; thence SOUTHWESTERLY by said swamp fifty-two (52) feet, more or less, to land now or formerly of Elihu Loomis; thence SOUTH 22 1/2 degrees EAST by said Loomis, one hundred fifty-two (152) feet, more or less, to said State Highway; and thence NORTHEASTERLY by said State Highway, forty-nine (49) feet, more or less, to the point of beginning. The dwelling on the above described premises shall be limited to five (5) bedrooms and no more. For title see deed recorded with said Deeds in Book 17122, Page 271. s ggFG SSTge� BARNSTABLE REGISTRY OF DEEDS JUN, 23. 2003 10: 13AM SIEGMUND ENVIRON NO. 994 P. 1 June 18,2003 SIEGMUND ENVIRONMENTAL -SERVICES,Inc. Tom McKean Public Health Division 49 Pavilion Avenue Town of Barnstable Provident,RI 02905 Tel 401-78S.0130 200 Main Street Fix a H arinis, MA, 02601 B�m2begi@ il;sai® y siesmundgmup,eom . VIA FACSIMME 508-790-6304 A Sicptnund0roap Ceniptiny RE: Singulair Installation, 562 S.Main St. Centerville --_ASSOCIATED coMPANW:___--___ Testing Rumen __ ------------- ------- —-- - ui. Dear Mr, McKean, A.J.Rawumes bfgaaaeAuaetia I111NOARY MoaeILKR. The S'ingulair being specified for installation will be covered by a 2 year Operation and and Maintenance contract. Testing for the aforementioned property will follow MA DEP Proles-Aqua,KR pHdopaet Remedial Installation regulations and will consist of quarterly effluent sampling for the I" RUSSIA year of operation for the following constituents: 6caAtamodar Krwrradkir BODS mg/L SIAVA&REPUBLIC TSS mg/L Bkostarwso spot•stm. pH Temkiaev Total Nitrogen wasT nv_ntes Rotm k►symeau,N.V. Sampling will be performed via"Grab Sample"method by Joe Martins of Accusepcheck, St.Mkia►ten Inc„MA DEP Class IV Certification##5057. Copies of all inspection reports and sampling MoAlaalo¢,Lid. results will be provided to your office, Nevis YUcoaLAYIA In accordance with MA DEP,at the end of the V year of operation,SESi will petition the IiKBPoaa Depathment for cessation of testing if the system has met the 30/30 mg/L effluent quality Nevi Skid limits, A copy of that petition will be supplied to your office for additional review and comment. Flnd uc all In w".slegmundgmap.eom For the 2'year of operation,the system will be sampled at 6 month intervals for the same constituents,with results forwarded to your office for review, Re ds ter ie and Principal cc: Swectm Bngincoring,Inc. File I JUN. 17, 2003 11 : 16AM SIEGMUND ENVIRON NO. 978 P. 1 l June 17,2003 SIEGMUND ENVIRONMENTAL _ SERVICES,Inc. Tom McKean Public Health Division 49 Povillon Avenue Town of Barnstable Providence,Al 02905 Tel 401-795.0130 200 Main Street Fax 401-195.3110 Hyannis,MA. 02601 $-mtulmsls Y sicgmundgmup,eom VIA FACSDAILE 508-79 -6304 A SiegmundGraup Company 61-S-Main-St Cententill� ABBOC1ATriD COMPAN035 - -- RE:- - $1 gulaiT klstellat on, - - ---.--- - - - Testing Regimen U. & A.L Resources MasYachwatls itY Dear Mr.McKean, Marlou YJ. sod Prefea-mull,;M The S.ingulair being specified for ' stallat' n will be covered by a 2 year Operation and Maintenance contract. Testing fo the orementioned property will follow MA DEP AUBsrn Remedial Installation regulations an ill consist of quarterly effluent sampling for the 19r BesAtunodat ICrasmadarnadar year of operation for the followin nstituents; BLOVAKR 20_UC GODS mg/L uWalar/"an ap01,sr.0. mg/L I. bma8°V TS 8 H� PH (tosewaler Byefcros,N.V. Total rtrogen SrAlamven MoAlastair,Ltd. Sampling will be rformed via"Grab ample"method by Joe Martins of Accusepcheck, Nevis Inc.,MA DEP ass IV Certification# 57, Copies of all inspection reports and sampling YucoSLAyrA results will b provided to your office, EKMM Novi Sad In acgor ce with MA DEP,at the end f the 1"year of operation,SESi will petition the Dep . ent for cessation of testing if th system has met the 30/30 mg/L effluent quality limit., A copy of that petition will be s plied to your office for additional review and Flud as all In I .slogmundoroup room CO ent. you for your time and consideratio Re ands, 1 ter ;2mund Prin -c cipal eel sweeUcr Engineering,Inc. File JUN. 23. 2003 10: 13AM SIEGMUND ENVIRON NO. 994 P. 1 June 18,2003 SIEGMUND ENVIRONMENTAL SERVICES,Inc. Tom McKean Public Health Division 49 Pavilion Avenue Town of Barnstable Providence,RI 02905 Tel 401.79S.0130 200 Main Street Fax ao 3110 &mobeald,eai® HY anAis,MA. 02601 siegmundpoup,eom VIA FACSIMILE 508-790-6304 A SFejinuirdQroup Company RE: Singulair Installation, 562 S.Main St.Centerville ASSOCIATED COMPANIES: Testing Regimen U.B.L. Dear Mr, McKean, A.1.Raoutoes bfgaaaehuaella ZR.TNOA tr V MoTldt Ktt. The S'ingulair being specified for installation will be covered by a 2 year Operation and and Maintenance contract. Testing for the aforementioned property will follow MA DEP P`°f°gki"''KA' A>rdopeat Remedial Installation regulations and will consist of quarterly effluent sampling for the 16e RUM year of operation for the following constituents: Seel-Krasnodar X BOD5 mg/L rwrlodar SIZVAR RSPosuC TSS mg/L Skostar/aso spot.sr.o. PH Tommy Total Nitrogen WII3T INDIL9 Romwatee Systems,NN. Sampling will be performed via"Grab Sample"method by Joe Martins of Accusepcheek, Stmoorlen Inc.,MA DEP Class IV Certification##5057. Copies of all inspection reports and sampling MoAlaslau.Ltd. results will be provided to your office, News YUcosLAyiA In accordance with MA DEP,at the end of the?year of operation,SESi will petition the ntc 93 Depatt rient for cessation of testing if the system has met the 30/30 mg/L effluent quality NOVISed limits, A copy of that petition will be supplied to your office for additional review and comment. Find �o For the 2'W P Y P www.eleginundpo up.com year of operation,the system will be sampled at 6 month intervals for the same constituents,with results forwarded to your office for review, Re ads ter , -1 and Principal cc: Swectzor Engineoring,Inc. File JUN. 23. 2003 10: 13AM SIEGMUND ENVIRON NO. 994 P. 1 June 18,2003 SIEGMUND ENVIRONMENTAL SERVICES,Inc. Tom McKean Public Health Division 49 Pavilion Avenue Town of Barnstable Providence,RI 02905 Tel 401.78$.0130 200 Main Street Fax 401- I0 Hyamis, MA. 02601 8•mail:9egi@;sesi® siegmundgroup,com VIA FACSIMILE 508_790.6304 A SerpineAd(boup Conipnrty RE: Singulair Installation, 562 S.Main St. Centerville ASSOCIATED COMPANIES; Testing Regimen U.S.A. Dear Mr, McKean, A.I.Itesouroes Ma88n[hi/BellA 1,IUNOARY The Singulair being specified for installation will be covered by a 2 year Operation and IvlarlWW Maintenance contract. Testing for the aforementioned property will follow MA DEP Proles-Aqua,Kn.Gazdapssl Remedial Installation regulations and will consist of quarterly effluent sampling for the I" RUSSIA year of operation for the following constituents: Scal-KTasnodar BOD5 mg/L Rrasnoiwdar SLOVAK REPUBLIC TSS mg/L Bkaetadvso spol.sr,o. pH Tomasev Total Nitrogen WBST IIVDIB9 Rosewater Syslems,N.V. Sampling will be performed via"Grab Sample"method by Joe Martins of Accusepcheck, SI,Maarlm Inc,,MA DEP Class IV Certification#5057. Copies of all inspection reports and sampling McAlaslair,Lid, results will be provided to your office, New YUGOSLAVG+. In accordance with MA DEP,at the end of the V year of operation, SESi will petition the EKs/usa Depattment for cessation of testing if the system has met the 30/30 mg/L effluent quality Novi Sad limits, A copy of that petition will be supplied to your office for additional review and comment. Find us all in w .alegmundgroup.eam For the 2m' ww year of operation,the system will be sampled at 6 month intervals for the same constituents,with results forwarded to your office for review, Re ds o ter , ie and Principal cc: Swectzor Enginccring,Inc, File f Q f r Ilk Fax To: I From: Fax: _ �e.. �30 Pages: Phone: Date: ks ❑Urgent ❑ For Review ❑Please Comment ❑Please Reply 0 Please Recycle o aq •wc.TP S •�-�! n � ��• ou. Ca•�.a� �s . V 6R. I L/►� EMAIL. Irlenddsouthwindsor.org r Town of South Windsor TIMOTHY FRIEND Pollution Control Plant Supervisor WATER POLLUTION CONTROL FACILITY 1 VIBERT ROAD TEL.