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HomeMy WebLinkAbout0571 STRAWBERRY HILL ROAD - Health 571 Str vvber ry Hill Ind Centerville A = 249 - 014 /!I SMEA®® No.2-153LOR UPC 12534 smead.com - Made in USA 3 - [ p�(�pN1iflSPRODUCTIRk SFI OFTI�SFIPROGAAM � Sol�Rtwo y,M,ryV.SF�itOGQAA�.Oit(i 1 TOWN OF BARNSTABL^E' LOCATION r �.,(C W�GE# V,LLAGE GJ2n�-"M2 ASSESSOR'S MAP&PARCEL ' — INSTALLER'S NAME&PHONE NO. S GC1 'A C;r-CAr S__0 i oJ9Y 00b5 SEPTIC TANK CAPACITY ciC_ J-(_,AV,_ 14),0 f3 aQX LEACHING FACILITY.(type) (size) (9 NO.OF BEDROOMS OWNER 9e.!c PERMIT DATE: J�:11 �O 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 �C�l� ,z A 4 - sS7 o a 4. 5® �"� a. 'r Fee c. 4 No.---,1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS es f 01ppliLation for Misposal .pstrm Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade A Abandon( ) XComplete System ❑Individual Components Location Address or Lot No. 57151iVaibepn7 A'// /?+FiO Owner's Name,Address,and Tel.No. Cc,i N, Re,-rfs Assessor's Map/Parcel Installer's Name Address,and Tel.No Designer's Name Address,and Tel.No. 5M-'771—7 SG 2.- c r � its G t a y��r,,o. r�J a 9 Y 6 U(105 ' cs tQ6 • %q a: Type of Building: Dwelling No.of Bedrooms -119r-ee Lot Size � (�A sq.ft. Garbage Grinder(/ilk, Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 331 gpd Plan Date Number of sheets Revision Date Title©sc cl _:&p/a�� , 'Miog m d. lojmm Size of Septic Tank / Type of S.A.S. Description of Soil 5 ee- Pv- 8 7 rin ✓�/�„ Nature of Repairs or Alterations(Answer when applicable) VD (�_ Mi u Y 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 oiFlJealth. N Signed Date Application Approved by `V05 Date 49 G t Application Disapproved by d►%-" Date ' for the following reasons rW (K e 0 ':-' d — kl—� �lS1 bvlL cv� � %SL. w CW .3s+ vy-- Y e y-, iiv-t f N Permit No. Date Issued / ' / .- � j ��' '� ��� A '6.... t•4 ., poi -� a �5 No. Fee THE COMMONWEALTH OF I ASSACHUSETTS Entered in computer: Y es 4 PUBLIC HEALTH DIVISION��-TOWN OF BARNSTABLE, MASSACHUSETTS �.. ftpYication for Misposal 0stelveonstruction 3permit Application for a Permit to Construct( ) Repair( ) Upgrade�<) Abandon( ) ,Complete System ❑Individual Components Location Address or Lot No. 57/Sl+awbcrr A</ ,,,0 Owner's Name,Address,and Tel.No. Cc.t/rwd/a �P, P�rr'�s _ Assessor's Map/Parcel ZVg alw 571 5 frv(.l-k rr 141)1 ?./1 6,k- J,ate Installer's Na Me,Address,and el.N R esigner's Name,Address,and Tel.No. � gZ i ,S0{�,, r � 1 of o. ty J �rMo. ( c������3'�aZ�•�f" �� rV(�y 'r �, � w'('�^r��''""�."~~~�..7`�".`1�d�1�i' S4vrzF .Irl �' tius 02G6/ Type of Building: _ Dwelling No.of Bedrooms ArC4 Lot Size � sq.ft. Garbage Grinder(A/6 t Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) .3 3 d gpd Design flow provided 33/ gpd Plan Date g1/1 Z61,6 Number of sheets Revision Date Title ICI Uro Sc 0109 M c/s P/,QH e Size of Septic T /ank p6 j&&4,7S Type of S.A.S. 2 TF'Lrlc4'6 t 2"X 3�K 32 Description of Soil 5 ce- P— i5 9 f Nature of Repairs or Alterations(Answer when applicable) U I!.Madz: ,Tclsk, -,4e »rest N,4 T kIC "'y IMai cn;'5 —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 Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board o I�Iealth. N Signed / r�—'( �L / Date •� O Application Approved by RA {"1/"U_J �i Date O Application Disapproved by V tL Date for the following reasons f 10 3 3 UP �T" 17 {'tie +,e 0 ti- Permit No. d^O �0 `p� Date Issued 0 b THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded Abandoned( )by Y(_0 o at �( S�r�.w�b�S r Vl�t` � has been constructed/in accotddance /��/( with the provisions iof�Title 5 and the for Disposal System Construction Permit No. �ot �U 'dated 01�1/ Installer Sc� Yi M C-,r Vt Designer QL.x /.l-j'`)'r #bedrooms Approved design flow /1:T 3 I I gpd The issuance of this erm"t shall not be construed as a guarantee that the system will function as designed. Date hl 6 Inspector tV' --------------------------------------------------------------------------------------------------------------------------------------- No. a,O ( V - a 6 j Fee THE COMMONWEALTH OF MASSACHUSETTS - PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS VsposaY 6pstrm (Construction i3ermit ti Permission is hereby grante to Conqtxqct( ) Repair ) 1 Upgrade( � ! Abandon( ) System located s>J} 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. �/�� t 1� Date C' Approved by / ' ` ' 1 1"' Town of Barnstable Regulatory Services Richard V. Scali,Interim Director • BARNSPABM MAC Public Health Division i639• �� �E1639 a Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: q /4 /b Sewage Permit# 2616- 28Jr Assessor's Map\Parcel Designer: 13a k;:,, _ Uuc Installer: $c,4 �.%i< Address: ?mod 1r4 �.