HomeMy WebLinkAbout0114 STONEY CLIFF ROAD - Health 114 Stoney Cliff Road
Centerville
A= 190-037
S M E A D
No.2-153LOR
UPC 12534
—
• umb M uv
1
1�
wD1WrMM0011QW
L04SR
Mwo mm"m
TOWN OF BARNSTABLE
LOCATION It-4 STOj.I e�l CUFF R b , SEWAGE## Z0Z0
VILLAGE C.gr4TCe (L(-E- ASSESSOR'S MAP&PARCEL I9t f 37
INSTALLER'S NAME&PHONE NO. 908(FCT 6• 60-2. (508)QZ7 -6677
SEPTIC TANK CAPACITY (SOO op�. TAiJK
LEACHING FACILITY:(type)SOOpj�.CfiAMBOM (size) .12 8' 2( Z5'
NO.OF BEDROOMS
OWNER -0,-
PERMIT DATE: 10 1 .30 I ZO COMPLIANCE DATE: (( 3 1 ZO
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility �p hO® 12- 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.facciility)ty) '�9 Feet
FURNISHED BY �QL ' (V • DCJ� Co .
-3 C Y
( 23.Z tZ.9L 41 5
Z 3�.3 tl•9 3
3 �14.5 ��7.9 z a C-
e 7 c(,
Ll
c�o
C/O
/0_0
No. 000a — 5' Fee /
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: =
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01pplitation for Misposal &pstem Construction permit
Application for a Permit to Construct( ) Repair( ) Upgrade b�—Abandon( ) jjg�,omplete System ❑Individual Components
Location Address or Lot No. %A STD,n Q Y G I*AC r,j0 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel 4 O 3—I V /t o�d w(Yi (^�( (Ct/t
Installer's Name,Address,and Tel.No. '3CosN Wt&,i c5 Pam& Designer's Name,Address,and Tel.No.
►�' O J �-�'• c. 4't l 1 S L �h Lcc�
Type of Building:
Dwelling No.of Bedrooms Lot Size O + sq.ft. Garbage Grinder( )
Other Type of Building 1 No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3 p gpd Design flow provided 3 �{`l gpd
Plan Date I(7.-'Z�� 'LO ,Number of sheets Revision Date
Title 1 j Wt CW^r
Size of Septic Tank 'L Type of S.A.S.�? l ��a ►�(� ����A �,�-
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) pc�}�.vv�.c.,. (pe
W Gw l i too C /yl w- la S u��►� i7�^� �.�-- 2c� l7
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 e lth.
Signed Date O Z Z - Za Z�
Application Approved by Date -z
Application Disapproved by Date
for the following reasons
Permit No. �d 9 Date Issued D ?jD
No ��zo ���-- � f�49
Fee
�^ Entered in computers /
THE COMMONWEALTH* MASSACHUSETTS
Yes
PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS
'w .i � "
r` ftplitation for �I8' 0$'�Y pstPrtt C�CollstrUction permit
Application for a Permit to Construct( ) Repair( ) Upgrade(J)- Abandon( ) ' C9mplete System ❑Individual Components
Location Address or Lot No. STO Yj 9 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel t Gt 0
Installer's Name,Address,and Tel.No. 116 Designer's Name,Address,and Tel.No.
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size R c) sq.ft. Garbage Grinder( ) s
Other Type of Building Cj - , No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) C!!. gpd Design flow provided gpd
Plan Date 1 ( Number of sheets ! Revision Date
Title , S i'i!`✓► ,.— �.\�
Size of Septic Tank � ��iJ l Type of S.A.S.C '�_� j O a �,�.(� A«t C
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 4($fl�r, c,, „� . ti � i �,,�^') �,.e. e-, {,,,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 ealth.,,—'-,
_ S
VV
I;r: Signne�d` r_.L a°'" Date 0/ `2 2--
..AApplication Approved by /�" ,//r~ - Date
Application Disapproved by > Date
for the following reasons
v � d
C1 () Date Issued /0 0
Permit No. %
. �. THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
(Certificate of Compliance
THIS IS TO CE{{RTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded O
Abandoned( )by 1�.C7 .f+. O ..,a r t
at- 1`( T l� i!l { (��`i / ( has been constructed in accordance
y
with the provisions of Title 5 and the for Disposal System Construction Permit No �� �'��dated 4-3)/ c'.,- p
Installer , �,� x 6 u1 C o, r
(rif't( Designer � �_ �.1s1� ��,� • �
#bedrooms Approved design.floow� w �_ f gpd
The issuance of this permit sha 1 not be construed as a guarantee that the system�functiA, des gned.•"""""""°
Date �!I Inspectors
__
_.._.. - --- �_ .,.. _ - .._. .... - __..
----
No. b Fee
THE COMMONWEALTH OF MASSACHUSETTS—
PUBLIC PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
Misposal *pstrm Construction Permit
Permission is hereby granted to Construct( ) Repair( ) Upgrade(() Abandon( )
System located at 1 i a T r� ✓? -e t e a r ? °f'-,t`.-A 'r
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 within three years of the date of this permit. -
Date -Dr Approved by /t
Town of Barnstable
Regulatory Services
t Richard V.Scali,Interim Director
• a►wvsr�®t.e.
Public Health Division
arEota Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date: 11-3-20 Sewage Permit# ZOZ>-,?45. Assessor's Map\Parcel 190/37
Designer: TC- Er1�}tneer y� '=',nr_,' Installer: Robert B. Our Co., Inc. (RBO)
Address: 2-854 Cranberry i gSnwa y Address: 363 Whites Path
t:ask ware_%am WA 0 253 South Yarmouth,MA.