•i (860)289-018S SOUTH WINDSOR,CT 06074 FAX: (880)291-297& Town of Barnstable 13'4msimm ; Regulatory Services 9� 9: �•� Thomas F. Geiler,Director RFD MA'S A Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 - s s DATE: :S:r�Ag- 18 2CD3 NUMBER OF PAGES TO FOLLOW: TO: FROM: r---� PHONE: PHONE: (508)862-4644 FAX PHO FAX PHONE: (508)790-6304 N ZS 211 2.9I S cc: NOTES/COMMENTS: Q:UfEALTH\Fax Form.doc 'I' Town of Barnstable Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MS Wayne Miller,M.D. June 18, 2003 Mr. Robin W. Wilcox, P.E. Sweetser Engineering Co. P.O. Box 713 South Dennis, MA 02660 RE:. 562 South M iin�.Street,,Centerville A 186-047' Variances/ Singulair,-Treatment Facility with UV Disinfection Dear Mr. Wilcox, You are granted conditional variances on behalf of your client, Timothy Friend, to construct an onsite sewage disposal system at 562 South Main Street, Centerville. The variances granted are as follows: PART VIII, SECTION 1.00: The soil absorption system will be located only 34.48 feet away from wetlands, in lieu of the one-hundred (100) feet minimum separation distance required. PART VIII, SECTION 1.00: The pump chamber will be located 28 feet away from wetlands, in lieu of the one-hundred (100) feet minimum separation distance required. PART VIII, SECTION 1.00: The septic tank will be located 31.8 feet away from wetlands, in lieu of the one-hundred (100) feet minimum separation distance required. 310 CMR 15.211`. The soil absorption system will be located 3.6 feet away from the property line, in lieu of the ten (10) feet minimum separation distance required per Title V. WilcoxFriendVariance I These variances are granted with the following conditions: ✓(1) The applicant shall submit a revised influent and effluent wastewater monitoring plan prior to obtaining a disposal works construction permit. The influent and effluent shall be sampled and analyzed quarterly during the first year and once every six months during the second year for the following constituents: BOD TSS pH Total Nitrogen Results of each. testing shall be mailed to thePublic Health Division Office, 200 Main Street, Hyannis, Massachusetts. (2) The applicant shall submit an operation and maintenance (O&M) plan for };nneo^Rr the proposed Singulair Treatment Facility to the Public Health Division t ted34yo prior to obtaining a disposal works construction permit. „('3) The Total Nitrogen levels shall be reduced by 50% or greater with the use of the innovative/alternative nitrogen reduction system proposed. (4) No more than five (5) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (5) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to five (5) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (6) The septic system shall be installed in strict accordance with the engineered plans dated March 26. 2003. (7) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the submitted plans dated March 26, 2003. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to the close proximity wetlands adjoining the. property at two sides. It is the opinion of this Board that the proposed new soil absorption system is designed to meet the WilcoxFriendVariance ar q maximum feasible compliance standards contained within the State Environmental Code, Title V. Sin erely yours, l ay"e Miller, M.D. ' Chairman WilcoxFriendVariance F Town of Barnstable Conservation Commission . ,,,R,, 200 Main Street 9Q, WAM ,�� Hyannis Massachusetts 02601 '°lFD MA't A Office: 508-862-4093 FAX: 508-778-2412 Enclosures to be returned to the Conservation Commission 200 Main Street Hyannis,MA 02061 Dear Applicant: Please find attached Forms A,B and C referenced in the Special Conditions Section of your enclosed Order of Conditions. • Forms A and B must be fully executed and returned to the Conservation Commission prior to the start of work. Form C must be executed by your agent at the time a Certificate of Compliance is requested, once work.is complete. Thank you,for your attention to this detail, and for your anticipated compliance with your Order of Conditions. Please call us with any questions. Sincerely, Rob Gatewood Conservation Administrator q:farms:formmt Olt ZHE T Town.of Barnstable Conservation Commission 200 Main Street HAM 03amp Hyannis Massachusetts 02601 rBD MA'1 Office: 508-862-4093 FAX: 508-778-2412 Form A For SE3 ALL PARTIES INVOLVED WITH THIS PROJECT MUST SIGN THIS STATEMENT The undersigned confirm that they have read and understand the Notice of Intent, Order of Conditions, and approved plans for the project.The undersigned also understand that subsequent plan revisions shall require advance approval by the Conservation Commission. Please do name on this line. Please print name on this line. Property Owner Date Return this form to: Barnstable Conservation Commission 200 Main Street Hyannis,MA 02601 Fax: 508-778-2412 rev3/12/02 oF,H�r Town. of Barnstable Conservation Commission ' 200 Main Street SAMSTABM • 9q, 1659: .0� Hyannis Massachusetts 02601 office: 508-862-4093 FAX: 508-778-2412 Form B For SE3- Below please find the.names, addresses, and business telephone numbers of the project supervisor and alternate project supervisor who are responsible for ensuring on-site compliance with the Order of Conditions. Project Supervisor Alternate Project Supervisor Name. Name Address Address Business Telephone# Business Telephone# Property Owner's Signature Date Print Name Applicant's Signature (if different) Date Print Name Return this form to: Barnstable Conservation Commission 200 Main Street, Hyannis, MA 02601 rev.3/14/02. ,+ OF'THE Town of Barnstable . Conservation Commission snsivsr = 200 Main Street A.�� Hyannis Massachusetts 02601 Office: 508-862-4093 E-mail: conservation@town.barnstable.ma.us FAX: 508-778-2412 Certificate of Compliance— Form C Please check the appropriate box. Enter n.a. if not-applicable. Compliant Non- File No. SE3 Com liant ❑ Work limit line was not exceeded by any alteration or cutting. P E] A certified.foundation plan was submitted to the Conservation Division. Before and after photographs of the undisturbed buffer were ❑ submitted to the Conservation Division. ❑ No plan deviations within the 50' setback from resource area. ❑ Q No plan deviations between 50' and 100' of the resource area. Q Areas disturbed during construction have been revegetated. Mulching is not a substitute for vegetation. ❑ Drywells or gravel.trenches were installed. ❑ Landscaping or vista pruning was dome in consultation with Conservation staff Work limit markers (wood stakes) remain in place. ❑ Pool disinfection is by ozone injection El Post-dredgebathymetric survey was submitted :::�=nd iers,ramps, floats and outhaul pilings are the permitted size, shape confi ration ❑ Piers,ramps and floats in storage are the permitted size, shape and configuration This checklist does not relieve applicants and their representatives from compliance with other general and special conditions of the Order of Conditions. Please describe all deviations in your request letter. Please submit this completed checklist with your written request for a Certificate of Compliance and your check of $50 made payable to the Town of Barnstable. Representative's Signature Date Q:\Conservt\DEPFORMS\FORMC.doc rev:4/11/2002 CRAIG R. SHORT, P. E. 235 Great Western Road P.O. Box 1044 Telephone(508)398-8311 South Dennis, MA 02660 Fax (508)398-3063 PROFESSIONAL CIVIL ENGINEER, SOIL EVALUATOR, SEPTIC INSPECTOR SEPTIC SYSTEM DESIGNS, COASTAL&BUILDING DESIGNS AGREEMENT FOR PROFESSIONAL ENGINEERING SERVICES INSPECTION OF SEPTIC SYSTEM WITH PRESSURE-DOSED TREATMENT PLANT Craig R. Short; P.E., (Engineer) agrees to provide for the fees listed below to: M. Timothy Friend, 887 Ellington Road, South Windsor, CT 06074, the following services for: 562 So. Main Street, Centerville,MA Inspection of the construction of Septic System with Pressure-dosed Treatment plant 1. Stake out of Septic System by Sweetser Engineering 2. Inspection Prior to AND during the setting of tanks 3. Inspection of removal of unsuitable material prior to placing new sand 4. Inspection of new sand prior to placing washed stone 5. Inspection of Soil Absorption System Piping prior to Chambers 6. Inspection of Entire Septic System&Piping prior to Backfill 7. Activation of Singulair Treatment Plant 8. Witness Pressure Test with water 9. "As-Built"Plan and Certification Letter to the Barnstable Health& Conservation TOTAL ESTIMATED FEE: Additional inspections if re uired will be charged at the rate of$75.00 per hour. NOTE: 48 hours notice reauired prior to the start of construction, (i.e. Stake Out) TERMS: Signature Please sign and return this proposal acknowledging work to be done then submit Payable to CRAIG R. SHORT,P.E.,Engineer Z weeks prior to start of construction Work to commence upon receipt of signed contract and payment Agreed upon by: Ll Craig R. ort,P.E.