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0023 STAGE COACH ROAD - Health
23 STAGECOACH RD. CENTERVILLE - A = 172 110 UPC 12534 N0.2-153LOR AQ�GONSJ��o- HA$TINGB,MN t TOWN OF BARNSTABLE LOCATION �01-f C�I�-SEWAGE# CJ�a VILLAGE �'r�+r/��/1���= ASSESSOR'S MAP&PAR EL 72-//b \ INSTALLER'S NAME&PHONE NO_�DF�Z4- a-5eA 15,g,enrS SEPTIC TANK CAPACITY LEACHING FACILITY:(type) = (size) NO.OF BEDROOMS OWNER d" PERMIT DATE:3��-,° °.�.� COMPLIANCE DATE:,3";Z 0 Separation Distance.Between the: Maximum Adjusted,Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feef Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY � nn GA 1-7 Al z 3. 3 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppYitatiou for Disposal *pstrm Construction 30rrmit Application for a Permit to Construct( ) Repair(e4-Upgrade(�andon( ) ❑Complete System ❑Individual Components Location Add re o. 3 ��j/_'Cps C// Owner's ame, ddre s, d Tel.No. Assessor's Map/Parcel In taller's ame,Address,and Tel.No.5`Og—��o �738 De igner's ame,Addr ss,and Tel.No.SD$ ✓sose,��, D e (3�r�vs 1,SP&W Z_/�i� , ;61 Type of Building: Dwelling No.of Bedrooms .3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 0 gpd Design flow provided 3 747 gpd Plan Date Number of sheets Revision DateZook A-111 Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) /5 00��lG 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 Certificate of Compliance has been issued by this Board of Health. Si Date Application Approved by Date Application Disapproved by Date for the following reasons � �t�rQ Date Issued � Permit No. �� THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA y No. Lo"�� (U i ter: `n Fee ,V y THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes. 01pplitation for Disposal *pstrm Construction 3pPrmit Application for a Permit to Construct( ) Repair(Upgrade(G),,A6andon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 411 12d Owner's Name,Address,and Tel.No. Assessor's af/Parcel Installer's Name,Address,and Tel No �7%:3v Designer's Name,Address,and Tel.No. c G _ _C616.U, '�/-/'tF7•.,� i:4�' T /'/ �i„y rrCfl� .'7,�/` ''/l r �/ t— 's7 `ih-I 71 'i /; TyPe of Building: Dwelling No.of Bedrooms -7, Lot Size sq.ft. Garbage Grinder k > Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) '� / gpd Design flow provided 7/ gpd Plan Date y Number of sheets Revision Date 2 ' Title Size of Septic Tank Type of S.A.S. Description of Soil k , I 'Nature of Repairs or Alterations(Answer when applicable) i 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 Certificate of Compliance has been issued by this Board of Health. Signed —i., '7 / — 1._n> Date -. , / Application Approved by Date / r Application Disapproved by Date for the following reasons Permit No. � � �j Date Issued -----------------------------`=------------------------------------------------- ---------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS }R Ctrtificate of Compliance THIS IS TO CERTIFY;.that the On-site Sewage Disposal system Constructed( ) Repaired( �•)� Upgraded Abandoned( )by at ; i/,-,/ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No Bls gated -3 A�/ ew Installer��, s ,>:o�, /�� / 0„�5'. Designer 5' #bedrooms / Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will func �s)7�8 igned. Date: Inspector ti - - T/ ,,1 �i V No. /Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction 3pPrmit Permission is hereby granted to Construct( ) Repair( `)- Upgrade( ,) Abandon( ) System located at ! - _ ' ' and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed a within three years of the date of thi Cb Date Z-1 r'� Approved CL�) � /' — Town of Barnstable Inspectional Services Public Health Division 6 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 3/26/2020 Sewage Permit# 2020-061 Assessor's Map\Parcel 172/110 Designer: Horsley Witten Group(Joe Hendersonlnstaller: Joseph DeBarros-�/ Address: 90 Route 6A Address: 5</�'_,i W!W-e/ W01� Sandwich,MA 02563 On 3/2/2020 Joseph DeBarros was issued a permit to install a (date) (installer) septic system at 23 Stage Coach Road based on a design drawn by (address) Horsley Witten Group dated 9/26/2020 (designer) X I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in compliance with the to rms of the AA approval letters(if applicable) tµ OF yA JOSEPH E. o HENDE _.. H M0. m ( staller7 Signature) (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. WoaldeptMEALTMSEWER connectlSEPTICtDesigner Certification Form Rev 8-14-I3.DOC 7745213547 MW TRIBE HOUSING OFFICE Mashpee Wampanoag Housing 09:54:26 a.m. 03-02-2020 2/4 BARNSTABLE LAND COURT REGISTRY Doc:1.391s189 02-26-2020 3:5S BARNSTABLE LAND COURT REGISTRY fti Deed Restrictionogle , A k Whereas, Michelle Tobev,of 23 Stage Coach Road. .Centerville, Massachusetts,is the owner of property located at 23 Stage Coach Road, Centerville,Barnstable County,Massachusetts,by Deed recorded as Document Number/tf--V &3 shown on Certificate of Title Number a140 Af o said land being shown on Barnstable Assessor's Map 172 Parcel 110 and being . shown as Lot_on Land Court Plan—filed in the Barnstable County Registry of Deeds Land Court Department Xo v, �,c.�,� 3a8v�/'•i3 Whereas, (owner),as the owner of said lot,has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in the home built on the existing said lot. Whereas,The Town of Barnstable Board of Health, is requiring that the agreement for the restriction of the number of bedrooms in the house on the lot be put on record with the Barnstable County Registry of Deeds by recording this document. J� Now Therefore, Michelle Tobcy does hereby place the following restriction on the above referenced land in accordance with this agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding upon all successors in title: 1.Lot 110 Land Court Plan 8 E, house V-33 Stage Coach Road, Centerville. Massachusetts. may maintain upon the lot a house containing no more than 3 bedrooms. Michelle Tobev hereby agrees that this shall be a permanent deed restriction affecting the above described premises so long as the premises are not serviced by a public sewer. If in the futuie the premises are serviced by a public sewer, then tines restriction shall terminate. For title see deed recorded in the Barnstable County Registry of Deeds as Document Number / 3 noted on Certificate of Title Number cZ Z,t%s—.2— Executed as a sealed instrument this day 20� Si ature 0&s►- Mich ell Tobev Typed Name .7745213547 MW TRIBE HOUSING OFFICE Mashpee Wampanoag Housing 09:55:00 a.m. 03-02-2020 3/4 w w � 4 .� M BARNSTABLE LAND COURT REGISTRY O VJ O ' c4 1 �o ell COMMONWEALTH OF MASSACHUSETIS (NOTARY PUBLIC I1VFORMA770N w a M w • Barnstable,ss U G year . On this 42L day of d 2abbefore me,the undersigned notary public, personally appeared Michell obey,proved to me through satisfactory evidence of identification,which was a Massachusetts Driver's License,to be the person whose name is signed on the preceding or attached document,and acknowledged to me that he signed it voluntarily for its stated purpose, Notary Public: Com Exp:_ in&ZL. 3 ! EO:SHEILA SHURTLEFF 4,� 1. �Cort--"Afi of AlceaacAwetii �� �COmnection E+yr_0d 79�Q21 ury /��"•.�..a o„.r'•`• 6AF►NsrABL E COUNTY REGISTRY OF DEEDS A TRUE COPY,ATTEST JOHN F.MEAD REQIBT®N BARNSTABLE REGISTRY OF DEEDS John F. Meade, Register .77745213547 MW TRIBE HOUSING OFFICE Mashpee Wampanoag Housing 09:55:14 a.m. 03-02-2020 4/4 •::---; d f f „ RECEIPT Printed: February 26, 2020 0 15:58:5 BARNSTABLE LAND COURT REGISTRY JOHN F. MEADE. REGISTER Trans#: 43246 Oper:DIANNEJ MICHELLE TOBEY Docn: 1391189 Ct w 1107 Rec:2-26-2020 @ 3:58:51p BARN DOC DESCRIPTION TRANS AMT 1 TOSEY, MICHELLE D RESTRICTION 30.00 County Fee $30.00 Surcharge CPA 50.00 State Fee $20.00 20.00 Surcharge Tech $5.00 5.00 Document Copy -Man 2.00 Total fees: 107.00 ■** Total charges: 107.00 CHECK PM 250 107.00 i i Town of Barnstable BAMSTABLF� Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 John Norman Donald A.Guadagnoli,M.D. Paul J.Canniff,D.M.D. October 2, 2019 Ms. Beth Kittila Horsley Witten Group 90 Route 6A Sandwich, MA 02563 'SItPgP Coach E!Dear Ms. Kittila, You are granted variances on behalf of your client, Michelle Tobey, to construct an onsite sewage disposal system at 23 Stage Coach Road, Centerville, Massachusetts. The variances granted are as follows: 310 CIVIR 15.4050): To construct a soil absorption system 4.42 feet above the maximum adjusted high groundwater table, in lieu of the minimum five feet vertical separation distance required. These variances are granted with the following conditions: (1) The new septic tank shall be located closer to the foundation in order to increase the pitch to one quarter inch per foot. The engineering plans shall be revised to show the relocated septic tank. (2) No more than three (3) 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. (3) 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 three (3) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. Q:\WPFILES\Kittila Tobey 23 Stage Coach Road Sep20l9.docx (4) The septic system shall be installed in strict accordance with the revised engineering plans. (5) 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 revised plans. This variance is granted to allow a gravity flow system onsite (rather than a pump system). The proposed system will be redesigned to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sin re yours, ohn Norman. Chairman Q:\WPFILES\Kittila Tobey 23 Stage Coach Road Sep20l9.docx �1NE DATE: $95.00 FEE*: BARNMEM ,0� Town of Barnstable REC.BY: {'3 ,•:-a SCHED.DATE � s Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi VARIANCE REQUEST FORM LOCATION `� Property Address: (� Assessor's Map and Parcel Number: t�2 — t `� Size of Lot: V Wetlands Within 300 Ft. Yes Business Name: No � 'n nn(((( Subbdiiv(issiion Name: q APPLICANT'S NAME: 9"t(Vr►rC,l l� T Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON_ �jQ/ Name: KO NA- V Name: Address: 'S�00 �06 t l Address: _O GkX 0 A �a4-CWOW Phone: l F11V� Phone: 63 ^Vo EMAIL: '�l V Vt`C - 1 VARIANCE FROM REGULATION pnol.Reg.Code ) REASON FOR VARIANCE(May attach separate shee if more space needed) a ` 1I NATURE OF WORK: House Addition House Renovation LJ Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit first four on list as 5 collated packets. A. Five(5)copies of the completed variance request form B. Five(5)copies of MA DEP approval letters for Innovative/Alternative septic system(when proposing an I/A system or secondary treatment unit(S.T.U.). C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: health@town.barnstable.ma.us D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version. 41 A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or R.S. Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). Fee Submitted*$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3)New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance"). Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Donald A.Guadagnoli,M.D. C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\QDLJENHC\VARIREQ Rev APR 4- 2018.docx � S 7 MAIL-IN REQUESTS REASON FOR DISAPPROVAL Junichi Sawayanagi Please mail the variance fee amount of $95.00 (if applicable), along with the documents listed below, to the following address: Checks payable to: 'Town of Barnstable. Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 For septic system variance requests, each of five packets must include: 1) Variance Request Form, 2) Letter for the Board with further information on the reason for the septic variance request (Optional), 3) MA DEP Approval letters for proposed Innovative Alternative (I/A) septic system or a proposed secondary treatment unit (S.T.U.) 4) Engineering plans, 5) Floor plans. In additional to the five septic packets above, include one copy of the seven (7) page checklist, the authorization letter, copy of abutters notice, and fee, if applicable (see checklist below). Please send one electronic submission using a PDF or .jpg of the engineering plan and floor plans to email: health _town.barnstable.ma.us. (Total email must be less than 10 megabytes.) For grease trap variance requests, each of five packets must also include a full menu. (see checklist below). Checklist - Please submit first four on list as S collated packets. A. Five(5)copies of the completed variance request form B. Five(5)copies of MA DEP approval letters for Innovative Alternative septic system(when proposing an I/A or secondary treatment unit(S.T.U.). C. Five(5)hard copies of engineered plan submitted(e.g. septic system plans)and one(1)electronic version submitted to email: health@bamstable.ma.us D. Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version submitted to email: health@town.barnstable.ma.us A completed seven (7) page checklist, confirming all required items are on the engineered septic system plan submitted by engineer or registered sanitarian. ' Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant must notify the abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only) Fee Submitted*$95.00 for the following variances: 1)New construction,2)Septic repairs with increase in flows,3) New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an increase in flow and variances granted at the counter. 2) Monitoring Plans, and 3) Temporary Food(this is not a variance). Variance request submitted at least 15 days prior to meeting date. For further assistance on any item above, call (508) 862-4644 Email: health(cDJown.barnstable.ma.us Back to Main Public Health Division Page 1 f ' V Horsley Witten Group Sustainable Environmental Solutions 90 Route 6A•Und 1•Sandwich,MA 02563 508-833.6600•horsleywitten com f h September 10, 2019 Barnstable Board of Health 'j 200 Main Street Hyannis, MA 02601 Re: Septic System Repair— 23 Stage Coach Road, Centerville, MA Dear Members of the Board:. Please find enclosed the septic repair plan.at the location referenced above. The existing failing septic system will be replaced with a Title 5 compliant system. No increase in design flow is proposed. Assessor's data indicates the residence is a three- bedroom home. The septic system repair includes a 1,500-gallon septic tank, a 5-outlet distribution box and a 20' x 25' leach field. The existing septic system for the residence will be abandoned in accordance with Title 5. To accommodate the proposed septic system, one variance is being requested from Title 5 as follows: 1. Reduction to estimated seasonal high groundwater; Section 15.402(1)(h): 5' required, 4.42' provided (variance of 0.58' or 7" is requested). Granting a variance to the groundwater separation will allow a gravity system to be installed, otherwise a pump chamber will be required. No increase in flow is proposed. Thank you very much for your consideration. Sincerely, HORSLEY WITTEN GROUP, INC. �WV l Beth Kittila Design Engineer HorsleyWitten.com E @HorsleyWittenGroup ®Horsley Witten Group, Inc. SECTIONSENDER: COMPLETE THIS SECTION COMPLETE THIS DELIVERY ■ Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse ❑Agent so that we can return the card to you. ❑Addressee A Attach this card to the back of the mailpiece, B. Receive ed.Name) • 't. Date of Delivery 'r on the front if space permits. 1r P I. Article Addressed to: D. Is d address item 1, enter delivery below: Prop ID:173048 z EP 13 2018 1' BORDUN,JASON W 0 36 STAGE COACH RD CENTERVILLE,MA 02632ol ��� �•r� ��� cbL II �II III II I'I I II II I I'II I II I I II IIII I II I I I I S ice at. ❑Registityered real)Express® ❑AdTyp ult ature ❑Registered Mail ❑Adult Sign M I3t�Str+et i DelfYery ❑R Istered Mail ResMcted ❑Certified Mali® D ery 9590 9402 2594 6336 3832 64 ❑Certified Mail Restricted Delivery turn Rwelptfor ❑Collect on Delivery Merchandise _2._Article_Number_Mansfer-from service:iabe/l t ❑Coi[act on Delivery Restricted Delivery ❑Signature ConfinnationTm " i I Mail 0 Signature Confirmation 7 018'': 3 610'.0 0B 0 6 0 2 i 2 6 EF '. i Ma I Restricted Delivery 00) Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ; First-Class-Mail .Postage&Fees Paid USPS Permit No.G-10 9590 9402 2594 6336 3832 64 I I I United States Sender:Please print your name,address,and ZIP+4®in this box* OostAF Service ! Horsley Witten Group, Inc. 90 Route 6A, Unit#1 Sandwich, MA 02563 i i i il'ifilliliii'llivili.liiti.isjif'lioiii-;iiiiilil litflpiIi.lji.i1i � fI i SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse ❑Agent so that we can return the card to you. X s Z0 ddressee ■ Attach this card to the back of the mailpiece, B ived by(Printed r C. a Delivery or on the front if space permits. 1. Article Addressed to_;__ D. Is delivery address di t It 11?13 If YES,enter delivery belowt Prop ID:173025 LIHOU,IRENE W&CLIFFORD L JR 1052 OLD.STAGE ROAD CENTERVILLE,MA 02632 � k_ I I I II IIII I II III I II II I IIII I II I I I I(III I(I II I II I 3. Service El Adult e 0 Priority Mail Express@ ❑Adult Signature Restricted Delivery ❑Reeggistered Mail Restricted ❑Certified WHO 9590 9402 2594 6336 3832 26 ❑Certified Mail Restricted Delivery t1 Z m Delivery Receipt for 13 Collect on Delivery Merchandise 2. Article Number(Transfer from service IabeQ ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTm ; - r^ _ q_Insured Mail ❑Signature Confirmation .7016 `0 3 6 0 0 0 0 G 6-0 0 2 2 6 6 7 . lured Mail Restricted Delivery Restricted Delivery !er s500) PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt Up � ` `r,. ,s First-Class"Mail P PS Postage taa&'Fees Paid I ? - Permit No.G-10 I 9590 9402 2594 6336 3832 26 i United States 'Sender:Please print your name,address,and ZIP+4®in this box• stall Service i Horsley Witten Group, Inc. 90 Route &A, Unit#1 Sandwich, MA 02 6-3 i ij�lp(iif�}I1+ji,<I►lisi�tl�,i�iltl�ft�fl��liitii.F}� ip�j.is�'ili K., COMPLETESENDER: CGIMPLETE THIS SECTION • ON DELIVERY ■ CQm lateitems4 2,.and3 'A°*Sig lure . _ C% �.: .. ❑Agent ■ Print your name and address on the reverse X I so that we can return the card to,you. ❑Addressee ■ Attach this card to the back of the meilpiece, e. eceived by(Printed Nam) C. D e of elivery or on the front if space permits. R /t 1. Article_Addressed to: _ -- D. Is d ivery add ss di ff ' t from item 1? ❑Yes r If YES,enter delivery address below: ❑No Prop 1D:172108 LAWTON,DAVID %TAYLOR,BRYAN MATHEWSON 18 STAGE COACH ROAD 4 CENTERVILLE,MA 02632 II I IIIIII I'll I'I I II ll l I'll I II I I I it IIII I I I I I III 133. Service Type 0 Priority Mail Express® ❑Adult Signature ❑Registered MaIITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted ❑Certified Mail® De�ltery 9590 9402 2594 6336 3832 33 ❑cerdB t7-t't�certified .Reoalptfor ❑collect on Delivery Merchandise ❑Collect on Delivery Restricted Delivery ❑Signature ConfinnatlonTM _2._A[ticleNumber(Transfer from service/aben ___ ❑Signature Confirmation 7 018 b 3 6 0 0 0�014 6 D 0'2 20 O r 1 1 ai t nail Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt USPS TRACKING First-Class Mail Postage&Fee's Paid USPS Permit No.G-1Pp j 9590 9402 Y2594 6336 3832 33 jUnited States •Sender:Please print your name,address,and ZIP+4®in this box* Postal'Servide Horsley Witten Group, Inc. 90 Route 6A, Unit#1 -Sandwich, MA 02563 i i .... i!'a� �ilf a• i � ���! 11a } j'y. �•�_. . "•� �t• !i r� 1 r � ! t I ,, a , COMPLETE'SENDER: COMPLETE iHIS SECTION / ON DELIVERY ■ Complete iterns t,v2,•acif 3• A s' n tur ■ Print your name_ 66-dA_dress on the reverse X �� ❑Agent so thaYwen reti3rlthe card to you. ❑Addressee B. R,ceive y(Prin Name) C. Date of D very ■ Attach this mid to he back of the mailpiece, or on the f�Mfiflf space permits. _ LL 1__Article_Addressed_to:-- D..Is delivery address different from item 1? ' Yes If YES,enter delivery address below: ❑No Prop ID:173047 BURTON,KAHLER B \ \� 35 STAGE COACH ROAD I CENTERVILLE,MA 02632 t� /gi001-y 6� Il I�Ill�l I'll I'I I II lI I I'll I it l I I it IIIII I i Il III 3. Service Type 13 Priority Mail Express® ❑Adult Signature ❑Registered MaIIT'^ ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted ❑Certified Mail® Deyl'tery 9590 9402 2594 6336 3832 57 ❑Certified Mail Restricted Delivery l�Cetirm Receiptfor O collect on Dellvery Merchandise 2._Article Number(Transfer from servic®_labe/l-_, Collect on Dellvery Restricted Delivery p Signature ConfirmationTM 7 016 �0 3 6 0 0`0 0 0 '6 0 0 2 2 63 6- - `i OMail Restricted Delivery Signature Confirmation lion Ps Form 3811,July 2015 PSN 7530-02-000-9053 bomestic Return Receipt USPS TRACKING# First-Class Mail Postage.&Fees Paid, USPS Permit No.G-10 9590 9402 2594 6336 3832 57 United States •Sender.Please print your name;address;and ZIP+4®in this box* Postal Service Horsley Witten Group, Inc. 90 Route 6A, Unit#1 Sandwich, MIA 02563 I I g yp off 1f1i1 fill COMPLETE •MPLETE THIS SECTION ON DELIVERY ■ Complete items 1,`2;' tf'3. A Signature ■ Print your name and atleiress on the reverse X IZ7—" / ❑Agent so that we can return the card to you. �—'. , " ❑Addressee ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name C.Date of Delivery or on the front.if space permits. .911,1119 1. Article Addressed to: D. Is delivery address differe from item 1? ❑ es r - If YES,enter delivery zd ass below: ❑No Prop ID:172111 FULP,MATTHEW B 9 STAGECOACH RD CENTERVILLE,MA 02632 II I'IIII I'll III I II Il i illl I ll I I it III Ii IIII III 3. Service Type ❑Priority Mail Express® ❑Adult Signature ❑Registered MffiITM 0 Adult Signature Restricted Delivery ❑Registered Maif Restricted ❑Certified WHO Dellv ry 9590 9402 2594 6336 3832 40 ❑Certified Mail Restricted Delivery lm Receiptfor ❑Collect on Delivery Merchandise _2.Article Number(Tlansfer frgM seiviCe fabel)�_ 0 Collect on Delivery Restricted Delivery ❑Signature ConfirmationTm ;ured Mall O Signature Confirmation rt�� !i ? + luredier$500)Mali Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt I First-Class Mail Postage&Fees Paid USPS Permit No.G-10 9, 9402 2594 6336 3832 40 I United States •.Sender;Please print your name,address;.,and ZIP+4®in this box, Postal.Service Horsley Witten Group, Inc. I 90 Route 6A, Unit#1 I Sandwich, MA 02563 � I I I I 1ii�il�,,i�l,i„i ,.tii)��„ii��iii,li . , � ,►`, ,i ,fi , 1. r. BOARD OF HEALTH VARIANCE REQUEST ABUTTER NOTIFICATION LETTER DATE: 9/9/2019 RE: Upcoming Barnstable Board of Health Public Hearing To Whom It May Concern, As an abutter to the proposed project,please be advised that a VARiANVE REQUEST application has been filed with the Barnstable Board of Health. APPLICANT: Michelle Tobey PROJECT ADDRESS OR LOCATION: 23 Stage Coach Road Centerville ASSESSOR'S MAP&PARCEL: MAP 172 PARCEL 110 PROJECT DESCRIPTION: Repair of failed septic system. Variance request to reduce groundwater separation APPLICANT'S AGENT: Horsley Witten Group 90 Route 6A Sandwich,MA 02563 PUBLIC HEARING: Barnstable Town Hall, 367 Main Street,Hyannis Hearing Room -2nd floor DATE: 9 / 24 / 2019 TIME: 3:00 P.M. 1 NOTE: Plans and application describing the proposed activity are on file with the Board of Health, 200 Main Street,Hyannis (508-862-4644) E HoNley-Vill , t Sustainable Environmental Solutions "90 Route 6A Sandwich, MA •'02563 �._ `} .�=US POSTAGE • 02 ;1 P +�' 0 .6.800 . 00011 7309•;5 , SEP .09 20191 —�7018 0360 0000 6002 2674 I MAILED FROM 2IPCODE,02563 �IN v �\� s Prop ID:172110 TOBEY,MICHELLE D k, 1560 SANTUIT NEWTOWN RD _ COTUIT,MA 02635 _a _ 1VI kT e; 5 P-E' �F"��S i '.1'19 1 � ��yy CC ��qp9 pry p�•y �q s 1 .,d"a,1-.~'iic.V'}.P"•" TV -.�-t. .efid�33.. 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Y � „� �. _.-` -i Town of Barnstable PT f/ Department of Inspectional Services �ttiS�UARNSTAUM$ Public Health Division 'r63q. �0 'rF°µp1 L 200 Maio Street,Hyannis N IA 02601 Office: 508-862-4644 Date Scheduled r I l ` 1'itnc Soil StcitabilV Assessmen for Sewage Disposal Pcrfunoed B%,: fit . �t'1 r Witnessed BY: LOCATION & GENERAL INI.ORNIATION Locali on Addl-CS5: Z, S�m I t✓rl C d Owner's Nano: M C' k �' 1Gi3L4. f ,Tl{rf V I Owner's Address: S W V Sow v4U41Qd. (cio r Assessor's N4ap/t'arcel: I�2Ino Certified Sail Evaluators Name: Certified Soil Evaluators Entail: I jz�1 1 It, e hcot� u t l (, I New Construction or Repair: n, Ccnilictl Soil Ifvaluahrrs'I'cicphone fI ( (�� �}�3 �(} [ Land I:se La ULn Slopes(°o) Surftce Blanes Distances Born: Open Water Body Il Possible Wet Area 71CY-)n Drinking Water Well M ft It t t Drainagi-1V:iy 7 L} Il Property Line �'—Il Other li Parent limterifd(geok4cl GV "��` Depth to 13edrock > `y Depth to Groundwater Standing Water in Hole: �. 1J Weeping titan Pit Face 5 , p.✓2 Gstintateil seasonal High iounth;ter r �v" , Y I ETERIVIMATION FOR SEASONAL HIGH WATER TABLE rnn ` " �U Method used: �"ccc-R l a v-mn (-I-L- Depth l.tbsert•ed standing ut obs.hole: In. Deptll to soil mottles: in. �) Z Depth to tcceping from side of olm hole: r I in. Groundwater r )tunnent Indcs Well Reading Lane: �) htdcs 1Vcll Icvc �,O Adj.factor Adj.GrounJtsntcr I:cvcl _ 3-- •rimy PERCOLATION TEST Date 5 (],} H Observation 'PT—— I Time at 9" llt� ` •'1 f`J^ Depth of Pere l I Time at 6" Start Pre-suak'fimc,( find Pre-sunk Rate NQin./Inch ] Site Suitability Assessment: Site Passed Site Failed: Additional Testin&Needed(Y/N)_� 1� ' � t Deep Observation Hole Log Hole#: — Depth from Surface Soil Horizon Soil'fexture Soil Color Soil Mottling Other (in) I lt)SDA) (\lunscll) (Structure,Stones,Boulders, Cunsistcncv.%Gravel) 12 ' I I0(L 3b �2b lu: ( r Ks� { t! VSir rl r Deep Observation Hole Log Hole#: T2 'Z— Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (in) MSDA) (Alunsell) (Structure.Stones,Boulders, Consistency.%Gmyel �if Li;yy t) I u t f 31 L -2 Deep Observation Hole Log Hole.