�e,V- Address: 113 C)Ld yay mjv�k 12� �'l:Ho.Hhts DZGo/ �Y4NVIL9 �,Z,r�hf On R--1(o- 2016 was issued a permit to install a (date) (installer) septic system at 571 5+-sw 6,v"% M.,1( 1z R. Cch.4rvyi f(-e- based on a design drawn by (a dress) &,x V -- Quc dated e_/,g-2_o (designer) 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 terms of the I\A approval letters (if applicable) IN OF IygsSC 9 STEPHENALLYN y (Installer's Signature) o� wK oN No.30216 ti esigner's Signature) (Affix p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc Z b��' ��0;62 Town of Barnstable P# / 5, 2- �oF 1He rbky Department of Regulatory Services HAmsTABLE. : Public Health Division Date kibe/lro y MABS. tS ,6J9. 200 Main Street,Hyannis MA 02601 prE0 MAy A - f �j ✓ Date Scheduled Time�.� Fee Pd. � ) left Soil Suitability'Assessment for Sewa a Disposal , Performed By: Skj2 icn A 1�r lsa�/ . � Witnessed By: N C" � iPQ LOCATION& GENERAL INFORMATION Location Address.S7i S�rvWbtv-r I'll Iga Owner's Name f►1 Rcrr(S � 0, arne,-CaMod' Ccv..}tr-vi Address 571 Sfya,abtrr 1-111I Prj. eC✓l.fe'w' ;/1-t Assessor's Map/Parcel:.­, qq/O/y_ >ngineer's Name Baxitr^N Je NEW CONSTRUCTION REPAIR _ Telephone# 0$-�7/- Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water We.M ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 40 Parent material(geologic) !T JQ-Ctal O u4Gxy 911 Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION TEST Date /L Time 11;13aw1 Observation Hole# Time at 9" n Depth of Pere _ Time at 6" Start Pre-sonic Time a Time(9"-6") End Pre-sonk 'G.�s4k Rate Min./Inch Site Suitability Assessment: Site Passed V Site Failed:. Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation testis to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:HEALTH/W P/PERCFORM DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.° Gravel) /0 m /� / Z` C. f'p►�Q Sa�� ID �1Z ��6 — tract o� f.we DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) /O yr- �38 C mci 54-id la Vle 616 r DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, Consistency.° Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate Map: Above 500 year flood boundary. No— Yes Within 500 year boundary No L/ Yes Within 100 year flood boundary No L/ Yes Depth of Naturally Occurring 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? _I�-- If not,what is the depth of naturally occurring pervious material? Certification I certify that on r ri / (date)1 have passed the soil evaluator examination approved by the Department of Enviromnental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. Signature �E. Date ? A Z4V Q:HEALTH/WP/PERCFORM 4P. 2016 -010 0'Z Phone — 508 771-7502 Fax — (508) d 1?efernce: Deed Book 29179 Page 154 � ( ) " Date : 04-. er: Piitricia M. Perris & Dorothy Ellen—Gross Job Number. 2016-010 Scale 1 = 20 � I N/F JILL CONNOLLY DEED SK 14925 PG 262 PARCEL 249-015 �o <4o 100.00' (PLAN) C'� oxF� 95.84' CALC. 0 I 89'46'15" E I 4 `V WIRE FENCE rp �. g W PARC L 249-014 o tC) ® . AC cn W 9,660f S.F. ¢ / 28.3' I C Y / N/F RANDY S & kNN MARIE PEACOCK O j p) O I ftj ED BK 15020 PG 227 0 NJ PARCEL 249-021 / EXISTING / N N I Z DWELLING Q 00 #571 I j p DECK % Q �. 28.9' / o U WG 6 tt LP 0 otilit S� o CRUSHED .S. SHED / STONE I /F EDWARD B JR & I DRIVE �RIANNE 0 SULLIVAN 23.2' ED 8K 5417 PG 142 m S $9'46'15' - PARCEL 249-022 _ I 99.37' (CALC.) G�1o� 100.00' (PLAN) I. N/F EDWARD B JR & MARIANNE 0 SULLIVAN DEED BK 25524 PG 218 PARCEL 249-013 - � I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name Is information is required for every Centerville Ma 02632 1/19/2015 page. Cityrrown State Zip Code Date-of-inspection Inspection results must be submitted on this`form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:when P� filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. S.M.Jones Title V Septic Inspection Company Name 74 l3eldan Ln. Centerville Ma 02632 Citylrown State Zip Code 774-248-4850 smjonestitle5@gmail.com SI4522 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. 1 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 1/19/2015 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. d Co o I� t5ins•3/13 Title 5 Official Inspectioffor.nubsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The dwelling located at 571 Strawberry Hill Rd Centerville is served by a Title V septic system consisting of a 1000 gallon septic tank, distribution box and a 1000 gallon leach pit. The system was found to be in proper working condition at the time of inspection. 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 exMtration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System.Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °M 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 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 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 page. Citylrown 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): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 gpd t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °M 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 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: 2014 62,000 total = 170 gpd 2013 = 73,000 total = 200 gpd Sump pump? ❑ Yes ® No Last date of occupancy: vacant Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15:203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GM , 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1000 gallons How was quantity pumped determined? size of tank Reason for pumping: routine maintenance 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): t5ins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 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: system installed 1/4/94 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.5 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.): Joint were ok, no leaks, vented through the roof Septic Tank(locate on site plan): Depth below grade: 1 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 gallons Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 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.): Tank was cleaned at time of inspection and should be done again every 2 years for proper maintenance. Tank was structurally sound, outlet baffle was intact. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is Centerville Ma 02632 1/19/2015 required for every page. Cityrrown 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.): Distribution box was video inspected and was found to be in good condition with no sign of past hydraulic overloading. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 page. City/Town 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: ❑ 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.): Leach pit was dry with a high stain line approx 8"from the inlet invert. 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•3/13 Tide 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 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 page. Citylrown 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 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 a A2 A 21 '�, j! R�I = Z 5- A Z- 2� 3 O Y-Z= 2 I K A,3 :37 '6 20 g-y= 22 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 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: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , 571 Strawberry Hill Rd Property Address Earl Brown Owner Owner's Name information is required for every Centerville Ma 02632 1/19/2015 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 C t TOWN OF BARNSTABLE V LOCATION ` " !`'`� � `� `� SEWAGE # VILLAGE ASSESSOR'S MAP LOT —� i INSTALLER'S NAME 6a PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) NO. OF BEDROOMS PRIVATE a PUBLIC WATER BUILDER OR OWNER �, _ �9� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r I I j TOWN OF BARNSTABLE LOCATION � ° 4� SEWAGE # 73- 6 ?3 VIA, LAGE r SSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. e-" � `={ SEPTIC TANK CAPACITY LEACHING FACILITY:(type) k��4WAT (size) j NO. OF BEDROOMS � PRIVATE PUBLIC W7ATER BUILDER OR OWNER . DATE PERMIT ISSUED: f .n, 'I DATE COMPLIANCE ISSUED - / 3 VARIANCE GRANTED: Yes No r� I ' 1 1 _ Fas..... .C . APPROVED THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH "it.-9i&OWN OF BARNSTABLE Appliration for Di►ipniia1 �ii orki C onfitrurtion 1hrmit Application is hereby made for'a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System at r L ion ire s 1 /r .. ..- --•-----5.� .... .................................................. ...........4......__........hu.q. &NA� __..._.._ _ O nc --- o---------��----------- ------ ---------------------------------------------- 60x_....��C�..... .X Installer Address Type of Building Size Lot............................Sq. feet ..� Dwelling— No. of Bedrooms--------____--------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOth res --------------------------------------------------------------------------------------- ------- W person p •�j Design Flow........ f .........._�_. _--gallons per day. Total ly flow..._y�J .........................gallons. WSeptic Tank—Liquid capacity�..o�__gallons Length-------NJ...... Width----- ---------- Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ G1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----------------------------------------------------------•--....---.....----------........--'-•---......................................................... 0 Description of Soil........................................................................................................................................................................ x V ...............---------•----------•--....------------------•----------------•----•---------------------------------------------------------------------•--- W •-••----------------------------------------------------------------------------------------------------------------- ------ U N tur of e ai r Alterations—Answer when applicable_I �� �_..