On to 30 Zo RBO was issued a permit to install a
(date) lnsta er)
septic system at_114 Stoney Cliff Drive _based on a design drawn by
(address)
-SC Co gioeerin '10C. dated 10-21-20
(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 i iance with the terms
of the.1\A approval letters(if applicable) 4a`11A r Mass
O
O JM L
c CMRCkll4,,Ri,
( nsta is nature CMt
Ai
AP
O�
(D ner's Signature (Affix D=DSION.
p Here)
PL SE RETURN TO ARNSTABLE PUBLIC HEALT CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS.
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION,
THANK YOU.
Q:\Septic\Designer Certification Form Rev 8-14-13.doc
I
� r
Town of Barnstable
1�
B Inspectional Services Department
S&
r
�"'MA `� ' Public Health Division
MASS.
+h 200 Main Street, Hyannis MA 02601
Office: 508-862-4644
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL47015 1730 0001 4987 8043
September 30, 2020
FULLER, BARRY O & ROBERTA C
114 STONEY CLIFF ROAD
CENTERVILLE, MA 02632
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 114 Stoney Cliff Road, Centerville was inspected on
09/16/2020 by Daniel Hawkins, 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:
• Leaching facility with standing liquid level at or above the invert pipe (per
Town Code 360-20 h).
You are ordered to repair or replace the septic system within two (2)years 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
T �ean, .
4, 4G---
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\114 Stoney Cliff Road
Centervil►e.doc
Oct 0412 11:40a p,1
Commonwealth of Massachusetts
Title 5 official Inspection Form
k+ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
.:' 114 Stoney Cliff Road
Property Address
Barry Fuller _
Owner Owner's Name Y
information is required for Centerville MA 02632 10/312-12
__. .
every page. City/Town State Zip Code Date of Inspection
Inspection results must be submitted on this form.Inspection forms may not be altered in any
t«
way. Please see completeness checklist at the and of the form.
Men filling out Important: A. General Information
When filling
forms on the ( _
computer,use 1. Inspector: � V
only the tab key
to move your UUayne Archambeault
cursor-do not
use the return Name of Inspector
key. __.... _.. _...
Company Name 26 BOX 914
Company Address
Hyannis MA 02601
- ._. .
FmLA Citylrown State Zip Code
508-775-1362 355
Telephone Number License Number
B. Certification
I certify that I have personalty inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection.The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
C3
1013/2012
spector's Signature Date
The system inspector shall submit copy of this inspection report to the Approving Authority(hoar(!
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system ortz
has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the rrb
report to the appropriate regional office of the DEP.The original should be sent tol5the 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.
tsirs•11 r'0 Title I Irupedion form:Subsuface Sewage Disposal Soam•Page 1 of 17
Oct 0412 11:40a p.2
Commonwealth of Massachusetts
Title 5 Official Inspection Form
r= Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address
Barpr Fuller
Owner Owners Name
information is Centerville MA 02632 10l312-12 _required for ____�
every page. 61 rrown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® 1 have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired.The system, upon completion of the replacement or repair, as approved by
the Board of Health,will pass.
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 exfltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
"A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND(Explain below):
t5ins•11M0 Title 5 Official Inspection Fvm:Subsurface Sewage Disposal System-Paco 2 of 17
Oct 04 12 11:41 a p.3
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address
Barry Fuller
Owner Owner's Name
information is required for Centerville MA_ 02632 10/312-12 _
every page. City(rown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes(cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
tsins-lino TUe 5 0fri ial Inspection Form:Subsvfaoe Sewaas Disposal Sy3tem-Page 3 of 17
l—
Oct 0412 11:41 a p.4
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address
Barry Fuller
Owner Owners Name
information is Centerville MA 02632 1002-12
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 water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50.feet or
more from a private water supply well"".
Method used to determine distance:
'*This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal
coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal
to or less than 5 ppm,provided that no other failure criteria are triggered_A copy of the analysis must
be attached to this form.
3. Other:
D System Failure Criteria Applicable to All Systems:
Y PP Y
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'h day flow
15ins•11110 Tale 5 Official Inspection Form:SLbsurtace Sewage Disposal System•Page 4 of 17
Oct 04 12 11:41 a p.5
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address
Barry Fuller
owner Owner's fume
information is Centerville MA 02632 101312-12
required for
every page. City.Town State Zip Code Date of Inspection
B. Certification (cant.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303,therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered"yes"in Section D above the large system has failed.The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304.The system owner should contact the appropriate
regional office of the Department.
tsins•11110 Tate 5 Official IrMectim Form:Subsurfax Sewage Disposal System•Page 5 or 17
Oct 0412 11:42a p.g
Commonwealth of Massachusetts
.� Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
114 Stoney Cliff Road _
Property Address
Barry Fuller _^
Owner Owner's Name
information is required for Centerville MA 02632 101312-12
- -
every 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
❑ 19 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 NIA)
® ❑ 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)l
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
15 n:i•i vi o Tkie 5 Vidal Inspection Fo—Sibsudac Sewage Disposal System•Page 6 ar 17
Oct 04 12 11:42a p 7
Commonwealth of Massachusetts
-- r Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
y 114 Stoney Cliff Road
Property Address --- µ -- — — —
Barry Fuller
Owner Owner's Name
information is Centerville MA 02632 10/3/2-12
required for __..._. _.. ._.._ T
every page. CitylTown State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 2
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage na
g { Y 9 {9pd))�
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: 1013/2012
Date
Commercialllndustrial Flow Conditions:
Type of Establishment: ...... —
Design flow(based on 310 CM 15.203): Gallons per day(gpd)
Basis of design Flow(seats/persons/sq.ft., etc.): —
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
Ohs-1 t r-o Toile 5 official Inspect,on Form:Subsurface Selwage Disposal Syelefn-Page 7 of 17
Oct 0412 11:42a p.g
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
114 Stoney Cliff Road _.
Property Address
Barry Fuller
Owner Owner's Name
information is Centerville MA 02632 10/312-12
required for -
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancyluse: Date
Other(describe below):
General Information
Pumping Records:
Source of information: owner _
Was system pumped as part of the inspection? ® Yes ❑ No
If es volume pumped: a 0
, n
y p gallons
How was quantity pumped determined? site guages on truck _
Reason for pumping: maintainance and inspection of block cesspool
Type of System:
❑ Septic tank,distribution box,soil absorption system
❑ Single cesspool
® Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology.Attach a copy of the current operation and
maintenance contract(to be obtained from system owner) and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank.Attach a copy of the DEP approval.