#: Depth from Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (in) (USDA) (Munsell) (Structure,Stones,Boulders, Consistency,%Grovel Deep Observation Hole Log Hole#: Depth front Surface Soil Horizon Soil Texture Soil Color Soil Mottling Other (in) (IISDA) (\•lunscll) (Structure,Stones,Boulders, Consistency,%Gruvcl Flood Insurance Rate Map: / Above 500 year flood boundary No Yes V Within 500 year boundary No V Yes Within 100 year flood boundary No Yes _ Depth of Naturaliv Occurrine Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? _ �� If not,what is the depth of 1rdlly Occurring pervious material? Certification I certify that on Q 1 q (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was perforated by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature � Date SKETCH: (Or you can attach a separate sheet Y P ) (street name.dimensions of lot,exact locations of test holes x perc tesu.locate wetlands in proxmrity to hales) _ n y September 6, 2019 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Re: Septic System Repair—23 Stage Coach Road, MA Dear Sir/Madam: As the homeowner of 23 Stage Coach Road Centerville, I authorize Horsley Witten Group, Inc. to represent me for a request for variance at the Board of Health hearing on September 24, 2019. Thank you, Michelle Tobey Michelle Tobey 23 Stage Coach Road, Centerville,MA 02632 r 34' � 12' -. l own€.y t r _ Ali ✓ "¢ c & - a E24' a r fps s I � i,iKet " p v,y 4 c 1 5 `.QS 5 V � , YM AIM gig •�{ s 1 R 34. i 22' Etas mv [E2' t - r � r asement�; ' a 12 is ............ 22' BOARD OF HEALTH VARIANCE REQUEST ABUTTER NOTIFICATION LETTER DATE: 9/9/2019 RE: Upcoming Barnstable Board of Health Public Hearing To Whom It May Concern, As an abutter to the proposed project,please be advised that a VARI .NVE REQUEST application has been filed with the Barnstable Board of Health. APPLICANT: Michelle Tobey PROJECT ADDRESS OR LOCATION: 23 StaEe Coach Road Centerville ASSESSOR'S MAP&PARCEL: MAP 172 PARCEL 110 PROJECT DESCRIPTION: Repair of failed septic system. Variance request to reduce groundwater separation f APPLICANT'S AGENT: Horsley Witten Group 90 Route 6A Sandwich,MA 02563 PUBLIC HEARING: Barnstable Town Hall, 367 Main Street,Hyannis Hearing Room-2nd floor DATE: 9 / 24 / 2019 TIME: 3:00 P.M. NOTE: Plans and application describing the proposed activity are on file with the Board of Health, 200 Main Street,Hyannis (508-862-4644) A ' e ( 1 ' • - i o . . MAIL@ . C3 CERTIFIEDNAILLn ,, Only: Domestic Mail Only For delivery information,visitour website at www.usps.corn,-'0. nI For nl deliveryru OF F I C I A L O Certified Mail Fee \ rn a p�^ O certified Mail Fee t 1 Extra Services&Fees(check bay add fee ae appropriate) 4��' ^ Extra Services&Fees(check box,add fee as appropriate)' ` ', @9 y1.; ❑Return Receipt(hardoopy) $ 4 ❑Return Receipt(hardcepy) $ ... ,,a ;_ O ��ft } 16 r ❑Return Receipt(electronic) _ $ Postrhi k i'r E3 ❑Return Receipt(electronic) $ SEPg91I1 A } -t i 0 ❑Certified Mail Restricted Delivery $ (� Here tt ❑Certified Melt Restricted Delivery $ - Here 1.7 1`�?1 � ❑Adult Signature Required $ 6t, �7 p ❑Adult Signature Required $ B- I fir, ❑Adult Signature Restricted Delivery$ tY,�.. � ❑Adult Signature Restricted Delivery$ � Postage , v1563• Postage �k f1l $ C3 Pro Total Postage p ID:172108 r3 Total Pc Prop ID:173048 cc $ LAWTON,DAVID cO $ ` BORDUN,JASON W ra sent To %TAYLOR,BRYAN MATHEWSON rrq SentTo� 36 STAGE COACH RD C3 3lreeiandApf 18 STAGE COACH ROAD C3 $lreela CENTERVILLE,MA 02632 -------- CENTERVILLE,MA 02632 :rr 015 PSN 7530-02-000-9047 :•r 015 PSN 7530-02-000-9D47 . 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N , C3 Certified Mail Fee (> Certified Mall Fee t O w� _:. Extra Services&Fees(check box,add fee as eppropria �`' { Extra Services&Fees check box add fee as " ❑Return Receipt(hardeopY) $ iy •.I ( ePProOri `'{' _ '' ❑Return Receipt(hardeopy) $ 0 ❑Return Receipt(electronic) $ - - PO ❑Return Receipt(electronic) $ Postmark t 1 Q ❑Certified Mail Restricted Delivery $ Were E; ❑Certified Mail Restricted WNW $ Here ' C3 ❑Adult Signature Required $ i i^r t ❑Adult Signature Required $. CS- ❑Aduk Signature Restricted Delivery$ ❑Adult Signature Restricted Delivery$ C�`e._ .0 Postage,_... _ ®��,,,��,�. Postage i M $ Prop ID:172110 �563 $ Prop ID:172111 o Total Poi Total Postag FULP MATTHEW B TOBEY,MICHELLE D to $ent To 9 STAGECOACH RD 1560 SANTUIT NEWTOWN RD sentro I COTUIT,MA 02635 _______ $ , CENTERVILLE,MA 02632 Streee ar Siieel endAj PS Form 3800,Apiil 201511 rrr•r. TOWOlF BARNSx�B E l:kinoN, V'�t LAG>r BWAG Cep,�e v lI e Asst ®R�s NiAr&LO STA ,L,ELt'S NAME P1HOIdE NO Ir L ACIIING.1F+h�C I'1`Y ( e) r BEi?Rooms 3.----� )WILDERO CDWf�iZ gLN{�'I'Y)1'TE+ GS�NAgG.IRtiNCE AT PE Sapsration Dweuuaer`�stweeia Ifie - �Eees MAxlstsum Atljusted�Grausaciw�tet'Cable sa t{aG B�Itom,of Ls:achin�l�a;slst}r �-----��» P1IY�swlaxtisr Su t VJeik'Wad iL�ichts�g Pacty wary Irs19s exist 13P. &�ce9 ��sutG or withid2tl0 feot s�f letac�utt�fstGal►t}�) ..�.., Esi i�crf�►'.4 I"d and lLoachta�r aciDity� tty wetlands exist sec +•�ityaica.1t)t)fc.e� �1caclf n�fmd' } ."""'.""'""-�--r""-`" 1Furil3�ieil iY T ��G � �� G� A , # � {� . � . . � .a - ® ® ��,' r a -r]3 iF t. _g /� �j; �� i E GC� �,, 131 �tNEA�� Town of Barnstable i , $" A �MSS. ' Board of Health y n93. �► i639• 10 200 Main Street, Hyannis MA 02601 Office: 508-8624644 FAX: 508-790-6304 John Norman Donald A.Guadagnoli,M.D. Paul J.Canniff,D.M.D. October 2, 2019 Ms. Beth Kittila Horsley Witten Group 90 Route 6A Sandwich, MA 02563 RE: 23 Stage Coach Road, Centerville A = 172-110 Dear Ms. Kittila, You are granted variances on behalf of your client, Michelle Tobey, to construct an onsite sewage disposal system at 23 Stage Coach Road, Centerville, Massachusetts. The variances granted are as follows: 310 CMR 15.405(1): To construct a soil absorption system 4.42 feet above the maximum adjusted high groundwater table, in lieu of the minimum five feet vertical separation distance required. These variances are granted with the following conditions: (1) The new septic tank shall be located closer to the foundation in order to increase the pitch to one quarter inch per foot. The engineering plans shall be revised to show the relocated septic tank. (2) No more than three (3) 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. (3) 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 three (3) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. Q:\WPFILES\Kittila Tobey 23 Stage Coach Road Sep20l9.docx r�- (4) The septic system shall be installed in strict accordance with the revised engineering plans. (5) 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 revised plans. This variance is granted to allow a gravity flow system onsite (rather than a pump system). The proposed system will be redesigned to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sincerel yours, ohn Norman. Chairman Q:\WPFILES\Kittila Tobey 23 Stage Coach Road Sep20l9.docx 119 Horsley Witten Group Sustainable Environmental Solutions 90 Route 6A•Unit 1 Sandwich,MA 02563 �. 508-833-6600•horsleywitten.com September 26, 2019 Barnstable Board of Health Thomas McKean, Director 200 Main Street Hyannis, MA 02601 Re: Revised Plan Septic System Repair-23 Stage Coach Road, Centerville, MA Dear Mr. McKean: r Please find enclosed the revised septic repair plan at the location referenced above. Per the request at the hearing, the slope of the.pipe from the building to the septic tank has been shortened and changed from 1% to 2%. Additionally, the leach field has been slightly altered to avoid a tree with this new configuration. The original variance request of 7" to estimated seasonal high groundwater remains. Thank you very much for your consideration: Sincerely, HORSLEY WITTEN GROUP, INC. Beth Kittila Design Engineer HorsleyWitten.corn @HorsleyWittenGroup ®Horsley Witten Group, Inc. . r �try t Town of Barnstable e MSTABM 9� Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-8624644 FAX: 508-790-6304 John Norman Donald A.Guadagnoli,M.D. Paul J.Canniff,D.M.D. January 13, 2020 Ms. Beth Kittila Horsley Witten Group 90 Route 6A Sandwich, MA 02563 RE: 23 Stage Coach Road, Centerville A = 172-1.10 Dear Ms. Kittila, Your request to remove the condition requiring the recording a three bedroom deed restriction at the Registry of Deeds, as per condition #3 of the Board of Health variance decision letter dated October 2, 2019, was not granted. Bedroom deed restrictions are consistently required by the Board of Health when variances involve a septic system component reduction in setback to an environmental resource. In this case, this proposal required a variance from Section 310 CMR 15.405(1) of the State Environmental Code, Title V because the soil absorption system was proposed to be located 4.42 above the maximum adjusted high groundwater table, in lieu of the minimum five feet vertical separation distance required. If however, the soil absorption system could be elevated to five feet above the maximum adjusted groundwater table, the applicant would not need a variance and a three bedroom deed restriction would not be required. Sinc ly ours, hn Norman. hairman Q:\WPFILES\Kittila 23StageCoach December 2019.docx � From: Crocker, Sharon Sent: Monday, November 18, 2019 10:05 AM LO/ To: McKean, Thomas Subject: FW: 23 Stage Coach Road Centerville Tom, Would she need to notify abutters again inthis case-where she's asking to re.consider? Thanks, Sharon From: Beth Kh1i|a Sent:Thursday, October 31, 2D194:4SPK4 | /o: Cc: Crocker, Sharon ` Subject: 23 Stage Coach Road Centerville Hi Thomas: � I would like to request that the deed restriction on the bedroom count as stated in condition#3 of the variance approval letter be reconsidered a1 the Nm^weffil*ef--�hearing. �------- '!xee- /-7 � � The location of this house is not in any nitrogen sensitive area,Zone I or Zone 11.Therefore,the condition#3 should not apply to this house.The approved septic system is designed for 3 bedrooms.The homeowner does not want a bedroom restriction at this time. Thank you, Beth Kh1i|a Beth Kbdla I Design Engineer Horsley Witten Group, Inc. Office: 508*33-6600CAUTION:Thi I s email originated from outside � mf the Town' mf atta0ments or reply, unless you recognize the.sender's email address and know the-tontent.is safe! .B.arnstablel Do,not click links open � Town of Barnstable Barnstable Inspectional Services AN-AmL CaC► Bnrerrsra8M M" � ib;q.. Public Health Division A �6 W rFo �s 200 Main Street, Hyannis MA 02601 2007 Office: 508-8624644 FAX: 508-790-6304 Thomas A.McKean,CHO SECOND NOTICE CERTIFIED MAIL#7015 1730 0001 4987 9484 February 7, 2018 TOBEY, MICHELLE D 1560 SANTUIT NEWTOWN RD COTUIT, MA 02635 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 23 Stage Coach Road, Centerville, MA was inspected on 12/19/2017 by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1) year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\23 Stage Coach Road Centerville Second Notice.doc �WE r� Town of Barnstable Barnstable Regulatory Services Department AFAmelicaC j ensNsenst Public Health Division i639. ` m A P 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1730 0001 4987 6674 January 8, 2018 U S BANK,NA, TR C/O WELLS FARGO BANK,N A FORT MILL, SC 29715 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 23 Stage Coach Road, Centerville, MA was inspected on 12/19/2017 by Shawn Mcelroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH til�a/ R. ., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\23 Stage Coach Road Centerville.doc IKE rj Town of Barnstable AN�TlA76` R XAM � Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA-02601 Office: 508-862- 644 Richard Scab,Director FAX 508-790-6304 Thomas A McKean,CHO Feb 6, 2007 Rev. 5111116 DEADLINES TO REPAIR FAMED.SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) _ .An`'z'marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑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 the house due to an overloaded or clogged SAS or cesspool ONE 1 YEAR DEADLINE CRITERIA 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. (This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA q Single Cesspool- ❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components, etc) o Leaching pit or cesspool with high liquid level, <12"below inlet(per Town Code §360-9.1) ❑Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: Q:SEPTICIDEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts , - a�l , Title 5 Official Inspection Form rl, -�I Subsurface Sewage Disposal System Form Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 16.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 12-19-17 '-Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in.the future under the same or different conditions of use. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 �0 p—i Vc Commonwealth of Massachusetts �aa Title 5 Official Inspection Form � ,-11.1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin c@ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ 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. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y. ❑ N ❑ ND (Explain below): I t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts al Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin,@ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken*pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed r ElY ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by,the Board of Health: ❑ Conditions exist which require further evaluation by the Board of.Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet'of a bordering vegetated wetland or a salt marsh t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official InspectionForm Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is Centerville MA 02632 12-19-17 required for every ' page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ' ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface wate'r'supply. ❑ The system has a septic tank and SAS and the SAS is within' a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS,is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth.in cesspool is less than 6" below invert or available volume is less than '/Z day flow t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form fI : I Subsurface Sewage Disposal System Form Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin Gm 1-508-776-4486) Owner Owner's Name information is :- required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 1 0,000g pd. ® ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts :a=1 Title 5 Official Inspection Form .,.I Subsurface Sewage Disposal System Form -Not for Vol u ntary'Assessm ents a' §! 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin c@ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632' 12-19-17 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑' ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions,'depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 _ ' F + t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts �a=1 Title 5 Official Inspection Form , I Subsurface Sewage Disposal-System Form -Not for Voluntary Assessments '� �_r¢!✓ 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-171 . page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder?. ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): canons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present?, ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system?. ❑ Yes ❑ No Water meter readings, if available: t5ins.doc-rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts 1a=1 Title 5 Official Inspection Form i;,l 'I ; -, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17�- page. City/Town State Zip Code Date of Inspection D. System Information (cont.) x ' Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system , ❑ Single cesspool ❑ Overflow cesspool - ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attachh-a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts �;+ f Title 5 Official Inspection Form -'i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2001 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: s 12"feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. Septic Tank (locate on site plan): Depth below grade: 6" feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal Sludge depth: 12" t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 t" Commonwealth of Massachusetts :a=l Title 5 Official- Inspection Form \XL. ,.1I Subsurface Sewage Disposal System Form Not fior Voluntary Assessments � l 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins.doc•rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts ; Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) -. Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons r_ .Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Y Commonwealth of Massachusetts a� Title 5 Official Inspection Form f' 'A Subsurface Sewage Disposal System Form -Not for Voluntary Assessments l a�Y 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box was filled with solids and had stain lines above inlet invert. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts f Title 5 Official Inspection Form �i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type.• ❑ leaching pits number: ® leaching chambers number: Infiltrators ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Infiltrator leach field had signs of hydraulic failure with back-up into d-box and surrounding stone. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments -�;!,�% 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form I�I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is Centerville MA 02632 12-19-17 required for every ' page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately r Nr R C3 43 13 4. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts y :a=1 Title 5 Official Inspection Form rq r� ' i�;I Subsurface Sewage Disposal System Form Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12' feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database- explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. . Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form �'i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 23 Stage Coach Rd Property Address Bank Owned (Contact Ann Quinlin @ 1-508-776-4486) Owner Owner's Name information is required for every Centerville MA 02632 12-19-17 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins.doc-rev.6/16 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Health Complaints 06-Nov-01 Time: 11:00:00 AM Date: 11/5/01 Complaint Number: 3155 Referred To: LEE MCCONNELL Taken By: FLORENCE SMITH Complaint Type: NUISANCE CONTROL REG. 1 RUBBISH Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 23 Street: Stage Coach Rd. Village: CENTERVILLE Assessors Map-Parcel: 172/110 Complaint Description: Terminix chemicals in the driveway seeping into the ground. Trash is all over the backyard and in back grarge. Actions Taken/Results: called Ray Rioux (508-775-5499) from Terminix to come and remove terminix chemicals earlier in the day. When LM arrived chemicals had already been removed, no spills were noted around the yard or driveway. Trash was all over the back yard, mattresses, old dresser draws, newspapers, etc... discarded all around yard. Spoke with a neighboring boy who said "no one lived there anymore." There was smashed pumpkins all over the driveway. Lm will leave a violation warning on the door today (11/06/01) stating the trash must be removed! Mark Duchesneau is possible owner(508-420-2840). Investigation Date: 11/5/01 Investigation Time: 3:30:00 PM 1 ..M+vtiNti^}.`�-,.�."�,........-+sc^t..�r*n.-iti.rr�M..,,.,..•.--..,c..,.:,-.vic--�'+7. - ,. .. ., +�.r+-.-•,.�:-,_,,,r-rt.,.-..^-^/�.G^-.we1..v.�.:+n.,r***-✓N+k�nrir-+µFs,.rate"+n+t"�nr".-+�...,ds.+"r".^'""� TOWN OF BARNSTABLE BAR-W 2943 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager ,12C�y K Address of Offender MV/MB Reg.# Village/State/Zip � Business Name am/pm,> on 2001 Business Addressc Signature .of Enforcing Officer Village/State/Zip Location of Offense � '2 1. Y�. .G f k C1 :Al f1✓i4 V�c Enforcing Dept/Division Offense t x Cc 'Vt- Facts This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and. warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. I TOWN OF BARNSTABLE n LOCATION SEWAGE # Lo mot✓ .._ 4 P s..'.. .. VILLAGE z-�c�i t: r J�p _ASSESSOR'S,M4P & LOT INSTALLER'S NAME&PHONE N SEPTIC TANK CAPACTTY . :;::;1 1"._. j LEACHING,FACILITY: (type) e (size) NO. OF BEDROOMS BUILDER OR OWNER_Cc.`� a�J J 1 y✓J f PERMTTDATE: COMPLIANCE DATE: � J Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by t - A _ A3 i - TOWN OF BARNSTABLE �y LOCATION SEWAGE # � VILLAGE ASSESSOR'SW & LOT s INSTALLER'S NAME&PHONE N ✓'�== =' SEPTIC TANK CAPACITY Wit" �� f LEACHING FACILITY: (type) {$Cf (size) NO.OF BEDROOMS' BUILDER OR OWNER r bA-) I> PERMITDATE:' COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist. on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ,,,{ �.. A 6�� . ,a� � �'� � �� ��a - � �. �c UGH � ��Y ��� . ��a .�' ��� L�a� �� .. �� .. .- �t ��p, � P � � _ `^ _� No. `zo"/ Q 7r Fee �♦ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Apphratton for Mtgooar *pgtem Construction Vertu Application for a Permit to Construct( )Repair(Upgrade( )Abandon( ) ❑Complete System 'RIndividual Components Location Address or Lot No.,; 3 1 Wde C , W, Owner's Name,Address and Tel.No. .. -�- Assessor's Map/Parcel ju N e,Address,an 1.X. Designer's Name,Address and Tel.No. -t r f Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures c Design Flow �u 3� gallons per day. Calculated daily flow 1 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank V_;�'1 tip. \O?r-7 Type of S.A.S. Description of Soil S Nature of Repairs or Alterations(Answer when applicable) 1 ILSI A-& T:���'s L,Q ciC_ i Ir--rye �f�`TC(ZS ��� �(� Slll1tP Otc✓.SiC�c -T 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 vironmental Code and not to place the system in operation until a Certifi- cate of Compliance has bee;; 'ss d-)�3�-t ' o o ea t . Signed Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued ————————————--——————————————— - No. Fee : THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS Yes 01ppYication for �N!5pozar *pgtem Construction Permit Application for a Permit to Construct I ..pp' ( )Repair( )Upgrade( )Abandon( ) El System 0 Individual Components Location Address or Lot No.a3 S,�V+ e k W, Owner's Name,Address and Tel.No. Assessor's Map/Parcel s1alle�a1{(te,Address,and`Te,1.No Designer's:Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 30 gallons per day. Calculated daily flow. 3t �� gallons. Plan Date Number of sheets Revision Dafe Title Size of Septic Tank t- . �C-iff) Type of S.A.S. v Description of Soil Nature of Repairs or Alterations(Answer when applicable) 1 PSI a& ��(L ���C_1 l Co"C\A Date last inspected: 4 ' Agreement: i 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 E.vironmental Code and not to place the system in operation until a Certifi- cate of Compliance has b , eat . Signed Date Application Approved by Date Application Disapproved for the following reasons 4 Permit No. Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Smage Disposal System Constructed( )Repaired ( )Upgraded(V-j Abandoned( )by F. or q_�/- at o 2:1 Sx A�l� GO,-__4 T���✓1 t` has bee constructed in ac ordance with the provisions of Title 5 and the for Disposal System Construction Permit No.26 2)l 7dated Z G Installer 1, Designer Jn The issuance of this peV-114 all no ue c n trued as a guarantee that the sy M'ewill function as esign1A pp�� /� Date � Inspector /Vi /i / ,�_.,/ No. !�V �rd --------------------------Fee 's - '�' THE COMMONWEALTH OF MASSACHUSETTS 7 Z —//0 PUBLIC HEALTH DIVISION - BARNSTABLEs MASSACHUSETTS t &Zpogar *pgtem Construction Permit Permission is hereby granted to Construct( )Repair Upgrade( )Abandon( ) System located at 3 3 I and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of thi Date: Z/Z/e/ Approved by, — 1 -x,�Ap_wv I/ 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only.. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) h s , hereby certify that the application for disposal works construction permit signed by me dated �—g --Y7 , concerning the property located at . P3 meets all of the following criteria: = This failed system is connected to a residential dwelling only. There are no commercial or business / /uses associated with the dwelling. The soil is'classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. 1011*'There are no wetlands within 100 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system to-o' There is no increase in flow and/or change in use proposed i r There are no variances requested or needed. e bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted.groundwater table elevation..[Adjust the groundwater table using the Frimptor method when applicable]„ . • If the S.A.S.will be located with 250 feet of any vegetated wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: t A) Top of Ground Surface Elevation(using GIS information) .B) G.W. Elevation �?50 +the MAX. High G.W. Adjustment�17 = D, DIFFERENCE BETWEEN A and B00— SIGNED : DATE: —�c 0 [Please Sketch pro osed plan of sy n back]. NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:cert r`e.�a.,�-�.. ,m .� 23 J).Oo" �L _W FEE.. .......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTHc? o -----_---_----- Appliration for Disposal ur� Tonstrurtiuri rrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal 6'u Sys at 2� -• .... ti ..............U.........ffjt�.4........................................ on- ddress or Lot No. v� O ner — Ad ess Installer Address UType of Building,.- Size Lot-----------_................Sq. feet Dwelling No. of Bedrooms------------ _______________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures . W Design Flow _______________ allons per person per day. Total daily flow............ gallons. _----- W ` Septic 'Tank Liquid capacit _ -- "gallons Length---_---------- Width----------...... Diameter------------- D pth-_.............. x Disposal Trenuh—No_____________________ Wid h............ ... Le _________. _ To' o leaching area___��,�0---sq. ft. 3 Seepage Pit No....EX -( _______ Diameter _. __ :_ _____ ept el in ____..____ otal leaching area------------------ ft. z Other Distribution � Dosing tank0-4 ( ) W Percolation Test Results Performed by------------------- .--------•--------------------:...... Date--------------------------------------.. ,_ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ (4 Test Pit No. 2................minutes.per-inch Depth of Test Pit.................... Depth to ground water_________________-___--- O Description of Soil___________________________ x ------------------------ U --•------•••----••••••---••----•--------••---------•••••••-----•••--••-•-••-•----•----•----•••---••-•-••-••-••••--••-••••-•------•••••-----•••----------•------•- •-•----............................ W ---------------------------------------------------------------------•-------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------___________________________________. -----------------------•-------------------------------------------------------------------------___-------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code he undersigned further agrees not to place the system in operation until a Certificate of Compliance has beA issu ye r igned..-. • •- •••--• •••--••--•••---•-•--•••----•••- -- ----------- PP PP y ... ate ApplicationApproved -• - fr,? __-.- J -_--_-- Date Application Disapproved for the following reasons--------------------------------------------- •••----•-•-•------•---------•••----•-•----•-•••••••-•--•-••-...•-- -----•----•-•-•--•----•-•--••----••---•----••---•---------••-••---•----••---••-------•-•---•-•---•--------•---•---••----••------•-•-•••-•••••---•-•/�i - - -------------•- 'A Date Permit No. Issued-- ate .ems,. <.,.�..F.�-_`_ \ "; ;_� `I',� -. r i .w� `�. . `',� \_,__i i �-, � � , -• i I r i �I ' _ `�� `,� ,`` ..,, .- No......................... FiRm.. . ter`........... THE COMMONWEALTH OF MASSACHUSETTS BOAR® F HEALTH a ' .....OF..... Z__x.4° . .. Appliratiott for Utlipaiitt1 Nforks Tonstrurtion Vauti# Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Sys at ------------------------------------.. 9 q oon- d/dress or L - Lot No. •____fiIZL_v %-�•___•__�� ' ......................... ............•_---•........................................................._._..._................ Owner Address W Installer Address UType of Buildings Size Lot............................Sq. feet Dwelling-ems No. of Bedrooms-------------- .-_------_--•____-___-Expansion Attic ( ) Garbage Grinder ( ) `1 p-I Other—Type of Building ___________________________ No. of persons---____•____________-__---- Showers ( ) — Cafeteria ( ) a' Other fixtures __---------------------------------------------------- W Design Flow________________6=n- _._.___gallons per person per day. Total daily flow....._ .a .-..gallons. WSeptic Tank-•Liquid capacit A' gallons Length................ Width-------__.----- Diameter.....----------- Depth---------------- Disposal Trench—No--------------------- Width------ 'Dotal Len h.-•-- To "1 leaching area.-------------------sq. ft. 3 Seepage Pit No. Diametern�s _:- ,.r otal leaching area------------------sq ft. Other Distributionox ( ) Dosing tank ( ) �` W Percolation Test Results Performed by-------------------- ----r -:_ , - �7ntt_L ._ ) 'at .................. Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_-.-_______-__-__-_----. 1�1;4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_-.---_.-__--_--___----- a ------------------------------- -' ----------- p.....................................•------------•-----------•-•-•--•----------••------•---- Description of Soil______________________________ . --- ... =---------------------------------------------------------------------------------------------- U -------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•-•--•--------. W ----------------------------------- -------------------------------------------•--------•---•----------------•----------•-----•----------•--•---•-----•------•----...•----------------••--•••--------- U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------ ------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee .issu 9by e board` h nth. igned _ --- --. - a , Date Application Approved BY �� Application Disapproved for the following reasons:_. Dat ...... ---•-•------------ Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH (9rdif ira-t if m,"Plittttre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) ox Repaired ( ) bY-----•---------------------------------- j Installer, — -- " alter. ----------------- at------..--- "_ �t ----- '>= -__ }-. <,.---�,--4.:..�' Jam.-r'' � F:r,.- �R',h../ ..�4., has been installed in accordance wit1f the provisions of Article XI of The State Sanitary`Code as described in the application for Disposal Works Construction Permit No----------.^,:_i (: -` ___-_______ dated._ __ _jam.................... THE ISSUANCE OF THIS CERTIFICATE SHALL N®T �E CONSTRUED AS A'GUARA TEE THAT THE SYSTEM TILL F NCTI SATISFACTORY. DATE1 tl - Inspector ---------------------------- 7 THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF HEALTH .z i���,�tt1 �rk,� C��tt�trtts�i�tt rrnti� Permissionis hereby'granted----------------------------------------------•-----------------------------------------------------------------------------------------.----- to Construct (,, )-or Repair ( ) an Individual Sewage Disposal System Streetr` s r4✓ �L t; t�r� p w.. as shown on the application for Disposal Works Construction Permit No.:3 _.% Dated__---_ _f_.--- :_'_; --•------------- -------------•---------------------------•--•---------•-------------------------••-- Board of Health DATE................................................................................ FORM 1255?"HOBBS & WARREN, INC., PUBLISHERS FINISH GRADE OVER DISTRIBUTION BOXES=XX FT PROVIDE COVER AM) PROVIDE LOVER FINISH GRADE y RISERTHINS AM FIBER OVER TANK AND SEED OF FINISHED GRADEro WI LOAM _ _ _ ... GRADE EL.YJ( � GRAVEL DRIVE J BACKFILL 5� w 1000 Z z RESIDENCE_I"f---I " --__ _COMPACTED - - O j F,y�l I J CRUSHED - .. ....f MINIMUMSTONEBASE - K III II 3"DROP GAS . II li I 111 1=1 11 11=III= o 'I-III-III BAFFLE w -III INOTE - SOIL TEST PIT DATAIr r q_ o S: n S OF 3.4"COMPACTED I- - PROVIDE 5 OUTLET DISTRIBUTION BOX INSTALLED ON - w CRUSHEDSTONE -t I UNDISTURBED EARTH III-III- -' LEVEL STABLE BA BE. p•_.. -.-n - ._'- .._99.5 0-"""" TPA 2'_""'-"" 995 o. H-10 1500 GALLON SEPTIC TANK INSTALL FIRST 2 FEET OF OUTLET PIPES LEVEL. IY NOT TO SCALE 10 YR 3IZ 10 YR 312 PROPOSED H-10 DISTRIBUTION BOX DETAIL LOAMY SAND LOAMY SAND - PROPOSED 1SD0 GALLON CONCRETE SEPTIC TANK 1 Y' B.5 14" N ACME PRECAST OR EQUIVALENT LENGTH:IDS WIDTH:S'F DEPTH:S'A' NOT TO SCALE B . B I-w - p - 10YR5/4 10 YR 5/4 p`\' - �; LOAMY SAND LOAMY SAND - b 32" 96.8 37,_ 0'SCH.QPVCOBSERVATIONPORT - INSTALLEDINACCORDANCEWIT1/91DCM - C C - p Ik P SCH.10 PVC PIPE WITH SIB' 15.24D(13) .-2.5 Y 6/4 2.5 Y 614 : - EPII E CV - ERFORATIONS INSTALLEOIN ILTER FABRIC MIRAFI 140N0 40 PVC SITE LOCUS .. \ -ACCORDANCE WITH 310 CMR1S.251(B) APPROVED EQUAL dSTRIBUTION IATERAL(TYP.) FINE SAND FINE SAND NOT TO SCALE - MENOE� ERc 49 Rc 49 SURVEY NOTES CML \ �. -n P<2 M CN�/IN P<2 MI�NAN. 1.. THE TOPOGRAPHY AND EXISTING SITE CONDITIONS DEPICTED HEREON ARE THE RESULT OF AN ON THE GROUND FIELD SURVEY CONDUCTED BY THE MA�CBBS y'rILL Ste - _, - � EL_10D.0 _,.� - AVAVR S SEE SITE PLAN - h _ -HORSLEY WITTEN GROUP,INC.ON MAY 14,2019. _ BACP.FTLL- - - - BACKFILL - _ _ _ _ _ _ . ___ _ 1. I D IS ASSUMED. g I - i ___ 96 �78 ... 91.5 96'- _._ G M7B..' 9 _ HORIZONTAL " fff """- BREAKOUT - - WEEPINGWEEPIN z�� ,'� SADJUS EN 5'ADJUS EN 3. THE ELEVATIONS DEPICTED HEREON WERE BASEDON AN ASSUMED DATUM. 3'P-1112'000BLE WASHEDGTONE:,�.�4., �,�, INVERT IN UM N f�~ rn "' c . + 3.4 t-vz DOUBL wASHEDsroNE w _ O�ESHGW=93.5T p ESHGW=93.5T ---I 1..-k I SYSTEM DF "�- 5 4 PROPERTY LINES AND RIGHTS OF WAYS DEPICTED HAVE BEEN ESTABLISHED BY FIELD SURVEY AND DEEDS AND PLANS OF RECORD. Z EL VA Y -.PERFORMED BY:ELIZABETH KITTILA,HORSLEY WITTEN GROUP,INC THE ? WITNESSED B7 DAVID STANTON,HEALTH DEPARTMENT S. PROPERTY LINES FOR ABUTTING PROPERTY OWNERS ARE APPROXIMATE ONLY: a 4'- uNdsTuft8e0 EARTH DATE MAY 17.2019 4 2 UNDISTURBED EARTH 6. THIS PLAN DOES NOT SHOW ANY RECORDED OR UNWRITTEN EASEMENTS WHICH MAY EXIST.HOWEVER,THIS DOES NOT CONSTITUTE A GUARANTEE THAT ^4 N 32' - 1 16 eort(y Matlam areaniry vpprorad by lha Doparhwnt of Envaonmontnl Protaetlon paraaont to 310 - - NO SUCH EASEMENTS EXIST. TYPICALFIEWSECTION CMR 15.017 to waded a10 evaWahoasantl Nat Ma above.=Il ts has beanpadotmetl by me ZZ Npw " TYPICAL dSTRIBUTION LINE PROFILE ESTIMATED SEASONAL NIGH WATER EL93.5 <O?- asistat iha re9uired halo ng expe4na c.deapa I. daa dh 310CMR150171tu4her Iil(Y Z q wn,ry Mt lha results of aM.ou evaluahoa aamtlwbEm Nevtmcha45ou Evaluelun Form.ere 7. THE ACCURACY OF MEASURED PIPE INVERTS AND PIPE SIZES IS SUBJECT TO FIELD CONDITIONS,THE ABILITY TO MAKE VISUAL OBSERVATIONS,DIRECT W 7iLJ pis I aowrd...l-SIO CMR 15.100 through 15.107. ACCESS TO THE VARIOUS ELEMENTS AND OTHER CONDITIONS. _ - Z w U s¢ -' LEACHING FIELD DETAILS -' - 8. THE LOCATION AND/OR ELEVATION OF EXISTING UTILITIES AND STRUCTURES AS SHOWN ON THESE PLANS ARE BASED ON RECORDS OF VARIOUS UTILITY Q N a COMPANIES,AND WHEREVER POSSIBLE,MEASUREMENTS TAKEN IN THE FIELD.THIS INFORMATION IS NOT TO BE RELIED UPON AS BEING EXACTOR /✓+ - GENERAL SITE INFORMATION COMPLETE.THE LOCATION OF ALL UNDERGROUND UTILITIES AND STRUCTURES SHALL BE VERIFIED IN THE FIELD PRIOR TO THE START OF ANY J w W H - CONSTRUCTION.THE CONTRACTOR MUST CONTACT THE APPROPRIATE UTILITY COMPANY,ANY GOVERNING PERMITTING AUTHORITY.IN THE TOWN OF 1. PARCEL ID 172110.OWNER OF RECORD:MICHELLE TOBEY TRURO,AND"DIGSAFE"(1-888-344-7233)AT LEAST 72 HOURS PRIOR TO ANY EXCAVATION WORK IN PREVIOUSLY UNALTERED AREAS TO REQUEST EXACT . .N .... .. .. ADDRESS:23 STAGE COACH ROAD,CENTERVILLE MA FIELD LOCATION OF UTILITIES. Q - Q 2. LOT SIZE:0.34 ACRES+/-. Z tv z 3. EXISTING DWELLING SEPTIC IS FAILED.PROPOSED UPGRADE TO 9. THE PROPERTY IS LOCATED WITHIN THE AREA OF MINIMAL FLOOD HAZARD(ZONE X)AS SHOWN ON COMMUNITY PANEL NO.25001 C0561J DATED 7/t62014. U 173D21, - TITLE 5 STANDARDS. 1052 OLD SIACf:.ROAD - 4. NO KNOWN POTABLEWATER WELLS WITHIN 100 FEET OF THE 1'`- ~ of - Iy;F PROPOSED SANITARY ABSORPTION FIELD(SAS). WASTEWATER NOTES - - IRE:NE&CLIFFORD 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE IN ACCORDANCE WITH THE STATE ENVIRONMENTAL _Q - - LIFIOU JR : - :- CODE AND THE RULES AND REGULATIONS OF THE.LOCAL BOARD OF HEALTH. (n. - - VARIANCE 2 THIS PLAN IS INTENDED TO ADEQUATELY E THE INFORMATION NECESSARY TO UT AND CONSTRUCT THE PROPOSED SEWAGE DISPOSAL -EQ PROVIDE LAYOUT SE S POSA y N inn"40"E - N23 16'4U c s 1. SEPARATION TO GROUNDWATER(310 CMR 15.402(1)(h)): SYSTEM REPRESENTED ON IT. 5'REQUIRED,4.42'PROVIDED(VARIANCE OF 0.58'OR q / T'REQUESTED) 3. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE ENGINEER AND/OR THE LOCAL BOARD OF HEALTH(BOH)STAFF. OBSERVATION pp,q• ,I - 4. PRIOR TO CONSTRUCTION,THE CONTRACTOR SHALL COORDINATE WITH THE PROPERTY OWNER AND ENGINEER ON THE CONSTRUCTION SITE ACCESS PORT PROPOSED SOIL ABSORPTION -- - Y `' Gq'b - - AND MATERIAL STOCK PILE AREAS I 16.0'- SYSTEM-16 32 LEACH FIELD �.. . .. - 'TREATMENT SYSTEM DESIGN CRITERIA `- 5. :TRENCH SAFETY SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR INCLUDING ANY LOCAL AND/OR STATE PERMITS REQUIRED FOR THE TRENCH %.. •'R" WORK THIS WORK MAY BE REQUIRED TO TAKE PLACE OUTSIDE OF NORMAL HOURS OF OPERATION FOR THE FACILITY.THE CONTRACTOR SHALL PLAN - PROPOSED USE SINGLE FAMILY ACCORDINGLY. .. 'r. .. ..,. D-BOX 1D1 R \ rn,1 - NUMBER OF BEDROOMS EDESIGA) 3 .. y I` TITLE 5 DESIGN FLOW 110 GPD•BEDROOM: 6.- THE CONTRACTOR SHALL REPORT ANY DISCREPANCIES FOUND IN SITECONDITIONS FROM THOSE SHOWN ON THE PLAN TO THE DESIGN ENGINEER. . .PROP.4'DIA ZO .