-(Engineer) bate M. Timothy Friend DateL This proposal may be withdrawn or prices and time-frames may change if not accepted within 30 days. QUOTED PRICES VALID FOR 12 MONTHS FROM THE ENGINEERS SIGNED DATE ABOVE y Massachusetts,Department:of Environmental Protection �pIF ?byy� DEP File Number- • Bureau of Resource Protection -Wetlands • fABL& • WPA: Form- 5 Order of Conditions SE3-4126 mess_ Provided by DEP e Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII A. General Information Important: From: When filling out forms on Barnstable the computer, Conservation Commission use only the tab key to This issuance if for(check one): move your cursor-do Order of Conditions not use the return key. ❑ Amended Order of Conditions To: Applicant: Property Owner(if different from applicant): M.Timothy Friend M. Timothy& Kathleen M. Friend Name Name 887 Ellington Road 887 Ellington Road Mailing Address Mailing Address South Windsor CT 06074_ South Windsor CT 06074 City/Town State Zip Code City/Town State Zip Code 1.. Project Location: 562 South Main Street Centerville Street Address City/Town 186 047 Assessors Map/Plat Number Parcel/Lot Number 2. Property recorded at the Registry of Deeds for: Barnstable 7974 305 County Book Page Certificate(if registered land) 3. Dates: April 14, 2003 May 27, 2003 JI.V 1 2 Z003 Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance 4. Final Approved Plans and Other Documents (attach additional plan references as needed): Site Plan March 26, 2003 Title Date Title Date Title Date 5. Final Plans and Documents Signed and Stamped by: CraigShort, PE Name 6. Total Fee: $55.00 (from Appendix B:Wetland Fee Transmittal Form) Wpatorrr&doc•rev.619/03 Page 1 of 7 the Massachusetts.Department of Environmental Protection dF � DEP File Number. Bureau.of Resource Protection -Wetlands. WP�4 Form 5 Order of Conditions: SE3-4126 e�►se Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII B.. Findings Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based.on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: ❑ Public Water Supply ❑ Land Containing Shellfish ®_ Prevention of Pollution ❑ Private Water Supply ❑ Fisheries ® Protection of Wildlife Habitat ❑ Groundwater Supply ® Storm Damage Prevention ® Flood Control Furthermore,this Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: ® the following conditions which are necessary, in accordance with the performance standards set forth in the wetlands regulations, to protect-those interests checked above. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify ordifferfrom the plans, specifications, or other proposals submitted with the Notice.of Intent,these conditions shall control. Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations to protect-those interests checked above. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protectthese interests, and a final Order of Conditions is issued. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). General Conditions (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. W pafonn6.doc•rev.619/03 Page 2 of 7 f �111e, Massachusetts Department of Environmental Protection DEP Re Number: Bureau.of Resource Protection -Wetlands WPa. Form_ 5 - Order of Conditions SE3-4126 erg Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII B. Findings (cons.) 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years,the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended.by the issuing authority for one or more periods of up to three years.each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8.. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of,Deeds or the Land Courtfor the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order-shall also be noted-in the Registry's Grantorindex under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of-the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order; which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MA DEP"] "File Number SE3-4126 " 10. Where the Department of Environmental Protection is requested to issue a Superseding Order; the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant-shall submit a Request for Certificate of Compliance (WPA Form 8A) to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. fteform6.doo•rev.&9/03 Page 3 of 7 Massachusetts Department of Environmental Protection DEP File Number. Bureau of Resource Protection-Wetlands _ WPA: Form 5Order of Conditions sE3-4126 r vi P o ded by DEP .� Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII B. Findings. (cont.) 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a. Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction,the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed.The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. see attached Findings as to municipal bylaw or ordinance Furthermore, the Barnstable hereby finds (check one that applies): Conservation Commission ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: Municipal Ordinance or Bylaw Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw, specifically: Article 27 of Town Ordinances Municipal Ordinance or Bylaw Citation The Commission orders that all work shall be performed in accordance with the said additional conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. ftafonn5.doc rev'6/9/03 Page 4 of 7 r SE3-4126 Friend Approved Plan March 26,2003 Site Plan by Craig.Short;PE Special Conditions of Approval L. Preface Caution:Failure to comply with all.Conditions of this Order of Conditions can have serious consequences. The consequence may include issuance ofa stop work order,fines,requirement to remove unpermitted structures,requirement to re4andscape to original condition,inability to obtain a certificate of compliance, and more. The General Conditions of this Order begin on page Z and continue on pages 3 and 4. The Special Conditions.are contained on pages 4.1,4.2:and 4.3 if necessary.All conditions require your compliance. 11. Prior to the start.of-work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein,General Condition number 8 (recording requirement)on page 3 shall be complied with. 2. It is the responsibility of the applicant;the owner and/or successor(s) and the project contractors to ensure that all conditions of this Order-are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof) to project contractors prior to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Commission prior to the start of work. 3. General Condition 9 on page 3 (sign requirement) shall be complied with. 4. The Conservation Commission shall receive written notice 1 week in advance of the start of work. 5. The work limit line shown on the approved plan shall be staked in the field by the project surveyor/engineer. 6. Staked strawbales backed by trenched-in siltation fencing shall be set along the approved work limit line. Effective sediment controls shall remain until the site is stabilized with vegetation. 