® Other(describe):
cesspool with cesspool overflow and 1000 leaching pit overflow
:5m3.11M0 Title 5 Official Inspection Foin:Subsurface Sewage Ois:csal Sysler-Page go[17
Oct 04 12 11:43a p g
Commonwealth of Massachusetts
F= i Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address -
Barry Fuller _
Owner Owner's Name
information is required for Centerville MA 02632 10/312-12
_..._. .. _.,.
every 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:
unknown 1000 gal}on leaching pit installed 9/22/1987 permit#87-600
Were sewage odors detected when arriving at the site? ❑ Yes ❑ No
Building Sewer(locate on site plan):
Depth below grade: 2.5'feet
Material of construction:
❑cast iron ®40 PVC ❑ other(explain): - — -
Distance from private water supply well or suction line: feet
Comments(on condition of joints,venting,evidence of leakage, etc.):
Septic Tank(locate on site plan):
Depth below grade: na
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:
Sludge depth:
15ins-1111c Tllle E Officel Inspection Forth.Subsurface Sewage Disposal Syslern-Page 9 e 17
Oct 0412 11:43a p.10
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
4
114 Stoney Cliff Road
Property Address
Barry Fuller
Owner Owner's Name
information is required for Centerville MA 02632 10/312-12
every 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 - - —
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
How were dimensions determined?
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
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
W ns•11110 Tire 5 Oflioal Inspealon form:Subsuface Sewage Disposal System•Page 10 of W
Oct 0412 11:43a p.11
Commonwealth of Massachusetts
Title 5 Official Inspection Form
6 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address
Barry Fuller
Owner
Owner's Name
required for
is Centerville MA 02632 1013/2-12
required for
every page. Cityrrown - State Zip Code Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,
liquid levels as related to outlet invert,evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade: -
Material of construction:
❑concrete ❑metal ❑fiberglass ❑ polyethylene ❑other(explain):
Dimensions: -
Capacity: -
gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: - Alarm in working order.. ❑ Yes ❑ No
Date of last pumping: Dace
Comments(condition of alarm and float switches, etc.):
"Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
tshm.11 no Idle 5 Official Inspedien Form:Subsurface Sewage Disposal System-Page 11 of 17
Oct 0412 11:44a p.12
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address
Barry Fuller _
Owner owner's Name
information is squired for Centerville MA 02632 101312-12
-- tate —
every page. CitylTown S Zip Code Date of Inspection
D. System Information (cons.)
Distribution Box(if present must be opened)(locate on site plan):
Depth of liquid level above outlet invert na
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc_):
Pump Chamber(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.):
Soil Absorption System (SAS)(locate on site plan,excavation not required):
If SAS not located,explain why:
:5'ms.1 V10 Tile 5 Official Inspection Form Subsurface Swage Dispcs&System•Page 12 of V
Oct 0412 11:44a p.13
• J
Commonwealth of Massachusetts
_ Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address --
Barry Fuller
Owner Owner's Name - ....... _. _._.
information is Centerville MA 02632 10/3/2-12
required for _
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont)
Type:
® leaching pits number: 1 —
❑ leaching chambers number: -
❑ leaching galleries number.
❑ leaching trenches number, length: --
❑ leaching fields number, dimensions: --
® overflow cesspool number: 2
❑ 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.):
main cesspool acting as holding tank tees are in cesspool and at proper heights
second cesspool is in hydraulic failure
6x6 (10005allcn)leaching pit has liquid 4'below invert pipe
Cesspools(cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration 2 - -
Depth-top of liquid to inlet invert 4 --
Depth of solids layer 5' -
Depth of scum layer 6'
Dimensions of cesspool 6'x6 --- -
Materials of construction concrete block
Indication of groundwater inflow ❑ Yes ® No
tsms•11110 TiUe 5 Offciat trtspection Form:subsurface Sewage Disposal System-Page 13 o717
Oct 0412 11:44a p.14
Commonwealth of Massachusetts
--- - Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r 114 Stoney Cliff Road
Property Address
Barry Fuller
Owner - -...-.
Owner's Name
information is required for Centerville MA 02632 101312-12
_ ...—
every page. Cityfrown 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.):
main cesspool used as holding tank 2 sch 40 PVC tees liquid at proper levels
second cesspool in hydraulic failure
both cesspools are in good condition and show no signs of deterioration
6'x'6 precast pit added for leaching area liquid 4'below invert
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.):
I
drv5-WID Title 5 Official inspection Forth:SuCsurtace-0—ge Dsposai system•Page 14 of 17
Oct 041211:45a P 15
Assessing As—Built Cards 10/4/12 10:25 AM
TOWN OF 13ARNSTABLE
LOCATION fly SEWAGE# F 7- 6G p
VILLAGE r e,0T e-0 21 C ASSESSOR'S MAP-S LOT . 6 3-?