�' �\n,..2 I'� .. ..TOTAL DAILY DESIGNFLOW 330 GP0 SCH 40 PVC - - - 7. FAILING TO PROPERLY INSPECT OR PUMP THE SEPTIC TANKS AND TREATMENT SYSTEM OR CHANGES TO EFFLUENT FLOW,GRADING,OR LANDSCAPING, - -' APPROX.LOCATION + �_ GARBAGE DISPOSAL.' NO L=3'S=1Y WOODEN FENCE EITHER ON OR ADJACENT TO THE SITE,MAY RESULT IN IMPROPER FUNCTIONING OF THE SEPTIC AND LEACHING SYSTEMS. . �... EXISTING SEPTIC - - _ () :.. - . SEPifC TANK 17'1114 17304T : 200%OFOESIGNFLOW: 660 GALLON 8. CALL"DIGSAFE"AT LEAST 72 HOURS PRIOR TO COMMENCING CONSTRUCTION AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE'AGENCIES TO FIELD VERIFY SIAGE.COACH ., ;y -9 STAGE COACH PROTECT `� �\ - ROAD - LOCATIONS OF EXISTING UTILITIES. o J . .d :.. ROAD EXISTING TREE I l .. h.,- \ .. 35,1 .. .. *' `� N/F USE 1,500 GALLON SEPTIC TANK 9. -THIS ON-SITE WASTEWATER TREATMENT SYSTEM IS NOT DESIGNED-FOR USE WITH A GARBAGE GRINDER.- r t: 'KAHLER BURTON NATTHEYJ FULP PROP.1,500 GALLON� ( DEC h' PROTECT' _ o - - - SEPTIC TANK/ f0 0 RI EXISTING DECK' - _ LEACHING SYSTEM DESIGN CRITERIA 10. THE OWNER SHALL INSPECT AND PUMP THE SEPTIC TANK ONCE EVERY 2 YEARS. W I < - L- - --x '� - -' 11. PROVIDE WATERTIGHT SEALS BYUSE OF NON-SHRINK GROUT AT ALL POINTS WHERE PIPES ENTER OR LEAVE ANY CONCRETE STRUCTURES. a - T^110 SOIL ABSORPTION SYSTEM _ .. . ... 4 STAG=COACIi Q I 23 STFl[-CQ4DF1 - LEACROAG SYSTEM USED,• BED 12. USE SCHEDULE 40 PVC PIPING WITH WATERTIGHT JOINTS UNLESS OTHERWISE NOTED ON PLAN.ALL PIPE SHALL BE PLACED ON A COMPACTED FIRM BASE. ROAD ROAD J .. DESIGN PERCOLATION RATE:' 2 M/NAN. - a N;F i pROP.4'DIN. FFE fUt.B?FT - 1 SOIL CLASS' / 13. -THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING OPERATIONS AND MAINTENANCE INFORMATION FOR THE SEPTIC SYSTEM TO THE ENGINEER,IF MICHELL=TOBEY SCH 40 PVC I - LONG:7EPoNACCEPTANCE RATE(LTARI: 0.74 GPdS p NECESSARY.. _. _ 0. 10'S=2% ........... .--.....1.I TOTAL REQUIRED CODE.' 445 S.F.: ." d• 6 -- - - I - - 14, UNSUITABLE SOIL MUST BE REPLACED WITH TITLE 5 SAND AS SPECIFIED IN 310 CMR 15.255(3).ANY ADDITIONAL AREAS THAT ARE FOUND TO HAVE _ :TOTAL AREA REQUIRED TITLE 5: 446 S.F. UNSUITABLE MATERIAL SHALL BE REPORTED TO THE ENGINEER. LJ N•m x y O ' ~ I TOTALAREA PROPOSED: 15. ALL SEPTIC COMPONENTS SHALL BE INSTALLED WITH MAGNETIC WARNING TAPE +"• Z AREA PROPOSED(10M: WO S.F. 16. .THE CONTRACTOR SHALL RESTORE ALL SURFACES EQUAL TO THEIR ORIGINAL CONDITION AFTER CONSTRUCTION IS COMPLETE.AREAS NOT DISTURBED 1<v TOTAL ALLOWABLE-FLOW.- TOTAL 370 GPD CONSTRUCTION SHALL BE LEFT NATURAL.THE CONTRACTOR SHALL TAKE CARE TO PREVENT DAMAGE TO SHRUBS,TREES,OTHER LANDSCAPING �'p.q z / rc+•'.' o N AND/ORNATURAL FEATURES..WHEREAS THE PLANS DO NOT SHOW ALL LANDSCAPE FEATURES,EXISTING CONDITIONS MUST BE VERIFIED BY THE O z 1l3 35 ' I _3 iD'•tU'E_ .- __._ry CONTRACTOR IN ADVANCE OF THE WORK - a Q- _.-. . a,3'16.70"hY .. 1 7(.'U UO't\\' a a - - I I jl I -_a l e SCHEDULE OFELEVATIONS- 17, STING SEPTICTO BE ABANDONED PER TITLE 5REQUIREMENTS.(310 CMR 15.35413). 3 - �...::: 1 F '-... ...._.......-- LT-...' -_ - .. x eRLONcf-0uNLI477ON 10.89 WASTEWATER INSTALLATION INSPECTION NOTES Y STAGECOACH BUILDING INVERT our 99.22' i. THE CONTRACTOR SHALL PROVIDE A MINIMUM OF 24 HOURS ADVANCE NOTICE TO THE ENGINEER AND LOCAL BOARD OF HEALTH FOR ANY INSPECTION, li w SEPTIC TANK,INLET 99.02 .. 0' .. - .. .. ROAD D 2. ALL WASTEWATER SYSTEMS,INCLUDING THE LEACHING SYSTEM,SHALL BE INSPECTED BY THE ENGINEER OR LOCAL BOH REPRESENTATIVE PRIOR TO m. L - - lJ/'t SEPTIC TANK. 98.74 BACKFILLING.ATAMINIMUM THE FOLLOWING ITEMS SHALL BE INSPECTED: m STRBU7DISTRIB701V BOX 98.57 o w . 2.1. EXCAVATION OF LEACHING FIELD PRIOR TO PLACING SYSTEM NIATERIAL/COMPONENTS ws7weunoNeox•oLmET 99.sT Y o R - - D -- - Z2. LEACHING FIELD COMPLETE INSTALLATION PRIOR TO BACKFILL BE INVERT IN 98,31 < .O_ BREAKOUT 98,60 2,3: ALL SYSTEM COMPONENTS BASEAND INSTAL ON PRI KFILL-may • LATI OR TO BAC -I .. •/7,/� LATERAL DISTAL INVERT 98.3$ 2,4, LEAKAGE TEST ON SEPTIC TANK(MIN.24 HR)_ LZ o c=i a .fl N_,3"t643•E N2S°1R'l.T`E /,.FY/ BOTTOMOFSYSTEM 97.85 2.6.- .ABANDON EXISTINGSYSTEM ' -- 2.Q..FINAL INSPECTION OF BACKFILLED SYSTEM . .. .'S.US' 8500' - MIN COVER OVER SYSTEM 99.28 - - m . - - G.W.EIEVARON 93.50. 1 �--�' ���-��I - - 3,,-THECONITRACTORSWILLBE RESPONSIBLE TO MAINTAIN UP-TO-0ATE AS43UILTORAWINGS AND NOTES INDICATING THE LOCATION WITH I '.•j ' Ivi I"-' "' - - SEPARATIONTOG.W- 4.4- TWO TIES OF ALL SYSTEM COMPONENTS INSTALLED.THESE AS-BUILT DRAWINGS AND NOTES WILL BE UTILIZED BY THE ENGINEER FOR THE PREPARATION OF RECORD' ,.� .. : : PLANS. .. FINISH GRADE OVER (- DISTRIBUTION BOXES=XX FT Z w PROVIDE COVER AND -rTr-rim- RISER TO WITHIN 6"OF PROVIDE COVER FINISH GRADE T1 i-TC1-=Ti-1 p-LOAM AND SEED T..'1 AND RISER TO OVER TANK �_�J-J LL L-_J Ll__�IL _ =I1Lm�LL I L� -1 L LLj Q J r FINISHED GRADE GRADE EL.XX = -_- - - - - - - - - - - - - - - - �+- '' - - - - - - - - - - - - -� w rr.4:j CLEAN - - - - _ _ - GRAVEL DRIVE - -BACKFILL - - - - - MIN y - - - - - - ._..-..-_._ - - - - - - - BACKFILL - = FLOW- r- - - - - 1000 Z - O FLOW - I- O U - - - - - - I fI oa" - - - - - - - - - 6. OF 3/4" � COMPACTED -t>RESIDENCE _o � - - __7 - - CRUSHED w Y Z as" I I- - STONE BASE Q MINIMUM = _ 3"DROP GAS -III BAFFLE i III III-• . . . .. . .. . . . .. .. . . . . :. II � w III III I NOTES: SOIL TEST PIT DATA Cl- 6"OF 3/4"COMPACTED I -III PROVIDE 5 OUTLET DISTRIBUTION BOX INSTALLED ON UNDISTURBED EARTH-I I I I I I- TP-1 TP 2 CRUSHED STONE LEVEL STABLE BASE. ' [n INSTALL FIRST 2 FEET OF OUTLET PIPES LEVEL. 0"-.- _..__._ _._.__ . -99.5 0" - - - 99.5 23 w H-10 1500 GALLON SEPTIC TANK A A STAGECOACH Cl- STAGECOACH YR 3/2 10 YR 3/2 i ROAD NOT TO SCALE PROPOSED H-10 DISTRIBUTION BOX DETAIL I LOAMY SAND LOAMY SAND PROPOSED 1500 GALLON CONCRETE SEPTIC TANK ACME PRECAST OR EQUIVALENT 12"- 98.5 14' -98.3 oe rn LENGTH: 10'6" WIDTH:5'-8"DEPTH:5'8" NOT TO SCALE B B Iw- ca 10 YR 5/4 10 YR 5/4 �` Q rn 6 LOAMY SAND LOAMY SAND 61 i 32' 6.8 32' 6.8 0) 4"SCH.40 PVC OBSERVATION PORT tll OF '* V--I INSTALLED IN ACCORDANCE WITH 310 CM C C O 4"SCH.40 PVC PIPE WITH 5/8" 15.240(13) 2.5 Y 6/4 2.5 Y 6/4 "EPN F- 112 ERFORATIONS INSTALLED IN ILTER FABRIC MIRAFI 140N O 4"SCH.40 PVC SITE LOCUS I-, ACCORDANCE WITH 310 CMR 15.251(8) APPROVED EQUAL DISTRIBUTION LATERAL(TYP.) FINE SAND FINE SAND NOT TO SCALE HENOERSM co PERC @ 49" PERC @ 49' SURVEY NOTES CWIL C\2 EL. 100.0 _ _ r _ _ .__.,..__,T. _ <2 MIN/IN <2 MIN/IN 1. THE TOPOGRAPHY AND EXISTING SITE CONDITIONS DEPICTED HEREON ARE THE RESULT OF AN ON THE GROUND FIELD SURVEY CONDUCTED BY THE I •�1868a_ _ _ = VARIES SEE SITE PLAN -- a11�t-- VARIES SEE SITE PLAN_ fJ �'} � HORSLEY WITTEN GROUP, INC. ON MAY 1 019. ITE _ -- ---- __ ------------------ --_ _=___ __ _ ____ - - ----- _ -_-- _ _ -_------_ PI 4 2 =_--__=___-__- ______-_ _-__--_____-_____�- -_- _ __- -_-____--__=BAIZFII=_L ==== _=_____= =-=------ - - --- - --- __ -----_ ______---------------- -------- 96" '91.5 96 ___.__ ___.___ _.____91.5 2. HORIZONTAL DATUM IS ASSUMED. _ 1 ao -______________ _______ _____=- _-=_-_____- � I -_______--_-_____-__ _______-__________ ___--- WEEPING @78" WEEPING @78" -------------- --'------- -------- -------- BREAKOUT -=------- ----------- 0.5'ADJUSTMENT 0.FADJUSTMENT 3. THE ELEVATIONS DEPICTED HEREON WERE BASED ON AN ASSUMED DATUM. INVERT IN �-� I ( - - ESHGW= 93.5 ESHGW= 93.5 ( I 3/4"-1-1/2"DOUBLE WASHED STONE 6" BOTTOM OF 3/4"-1-1l2"DOUBLE:WASHED STONE 4. THE PROPERTY LINES AND RIGHTS OF WAYS DEPICTED HAVE BEEN ESTABLISHED BY FIELD SURVEY AND DEEDS AND PLANS OF RECORD. -� Z SYSTEM III PERFORMED BY: ELIZABETH KITTILA, HORSLEY WITTEN GROUP, INC ( � I I I I I III WITNESSED BY: DAVID STANTON, HEALTH DEPARTMENT 5. PROPERTY LINES FOR ABUTTING PROPERTY OWNERS ARE APPROXIMATE ONLY. H- N 4.4' UNDISTURBED EARTH 4 2, DATE: MAY 17, 2019 �I UNDISTURBED EARTH _I TY _ 6. THIS PLAN DOES NOT SHOW ANY RECORDED OR UNWRITTEN EASEMENTS WHICH MAY EXIST. HOWEVER, THIS DOES NOT CONSTITUTE A GUARANTEE THAT Q cn I� 32 16' 1 certify that I am currently approved by the Department of Environmental Protection pursuant to 310 �- CD 0 F-- t CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me NO SUCH EASEMENTS EXIST. Z Z H- 0 w C/) I TYPICAL DISTRIBUTION LINE PROFILE ESTIMATED TYPICAL FIELD SECTION SEASONAL HIGH WATER EL.93.5 consistent with the required training,expertise and experience described in 310 CMR 15.017. I further W � Q Q certify that the results of my soil evaluation,as indicated in the attached Soil Evaluation Form,are 7. THE ACCURACY OF MEASURED PIPE INVERTS AND PIPE SIZES IS SUBJECT TO FIELD CONDITIONS, THE ABILITY TO MAKE VISUAL OBSERVATIONS, DIRECT W :M W 0 _ d, accurate and in accordance with 310 CMR 15.100 through 15.107. ACCESS TO THE VARIOUS ELEMENTS AND OTHER CONDITIONS. Z U s U�t ® Z o LEACHING FIELD DETAILS 8. THE LOCATION AND/OR ELEVATION OF EXISTING UTILITIES AND STRUCTURES AS SHOWN ON THESE PLANS ARE BASED ON RECORDS OF VARIOUS UTILITY C� (- < V) NOT TO SCALE COMPANIES, AND WHEREVER POSSIBLE, MEASUREMENTS TAKEN IN THE FIELD. THIS INFORMATION IS NOT TO BE RELIED UPON AS BEING EXACT OR > Z W GENERAL SITE INFORMATION COMPLETE. THE LOCATION OF ALL UNDERGROUND UTILITIES AND STRUCTURES SHALL BE VERIFIED IN THE FIELD PRIOR TO THE START OF ANY w w H- w bb0 CONSTRUCTION. THE CONTRACTOR MUST CONTACT THE APPROPRIATE UTILITY COMPANY, ANY GOVERNING PERMITTING AUTHORITY IN THE TOWN OF o`jj w 1. PARCEL ID 172110. OWNER OF RECORD: MICHELLE TOBEY TRURO, AND"DIGSAFE" (1-888-344-7233)AT LEAST 72 HOURS PRIOR TO ANY EXCAVATION WORK IN PREVIOUSLY UNALTERED AREAS TO REQUEST EXACT = L-+-- U V) > ADDRESS: 23 STAGE COACH ROAD, CENTERVILLE MA FIELD LOCATION OF UTILITIES. (10 C) Q N re) w 2. LOT SIZE: 0.34 ACRES +/-. Z Lj.1 _l cV Z Q 3. EXISTING DWELLING SEPTIC IS FAILED. PROPOSED UPGRADE TO 9. THE PROPERTY IS LOCATED WITHIN THE AREA OF MINIMAL FLOOD HAZARD (ZONE X)AS SHOWN ON COMMUNITY PANEL NO. 25001CO561J DATED 7/16/2014. U Z w 173025 TITLE 5 STANDARDS. I=i._ _ ( v z 1052 OLD STAGE ROAD 4. NO KNOWN POTABLE WATER WELLS WITHIN 100 FEET OF THE ® Q v N/F PROPOSED SANITARY ABSORPTION FIELD (SAS). WASTEWATER NOTES f-- IRENE & CLIFFORD 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE IN ACCORDANCE WITH THE STATE ENVIRONMENTAL Z CODE AND THE RULES AND REGULATIONS OF THE LOCAL BOARD OF HEALTH. LIHOU JR VARIANCE -) 2. THIS PLAN IS INTENDED TO ADEQUATELY PROVIDE THE INFORMATION NECESSARY TO LAYOUT AND CONSTRUCT THE PROPOSED SEWAGE DISPOSAL r. N23'1640'E N23'16'40"E _ - - _ _ � _ 1. SEPARATION TO GROUNDWATER (310 CMR 15.402(1)(h)): SYSTEM REPRESENTED ON IT. 135 99' �T x x -120.00' x " " F REQUIRED, 4.42' PROVIDED (VARIANCE OF 0.58' OR 7" REQUESTED) 3. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE ENGINEER AND/OR THE LOCAL BOARD OF HEALTH (BOH) STAFF. X OBSERVATION 20 4 4. PRIOR TO CONSTRUCTION, THE CONTRACTOR SHALL COORDINATE WITH THE PROPERTY OWNER AND ENGINEER ON THE CONSTRUCTION SITE ACCESS " o PORT PROPOSED SOIL ABSORPTION AND MATERIAL STOCK PILE AREAS. SYSTEM - 16'x32 LEACH FIELD J9.,5 _ ; TREATMENT SYSTEM DESIGN CRITERIA X 5. TRENCH SAFETY SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR INCLUDING ANY LOCAL AND/OR STATE PERMITS REQUIRED FOR THE TRENCH �'' '•.' �,.��~r '" , �h� ' Temporary Beni 7arfq x � SHa WORK. THIS WORK MAY BE REQUIRED TO TAKE PLACE OUTSIDE OF NORMAL HOURS OF OPERATION FOR THE FACILITY. THE CONTRACTOR SHALL PLAN PROPOSED R USE: SINGLE FAMILY ACCORDINGLY. / D-BOX ;� NUMBER OF BEDROOMS (DESIGN) 3 X TITLE 5 DESIGN FLOW 110 GPD/BEDROOM 6. THE CONTRACTOR SHALL REPORT ANY DISCREPANCIES FOUND IN SITE CONDITIONS FROM THOSE SHOWN ON THE PLAN TO THE DESIGN ENGINEER. PROP. 4" DIA. 32.0' j' TOTAL DAILY DESIGN FLOW 330 GPD SCH 40 PVCN 173047 APPROX. LOCATION GARBAGE DISPOSAL: NO 7. FAILING TO PROPERLY INSPECTOR PUMP THE SEPTIC TANKS AND TREATMENT SYSTEM OR CHANGES TO EFFLUENT FLOW, GRADING, OR LANDSCAPING, C)L= 3 S= 1 /o EXISTING SEPTIC X WOODEN FENCE EITHER ON-SITE OR ADJACENT TO THE SITE, MAY RESULT IN IMPROPER FUNCTIONING OF THE SEPTIC AND LEACHING SYSTEM(S). '-' '---- 11 -� '� SEPTIC TANK "O 172111 " 200% OF DESIGN FLOW: 660 GALLON 8. CALL"DIGSAFE"AT LEAST 72 HOURS PRIOR TO COMMENCING CONSTRUCTION AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES TO FIELD VERIFY 10 O x 35 STAGE COACH LOCATIONS OF EXISTING UTILITIES. N •4 9 STAGE COACH _ ®PROTECT I ROAD EXISTING TREE o RN FD USE 1,500 GALLON SEPTIC TANK 9. THIS ON-SITE WASTEWATER TREATMENT SYSTEM IS NOT DESIGNED FOR USE WITH A GARBAGE GRINDER. Q N V r4 N/F `x _ x KAHLER BURTON Ld Z MATTHEW FULP PROP. 1,500 GALLON DECK PROTECT o LEACHING SYSTEM DESIGN CRITERIA 10. THE OWNER SHALL INSPECT AND PUMP THE SEPTIC TANK ONCE EVERY 2 YEARS. W I w 10.0 EXISTING DECK o M w 0 SEPTIC TANK x x - - - - - x N d 11. PROVIDE WATERTIGHT SEALS BY USE OF NON-SHRINK GROUT AT ALL POINTS WHERE PIPES ENTER OR LEAVE ANY CONCRETE STRUCTURES. O- 17211000 SOIL ABSORPTION SYSTEM I w t� 23 STAGE COACH 12. USE SCHEDULE 40 PVC PIPING WITH WATERTIGHT JOINTS UNLESS OTHERWISE NOTED ON PLAN. ALL PIPE SHALL BE PLACED ON A COMPACTED FIRM BASE. cn w 23 STAGECOACH ROAD LEACHING SYSTEM USED: BED o w q ROAD N/F DESIGN PERCOLATION RATE: 2 MIN./IN. 13. THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING OPERATIONS AND MAINTENANCE INFORMATION FOR THE SEPTIC SYSTEM TO THE ENGINEER, IF w � SOIL CLASS: I PROP. 4" DIA. FFE= 10 1.89 FT MICHELLE TOBEY NECESSARY. w Q f-- g SCH 40 PVC LONG TERMACCEPTANCE RATE (LTAR): 0.74 GPD/S.F. 0 N z x L= 10' S= 2% / TOTAL AREA REQUIRED-LOCAL CODE: 446 S.F. = p cV Z ca 14. UNSUITABLE SOIL MUST BE REPLACED WITH TITLE 5 SAND AS SPECIFIED IN 310 CMR 15.255(3). ANY ADDITIONAL AREAS THAT ARE FOUND TO HAVE a o w d' ---__ TOTAL AREA REQUIRED- TITLE 5: 446 S.F. U:a= z �j Q d UNSUITABLE MATERIAL SHALL BE REPORTED TO THE ENGINEER. ® Q .0-•co x w O :v co 3 O W N Q oo = w a o: � i 1 TOTAL AREA PROPOSED: 15. ALL SEPTIC COMPONENTS SHALL BE INSTALLED WITH MAGNETIC WARNING TAPE. (� o �'- J o- 1 AREA PROPOSED(Ift32): 500 S.F. 16, THE CONTRACTOR SHALL RESTORE ALL SURFACES EQUAL TO THEIR ORIGINAL CONDITION AFTER CONSTRUCTION IS COMPLETE. AREAS NOT DISTURBED 0 v V N o �'� TOTAL ALLOWABLE FLOW: 370 GPD BY CONSTRUCTION SHALL BE LEFT NATURAL. THE CONTRACTOR SHALL TAKE CARE TO PREVENT DAMAGE TO SHRUBS, TREES, OTHER LANDSCAPING n O•o w z n2 98.81 I ,00� N23 16 AND/OR NATURAL FEATURES. 