7. A sequence of color photographs showing the undisturbed buffer zone shall be submitted to the Conservation Commission. Note : the strawbales and siltation fence must show in the foreground (or bottom of) the photographs. 4.1 i III The following additional conditions shall govern the project.once work begins. 8. General conditions No. 12 and No. 13 (changes in plan)on page 3 shall be complied with. 9. General condition No. 17(maintaining sediment controls)on page 4 shall be complied with. 10. The work limit shown on the approved plan shall be strictly observed. 11. There shall be no disturbance of the site, including cutting of vegetation, beyond the work limit. This restriction shall continue over time. 12.. The Conservation Commission,its employees,and its agents shall have a.right of entry to inspect for compliance with the provisions of this Order of Conditions. 13. This permit is valid for 3 years from the date of issuance,unless extended by the Commission at the request of the applicant: 14. The brush pile on the slope adjacent.to the wetland shall be removed. Once done,the area shall be seeded to fescue grass and allowed to grow back unimpeded. 15. No area shall be left unvegetated for more than 30 days.All areas disturbed during construction shall be revegetated.immediately following completion of work at the site. Mulching shall not serve as a substitute for the requirement to revegetate disturbed areas at the conclusion of work. 16. All proposed lawn areas shall be underlain with a minimum of 4 inches of loam. 17. Herbicide,pesticide and fertilizer use is discouraged on lawns within Conservation Commission jurisdiction. If fertilizer is used,only slow-release low-nitrogen fertilizer shall be applied. Over-fertilizing shall be avoided. IV. After all work is completed,the following condition shall be promptly met: 18. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect,landscape architect or land.surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,.if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance. At the time of the request for a Certificate of Compliance. an updated sequence of color photographs of the undisturbed buffer zone shall be also submitted. p.4.2 t t„E Massachusetts:Department:of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 5 - Order of Conditions SE3-4126 v iv�ea Provided by DEP Massachusetts Wetlands- Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII B. Findings- (cont.) Additional conditions relating to municipal ordinance or bylaw: see attached This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions#4, from the date of issuance. Date This Order must be signed by a majority of the Conservation Commission. The Order must be mailed.by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered at.the same time to the appropriate Department of Environmental Protection Regional Office (see Appendix A) and the property owner(if different from applicant . Signatures: 14�A. AK� 1/ . 0 On Of ) Day Month and Year before me personally appeared to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. Notary Public My Commiss n Expires This Order is issued to the applicant as follows: ❑ by hand delivery on by certified mail, return receipt requested, ) ._. �Uy Date Date Wpafomi&doc•rev.5/27103 Page 5 of 7 Massachusetts:Department.of Environmental Protection Bureau:of Resource Protection -Wetlands. DEP Re"umber MARK- WPA. Form 54rd'er of Conditions sE3-4126 Massachusetts.Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP and Town of Barnstable Ordinances Article XXVII G. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject o to this Order, r any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10:03(7) within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is notthe.appellant. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, §40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extentthatthe Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. D.. Recording. Information- This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions.The recording informatics on Page T of-Form 5 shall be submitted to the Conservation Commission listed below. Barnstable Conservation Commission Wpafann5.doc•rev.6/9/03 Page 6 of 7 F Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection Wetlands WPA Form 5 - Order of* Conditions SE3-4126 Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of-Barnstable Ordinances Article XXVI I D. Recording Information (cont.) Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. -------------------------------------------------------------------------------------------------------------------------- To: Barnstable Conservation Commission Please be advised that the Order of Conditions for the Project at: 562 South Main Street, Centerville SE3-4126 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County Book Page Bk 17121 P935 171914 for: a 1.0 = 37u Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant wpaform6.doc•rev.6/9/03 Page 7 of 7 I t Town of Barnstable 9 , ' Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MS Wayne Miller,M.D. June 18, 2003 Mr. Robin W. Wilcox, P.E. Sweetser Engineering Co. P.O. Box 713 South Dennis, MA 02660 y�^:zt RED k56xSowsl� et� enterillA RR_ fiokn R01 Dear Mr. Wilcox, You are granted conditional variances on behalf of your client, Timothy Friend, to construct an onsite sewage disposal system at 562 South Main Street, Centerville. The variances granted are as follows: PART Vlll, SECTION 1.00: The soil absorption system will be located only 34.48 feet away from wetlands, in lieu of the one-hundred (100) feet minimum separation distance required. PART VIII, SECTION 1.00: The pump chamber will be located 28 feet away from wetlands, in lieu of the one-hundred (100) feet minimum separation distance required. PART VIII, SECTION 1.00: The septic tank will be located 31.8 feet away from wetlands, in lieu of the one-hundred (100) feet minimum separation distance required. 310 CMR 15.211: The soil absorption system will be located 3.6 feet away from the property line, in lieu of the ten (10) feet minimum separation distance required per Title V. W ilcoxFriendVariance _n These variances are granted with the following conditions: (1) The applicant shall submit a revised influent and effluent wastewater monitoring plan prior to obtaining a disposal works construction permit. The influent and effluent shall be sampled and analyzed quarterly during the first year and once every six months during the second year for the following constituents: BOD TSS pH Total Nitrogen Results of each testing shall be mailed to thePublic Health Division Office, 200 Main Street, Hyannis, Massachusetts. (2) The applicant shall submit an operation and maintenance (O&M) plan for the proposed Singulair Treatment Facility to the Public Health Division prior to obtaining a disposal works construction permit. (3) The Total Nitrogen levels shall be reduced by 50% or greater with the use of the innovative/alternative nitrogen reduction system proposed. (4) No more than five (5) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (5) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to five (5) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (6) The septic system shall be installed in strict accordance with the engineered plans dated March 26. 2003. (7) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the submitted plans dated March 26, 2003. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to the close proximity wetlands adjoining the property at two sides. It is the opinion of this Board that the proposed new soil absorption system is designed to meet the W ilcoxFriend V ariance maximum feasible compliance standards contained within the State Environmental Code, Title V: Si erely yours, ay a Miller, M.D. Chairman W i lcoxFriend V ariance _ I Of DATE: o 0 P rD • FEE: 9 MA88.. 