INSTALLER'S NAME&PHONE NO.zy.P,0 4 .,rrtl�Er S C_
SEPTIC TANK CAPACITY
LEACEMG FACILITY:(type) ��" (size) �,.G O Ci
NO.OF BEDROOMS PRIVATE WELL OR PUBLIC WASTE
BUILDER OR OWNER,,,,.-.-� �
DATE PERMIT ISSUED:
DATE .CO?3PLIANCE ISSUED:
VARIANCE GRANTED: Yes No E/
yy�
ir.
0 0
http:)'!www.town_barnstable.ma.us(Assessing!HMdisplay.asp?mappar=190037&seq-1 Page 1 of 2
Oct 0412 11:45a p.16_
i,\ c;ommonweann of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address
Barry Fuller
Owner Owners Name - -"
information
for is
re Centerville `
MA 02632 10/3J2-12
m _
every page. C own 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 bellow.-
hand-sketch in the area below
® drawing attached separately
i
Ens-11110 Title 5 Official Irspemon Form:Subsirfece Sewage Disposal System•Page 15 of 17
Oct 041211:45a p.17
Commonwealth of Massachusetts
Title 5 official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r 114 Stoney Cliff Road _
Property Address
Barry Fuller _.
Owner Owner's Name
information is Centerville MA 02632 101312-12
required for
every page. CityITown State Zip Code Date of Inspection
D. System Information (cunt.)
Site Exam:
® Check Slope
Surface water
® Check cellar
❑ Shallow wells
Estimated depth to high ground water: 30'
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: pate -
❑ Observed site (abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health-explain:
ground water chart on line ..
❑ Checked with local excavators, installers- (attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
TOB groung water elevations on line 30'
bottom of deepest SAS 9'
seperatiqn -- 21'
—.......... --
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
Slns-t too 7il le 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Oct 04 12 11:46a p.1 g
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
114 Stoney Cliff Road
Property Address ---
Barry Fuller
Owner Owner's Flame
information is
required for Centerville MA 02632 101312-12
every page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary:A, B, C, D, or E checked
® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
I
t5 ns-11110 rme 6 Official Inspection Four:Msurrace Sewage Disposal System•Page 17 or 17
TOWN OF BARNSTABLE
LOCATION Vie SEWAGE #
VILLAGE f P h 0 ���' ASSESSOR'S MAP & LOT 170 6� 7
INSTALLER'S NAME & PHONE NO. P IZz oki Z hC_
SEPTIC TANK CAPACITY
LEACHING FACILITY:(tyge) (size) -1, 000
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER �.�
DATE PERMIT ISSUED:
DATE COLIPLIANCE ISSUED: R
VARIANCE GRANTED: Yes No �/
. a
No...11.. a FE$.... ....�p,yp4.
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
Town...........oF.....Barnstable
.................................................................•.
Apli irtation for Disposal 3Vnrkii Tonstrurtiun Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair *)�) an Individual Sewage Disposal
System at:
Road Centerville
---------------------•-------------..... ----- ---------------------.....--------. ............ ---------------------------------
Location-Address or Lot No.
Ra.rry---lullar............................................................... -•----...........---•---••----••-•----•--•--------------......-------•----------•--------.........
Owner Address
aa. '�Macomber ------ •-------.
Installer Address._...
UType of Building Size Lot............................Sq. feet
Dwellin� g ';No. of Bedrooms............'J..............................Expansion Attic ( ) Garbage Grinder ( )
04
Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
d Other fixtures
W
Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons.
Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................
W Disposal Trench—No..................... Width.....-__............ Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No_____________________ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date---------------------------------------
Test Pit No. I----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................
44 Test Pit No. 2......:.........minutes per inch Depth of Test Pit.................... Depth to ground water------..........._......
P ---------------------------------- --------------------------------------------------------------------------
•-----------------
•-------------------------------
O Description of Soil..........................................5_and---.....-------•.....--------••-•-•--------------•----•--••-•-----•----•-•-••••••---•-•-••----•-•--------....._._
W
U ..............................................-••----••-•-•••----•---------•-•---•-••--------•--•-•-•••-•---•-...-•---------•....---•-••••---•••••-••-••-----...-•-••---•--•-------•••-•---....--••--••-
W
UNature of Repairs or Alterations—Answer when applicable._.1��00b._: a110..n pl t o ................•..
.............•--••---•---:-••-------••--••-•---•----••-••-•--••-•-•••--•-•-•-•-•--•--••--•----•-•••---•-------••••---•••••----••-•-•---••••--•-•-----•-•••-••-•---•--•--•--•-•-••-----•...............
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
TT�'}F^
the provisions of 'T t� 5 of the State Sanitary Code The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bee ss e board of h
;?n
Signed. ----•••-- -.9/13W.$7..........
Date
Application Approved By.............�zC�-�......V J
--•----••---------•----•-•--------------
Date
Application Disapproved for the following reasons-----------------------------•--------------------•---------------------------------------------------------••-
--------------------•--------•--------------•------•----------•-•---------...--------------------•---------------------------•••---•------••------•------•--------••-----•--•••••-••••••--••-•----------
Date
PermitNo........e..7 ---- ................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.l'r�C'is OF. I',a t ..
Apptira#iou for Disposal Works Tonstrurtiun 1hrmit
Application is hereby made for a Permit to Construct ( ) or Repair. (3: ) an Individual Sewage Disposal
System at:
v 1... .... -. :,- F i
,a },
Location-Address or Lot No.
....................... `'=£ - -----------. --------------- .__......
Owner Address
.... ... i7 f r
Installer Address
UType of Building Size Lot............................Sq. feet
Dwelling,T No. of Bedrooms...........
_-......._�...............................Expansion Attic ( ) Garbage Grinder ( )
Other—Type T e of Building ............................ No. of ersons....._..___......_.......... Showers —
yp g p � ( ) Cafeteria ( )
a
� Other fixtures -------------------------------•----•--•--------------....--------------------•--------- -
w Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid"capacity............gallons Length.................Width................ Diameter................ Depth................
Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area------_.............sq. ft.
Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
•-' Percolation Test Results Performed by...............................................................---'------ Date----'-••-------•-'•• ............
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_-----_-.-_.-._-..._.--.
44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a --•------••-------------•------•-•---•......-••-'--'-----••••----•-----•-•..........•-•-•----....••----.....-•••••--•--•-•••-•--...------•-----------.......
Descriptionof Soil x_ / .•-••---•......:.'--------------------•------------•----•---------...--------------'---------------........---------
x
c.,
w
U Nature of Repairs or Alterations—Answer when applicable__... - 1 -- `__t..t i �...
t.
----------------------------•------------------------------------------......--•---•-------------------.....------......---------------------------...................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T T L j of the State Sanitary Code— The undersigned 'further agrees not to place the system in
operation until a Certificate of Compliance has been issued by theboard of health.
r „Date
Application Approved By.:... .. .. ........ .::d..,-:. r-
Date
Application Disapproved for the following reasons:..............................................................................................................
---------------------•---------------'--'-----'----•••-•-•....'---------.....
Date
PermitNo...:...a ..................... Issued-.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH `
......................OF.....).a.::.rf?...� t l.(,
.............................................................
Cnrrtifiratr of TompliFaurr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired-,,(-. }
by
.......
a r.: - � Installer
,y
t , ..
has been instailed in accordance with the provisions of T I TI C: j of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No...... ...... dated------------------------------------------------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE...................... .'.. ".. .e� ...................... Inspector................. ...................................
V
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�:)vn n;. t "LlC,
......................................O F..---....------..--..................................................................
No....�
Disposal Works T-5onstr i.art Vrrmit
Permission is hereby granted...- ° '_•:: 1: `'L
to Construct (, ) or Repair. ( � ) an Individual Sewage Disposal System
atNO.... i y.....t J..ri..�/ ...l 1 ....._J...� .- t.. . L .LE, -------------•'•--•---••------•-•--••-••-••-•-•-.............................
Street
as shown on the application for Disposal Works Construction Permit Ng,7_,.C�___ Dated..........................................
................. � --- -�-- +�...................-
q f "�•y��Board of health �...�
TDATE ( 1..........................................................
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
WINDOW 5GHEDULE Ln
NUMBER (2TY 1VqIDTH HEIGHT R/O IDE5GRIFTION HEADER MANUFACTURER COMMENT5
W01 2 130 , 145 " 32"X50" DOUBLE.HUNG 2X5X35" (2) GREAT LAKES 5EABROOKE 6/6 GRILLE5 E E
o) � oo
W02 3 30 " 48 " 32"X50" loaf INLE HUNG 2X6X35"(2) GREAT LAKE5 5EA13ROOKE 6/6 GRILLE5 0'
W03 (2)001 VELUX MANUAL VENTING 5KYLIGHT5 R.O.21"X 26 1/5" 3 o
E
E N N.N
Q Z
N
i a
v v
6:12 PITCH
N
N
FW00011
® _ >i
iu �
� y� 10 E
Q0
0
3
REAR ELEVATION
® ® 5 +_+
O 3
0 M
FTIFI N
N
i
Date:
1.-21-13
RIGHT 51DE ELEVATION LEFT 51DE ELEVATION Revisions
2-14-13
Final Plans:
BUILDER TO CONFIRM ALL 2-25-13
CONDITION5
AND DIMEN51ON5 ON 5ITE
ELEVATION5 scale: 1/5=1-0
?accepted by: Date:
Note:These plans are for the sole purpose and
use of Gapizzi Home Improvement and are not
to be distributed or used for construction other e
Accepted by: Date- . than by Gapizzi Home Improvement.
�.
22-0 4X6 PT P05T5 ON a In
10"VIA 50NOTUBE5 E N E
m � o 0
4-0 BELOW GRADE o W- y Q)
8 F - - I _LINE OF DECK EXTENSION- I 1Q.3 3
- - - - - - - - - - - - - - - - - - -
ALL NEIN RAKES, FASCIA AND SOFFIT TO BE AZEK o� 0
- _
oZNa
4'-0" 14' 0" 4'-0" o ALL NEW GUTTERS AND DOWNSPOUTS TO BE z to �
.032 ALUMINUM N
I a
I � V
2X10RAFTERS 16 OC STRUCTURAL RIDGE 71LE 0 L
R-3b INS 51-1INGLEVENT II RIDGE VENTI¢
TIE IN TO I 2/2X10 BEAM I 1/2"05B ZIP 5Y5 5HTHG
EXISTING DECK -
I m / 6:12 PITCH
4X6 PT POSTS ON 24"BIGFOOT ASPHALT ROOF SHINGLE5, N _s
E o
50NOTUBE5 @ 45" BELOW GRADE I �o TO MATCH EXISTEING >L
<r r a - o OVER 15#FELT 2X6 GLG JOISTS 16 OG o
_ EXISTING P.T. 2X105 16 OG
Y AND FRAMING 2X65 16 OG;R-21 INS tc v O
Q TO REMAIN IN PLACE 1/2".ZIP SYS 5HTHG � `n a p o
o; REINFORCE AS NEEDED ;o WG SHINGLESILL .