'WHEREAS THE PLANS DO NOT SHOW ALL LANDSCAPE FEATURES, EXISTING CONDITIONS MUST BE VERIFIED BY THE z L-M �B. . NALSET 23 a ° U S2311640"W 20.00'"E CONTRACTOR IN ADVANCE OF THE WORK. � C w a N I J� 120.t - s� - _______ --- - SCHEDULE OFELEVA TIONS 17. EXISTING SEPTIC TO BE ABANDONED PER TITLE 5 REQUIREMENTS. (310 CMR 15.354/ 3). 0 - -- G --._ G -G p, F9 EL. BUILDING FOUNDATION 101.89 WASTEWATER INSTALLATION INSPECTION NOTES STAGECOACH BUILDING INVERT OUT 99.22 1. THE CONTRACTOR SHALL PROVIDE A MINIMUM OF 24 HOURS ADVANCE NOTICE TO THE ENGINEER AND LOCAL BOARD OF HEALTH FOR ANY INSPECTION. Ll- Lw Lw LL_ x W SEPTIC TANK-INLET 99.02 2. ALL WASTEWATER SYSTEMS, INCLUDING THE LEACHING SYSTEM, SHALL BE INSPECTED BY THE ENGINEER OR LOCAL BOH REPRESENTATIVE PRIOR TO Q m °D a ROAD SEPTIC TANK - OUTLET 98-77 BACKFILLING. AT A MINIMUM THE FOLLOWING ITEMS SHALL BE INSPECTED: m Q 44 DISTRIBUTION BOX-INLET 98.74 2.1. EXCAVATION OF LEACHING FIELD PRIOR TO PLACING SYSTEM MATERIAL/COMPONENTS Z w > DISTRIBUTION BOX-OUTLET 98.57 ? V 0 BED INVERT 1N 98.51 2.2. LEACHING FIELD COMPLETE INSTALLATION PRIOR TO BACKFILL 4 w w BREAKOUT 98.60 2.3. ALL SYSTEM COMPONENTS BASE AND INSTALLATION PRIOR TO BACKFILL _ I o: _ 2.4. LEAKAGE TEST ON SEPTIC TANK(MIN. 24 HR) o U cl LATERAL DISTAL INVERT 98.35 2.5. ABANDON EXISTING SYSTEM ' N23'1643"E N23016'43"E BOTTOM OF SYSTEM 97.85 2.6. FINAL INSPECTION OF BACKFILLED SYSTEM SHEET MIN COVER OVER SYSTEM 99.26 78.05' 85.00' 0 a G.W.ELEVATION 93.50 3. THE CONTRACTOR SHALL BE RESPONSIBLE TO MAINTAIN UP-TO-DATE AS-BUILT DRAWINGS AND NOTES INDICATING THE HORIZONTAL AND VERTICAL LOCATION WITH SEPARATION TO G.W. 4.4 TWO TIES OF ALL SYSTEM COMPONENTS INSTALLED. THESE AS-BUILT DRAWINGS AND NOTES WILL BE UTILIZED BY THE ENGINEER FOR THE PREPARATION OF RECORD 1 OF �D PLANS. FINISH GRADE OVER DISTRIBUTION BOXES=XX FT Z LLB \i PROVIDE COVER AND PROVIDE COVER FINISH GRADE _� _��TTT=� RISER TO WITHIN 6"OF �I\TTr=�T1-m-LOAM AND SEED�� AND RISER TO OVER TANK _L J�L--1JJ-1,�,L-�1_L_.. �LL FINISHED GRADE GRADE EL.XX _____ L+- CLEAN w ' GRAVEL DRIVE - - BACKFILL - - - - - - - _ - _ - 9"MIN ._ - - - - - - -- - - _ BACKFILL ' - FLOW - - - - - i is}C ZG .A - - - - ;:�� I - - - - - - - - - - 6 OF3/4" - V RESIDENCE ''� I fa" " `r '- - - - - - - - - - - w ;•t:.. COMPACTED ( I_ - - CRUSHED 177� I'IIN i MINIMUM 48 - STONE BASE < I h t'� '; I I I 3"DROP BAFGAS FLE - i III III- , . . ... . . ....• • . . . : : II � � � � � � � �- � � ) � � � i I NOTES: SOIL TEST PIT DATA A C 6"OF 3/4"COMPACTED I -I I ( PROVIDE 5 OUTLET DISTRIBUTION BOX INSTALLED ON o UNDISTURBED EARTH-� I I- TP-1 TP-2 CRUSHED STONE LEVEL STABLE BASE. INSTALL FIRST 2 FEET OF OUTLET PIPES LEVEL. 0"--. -.._._ _"____ ______ T_..99•5 0"- 99-5 23 w H-10 1500 GALLON SEPTIC TANK A 3 A STAGECOACH a 10 YR 3/2 10 YR 3/2 ROAD a NOT TO SCALE PROPOSED H-10 DISTRIBUTION BOX DETAIL LOAMY SAND LOAMY SAND PROPOSED 1500 GALLON CONCRETE SEPTIC TANK ACME PRECAST OR EQUIVALENT 12 98.5 14' 8.3 oe rn LENGTH: 10'-6" WIDTH:5=8"DEPTH:5'-8" NOT TO SCALE B B 0 10 YR 5/4 10 YR 5/4 oe a `V LOAMY SAND LOAMY SAND o 0 I 32"_ 6.8 32' 6.8 4"SCH.40 PVC OBSERVATION PORT �-%N OF� INSTALLED IN ACCORDANCE WITH 310 CM C C Cy CD 4"SCH.40 PVC PIPE WITH 5/8" 15.240(13) 2.5 Y 6/4 2.5 Y 6/4 EPN L C�2 ERFORATIONS INSTALLED IN ILTER FABRIC MIRAFI 140N O 4"SCH.40 PVC SITE LOCUS ACCORDANCE WITH 310 CMR 15.251(8) APPROVED EQUAL DISTRIBUTION LATERAL(TYP.) FINE SAND FINE SAND NOT TO SCALE @ 49" PERC @ 49" SURVEY NOTES MENCIML RSON � ----a EL. 100.0 y a fry <2 MIN/IN <2 MIN/IN 1. THE TOPOGRAPHY AND EXISTING SITE CONDITIONS DEPICTED HEREON ARE THE RESULT OF AN ON THE GROUND FIELD SURVEY CONDUCTED BY THE rA IF-iiI-IVARIESSEESITE PLAN _ _________ __ !1ii __ �__-------------- )�i1rIiVARIESSEESITEPLAN_ _ _ - -- ______ T ---------------- --------- ------------ ---__ ------ -------------- -----------777- 6_L-==-- _______- =_===BACKFILL- ---______- ______-_ - =__ _________ __________ ___ - _____ 96" -- 1.5 96" _91.5 2. HORIZONTAL DATUM IS ASSUMED. 40 =__=____________--___-__- ______-- __- _ ' I ______________ -_____-- ___ = =_====__- WEEPING @78" WEEPING@78�� - - - - _ ----------- ---- ==--- _ ___________ ____ -------- ----------- v - 1 I I 0.5'ADJUSTMENT 0.5'ADJUSTMENT 3. THE ELEVATIONS DEPICTED HEREON WERE BASED ON AN ASSUMED DATUM. �J� � -�- -`-- -�-------- BREAKOUT INVERT IN T13/4"A-1/2"DOUBLE WASHED STONE I 6" BOTTOM OF I I 3/4"-1-1/2"DOUBLE:WASHED STONE ESHGW= 93.5 ESHGW= 93.5 SYSTEM 4. THE PROPERTY LINES AND RIGHTS OF WAYS DEPICTED HAVE BEEN ESTABLISHED BY FIELD SURVEY AND DEEDS AND PLANS OF RECORD. Z _ I I PERFORMED BY: ELIZABETH KITTILA, HORSLEY WITTEN GROUP, INC O NF� I I I III I I WITNESSED BY: DAVID STANTON, HEALTH DEPARTMENT 5. PROPERTY LINES FOR ABUTTING PROPERTY OWNERS ARE APPROXIMATE ONLY. I- N 4.4' UNDISTURBED EARTH 4 2, DATE: MAY 17, 2019 UNDISTURBED EARTH 16' TYP -� I certify that I am currently approved by the Department of Environmental Protection pursuant to 310 6. THIS PLAN DOES NOT SHOW ANY RECORDED OR UNWRITTEN EASEMENTS WHICH MAY EXIST. HOWEVER, THIS DOES NOT CONSTITUTE A GUARANTEE THAT QCD cr� 32' -I NO SUCH EASEMENTS EXIST. F_ I- I CIWIR 15.017 to conduct soil evaluations and that the above analysis has been performed by me Z Z p L,� TYPICAL DISTRIBUTION LINE PROFILE ESTIMATED SEASONAL HIGH WATER EL.93.5 TYPICAL FIELD SECTION consistent with the required training,expertise and experience described in 310 CMR 15.017. 1 further L_LJ [C Z O certify that the results of my soil evaluation,as indicated in the attached Soil Evaluation Form,are 7. THE ACCURACY OF MEASURED PIPE INVERTS AND PIPE SIZES IS SUBJECT TO FIELD CONDITIONS, THE ABILITY TO MAKE VISUAL OBSERVATIONS, DIRECT W � La.� © 0 _ Qaccurate and in accordance with 310 CMR 15.100 through 15.107. ACCESS TO THE VARIOUS ELEMENTS AND OTHER CONDITIONS. I L i.l U C o LEACHING FIELD DETAILS `s �_ CD < N 8. THE LOCATION AND/OR ELEVATION OF EXISTING UTILITIES AND STRUCTURES AS SHOWN ON THESE PLANS ARE BASED ON RECORDS OF VARIOUS UTILITY CD < � NOT TO SCALE COMPANIES, AND WHEREVER POSSIBLE, MEASUREMENTS TAKEN IN THE FIELD. THIS INFORMATION IS NOT TO BE RELIED UPON AS BEING EXACT OR W W_ GENERAL SITE INFORMATION COMPLETE. THE LOCATION OF ALL UNDERGROUND UTILITIES AND STRUCTURES SHALL BE VERIFIED IN THE FIELD PRIOR TO THE START OF ANY -� w F_ w 4�0 CONSTRUCTION. THE CONTRACTOR MUST CONTACT THE APPROPRIATE UTILITY COMPANY, ANY GOVERNING PERMITTING AUTHORITY IN THE TOWN OF > C:d 0 J 1. PARCEL ID 172110. OWNER OF RECORD: MICHELLE TOBEY TRURO, AND "DIGSAFE" (1-888-344-7233)AT LEAST 72 HOURS PRIOR TO ANY EXCAVATION WORK IN PREVIOUSLY UNALTERED AREAS TO REQUEST EXACT -Cc ADDRESS: 23 STAGE COACH ROAD, CENTERVILLE MA FIELD LOCATION OF UTILITIES. C = Q Li w 2. LOT SIZE: 0.34 ACRES +/-. Z L.J J N Z Q 3. EXISTING DWELLING SEPTIC IS FAILED. PROPOSED UPGRADE TO 9• THE PROPERTY IS LOCATED WITHIN THE AREA OF MINIMAL FLOOD HAZARD (ZONE X)AS SHOWN ON COMMUNITY PANEL NO. 25001CO561J DATED 7/16/2014. U <L Z w 173025 TITLE 5 STANDARDS. L� _ C v 4. NO KNOWN POTABLE WATER WELLS WITHIN 100 FEET OF THE 1 G52 OLD STAGE ROAD PROPOSED SANITARY ABSORPTION FIELD (SAS). WASTEWATER NOTES C:)N/F F_ � IRENE & CLIFFORD 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE IN ACCORDANCE WITH THE STATE ENVIRONMENTAL Z CODE AND THE RULES AND REGULATIONS OF THE LOCAL BOARD OF HEALTH. LIHOU JR VARIANCE � 2. THIS PLAN IS INTENDED TO ADEQUATELY PROVIDE THE INFORMATION NECESSARY TO LAYOUT AND CONSTRUCT THE PROPOSED SEWAGE DISPOSAL )( )) N23°1640"E N23°16"40"E _ x�- - 1. SEPARATION TO GROUNDWATER (310 CMR 15.402(1 h SYSTEM REPRESENTED ON IT. � I• ?' �._ ,tt 135.99' x x -120.00` x x x 5 REQUIRED, 4.42 PROVIDED (VARIANCE OF 0.58 OR p 7" REQUESTED) 3. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE ENGINEER AND/OR THE LOCAL BOARD OF HEALTH (BOH) STAFF. j ) f, ` OBSERVATION 20.4' I 4. PRIOR TO CONSTRUCTION, '"+ / ,{ C\2 THE CONTRACTOR SHALL COORDINATE WITH THE PROPERTY OWNER AND ENGINEER ON THE CONSTRUCTION SITE ACCESS r ` . A� o PORT PROPOSED SOIL ABSORPTION 1 t AND MATERIAL STOCK PILE AREAS. SYSTEM - 16'x32' LEACH FIELD ' IUD X TREATMENT SYSTEM DESIGN CRITERIA/ �,, I � 5. TRENCH SAFETY SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR INCLUDING ANY LOCAL AND/OR STATE PERMITS REQUIRED FOR THE TRENCH ✓' � r ��� � ,;• x WORK. THIS WORK MAY BE REQUIRED TO TAKE PLACE OUTSIDE OF NORMAL HOURS OF OPERATION FOR THE FACILITY. THE CONTRACTOR SHALL PLAN N • USE: SINGLE FAMILY ACCORDINGLY. \� r PROPOSED NUMBER OF BEDROOMS (DESIGN) 3 \' y X D BOX TITLE 5 DESIGN FLOW 110 GPD/BEDROOM 6. THE CONTRACTOR SHALL REPORT ANY DISCREPANCIES FOUND IN SITE CONDITIONS FROM THOSE SHOWN ON THE PLAN TO THE DESIGN ENGINEER. PROP. 4" DIA. 32.0' . TOTAL DAILY DESIGN FLOW 330 GPD SCH 40 PVC APPROX. LOCATION X GARBAGE DISPOSAL: NO 7. FAILING TO PROPERLY INSPECT OR PUMP THE SEPTIC TANKS AND TREATMENT SYSTEM OR CHANGES TO EFFLUENT FLOW, GRADING, OR LANDSCAPING, O L= 3' S= 1% EXISTING SEPTIC WOODEN FENCE EITHER ON-SITE OR ADJACENT TO THE SITE, MAY RESULT IN IMPROPER FUNCTIONING OF THE SEPTIC AND LEACHING SYSTEM(S). __ II '0"' 173047 SEPTIC TANK X 200% OF DESIGN FLOW: 660 GALLON 8. CALL"DIGSAFE"AT LEAST 72 HOURS PRIOR TO COMMENCING CONSTRUCTION AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES TO FIELD VERIFY 172111 35 STAGE COACH �` x LOCATIONS OF EXISTING UTILITIES. cv 9 STAGE COACH PROTECT ROAD EXISTING TREE ROAD USE 1,500 GALLON SEPTIC TANK s o � I / o N/F 9. THIS ON-SITE WASTEWATER TREATMENT SYSTEM IS NOT DESIGNED FOR USE WITH A GARBAGE GRINDER. Q Q p N/F ix LW KAHLER BURTON > ca MATTHEW FULP PROP. 1,500 GALLON DECK PROTECT x o LEACHING SYSTEM DESIGN CRITERIA 10. THE OWNER SHALL INSPECT AND PUMP THE SEPTIC TANK ONCE EVERY 2 YEARS. W I p SEPTIC TANK 10.0 EXISTING DECK o M w x x- /--- x N 11. PROVIDE WATERTIGHT SEALS BY USE OF NON-SHRINK GROUT AT ALL POINTS WHERE PIPES ENTER OR LEAVE ANY CONCRETE STRUCTURES. CL � W _ _ 172110 _ � SOIL ABSORPTION SYSTEM � w 23 STAGE COACH 12. USE SCHEDULE 40 PVC PIPING WITH WATERTIGHT JOINTS UNLESS OTHERWISE NOTED ON PLAN. ALL PIPE SHALL BE PLACED ON A COMPACTED FIRM BASE. � N w p 23 STAGECOACH ROAD LEACHING SYSTEM USED: BED o w ROAD DESIGN PERCOLATION RATE: 2 MINAM PROP. 4" DIA. FFE= 101.89 FT N/F SOIL CLASS: 1 13. THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING OPERATIONS AND MAINTENANCE INFORMATION FOR THE SEPTIC SYSTEM TO THE ENGINEER, IF �"�. 