165 ,0�` REC.. BY Town of Barnstable s®. DATE: Board of Health 367 Main Sheet,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S.FAX 508-i90-6304 Sumner Kaufinan,M.S.P.IL Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION Property Address: 562 South Main Street,Centerville,MA Assessor's Map and Parcel Number: MAP 186 PARCEL 047 Size of Lot: .16 Acres Wetlands Within 300 Ft. Yes_X Business Name: No Subdivision Name: APPLICANT'S NAME:Timothy Friend Phone: 1-860-289-0185 Did the owner of the property authorize you to represent him or her? Yes X_ No PROPERTY OWNER'S NAME CONTACT PERSON Name Timothy&Kathleen Friend Name.Robin Wilcox, Sweetser Engineering Address 887 Ellington Road Address P.O.Box 713 S.Windsor,CT 06074 South Dennis,MA 02660 Phone 1-860-289-0185 Phone 508-398-3922 VARIANCE FROM REGULATIONS REASON FOR VARIANCE #15.211 S.A.$. less than 100' from wetland 65.62' variance requested 415.211 S.A.S. less than 10' from lot line - 6.4l'variance requested #15.211 Septic Tank&Pump Chamber less than 100' from wetland— 71.39' variance requested No Reserve Area. , NATURE OF WORK. House Addition Q House Renovation C Repair of Failed Septic System Che list(to be completed by office staff-person receiving variance request application) Four(4)copies of the.completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) . Four(4)copies of labeled dimensional floor plans submitted(e.g,house plans or restaurant kitchen plans) Signed letter stating.that the property owner authorized you to represent himllter for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for_Z itle V and/or local sewage regulation variances only) .Full menu submitted.(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals(same ownedleasee only],outside dining variance renewals(same owner/lessee only],and variances to repair failed sewage disposal systems (only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask;R.S„Chairman NOT APPROVED _ Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/VARIiMQ. FROM Town Of South Windsor WPCF PHONE NO. 2602912970 Apr. 16 2003 07:29AM P3 �wG[_iaeRI'Iill`It.t.K1NU _I L�y� 12r-J197; P,0 "funothy Friend 887 IEiflin&n Road Sauth'Windsor,CT 06,074 April 15, 2003 'testable Board of Health coo Sa*ee�er EaginoGring . P. Q: Box 713 South Dcauls,MA 02660 KIE:.Rep emAtstion at Board of Health Hearing This letter authorizes Rohin W. Wilcoz 0'fS4w&wEngfncerIng to rc�resent me at the Samstable Board of Health He:adng,to be 11cid on May 27, 2003 rega%ift the proposol septi,s degigtt verianccs f0t TnY property at%2 S)Uth M&in Street,Ccntcrv'IK K4. Sinc��reiy, .. Timothy.Friead i SWEETSER ENGINEERING P.O. BOX 713 —SOUTH DENNIS - MASSACHUSETTS 02660 TEL(508)398-3922 FAX(508) 398-3063 LAND SURVEYING - ENGINEERING - TITLE 5 SEPTIC SYSTEMS April 14, 2003 NOTIFICATION TO ABUTTERS OF: Applicant: M.Timothy Friend CERTIFIED MAIL 887 Ellington Road RETURN RECEIPT REQUESTED S.Windsor,CT 06074 Re: Septic System at 562 South Main Street,Centerville,MA Dear Abutter, A public hearing has been scheduled for the Barnstable Board of Health to take action on an application for variances from the Regulations of the Mass. Department of Environmental Protection, Title 5;and/or the Town of Barnstable Regulations for Subsurface Disposal of Sewage, as follows: TITLE 5 REGULATIONS Section 15:211 Distances requires all Septic System Components be installed 50' from Wetland A 15.62'variance for S.A.S.and A 21.39'variance for Tank&Pump Chamber are requested Distance between S.A.S.and lot line-10' required—6.41' requested Section 15:248 Reserve S.A.S.required for new system—no reserve—variance requested - BARNSTABLE BOARD OF HEALTH REGULATIONS: Chanter III, Section 31 Town Distance requires all Septic System Components be installed 100'from Wetland A 65.62'variance for S.A.S.and A 71.39' variance for Tank&Pump Chamber are requested Town Distance requires S.A.S. be 10' from lot line-6.41'variance requested Reserve S.A.S.-No reserve S.A.S.area proposed—variance requested The application and plans are available for review at the Barnstable Health Department, 200 Main Street, Hyannis, MA 02601, Monday through Friday(excluding holidays) from 8:30 AM to 4:30 PM.A tentative hearing date is scheduled for May 27, 2003 beginning'at 7 PM, please call Barnstable Health Department to confirm date and time(508-862-4644) Sincer Robin W. Wilcox ABUTTERS OF: Tim Friend 562 So. Main Street, Centerville, MA AM 186/47 File#5604 BOH M. Timothy Friend Kathleen M. Friend AM 186/47 Owner 887 Ellington Road S. Windsor, CT 06074 Edmund E. Schmegner 556 So. Main Street AM 186/48 Centerville, MA 02632 School St. Realty Nom. Trust 619 Main Street AM 186/92 Centerville, MA 02632 Patrick Tobin Tr. Tobin Realty Trust AM 186/79 568 So. Main Street Centerville,MA 02632 Lilyan M. Padula and James W. Padula Tr. Lillian Realty Trust. AM 186/78 7 Brown Road Grafton, MA 01519 John Borden Williams Jennifer Morgan Williams AM 206/71 545 So. Main Street Centerville,MA 02632 12-V-2002 "02'26PM FROM SWEETSER ENGINEERING TO 18602912973 P.03 SWEETSERENGINEERffG P.O.BOX 713—SOUTH DMPIIS—MAWLCHUSETTS 02660 TEL(508) 398-3922 FAX(508)388-3a63 LAND SURVEYING--ENGINEEl"1NG—TITLE 5 SEPTIC SYSTEMS SEPTIC_DESIGN PROPOSAL PAGES: PROPERTY SU,R EY,01D FL�t3R PLAN SKETCH � Plene fill sat this form,imdAd1mr&e>Elmr tkm md retum to us with the seed proposal and retainer. This.W9rmation ii Q*=*ftT to groWfy pt! re y"rScp&* em Desist• _•Y_ !F YOU ARE PLA11lYING AN ADDrMN ILEASE INCLU331 TEAT UM)RMA'ITON ALOKG Wrm TEE FOUNDATION DE I MONS AND LOCATION FOR.TEE NZW ADC►MK)N. .�� Total#of moms Year Round Home_ 5easonal Rome; Owner Occaipied Jam' #Bedrooms L Family Room/Den 2 Living Room Dining Room Z #$ _ ✓ ✓O Wuha/Dryer DLTo:vd Ga Serh vice Town w_atier - - O In-ground Electric Wires' O ftWi aund Oil Tank O In-ground.Sprinkles" ✓ir-grvunci Gas A - `__' - °Please.tlotea�sii�. '.'"�--;',•nti. ,wisere:lgcat�ed: Sweerser Engineering a��s nct responstbiIity if in-ground�nmponeatsare:'.� :•�:'�'• damaged,during Soil Teadng%bspead*M Lacadms of pallor Sngtic Sysi�em. �:of Near :...�,.....;:,....:�. Cellar loll Partial(CMWl) Slab Wd�s D Main Usa _lzripfi=Only (4mi ps,oridily j ofda we&) PLEASE:USE TI7iE,SPACE BELOW AND TBE BACK OF TMS SH-M-I'TO PROVIDE US WITH A� :SKETCH THE EXISTING FLMR PLAN(ALL FLOOR'S). Also include any items tfnit should be avowed,iT'rEAU F�,Lc trem.patios,e1letric lines,tanim,ate. -- IP YOU ARE P1AANINGr ANADDITION.PLEASE PROT/Dig ME LOC4770N.lM FOUNDA27ON DI�V�10ft LA16je �-ws n RA i� N Lt� 134 013 0k WATT �s�A3 lV ........... XNA TOTAL P.03 _ _ t vAssss; h �SSACNOSETTS 74 . 10 ill ,y a 1 � Cam• i .6� 10 64 10I L �4- Via 88-1 v o(,• job 70AC. It 4 , �1Ac �' / �, onJL , AV + .V. 70 00 eJssc i r sae B6 � / •OS.:•. i 14 � � FROM Town Of South Windsor WPCF PHONE NO. : 8602912978 Jun. 12 2003 03:06PM P2 w sV "WIJIj aJ.L--ll i i I ,\U I Jwr-n I JCR ci4U1I'me I I%a I U slzomU"&NMONNwiTA[.S,RRVICE INC 49 Pavilion Avenues,I Ncoyidaicc,lthode IBlend 02905 W: 401785 01?0 fiat:401785 3110 DM('IAL, SINGULAIR X nvTENA]V(;E CONTRACT IN MASSACMSE]- For GOAVdd VS9 and Baa+edi j tlsc 3yAMI-Zkdgda 1 yam+'guotarly Te&g A VV Dlakt&� dom 6stem ,;"cg ?his c=M4 enher$4 into betwom Siegmuisd &2vko=ental Sesviaes, �, C Inc,, (SE3i)end J'tha I'`rfe �Io; c yner)July,200it shall be bin.'&18 upon both parties in accordance sit1l the aonclitiOns mid tcaas-set 6&bsIoW: Term.of Conttsot; Jaly 2003 to ady 2005 L0021404 of SIQWairt 562 S,-ttn S�Irg9tt Centerville MA SESi Jab N=bar; !88* Tv,Smsdae aild Watoa*aae uvnhsat shell consist o.'four regal@ eervire Vidita at appn otimately six matinberti'a}9 by"wined tec�tl`,m to; :) leeFeot+lhedmpehoi`eolldafmtkaYl�tehs�r�beraagnetifysheh4mcowaetitpu�apiagie=oaomrr�endod 2) aheak Est UVQMV draw of the moon-IS within DroD�operating limps =1) remove'zed Olean nit Sh dt and 041mml �I) imapect,e0adman of d a Ur,mace if;n m aatyr =� 4eck ov g o8aaad=of uctt � � wmQleJo iaapoction#bsai and>suba�tt a�lhomeowaes acid Jocai/atase authorldat,tf p° �N 1Y ePllueQ; Olt fbr!year rtt report to lovai and Sara replmry agesci ft in additiem to the fgWlrly mCheduled 62Mce vial 91?Si will r pond to="CheduiCd evt=wishiu 148 ]iota period from lime�FRoti33eati�t. SESi will aFDIY s:�hatge for labor,�portarion,and accorcJan�e with t Si�gti;a{t fifty year cxahactgo Irro for rcplseeraant of repair to the as mor mm�m Nor"Chodul"d serv'ce V111ti9 resnittn8 atom prodIgat ate in a ltushster jDft 11ittint with the diradotts ecaulao JIn the Owner's Maculul, >segugencs, tnodUcetiomi of ego4mgUt, terminstlan of eYoctri �tor, � or UU'authorin d ahoMtekls,malfincdons not aMIbutable to 1616 31UP dhwhalr System or Other itugg r use of w 111 result in a service c�(ttrge $7s payable at the#lane of`ertim Should payment be contested or not made,the ba�Mee due WM be app&d in futare scheduled servleo Vhft8* When calling about your gfiWair Wastewater 7Yea>�n�1t Sy9tem, plcaso refer to the SESi Job Number. 