- r� IL
pI
LL, ADD 3/4"T&O ADVANTEGH 5UBFLR I OVER AMOI^IRAP. 3
W ADD 1/2" PT PLY ON UNDERSIDE OF �� m � t
I EXI5TIN6 FRAMING I �oi�'
TRIPLE P.T.2X105 V EX15TING 2X10 JOISTS 5/5;'X b"J-BOLT IN/
OUT5IDE BOX(TYP)
V�4
16,"OG iN5TALL 3/4 T&O BOLTAND WASHER
ic 1 — — — — — — — — _ — — — — — ADVANTECH 5UBFLR R-30 INS t
* r k 4 II /
INSTALL 1/2 PT
— — — — PLY ON UNDER51DE 3-Zxl� u a o�
P ' ✓/ OF EX FLOOR FRAME
AfiT Z � 1 • TO BE BUILT UP >r
— v
2/2X10 PT BM ON
TO BE LEVEL .v N
EXISTING FOUNDATION 4X6 PT POSTS ON. O �
Y41EX FLR LEVEL o 12" DIA BIGFOO.T
v I I I 50NOTUBE5-@ 4-0 0
BELOkN GRADE ca v
14'-0"
Date:
1-21-13
FOUNDATION/50NOTUBE LAYOUT scale: 1/4=1-0 E_ SECTION Cal PROP05ED ADDITION scale: 1/4=1-0 Revisions:
2-14-13
�ZNOFMAs
Final Plans:
ya`�P s90 BUILDER.TO`CONFIRM ALL 2-2b-13
MICHELE �cu, CONDITIONS
CUDILO
a
AN DIMENSIONS
D D EN51
o ON5 ON SITE
� STRUCTURAL N
0--
Accepted by: Date: . N 34774
�909Fo/sTS �,�c Note:These plans are for the.sole purpose and
FssioNAL� use of Gapizzi Home Improvement and are not
to be distributed or used for construction other 20
Accepted by: Date: l�r
than by Gapizzi Home Improvement.
t 22'-0"
MAgsq 3>� �3
3-0 HIGH RAILING �ti�- �yGLn
? MICNELE m
CUDILO E E
r o S-fFIUGTURAL n > o 0 0
o NO 34774 2 w' : ui
4-0 14'-0" 4'-0" _ �o �Q a N o
DECK EXTEN51ON TO A9o9Fc�s1E�`�,�`` E o
PATIO AND 5WOWER 7.0 `kssiONAL�'
E w V)
O Z_N
U, V
NEW DECKING I a 3
TO MATCH I
EXISTING _ FAMILY ROOM
c� ADDITION w°
'— CATHEDRAL CEILING
EXISTING DECK M (GARPETAND PAD FLRG BY OWNER)
TO REMAIN A5 15
(not drawn to scale) 1 v W03 W0 _ t
W03
a EXISTING o
NEW 5TEmin,
M PATIO LL
73
" (2)VELUX MANUAL `� 4
REUSE SLIDER (y VENTING SKYLIGHTS g `n o
0
CO1 (R.O.21 X 26 7/6) �'•Q o 0
EX15TINO 3
. . � SHOWER
Tic
CA5ED OPENING W/ ( L
45 ANGLE AT UPPER
CORNERS r—
EXISTING 2)13 �� EfX15TING, EXISTING
EXISTING DINING " L.VL KITCHEN BATHRM /��
o ENTRY Sti►J(�� tK�S —
EX15TING o ��
j BEDROOM o
ca v�
° ED 1
Oj 7868 Date:
1-21-13
Revisions:
F 2-14-1.3
Final Plans:
BUILDER TO CONFIRM ALL 2-28-13
CONDITIONS
AND DIMENSION5 ON SITE
Accepted by: Date:
FI R5T FLOOR PLAN scale: 1/4=1-0 Note: These plans are for the sole purpose and
use of Gapizzi Home Improvement and are not
Accepted by:
to be distributed or used for construction other •
Date:
than by Gapizzi Home Improvement.
-- - -
T.O.F. EL.-- 51 .0't FINISH GRADE OVER D-BOX= 50.6'± FINISH GRADE OVER CHAMBERS= 50.3' - 51 .5' PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE GENERAL NOTES
PROVIDE EXTENSION RISER SLOPE @ 2% MIN. OVER SYSTEM 3/4"TO 1-1/2" DOUBLE WASHED
REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE
WITH COVER OVER INLET& FINISH GRADE OVER TANK EL= RISER TO WITHIN 6"OF FINISHED GRADE ,. I. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
FINISHED GRADE OUTLET TO WITHIN 6'OF F.G. 5Q.3,t 4 SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
5" DIA. OUTLET(S) MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2 OF 1/8 OT 1/2 DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES.
@ FOUNDATION = 50.4'± STONE OR GEOTEXTILE FILTER FABRIC
24"MIN.ACCESS 9"MIN _ _- - 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
COVER (3 TYP.) 36" MAX. f TOP OF SAS= 47.50' PLACE RISERS ON ALL DESIGN ENGINEER.
PROP. SCH. 40 PROP. SCH. 40 9 MIN. 4.0' MAX. CHAMBERS TO WITHIN 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
PVC SEWER PVC SEWER ' 36" MAX. 4Cj,rjQ' SEE NOTE 23 BREAKOUT EL= 47.00' 6"OF FINISHED GRADE ° SYSTEM UNLESS OTHERWISE NOTED.
6�3„ 2" DROP MIN. � AS SHOWN ON PLAN
MIN.SLOPE @ 1% - 1 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
3" DROP MAX. 3' 9 MIN.SLOPE @ 1% �'-9 t PROVIDE WATERTIGHT ELEVATION =47.00' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A
0
13" 4" PVC IN FROM JOINTS (TYP.) �w� 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF
- *48 1'+ 14" t�7 00' SEPTIC TANK 4" PVC OUT TO 0 0 0 0 0 0 0 o 0 0 O 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
• LEACHING FACILITY I o0 0 0 VT
0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
47.25' INLET TEE 12 a o
4 OUTLET TEE 46.87' MIN. 46.70' ao 0 0
6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
8 2 0 0 00 000 o� 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
SEE NOTE 23 TEES TO BE CENTERED GAS BAFFLE 6" CRUSHED STONE o 0 0 0 o 0 00 0 oo FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
DIRECTLY UNDER RISERS OVER MECHANICALLY a NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
7.6' OFFSET TO FND COMPACTED BASE
4.0' _ I 4.0' I---- AND DESIGN ENGINEER.