41 MICHELLE TOBEY NECESSARY. w a SCH 40 PVC j LONG TERM ACCEPTANCE RATE (LIAR): 0.74 GPD/S.F. a w z c� '-' L= 10' S= 2% TOTAL AREA REQUIRED-LOCAL CODE: 446 S.F. o N Q w 0 14. UNSUITABLE SOIL MUST BE REPLACED WITH TITLE 5 SAND AS SPECIFIED IN 310 CMR 15.255(3). ANY ADDITIONAL AREAS THAT ARE FOUND TO HAVE d' o TOTAL AREA REQUIRED- TITLE 5: 446 S.F. cz3 4- �'d UNSUITABLE MATERIAL SHALL BE REPORTED TO THE ENGINEER. �) <t.9-6 O r co3 OLj N i°O = J Q 0) o i TOTAL AREA PROPOSED: G'-) < y �1 � w a. 15. ALL SEPTIC COMPONENTS SHALL BE INSTALLED WITH MAGNETIC WARNING TAPE. na 101 AREA PROPOSED(16k32): 500 S.F_ 16. THE CONTRACTOR SHALL RESTORE ALL SURFACES EQUAL TO THEIR ORIGINAL CONDITION AFTER CONSTRUCTION IS COMPLETE. AREAS NOT DISTURBEDAm tyi C}j J 98$� ' �I TOTAL ALLOWABLE FLOW: 370 GPD BY CONSTRUCTION SHALL BE LEFT NATURAL. THE CONTRACTOR SHALL TAKE CARE TO PREVENT DAMAGE TO SHRUBS, TREES, OTHER LANDSCAPING ' o•o B• 8,81 >oo AND/OR NATURAL FEATURES. WHEREAS THE PLANS DO NOT SHOW ALL LANDSCAPE FEATURES, EXISTING CONDITIONS MUST BE VERIFIED BY THE Z L 113.35' 23°1640"E N23°16 <CL 120.00 120.I CONTRACTOR IN ADVANCE OF THE WORK. w r C) S23°16 40"W -_ o -� SCHEDULE OF ELEVA TONS 17. EXISTING SEPTIC TO BE ABANDONED PER TITLE 5 REQUIREMENTS. (310 CMR 15.354 13). \ � --- G G G ----m p., Y WASTEWATER INSTALLATION INSPECTION NOTES Y J- EL. BUILDING FOUNDATION 101.89 W cr_ a- x STAGECOACH BUILDING INVERT OUT 99.22 1. THE CONTRACTOR SHALL PROVIDE A MINIMUM OF 24 HOURS ADVANCE NOTICE TO THE ENGINEER AND LOCAL BOARD OF HEALTH FOR ANY INSPECTION. LL_ w w L_ SEPTIC TANK-INLET 99.02 O j= m SEPTIC TANK- OUTLET 98.77 2. ALL WASTEWATER SYSTEMS, INCLUDING THE LEACHING SYSTEM, SHALL BE INSPECTED BY THE ENGINEER OR LOCAL BOH REPRESENTATIVE PRIOR TO m ROAD DISTRIBUTION BOX-INLET 98-74 BACKFILLING. AT A MINIMUM THE FOLLOWING ITEMS SHALL BE INSPECTED: m p a • 2.1. EXCAVATION OF LEACHING FIELD PRIOR TO PLACING SYSTEM MATERIAL/COMPONENTS w > DISTRIBUTION BOX-OUTLET 98.57 2.2. LEACHING FIELD COMPLETE INSTALLATION PRIOR TO BACKFILL < U BED INVERT IN 98.51 .Q w CL 2.3. ALL SYSTEM COMPONENTS BASE AND INSTALLATION PRIOR TO BACKFILL a BREAKOUT 98.60 2.4. LEAKAGE TEST ON SEPTIC TANK (MIN. 24 HR) Q_ o \ Q LATERAL DISTAL INVERT 98.35 2.5. ABANDON EXISTING SYSTEM x N23°1643'E N23°16'43'E BOTTOM OF SYSTEM 97.85 2.6. FINAL INSPECTION OF BACKFILLED SYSTEM SHEET 10 78.05' 85.00' O 40 MIN COVER OVER SYSTEM 99.26 G.W.ELEVATION 93.50 3. THE CONTRACTOR SHALL BE RESPONSIBLE TO MAINTAIN UP-TO-DATE AS-BUILT DRAWINGS AND NOTES INDICATING THE HORIZONTAL AND VERTICAL LOCATION WITH 1 SEPARATION TO G.W. 4-4 TWO TIES OF ALL SYSTEM COMPONENTS INSTALLED. THESE AS-BUILT DRAWINGS AND NOTES WILL BE UTILIZED BY THE ENGINEER FOR THE PREPARATION OF RECORD I OF �D PLANS. FINISH GRADE OVER DISTRIBUTION BOXES=XX FT Z W r;1 PROVIDE COVER AND PROVIDE COVER FINISH GRADE T r�TTT=�T�" " ' =T(f-1 f l TT 1=1 f r=_ f-T L l-f i-TT 1-11 T RISER TO WITHIN 6"OF - .LOAM AND SEED -- AND RISER TO OVER TANK1 LI- -_�11-L1.L®�L._.__ r�•; FINISHED GRADE GRADE EL.XX I - - - - - - - - - - - - - - - - - - - _ GRAVEL DRIVE CLEAN _ ___ _ - -_BACKFILL •. .• I. 9"MIN. 3" ... _ -- - - .._. - - - - - - - . 9" BACKFILL _ - - - - - - - - _- FLOW - _ _ - 1000Z O - O FLOW = - O U I I I I I j� � - COMPACTED RESIDENCE - CRUSHED w �Z c IMM a STONE BASE MNIU S oAFFLE3"DROP GA B 1 NOTES: SOIL TEST PIT DATA ACL 6"OF 3/4"COMPACTED I PROVIDE 5 OUTLET DISTRIBUTION BOX INSTALLED ON CRUSHED STONE -� I I I UNDISTURBED EARTH -1 1 I I I I- LEVEL STABLE BASE. TP-1 TP-2 m N H-10 1500 GALLON SEPTIC TANK INSTALL FIRST 2 FEET OF OUTLET PIPES LEVEL. 0° - A" -99.5 0° -- " A -99.5 zs w STAGECOACH a- 10 YR 3/2 10 YR 3/2 ROAD Cl- NOT TO SCALE PROPOSED H-10 DISTRIBUTION BOX DETAIL LOAMY SAND LOAMY SAND PROPOSED 1500 GALLON CONCRETE SEPTIC TANK ACME PRECAST OR EQUIVALENT 12 98.5 14' 98.3 N a LENGTH: 10'-6" WIDTH:5'-8"DEPTH:5'-8" NOT TO SCALE B B �oe W - - a co 10 YR 5/4 10 YR 5/4 oe o rn LOAMY SAND LOAMY SAND o 0 1 32" 6.8 32' 6.8 4"SCH.40 PVC OBSERVATION PORT C C • } INSTALLED IN ACCORDANCE WITH 310 CM OF O 4"SCH.40 PVC PIPE WITH 5/8" 15.240(13) 2.5 Y 6/4 2.5 Y 6/4 JCSEPH L C\2 ERFORATIONS INSTALLED IN ILTER FABRIC MIRAFI 140N O 4"SCH.40 PVC SITE LOCUS ACCORDANCE WITH 310 CMR 15.251(8) APPROVED EQUAL DISTRIBUTION LATERAL(TYP.) PERC @ 49" PERC @ 49" SURVEY NOTES FINE SAND FINE SAND NOT TO SCALE NENOERSOM CIVIL C\2 _ _ E . 100.0 <2 MIN/IN <2 MIN/IN 1. THE TOPOGRAPHY AND EXISTING SITE CONDITIONS DEPICTED HEREON ARE THE RESULT OF AN ON THE GROUND FIELD SURVEY CONDUCTED BY THE f48M�U VARIES SEE SITE PLAN VARIES SEE SITE PLAN __-_-__=____-_____-- -_--_ __-__- ____ _________-_- _-__-______________-_-____= HORSLEY WITTEN GROUP, INC. ON MAY 14, 2019. A _ _ -- --------- ---- ------- - ----- ----- --- - ------- --------- ==BACKFf6L-==---------- - �4 ------ _ --- - ---- ----- --- ----------- -------- ------------- ------- -------------_- -------- G __---BACKFILL=__- --------- - -------- ---_-- ---- _ -_-__- 96,E 1 5 96" 91.5 2. HORIZONTAL DATUM IS ASSUMED. IONAI� __-_-______--_______ ________ _-____-- I ___=-_____-________-_-_e_r=__- _-________-_- -_-_-___" __-__= WEEPING @ 78" WEEPING @ 78„ 1 ______________ ___________ ________ ________ BREAKOUT --- 3. THE ELEVATIONS DEPICTED HEREON WERE BASED ON AN ASSUMED DATUM. -- ----------- 111 -------- - 0 5'ADJUSTMENT 0 5'ADJUSTMENT INVERT IN 3/4"-1-1/2"DOUBLE WASHED STONE I 6" I I 3/4"-1-1/2"DOUBLE:WASHED STONE ESHGW= 93.5 ESHGW= 93.5 BOTTOM OF - - - 4. THE PROPERTY LINES AND RIGHTS OF WAYS DEPICTED HAVE BEEN ESTABLISHED BY FIELD SURVEY AND DEEDS AND PLANS OF RECORD. SYSTEM III PERFORMED BY: ELIZABETH KITTILA, HORSLEY WITTEN GROUP, INC WITNESSED BY: DAVID STANTON, HEALTH DEPARTMENT III III III III I I 4.4' UNDISTURBED EARTH 4 2, DATE: MAY 17, 2019 5. PROPERTY LINES FOR ABUTTING PROPERTY OWNERS ARE APPROXIMATE ONLY. J UNDISTURBED EARTH _I n'P• _ 6. THIS PLAN DOES NOT SHOW ANY RECORDED OR UNWRITTEN EASEMENTS WHICH MAY EXIST. HOWEVER, THIS DOES NOT CONSTITUTE A GUARANTEE THAT �[ Cn 16' 1 certify that I am currently approved by the Department of Environmental Protection pursuant to 310 H- CD � I- I� 32' NO SUCH EASEMENTS EXIST. IF— �- CMR 15.017 to conduct soil evaluations and that the above analysis has been performed by me Z ZQ W TYPICAL FIELD SECTION TYPICAL DISTRIBUTION LINE PROFILE ESTIMATED SEASONAL HIGH WATER EL.93.5 consistent with the required training,expertise and experience described in 310 CMR 15.017. 1 further W nr- Z Q C/) QI certify that the results of my soil evaluation, as indicated in the attached Soil Evaluation Form,are 7. THE ACCURACY OF MEASURED PIPE INVERTS AND PIPE SIZES IS SUBJECT TO FIELD CONDITIONS, THE ABILITY TO MAKE VISUAL OBSERVATIONS, DIRECT W � W C:) 0 accurate and in accordance with 310 CMR 15.100 through 15.107. ACCESS TO THE VARIOUS ELEMENTS AND OTHER CONDITIONS. 0. Z LAJ U U C\2 Q C:) z c�� < 0 LEACHING FIELD DETAILS 8. THE LOCATION AND/OR ELEVATION OF EXISTING UTILITIES AND STRUCTURES AS SHOWN ON THESE PLANS ARE BASED ON RECORDS OF VARIOUS UTILITY � `z � NOT TO SCALE COMPANIES, AND WHEREVER POSSIBLE, MEASUREMENTS TAKEN IN THE FIELD. THIS INFORMATION IS NOT TO BE RELIED UPON AS BEING EXACT OR 5 Z W GENERAL SITE INFORMATION COMPLETE. THE LOCATION OF ALL UNDERGROUND UTILITIES AND STRUCTURES SHALL BE VERIFIED IN THE FIELD PRIOR TO THE START OF ANY CONSTRUCTION. THE CONTRACTOR MUST CONTACT THE APPROPRIATE UTILITY COMPANY, ANY GOVERNING PERMITTING AUTHORITY IN THE TOWN OF > J 1. PARCEL ID 172110. OWNER OF RECORD: MICHELLE TOBEY TRURO, AND "DIGSAFE" (1-888-344-7233)AT LEAST 72 HOURS PRIOR TO ANY EXCAVATION WORK IN PREVIOUSLY UNALTERED AREAS TO REQUEST EXACT = L'- W y ADDRESS: 23 STAGE COACH ROAD, CENTERVILLE MA FIELD LOCATION OF UTILITIES. _ Q 2. LOT SIZE: 0.34 ACRES cv w Z / 3. EXISTING DWELLING SEPTIC IS FAILED. PROPOSED UPGRADE TO 9. THE PROPERTY IS LOCATED WITHIN THE AREA OF MINIMAL FLOOD HAZARD (ZONE X)AS SHOWN ON COMMUNITY PANEL NO. 25001CO561J DATED 7/16/2014. 173025 TITLE 5 STANDARDS. t� _ U 4. NO KNOWN POTABLE WATER WELLS WITHIN 100 FEET OF THE 1052 OLD STAGE ROAD ® CC 0� N/F PROPOSED SANITARY ABSORPTION FIELD (SAS). WASTEWATER NOTES F- ---- IRENE & CLIFFORD 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION METHODS SHALL BE IN ACCORDANCE WITH THE STATE ENVIRONMENTAL Z CODE AND THE RULES AND REGULATIONS OF THE LOCAL BOARD OF HEALTH. Q LIHOU JR VARIANCE to r, 2. THIS PLAN IS INTENDED TO ADEQUATELY PROVIDE THE INFORMATION NECESSARY TO LAYOUT AND CONSTRUCT THE PROPOSED SEWAGE DISPOSAL N23°1640 E _ N23°1640'E _ 1. SEPARATION TO GROUNDWATER (310 CMR 15.402(1)(h)): SYSTEM REPRESENTED ON IT. L U X _-- x x 5' REQUIRED, 4.42' PROVIDED (VARIANCE OF 0.58' OR 135.99' ��x x -120.00' Q � 7" REQUESTED) 3. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE ENGINEER AND/OR THE LOCAL BOARD OF HEALTH (BOH) STAFF. _" OBSERVATION ' 20.4 I 4. PRIOR TO CONSTRUCTION, THE CONTRACTOR SHALL COORDINATE WITH THE PROPERTY OWNER AND ENGINEER ON THE CONSTRUCTION SITE ACCESS PORT PROPOSED SOIL ABSORPTION AND MATERIAL STOCK PILE AREAS. A ►.. SYSTEM - 16'x32' LEACH FIELD 16.0' --I x TREATMENT SYSTEM DESIGN CRITERIA 5. TRENCH SAFETY SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR INCLUDING ANY LOCAL AND/OR STATE PERMITS REQUIRED FOR THE TRENCH � ' Temt�aryEen " / x WORK. THIS WORK MAY BE REQUIRED TO TAKE PLACE OUTSIDE OF NORMAL HOURS OF OPERATION FOR THE FACILITY. THE CONTRACTOR SHALL PLAN -� PROPOSED i USE: SINGLE FAMILY ACCORDINGLY. � D-BOX 101 . TP 1 a NUMBER OF BEDROOMS (DESIGN) 3 9 � ii PROP. 4" DIA. 32.0' �� ' / TITLE 5 DESIGN FLOW 110 GPD/BEDROOM 6. THE CONTRACTOR SHALL REPORT ANY DISCREPANCIES FOUND IN SITE CONDITIONS FROM THOSE SHOWN ON THE PLAN TO THE DESIGN ENGINEER. SCH 40 PVC TP 2 TOTAL DAILY DESIGN FLOW 330 GPD o L- 3' S= 1% APPROX. LOCATION X WOODEN FENCE GARBAGE DISPOSAL: NO 7. FAILING TO PROPERLY INSPECT OR PUMP THE SEPTIC TANKS AND TREATMENT SYSTEM OR CHANGES TO EFFLUENT FLOW, GRADING, OR LANDSCAPING, CV i EXISTING SEPTIC EITHER ON-SITE OR ADJACENT TO THE SITE, MAY RESULT IN IMPROPER FUNCTIONING OF THE SEPTIC AND LEACHING SYSTEM(S). 11 � 173047 SEPTIC TANK 172111 " 200% OF DESIGN FLOW: 660 GALLON 8. CALL"DIGSAFE"AT LEAST 72 HOURS PRIOR TO COMMENCING CONSTRUCTION AT 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES TO FIELD VERIFY 10 X 35 STAGE COACH 9 STAGE COACH PROTECT O LOCATIONS OF EXISTING UTILITIES. o ROAD _ w w ROAD EXISTING TREE o N/F USE 1,500 GALLON SEPTIC TANK 9. THIS ON-SITE WASTEWATER TREATMENT SYSTEM IS NOT DESIGNED FOR USE WITH A GARBAGE GRINDER. `Q Q N/F Ix W KAHLER BURTON W N w MATTHEW FULP PROP. 1,500 GALLON I DECK PROTECT o N LEACHING SYSTEM DESIGN CRITERIA 10. THE OWNER SHALL INSPECT AND PUMP THE SEPTIC TANK ONCE EVERY 2 YEARS. L� �1 <t p SEPTIC TANK ' 10.0 EXISTING DECK o Cn � W x x - - -- -- x N 11. PROVIDE WATERTIGHT SEALS BY USE OF NON-SHRINK GROUT AT ALL POINTS WHERE PIPES ENTER OR LEAVE ANY CONCRETE STRUCTURES. � 172110 - c�°o SOIL ABSORPTION SYSTEM I w t�0 F_ 23 STAGE COACH 12. USE SCHEDULE 40 PVC PIPING WITH WATERTIGHT JOINTS UNLESS OTHERWISE NOTED ON PLAN. ALL PIPE SHALL BE PLACED ON A COMPACTED FIRM BASE. to W v 23 STAGECOACH ROAD LEACHING SYSTEM USED: BED Q ROAD N/F DESIGN PERCOLATION RATE: 2 MIN-/IN. �- a U) PROP. 4" DIA. FFE= 101.89 FT MICHELLE TOBEY SOIL CLASS: ! 13. THE CONTRACTOR IS RESPONSIBLE FOR PROVIDING OPERATIONS AND MAINTENANCE INFORMATION FOR THE SEPTIC SYSTEM TO THE ENGINEER, IF j w � x SCH 40 PVC LONG TERMACCEPTANCE RATE (LTAR): 0.74 GPD/S.F- NECESSARY. � P z L= 10' S= 2% TOTAL AREA REQUIRED-LOCAL CODE: 446 S-F. = C:N M Z Z o T� 14. UNSUITABLE SOIL MUST BE REPLACED WITH TITLE 5 SAND AS SPECIFIED IN 310 CMR 15.255(3). ANY ADDITIONAL AREAS THAT ARE FOUND TO HAVE o <t w c� TOTAL AREA REQUIRED-TITLE 5: 446 S.F. U�= I Z C�2 a UNSUITABLE MATERIAL SHALL BE REPORTED TO THE ENGINEER. C� Q •Q-co p -� W m = J a � N oo m TOTAL AREA PROPOSED: 15. ALL SEPTIC COMPONENTS SHALL BE INSTALLED WITH MAGNETIC WARNING TAPE. (on) J � o N 10 AREA PROPOSED(Ift32). 500 S.F. 16. THE CONTRACTOR SHALL RESTORE ALL SURFACES EQUAL TO THEIR ORIGINAL CONDITION AFTER CONSTRUCTION IS COMPLETE. AREAS NOT DISTURBED C0 98$� TOTAL ALLOWABLE FLOW: 370 GPD BY CONSTRUCTION SHALL BE LEFT NATURAL. THE CONTRACTOR SHALL TAKE CARE TO PREVENT DAMAGE TO SHRUBS, TREES, OTHER LANDSCAPING p•o / i B.MI NAILSET '�� ° ° AND/OR NATURAL FEATURES. WHEREAS THE PLANS DO NOT SHOW ALL LANDSCAPE FEATURES, EXISTING CONDITIONS MUST BE VERIFIED BY THE O Z L_m 113.35' d �- _� 23 01640 E N23 16 Q a- +' " 120.00' 120.1 CONTRACTOR IN ADVANCE OF THE WORK. n_ ` S23°16'40"W n Q ss, 17. EXISTING SEPTIC TO BE ABANDONED PER TITLE 5 REQUIREMENTS. (310 CMR 15.354!3). -� o - - _ - - SCHEDULE OFELEVA TONS d BUILDING FOUNDATION 101.89 WASTEWATER INSTALLATION INSPECTION NOTES w w 0- x a^ �+c(, �+ BUILDING INVERT OUT 99.22 1. THE CONTRACTOR SHALL PROVIDE A MINIMUM OF 24 HOURS ADVANCE NOTICE TO THE ENGINEER AND LOCAL BOARD OF HEALTH FOR ANY INSPECTION. ily STAGECOACH ®�lsH SEPTIC TANK-INLET 99.02 0 m 2. ALL WASTEWATER SYSTEMS INCLUDING THE LEACHING SYSTEM, SHALL BE INSPECTED BY THE ENGINEER OR LOCAL BOH REPRESENTATIVE PRIOR TO m G w7 SEPTIC TANK-OUTLET 98-77 j- G� R��® DISTRIBUTION BOX-INLET 98,74 BACKFILLING. AT A MINIMUM THE FOLLOWING ITEMS SHALL BE INSPECTED: m M 2.1. EXCAVATION OF LEACHING FIELD PRIOR TO PLACING SYSTEM MATERIAL/COMPONENTS z ® > DISTRIBUTION BOX- OUTLET 98.57 Q ? V C) o BED INVERT IN 98.51 2.2• LEACHING FIELD COMPLETE INSTALLATION PRIOR TO BACKFILL 2.3. ALL SYSTEM COMPONENTS BASE AND INSTALLATION PRIOR TO BACKFILL wI <L w �- BREAKOUT 98.60 2.4. LEAKAGE TEST ON SEPTIC TANK(MIN. 24 HR) Q_14 o v Q LATERAL DISTAL INVERT 98.35 2.5. ABANDON EXISTING SYSTEM N23°1643"E N2301643'E BOTTOM OF SYSTEM 97.85 2.6. FINAL INSPECTION OF BACKFILLED SYSTEM SHEET 78.05' 85.00' 0 40 MIN COVER OVER SYSTEM 99-26 G.W.ELEVATION 93.50 3. THE CONTRACTOR SHALL BE RESPONSIBLE TO MAINTAIN UP-TO-DATE AS-BUILT DRAWINGS AND NOTES INDICATING THE HORIZONTAL AND VERTICAL LOCATION WITH 1 1 W SEPARATION TO G.W. 4.4 TWO TIES OF ALL SYSTEM COMPONENTS INSTALLED. THESE AS-BUILT DRAWINGS AND NOTES WILL BE UTILIZED BY THE ENGINEER FOR THE PREPARATION OF RECORD I OF I U) �D PLANS.