9ESi: _Bozo:•�„ Homvovwnar;._ Dabs;_„_`� The oona'dot S275i &year*Ur the�isitral year 9e,'vtee cai�ttraet has UA D,EP requ.tra a WMserylee cmgmct for iaa,!!e a eha >�n. P C & d P�ectenata ,hat l l �► atlurt:o Qo+apTy wldls DEP mandate M9 dance the homeowner to 116UO to,)`bres aitdlar��uh�ye neeaakras. Thdr oonsrac:t tr �e1errccble ±OTAL P.02 2 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION FAILED INSPECTION RECEIVED TITLE 5 FEB 2 8 2003 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY AM WKNT15,BLE SUBSURFACE SEWAGE DISPOSAL SYSTEM F RMHEALTH DEPT. PART A CERTIFICATION Property Address: 562 South Main Street Centerville, MA 02632 Owner's Name: Tim Friend Owner's Address: Date of Inspection: December 28, 2002 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O. Box 49 Map: 186 Osterville,MA 02655-0049 Parcel. 047 Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT 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 Need Further Evaluation by the Local Approving Authority ✓ Fail Inspector's Signature: Date: January 4, 2003 The system inspector shall subm' a copy of this in report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 • Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health, will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 • Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than 'h day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia F 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.] Yes (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either`yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area- IWPA)or a mapped Zone II of a public water supply well If you have answer "yes" y answered `y s to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 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 ? n/a Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ _ Was the site inspected for signs of break out? ✓ Were all system components,excluding the SAS, located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum ? ✓ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes No _ ✓ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 i Page 6 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): n/a Number of current residents: 0 Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system (yes or no): No [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAIJINDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): pd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unavailable Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: Qallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool ✓ Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Original unknown-Pit added on Sep. 13178 Were sewage odors detected when arriving at the site(yes or no): No 6 • Page 7 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) (Cesspool acting as septic tank) Depth below grade: To grade Material of construction: _concrete _metal _fiberglass _polyethylene ✓ other(explain) Cesspool block If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 4'W x 4'T x 6'bottom to grade Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle: 3'6" Scum thickness: 8" Distance from top of scum to top of outlet tee or baffle: -- Distance from bottom of scum to bottom of outlet tee or baffle: -- How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): The liquid level in the cesspool was up to the outlet pipes. The cover was to grade. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: izallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: None (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 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.): PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): 8 I Page 9 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 6'x 6'-1000 gal. leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: ✓ overflow cesspool,number: 1 Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): The pit had 6"of water on the bottom. The scum line was up above the inlet pipe. There were signs of failure. The cover was approximately 2'below grade. The original cesspool(4'Tx 4'W x 6'bottom to grade)was dry. There were signs ofpast failure. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 9 I Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 Map: 186 Parcel. 047 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. &Auk 3 CcssPw 1 f1 B P,r ti T .3 3q y� c c,csp vel � y 3 10 I Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 562 South Main Street Centerville, MA Owner: Tim Friend Date of Inspection: December 28, 2002 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 25 +/- feet Please indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record- If checked, date of design plan reviewed: ✓ Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: Topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed US,GS database-explain: You must describe how you established the high ground water elevation: Using the Barnstable topographic map and the Cape Cod Commission water contours map, the maps were showing approximately 13'+1-to ground water at this site. The cesspools are within approximately 25'of wetlands in the back yard. This report has been prepared and the system inspected and failed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 1 -� TOWN OF BARMTABLE '2- ` SEWAGE# s003- y03 LOCATION VII.,LAGE ASSESSOnnR'S MAP & LOOT �� INSTALLER'S NAME&PHONE NO. or o t SEPTIC TANK CAPACITY i�i a �' ' ''11 LEACHING FACILITY: (type) AZ�� itfj �°� AjtLr (size) 2(v 2� X I NO.OF BEDROOMS BUILDER O WNE0��` PERMTTDATE: <3-2 t-O- 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 Feet A site or within 200 feet of leaching facility) Ed of Wetland and Leaching Facility(If any wetlands exist Feet gqathin 300 feet of leaching facility) Furnished by 1 " 12-27'-2002 -02:26PM FROM SIxIEEfSER ENG I NE:ER I NG TO 18602912973 P.03 S WEE ER FdNG rE.L:/l e.1NG P.O.BOX 713—SOUTH MMIS—MASSACHUSETTS 02660 TEL(308)398-3922 FAX(508)398-3063 LAND SURVEYING—EN(31NE@r,[ING•-TnI-.E:5 SEPTIC SYSTEMS SEPTIC DESIGN PROPOSAL PAGE,2 1 Aug PROPERTY SURVEY A.N7D FLOOR FLLL4IN SIKETC� Plem fill out this foam,imAding the t7avrWan suet&and rem to us with the si1paed pmwul and rcu iw. This isd0rms Wn it aeCMMy to preWfy prepare your Septic Sy*=.Design. W VOt;ARE PLA14NOG AN ADDITION UZAM INCLUDE TIMT nM)RMA170Nt ALONG WrM THE - FOUNDATION DIMENSIONS AND LOCATION FOR THIC NEW ADC►m[ON. 'Total#of Rooms Year Round Home Seasoaal Plane: Owner Occupied R Bedmoms L Family RoomlDm 2_Living Room Diniag Room O Washer/Dryer a Dishwasher .Garbage Dlspo:mai Gas Service ✓Tows�P=.. O growid Elmic Wlres- O In-Ground Oil Tank"' O In- and S er ✓it µ~�-gip:,':;:' [n- �1D Prinkl � -grdunclGasPip�*:..�_•___•._ Please note on mkefth where bated. Swecuer Engineer-mg am=cs no responsibility if in-ground oomponeats ati ;z._: .' �dmm Soil T dama�¢ed �, esdiigg,Inspecti+oms,Locatiom9 of�+iiar bmtallsraion.of New o System. _•,;:4 ' _- CcUr LC l,'ult — .Paciial(Crawl) Slab Wds: O %MR Use 0 imisadola Only Glues ppoy de loea 1 of 4a"VMS) v PLEASE USE'I']iE SPACE BELOW AND TBE BACK OF'TWS SHEET TO PROVIDE US WITH ASICE'Tt'H OF .;_`. THE EXISTING FLOOR PLAN(ALL FLOORS). Abu indadie any item timit should be avoided, trees.patine,eearit lives,tanim,etc- _- - -- IFYOuARE PL4ATI GANADDITlON,FLEASEF.t[OI� ! 