6"CRUSHED STONE 5 OUTLET DISTRIBUTION BOX TYFI) 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 50.00,
OVER MECHANICALLY TO BE INSTALLED ON A LEVEL STABLE 25.0' ( ESTABLISHED ON A NAIL SET IN 18"TREE AS SHOWN ON PLAN.
COMPACTED BASE BASE. FIRST TWO FEET OF OUTLET 44.50' GROUND WATER ELEV= < 38.30' 12.83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
PIPES TO BE LAID LEVEL.
PROPOSED 1 ,500 GALLON CONCRETE SEPTIC TANK 2 - 500 GALLON CHAMBERS 5' MIN. .,IAI\fIi�CK 1=ftiLJ V'i `vv THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
LENGTH 10'-6' WIDTH 5'-8" DEPTH 5'-811 CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
ELEVATION PR i u VERIFY LA101 ING (Dimensions per TYPICAL CHAMBER PROFILE TO THE DESIGN ENGINEER.
PRIOR TO ANY WORK & .3 t , ,,, _._ ILL ACME/Shorey) D I s) IN i�v �j%"j Lj ETAI L H-2 V CH DETAILS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT.
NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE ` NOT TO SCALE NOT TO SCALE
or
• ;+ + . �',. ' • : ` ,.;��� - EST A 11 REGULATIONS. OWNER/APPLICANT TION HAS BEEN MADE
TO OBTAIN SUCH E,TERMINATIIONITH DEEDED OFROMNING
1, T PIT DATA
/'� i • APPROPRIATE AUTHORITY.
�. PERC NO. TPT-20-211
� // r • �t '` • . f J f 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED
*, * . • . • • tJ INSPECTOR: Donald Desmarais(BOH) UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR
• f f %'` • EVALUATOR: Michael Pimentel, EIT, CSE TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING.
l! ` � �} • t, C.S.E. APPROVAL DATE: Oct. 27, 1999
13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
ll r• f �`. l DATE: October 8, 2020
14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
Z, i j _ �( ' : .• • ' TEST PIT#: 1
MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
+�� J' / a ¢ ° �. » . ' ' "'' " l' ELEV TOP= 50.30' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
Q Z _ 11 ` .' • -" . , f • '�• FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
O O� / w _ O a . . . . ,> i• . . s ELEV WATER = < 38.30'
MAP 190 �• • •• • • '� - /`• • 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
�f • • E3 • • �.• PERC RATE_ < 2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
Gam'3 1 "� MAP 190 LOT 36 N �--• .bra betl'Y
LOT 37 ,• •• . •. gs :;, . •♦�•. CAR DEPTH OF PERC = 36 -FA 16. PROPOSED PROJECT IS LOCATED WITHIN:
��O 151110± S.F. !� • • • • * i • ' 4w • • t_ /�
a ` "',,Jii .,w r' \ '�` •�� •' "1 TEXTURAL CLASS: 1 ASSESSOR'S MAP 990 LOT 37
`s o ' _ �JI r� . •• • + •' • r ` •, • , ; r - OWNER OF RECORD: BARRY FULLER & ROBERTA FULLER
• •'A ,
8°47, a ! �►�� "1{ • 0" 50.30' ADDRESS: 114 STONEY CLIFF ROAD
ASS Spry � ��� _�.�.• :�, � LOCUS
PROPOSED INSPECTION PORT / / 90, F EXISTING CESSPOOL �- 7 • `� . ,h Q CENTERVILLE MA 02632
PLACE RISER ON CHAMBER (APPROX. LOCATION f ? It ` , some Fill
r ONLY)TO BE PUMPED, • '. FEMA FLOOD ZONE X
#114 ' r 1I S h ✓ . • . BM 60 COMMUNITY PANEL# 25001 C0561 J
FILLED w/ CLEAN SAND& '
i 51x5' EXISTING v / , ,r e� ,/ ,u Natctilery %' s� ��``' ' ' f 36" T 47.30'
PROPOSED TWO (2) 500 3-BEDROOM /,Qw ( ABANDONED (TYP OF _ 11 ! t` 17. DEED REFERENCE: BOOK 22291, PAGE 90
GALLON H 20 LEACHING f F POLE DWELLING I f '/1 �° •' `� RD .• • Perk
CHAMBERS w/ STONE O PROP. ,1 / / // �# '� J 54 18. PLAN REFERENCE: PLAN BOOK 204, PAGE 117
�. . Loamy Sand
/ "D-BOX" co / 4 a`i ` ' lj 1 2.5Y 6/6 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
o O TOF=48 1'± ^ / ( M. f _ ,. { 4_ ..- f r I/ 4 : C-1 (10-20%gravel)
u� 1 26 i ' , f f••• •i .-� I . 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
/ - 10111 I r' FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
//
a /SI Umt-) F-51.0± T/� 1 /� ranb@>try f •* • � �_ 72" 44.30' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
TO
%
�y / ` / - , - -�' 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A,VERTICAL POSITION TO A
� I �, ' t; DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A
TP 2 i p IA . ;�Cranberr •
PROPOSED 4" SCH. 50x3' /, Cp ' R coo .mod' / Y Medium Sand REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS.
40 PVC VENT r TP 1 ' / , �� h �' / C-2 2.5Y 6/6
/ , c / "' 22. OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL
50x3' - REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT.
SO 5° , �w�` ��� . / LOCUS PLAN
/ / / 0 � 23. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE
APPROVALS ARE REQUESTED FROM 310 CMR 15.211 & 15.221 7
PROPOSED 1,500 �� � ( ��-- / // /� � SCALE: 1"= 1000' � )'
GALLON SEPTIC TANK ')`CF'f� ` r,h, / 72 / / / , / 144" 38.30' j (1.) A 9.9'WAIVER(20.0'- 10.1') FOR THE SETBACK FROM THE SAS TO HOUSE FOUNDATION.
(2.) A 2.4'WAIVER (10.0--7.6') FOR THE SETBACK FROM THE TANK TO HOUSE FOUNDATION.
No Mottling, Standing or Weeping Observed i (3.) A 1.0'WAIVER (3.0'-4.0') FOR THE MAXIMUM COVER OVER THE H-20 SAS.
f `o ! PROP. ,/ J � � _ _ _
w / / CLEAN-OUT DESIGN DATA f I I ! I. I E G E N
MAP 190 O� (TYP OF 2) / ,moo / �QyO PERC NO. TPT-20-211
/ 00
N ��` O INSPECTOR: Donald Desmarais(BOH) j 50xO' EXISTING SPOT GRADE
LOT 38 �00/ / �o /% Oo/ O�� NUMBER OF BEDROOMS 3 _
O ; EVALUATOR: Michael Pimentel, EIT, CSE '. -- 50 - - EXISTING CONTOUR
^oo/ Benchmark / `SS8° n,�' _ / �1 DESIGN FLOW 110 GAUDAY/BEDROOM ' Oct. 27 1999
Nail in 18"Tree �r-' , SWING-TIES SCALE: 1"=20- C.S.E. APPROVAL DATE.
Elev. = 50.00' 7S�p F � / I TOTAL DESIGN FLOW 330 GAUDAY DATE: October 8, 2020 r 50 PROPOSED CONTOUR
/ Approx. M.S.L. // DESCRIPTION HCA HC-2 HC-3 DESIGN FLOW x 200 % = 660 GAUDAY TEST PIT#: 2 50 PROPOSED SPOT GRADE
SEPTIC COVER IN (1) 22.3' 11.5' -- USE PROPOSED 1,500 GALLON SEPTIC TANK ELEV TOP= 50.30' GAS EXISTING GAS LINE
SEPTIC COVER OUT(2) 29.6' 11.1' - ELEV WATER = < 38.30' i
J/H/ W EXISTING OVERHEAD UTILITIES
CORNER OF STONE (3) -- 15.5' 50.9' ! PERC RATE_
INSTALL 2 - 500 GAL. H-20 CHAMBERS W/ STONE w - EXISTING WATER LINE
CORNER OF STONE(4) - 25.8' 54.9' DEPTH OF PERC=
' ( SIDEWALL CAPACITY ; % TEST PIT LOCATION
CORNER OF STONE (5) -- 26.6 33.8 1 TEXTURAL CLASS: 1
(LENGTH + WIDTH) (2 SIDES) (2 HIGH) (0.74 GPD/S.F.) = GAUDAY
CORNER OF STONE (6) -- 16.T 26.8' (25.0' + 12.83') ( 2 ) ( 2' ) (0.74 GPD/S.F.) =112.0 GAUDAY PROPOSED 1,500 GALLON SEPTIC TANK
i
r - i BOTTOM CAPACITY 0' 50.30 PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE
(LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY
(25.0'x 12.83') (0.74 GPD/S-F.) = 237.4 GAUDAY Fill �. PROPOSED DISTRIBUTION BOX
QO �O PROPOSED 500 GALLON H-20 LEACHING CHAMBER
Q-' TOTALS: 36" a7.3o'
�Ck OJ TOTAL NUMBER OF CHAMBERS 2
HC-3 ' TOTAL LEACHING AREA 472.2 SQ-FT. Loamy Sand REV. DATE BY APP'D. DESCRIPTION
.� "Q ry `� TOTAL LEACHING CAPACITY 349.4 GAL.JDAY C-1 (10-20%gravel) PROPOSED SEPTIC SYSTEM UPGRADE
9
�O (5 #114 <v PREPARED FOR:
NOTES: �� \ 728, EXISTING 72" 44.30'
�-{6) 3-BEDROOM , ROBERT B. OUR CO., INC.
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF 7p DWELLING
EACH SEPTIC SYSTEM COMPONENT.
O 7� Medium Sand
C-2 2.5Y 6/6 LOCATED AT
2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF 114 STONEY CLIFF ROAD
THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST ��0� O
PIT DATA SHOWN N THIS PLAN. REPORTENGINEER AND L AL TOF=51.0'± I.
0 o s LA REPO TO oc CENTERVILLE, MA 02632
BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. (4 ^ ___._--___._____.__..-..�.____�_..._.
(3 HG2 f SCALE: 1 INCH = 20 FT. DATE: OCTOBER 21, 2020
3.) ENTIRE PROPERTY IS LOCATED WITHIN THE ESTUARINE WATERSHEDS. �°j O 1` 38.30' 0 10 20 40 80 FEET
(2 No Mottling, Standing or Weeping Observed
4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A HC-1 --
}1 OF
(1 ��yjS PREPARED BY:
COURTESY FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE ,moo p RESERVED FOR BOARD OF HEALTH USE 0 JOHN L cyG JC ENGINEERING, INC.
MEASUREMENTS IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. �,�10 o CHURCHILL JR. m
CONTRACTOR SHALL NOTIFY ENGINEER IF MEASUREMENTS APPEAR TO BE o IVIL 2854 CRANBERRY HIGHWAY
41 Cn EAST WAREHAM, MA 02538
INCORRECT.
SITE PLAN G`s
SCALE. 1 -20 508.273.0377
Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.5344
�i