7I n LOC4TlONAND J70UNDA27&1NDajENS[0vv . "_ ;W el L MIX R. 41 Lnor = :.... _-__- -- WdATE • � , 'I TOTAL P.03 L O CATION SEWAGE PERMIT NO. VILLAGE INSTA LLER'S NAME i ADDRESS BUILDER OR OWNER S, Ala tv Do DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Pr �., �`� � � �t �� <� - . �U �" ,f. No... ........... ti.� Fmc.............................. THE COMMONWEALTH OF MASSACHUSETTS '�/ BOARD OF HEALTH ....-.-.....Town..................OF.......B-arna abl-e---.-..---..-.._.-.....---------....-...-..._._. Appliration for Dispaii it Works Tomtrnrtinn Urrutit Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal System at: 56_2...59-m-th...Main... -------- ---------------------------------•-------------------------------•----.................•--•--•---- . Location-Address or Lot No. .,t...x9rt4?� 62South Mang..., -Center.Y.i1� ....... Owner Address a A-_&__-B---Cesspool---Service-•-•_--_--_•--•---------------- 128-_Bishops •Terrace_1••-Hyannis - Installer Address dType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms._.____................................_Expansion Attic ( ) Garbage Grinder ( ) .:. 004 Other—Type of Building ____________________________ No. of persons............................ Showers Cafeteria ( ) aOther fixtures ---------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter_:___........... Depth................ Disposal Trench—No_....................._Width—................. Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter_..................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by---------------........................................................... Date........................................ aTest 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--------SSrid-------------•--•-----------------...•••-•-------•------------------•--------•-------------•-------------------.................................... x t., W ------------------------ --------------------------------_------- ------------------- -------------- -• ----------••----- x 1 b00 one iousan, ---aYlon - -------------- U Napm Re at s o Alteratio Answer when applicable_____�_____________�_______.___ . g son�d pa 'Ved overi.ow, -------•------_----- - - --------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with . the provisions of iITi : p 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 f 1 lth- Date Application Approved By....{ �- ' - ...._. ... lt3- 7� Date Application Disapproved for the following reasons_............................................._............................................................. :_... -•------------------•-•------•----...-------•----------------------------------•_._............---•--------•---••---------•---------------------••------------•---------------------------------•------- f Date PermitNo............................................------------- Issued_...... � �J l•- v d-__ ............... Date ,.-.•..^.- ate=': � f,/ u� No. ...... FRs............................... THE COMMONWEALTH OF MASSACHUSETTS 'r"� BOARD OF 'HEALTH . m.O.-in..... OF....... arn°e t,ab'�e.----'-------------•--......._....---------'------ } fira#ion for'' DiapasFal Workli Tontitrur#ion "rani# A&il ,a js;hereby-made for a Permit to Construct ( ) or Repair (X ) an Individual .:Sewage Disposal System of ..................................................... ............. Location Address or Lot No. . �... ....-----•---------•-- 62 South Main St CentervIll e •---•.................•-•••.._. ._.... ---------................ ....•-_. .:... �t Owner a A - e 128Bih ce n ... _......... ... .... , r - Installer Address w Type of.Building Size Lot................. ....Sq. feet lu Dwelling-No. of Bedrooms______ _______ Expanslo4 Attic ( ) Garbage Grinder ( ) Other T e;of Building No. of ersons Showers — 'Cafeteria ----------------- --••--••-•-- Other fixtures .............................. W Designi,Flow gallons per person per day. Total daily flow....................................." __::rgallons. WSeptic IMInkj Liquid'capacity gallons Length______ _______ Width._.__.____.____. Diameter._._.. Dept7� ............ x Disposlj,„.rench Nb ... Width ................. Total Length...................... Total leaching area f ....sq. ft. Seepage33Prt,No ... Diameter ................ Depth below inlet.................... Total leaching ari ......sq. ft. E Other Ss r�,utton bok ( ) Dosing tank ( ) r Percol .ln�. stk Results Performed by =--------------------------- Date._ ' 14 Test�Ity N" 1 ...............minutes per inch .Depth of Test Pit ............... Depth to ground water f ................. (s, T�t Ne' 2..:::..::.:.....minuies per inch Depth of. Test Pit .............. Depth to ground water .................. Descript ti o of foil s' ..................... 4 1 / \ .............................. i _________________________ _____._._.____._._..____._.__ ______..___.____._._____.._.____.__.__._____.... ...................... W ... _______________ ._.. __...._........__.... ..._ x � - -1.--- -- 7 0-00 (dh VA6'( §&hd'j gallv�a------------ U ure. f ate aI s o Alteratio —Ansyver.:'when applicable_____! _.. _________________________________________ _._________.._____. one vacAced, ,over$�ov.e, __,_. #h4fK { ;yen, ,. ��- _ greement. ; The ttnd'ersigned agrees' to install the aforedescribed Individual Sewage Disposal System in accordance with the 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. A-1I-j Date Apphca'YinV Approved ,Be./f ,,,� `�'"�/3 �' " ' 7 t." d^ x,4 I . Date Application�D> approved for the following reasons: 4 __ __.9 �'�:`!'MM ................ ........................................................_._.._._____....___............_._... l 4.+i`r71"+L` � t,•v% ,. ¢ . ,.Date PermitNo......... ....................... Issued-...................................................... t• Date a; THE COMMONWEALTH: OF MASSACHUSETTS 190ARD 0. HEAL H 00 Tntifiratr of Tompliaurr CERPW,4Y Th, `the vidual Sewa Disposal System constructed ( ) or Repaired • . ?..... . /j •........ ......•........ 20 G .z at + ------- ..... �F?s.. . -•--- ........................................ has been installed in accordance with the provisions of r ` of The State Sanitary Code as described in the x application for Disposal Works Construction Permit No. -�_----_-__-._•-- _ da.ted_- / _`................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEal"'WILL FUNCTION SATISFACTORY. Jr is. DATE...............................:,•_______.___.._..........---•.....--•••...-•• inspector................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEAL H w 7 ............ ......� ......OF.. N ................... FEE... .... Permission is herebygrant _.. ._. ...5.,. ___.� g ............... .. ........... . ... ...................................... to Cons rue V or Repair,(' ) Indi M 0 ra e Dis os Sy Street . t as shown on the application for Disposal Works Construction Per„pZij�No....=. f�...._ Dated..../�"�.......................•..... ` / f� J Board of Health DATE 5� `-�..- �--------------------••--•---......-•--•--•-....... �. . FORM 1255 HOBBS & WARREN, INC., PUBLISHERS �M1 ~ PROJECT TIT-LE _flup 0 " r ' { orv... _..... I r. Ai i e ZY L-►6 z s Z 1!° 2-It 4� I I �7�/� Je�'3• - � � . ai _ I' { = 3 UGh�cr b �lT\�� i r � � PARED FOR 1 i 606 P._,i , u y on ��a' C struc#ion Compa ny, I D{nt{N1�Y111 Kk�G1J 6 Steve-Devlin -m President . . . 261 Blackthom Drive•Marston Milk,MA 02648 508420-13.40 i Z4�(6 1 a� Lys 6 i ZD 3 Loa C SCALE O a DATE DWG NO. DESIGN Sr0 tvLhN CHECK DRAWN 'OF PROJECT TITLE Cal 9-,w o i I - bor_ OR z v �:, i - 6 ;'e a• i {: 1 I 2ti - �' — _ _ ._ i , � PREPARED FOR _ } I ii - - h Central Construction Com an (}/• ) ? I ` 't _IL Steve Devlin •President. 0 I 261 Blackthorn Drive• 0 •Morstons Mills,MA A48 508-42t �., SCA�: = II .O ! DATE DWG NO., DESIGNS to CVLk CHECK DRAWN 20 FT. MINIMUM FROM CEO:A.R 4" SCHEDULE 40 PVC PIPE SOIL TEST P f 10*451 H�CHDrtAR1C i c.T � CLEAN SAND VENT W/CARBON F'_TER DATE OF SOIL TEST 1G MlN+MUM FROM SLAB OR CRAWL SPACE r M.N. PITCH %8" PER -- ;NSf'ECT'OI`: PORT PAINTED DARK FLAT BROWN SOIL EST DONE BY $�WEETa2_LNQl�(FFRING TOP OF FOUNDATION � _ - - r 2" LAYER OF T ELEV. = 1_&_O_ 10 FT. MINIMUM \ \1/8- TQ '/'2„ CAP & WITNESSED BY (NGvG) ! ® 2" PRESSURE PIPE - _ ia.!!0 WASHED STONE VALVE O&MVATM HOLE I ELEV.= 18.20 _ 24" MANHOLE�-� TREATMENT E136 - - --_ 1�� �. PERCOLATION RATE _ < �_ MIN./INCH AT 84 INCHES COVER \ TREATMEN PLANT 150 PSI MINIMUM - � /� ' _ \MODEL 960 ON ir 24" MANHOLE �, I ' �i - I DEPTH HORIZ TEXTURE COLOR MOTT. OTHER COVERS { z ! 0-10 FILL NO 3.00 - ----+� ��- Moo �- 4" CAST IRON PIPE I (OR EQUAL) MiNIM'JM i \ 0 0 ! 0 1 i I I I ELEV = _12.80- a 10-17 B LOAM' SAND i 10YR5,/4 PITCH ? a" PER FT:. 2" DIAMETER of I -. 00 0 12. civil / �AZINOLE VA o 1 ro i 17-132 C MEDIUM SAND 7.5YR7/4 LIN t :)�D o�ji__. ° ° o o o o ° o o "o 0, 0 0 0 000 o O 'J O O p n p G 1 0 O O�p 3/8" DR!L_ -�__ .. -�-_ ---��Ems= i4c.a�! 5L16" DIAMETER ELEV. _ _1QQ_ 10" ! HOLE 12.eo__ 24 STANDARD INFILTRATORS Zi -" _ - DRAIN HOLE MIN. ( L�J C WITH STONE IN AN _ ELEV. = 14_00_ 1 x 3 MANIFOLD 26' X 29' FIELD FORMAT!ON �10 LE V, CHECV SOIL ABSORPTION WELL NIA U VALVE 3/4" TO 1 1/2" ZONE WASHED STONE 'SYSTEM � ---�---_ ! --1- (TO BE PLACE, ON IPRM BASE) L_�.__- (SAS) INDEX ! , MYERS SRM 4 0.4 HP i ADJUST NO WATER ENCOUNTERED AT i,3L_ ELEV, SINGULAIR TREATMENT ; PUMP \- (OR EQUAL)GPM W; 2 HEAD -- ' DESIGN CALCULATIONS PLANT USGS PROBABLE WATER TABLE ELEV. _ CH R i:'BSERVED WATER TABLE ( / / ) ELEV. = _ 6 " CONCRETE BOTTOM OF TEST HOLE ELEV. = __ NUMBER OF BEDROOMS _ 5__ SAMPLE CATCH AND H--20 B0' GARBAGE DISPOSAL UNi'. _ NO _ RECIRCULATING PUMP 00 G T T0(110 ESTIMATED GAL/�/DAY X 5 BR.) __5S0 GAL./DAY LOW l(iT I T PUMP CHAMBER CALCULATIONS. MINIMUM TANK SIZE _- GAL. I ELEV. A N rER NlE - �- E-Ev. A, ALARM ON ACTUAL TANK SIZE _15._ GOAL. ULTRAVIOLET,, IDISINFECTOR GPM 6 -_� - 'REQUIRED F )W PER CYCLE 25 k ,'�,'� = 1�7.� GAL./CYCLE 1 SOIL CLASSIFICATION ELE`v AT PUMP ON OLUME PER '.'YCLE R§ GAL/CYCLE /7.48 GAL./CU. FT. = 1& 8 CU. FT,/CYCLE r < UV "THE/j*S,tNFECTOR" INC. EL EV AT PUMP OFF - - ; , ,_ME ;jF vtATER IN PIPE 3 14 X O OQ694 k _ _ FT = _Q44 CV FT DESIGN PERCOLATION RATE � MIN /N. BOTTOM OF INSIDE PUMP CHAMBER - 'C"� MiNIMLM VOLUM- PER CYCLE T EFFLUENT GOADING RATE Q��-/� GAL./DAY/S.F BOTTOM OF OUTSIDE PUMP C�AMBEk �---- "1�.� CV F ) LEACHING .AREA 1fd-M SQ. FT. SEWAGE DISPOSAL SYS V PROFILE DISCHARGE _1_�� GU FT / 36.11 CU FT./FT a -0.52_ FT. (10.F Q.S.T. -STORAGE CAPACITY (�_ GAL./DAY /7.48 GAL./CU.FT./36.11 CU.FT./FT. = 2.04 FT. 29 X Zd SCALE __za4__. REQ iRED _ZL}Q PROVIDED _-� LEACHING CAPACITY (AREA X RATE) 557•_98 GAL./DAY f r�.3 / �/ 10 0 754.00 X 0.74 17. THE CONTRACTOR IS TO CONTACT THE DESIGN ENGINEER FOR THE RESERVE LEACHING CAPACITY NO _ _ GAi_./DAB y ' I FOLLOWING MINIMUM uNSPECTIONS: f j j LEGEND: 1. STAKE OUT SYSTEM. NOTES: 2. PRIOR TO AND DURING THE SETTING OF THE TANKS. 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. EXISTING SPOT ELEVATION D0.0 3. !F ANY DEBRIS IS ENCOUNTERED DURING EXCAVATION � J T TITLE 5 AND THE TOWN OF _.����F. RULES AND EXISTING CONTOUR ---00---- 4. EXCAVATION OF THE SAS, PRIOR TO FILL PLACEMENT. REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. FINAL SPOT ELEVA7'`N 0 5. COMP! LA ?ON OF ALL PIPING. BE BROUGHT TO 4.8 5 FINAL CONTOUR---•- C -- 6. COMPLETION 0� SEPTIC SYSTEM, PRIOR TO BACKFILL 2. ALL COVERS TO SANITARY UNITS SHAD / t.6/ ` + 1 / SOIL TEST ' OCA'nOf: WITHIN 6" OF FINISHED GRADE - � 7. FINAL INSPECTION AFTER FINISHED GRADING AND LANDSCAPING. 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF c: \ UTILITY POLE. -J- 18 VARIANCES TO BARNSTABLE REGULATIONS AND TITLE 5. { C�l / •, � / / T � -�--- WITHSTANDING H-20 LOADING OWN WATER 4 ��--W A SCIL .ABSORPTION SYSTEM LESS THAN 100' FROM WETLAND. CATCH BASIN i B. SOIL ABSORPTION SYSTEM LESS THAN 10' FROM LOT LINES a. ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALT 1 GAS LINE -,-- =- -- C SEPTIC TANK & PUMP CHAMBER LESS THAN 100' FROM WETLAND, BE MORTARED IN PLACE. I �t�i 5.5 / / CESSPOOL C.P. i D. NO RESERVE AREA. 5 NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WIT' / 'S // /1 / J �P'� --.�-d�C 0 19. CONTRACTOR TO SUPPLY ANY NEEDED SHORING. DEEDED OR ZONING REGULATIONS. OWNER APPLICANT !S TO Ci_EANr !T / "uv�FILTER 20. CONTRACTOR t; TU SUPPLY A CLEAR PIPE GRADUATED W'; 1" MARKINGS OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. ! Fr,. P�� - : R!E r'0N A`EPA 6 ,TL!TIE' SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR A • ,'L/• •V�NI '�j m� ' `�. �. CCS i,-.l Y , ,,..,Te 'i.4..t�.._.-7'1 Z3 .A'r t A`�T t-i"'�{ c O' &. l!AAICTCR' i � i T ;- _ . 7. �'OR TO (;0�"fME�,:�i��tC, 'WORK ON SITE. � ' N1RAC _,,F F4 s GRADE$ AND ELEV 0NS AS W£ AS CATCH /4 DISTRIBUTION LINE � 5/16" HOLES 0 5' 0,C. /� SITE COND"'ONS PROR PTO GOMMENC•NC WORK ON SITE. AN, 'AR A'ON I 18.9 L A TERNATE SIDES S O BE BROU H� TO CIE ATTENTION OF THE DESIGN ENGINEER COI � DE i cj (® 10 AND 2 O'CLOCK) pMEDiATELYr FLOOD ZONE A�itLi0�0I. 1t B I 8. PARCEL IS IN 1 - -^ 9. LOT lc SHOWN ON ASSESSORS MAP _.1 AS PARCEL 33 ti / ' `? o`- -�� L `- 10. PUMP AND ALARM ARE TO BE ON SEPER.ATE CIRCUITS. SIN/GU R 1 .Y vc'- 3" PVC MANIFOLD END VIEW 11• ALARM IS TC BE BOTH AUDIO AND VISUAL. / 9 0 Dv DISTRIBUTION LATERALS SIDE VIEW 12. AN DISINFECTING ULTRAVIOLET LIGHT IS TO BE INSTALLED. A AT 50" O.C. 13 AN ELECTRIC PERMIT IS REQUIRED TO WIRE PUMPS, LIGHTAND AL ARM 14, ALL UNSUITABLE MATERIAL SHALL BE REMOVED FROM UNDER AND 1 VALVE �9 2 5 S.Oi--.� i OR A MIPv1MUM OF S AROUND SOIL .ABSORPTION SYSTEM AND BE ' .3 BOXESIT i le REPLACED WITH MATERIAL AS SPECIFIED IN 310 CMR 15.255.(3). I T - - T t - 15. EXISTING CESSPOOLS .ARE TO BE PUMPED AND 2 I �^ REMOVED ALONG WITH ANY POLLUTED SOILS. j N 16. THE SEP71C TANK AND PUMP CHAMBER ARE TO BE SET ON A -!RM 74 +\\ BASE OF -3/4" TO 1 1 /2" STONE 6" THICK. 16,5 -- -- APPROVED: BOARD OF HEALTH 16.9 5' 5.0' 5,0' { L.C. Pi TOP VIEW - / DATE AGENT j o 6.7\ PROPOSED SEPTIC D��GN i �o >< 1s.2 / ej 9 '6.23'�` MAIN FOR I I ,• , LOCUS 0+•%' Fw / \ / i � \\ f - f' �c7 / 16.7 G I 18.00 1805 / j- i `�\ PROJECT LOCATION '! 16) 15. \ CB (END. i �Tf t T V { j 16.5 . 2.2 ` ' ' CE11 1 r1R�, BASTABli� 1 I 1 t / ! / k I 4,� 129 !! fir }� �3, 1 1 �� 15.6. fi'4 4 !ag 00 / ��' a7 tl� M �,� t 235 GREAT WESTERN ROAD � \' �= 13.8 \ / ,l / /EEL P. 0. BOX 713 i g i CENRI?.LE 508- c 60 Pdwo / --. {98-3922 SOUTH DENNIS, MASS. 026E0 4" H/GH R Af c 12.1 77PPED 6 x 12.2 / _ DATE SC ALE U ,.� - M A �6, 200,3 + jOB NO {� M 1 5#iUR� .3t3 tS z% PO 7.8 REVISED 5604-� L_ CO I Ti 0 N ^��A.� ; ; REVISED I � SHEET 1 OF I L r ✓ ---___� �/ ___ -��,-� ��__ _- __��_��__-_-- ---_-_--__�_____ .__,_._ C: '�SB`iPROJ`-0©�dwg'�-OO.DWG 02003 SWEETSER ENGINEERING I D - W - TUB • PORCH SL OPE CL. ` STORAGE W PRATH. ►� I REF. O I 8 T l J I , D D W l� IT —� 9 Co 4�" ^�cy 8 -6 CL. CO. W W W HALL CH. CO SR. 3 ^ Ki T D HALL � i Lu . �cV ON m rn CL. CL. DIN. D _J'-4 v REF CO. CL. 1 2 1 H I 8'- 11L» W CL KI T . STOVE N 1 I 7'—8 11 '-51 i Ll CO. 16'--2� w i BR. 2 W D CO. BR. 4 L I V. w ( I � 4) W CL. DIN. W p 1 CL. o0 w SL OPE CL. p 31 2 SL OP CL. — CO. -� I W 8R. 1 HALL CO. 25 — ' FIHS PLAN WAS DR-.WN AND IS i � ' ROOF BELOW T() BE USED t:OR �r11E EXPRESS � PU IRD ON HEAlfll OBTAINING BOA VARIANCE CL. \ NOR '17'1'1,E S SEPTIC DESIGN. CRAgi W W D aiQw r W W PORCH LI V. F;., W; I EX, S TING FL OOF' I �� 15 — EXISTING FLOOR PLAN PL4N No 1 -962 _ D;_ 1 5-03 TIMOTHY FRIEND w w D w w LEGEND: REVISED CC CASED OPENING (NO DOOR) —2 2 W DOOR LOCATION 562 SO . MAIN STREET DW SL LIDIN S G DOOR CENTERS MASS _ EXISTING FIRST FL DOR CRAIG 1� SHORT P. E. DESIGNED b r #z35 GREAT wt5 TERN RUAV P.O. BOX 1044 508 398—b311 SOUTH DENNIS-, MA 02660 SCALE 1• = 4p DRAWN BY CRS DJS IFILE No 1-962 02003 CRAIG R. SHORT, P.E. SHEET No