__�d v�..... .......... .. . c}cc� /.. IOU— A r�ment: g The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli ncenhas been issued ';th bard of health. 2 �,�. ................... .................' � 9 �J Signed .......���..�. �e..........:...... Application Approved By ..............� � ....... .��..:-.. b.._p..cL._.) Application Disapproved for the following reasons: ............ ... ................................... . ... . ...............-------------------- ......................................................................... ..... .........................----------........ ................ .. . . .' ......................... . ........................................ Dare PermitNo. -----.-��.:-- �.. ....................... Issued ...........................te....................................... Date rrc.�ti,�1..+'r.-..fYur,.,,.,.ry r.�..,.�.: ...�lr..._.�r�......-✓3./'ti'ti.,��•; y��s—.,,j r— " .,, vv, ,. � •v v.-.. y., u�*7i4 ... --..: —. .� � .� -� Fizz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH S-)TOWN OF BARNSTABLE Applirativtt for Diripa!ml Worko C omitrttrt"ton Frrutit Application is hereby made fora Permit to Construct ( ) or Repair Individual Sewage Disposal System at f l} l-t(J RCI1 ..----4---- -•--- --... - ---•• ... --- ,^ . t L •tion- \ddress !e L o. Iqt N U J I tC _._ 1 .......... ---------- veer �- 1 /i Ounc Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms___________________________________________Expansion Attic ( ) Garbage Grinder ( ) 114 Other—Type of Building ________________________ -No. of persons_________._.-_-------__.___- Showers ( ) — Cafeteria ( ) 04 Oth-C11er },�res ................... ------'---------------------------`.--_'__-------='----------------- �j �. --------- ....... W Design Flow ..................... ..... ...gallons per person p , day. Total ]daily flow.....v7.�,? ...._.....•...............gallons. WSeptic Tank—Liquid capacity �� _.gallons Length------ _.... Width._.'----------- Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed bY.......----............................................................... Date........................................ Test Pit No. I................mmutes per inch Depth of Test Pit.................... Depth to ground water........................ f1 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ............................ ......................................................... ODescription of Soil........................................................................................................................................................................ x w •--------------............ ----- U Natur of eyaip pr Alterations—Answer when applicable.- �...._�. V�... f..._.. � AgrI2ement: ,4 , The undersigned agrees to install the,aforedescribed`Ihdividu Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed (—I) .. ..'.�M J ........................... ........................................` Application Approved BY ---------- .. a<, .�xr .l.��„--.-..1h...-..�✓ 3 �1 ................................. E', Application Disapproved for the following rearons: ..................... ................................................... .. -- ..................... ...._....... ..........................................:................................................................----....----.-----...----------.--------..------I--------------------------------------.....--..... --- ---..c.................... e PermitNo. ......... ..,,........ Da......_..a........,y'�a.... ..............,. Issued .......---........-------.......---.............._....._........... Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Cfeztiftrate of Tomplianre THIS IS TO CERTIF Tat the Indivld al Se a f e Dt posaI System constructed ( ) or Repaired �:. U�. ic:rtc�- �-- by ------- -------- --------- --------- Y.s . I - has been installed in accordance with the"provilsiins of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ------- �, .-.(_fit.. ...__.._.. dated ................._._---------------___ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.-....------- f...... J�.....6,...`�'.J?........__._. Inspector - , ��-- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE io�roottl mbut tr ' 1 u Vrrutit Permission is hereb ranted. " �.___.1 Y g •---------------------- •-----------.........---•--... to Construct ( ) or Repair �n Ind`�.,-,dlual Sewage/Disposal System(,, -J Ul at No.•••-•-•----•• •.... t '... _�`'�-=---;�_..�J-�` Kitt Gt�( ,. .....••. •----------- Street ��! ` as shown on the application for Disposal Works Construction Permit No.•,.�,..__�r .. Dated........................................... ................................, �------------------------•-----------------•� `J - -----•--.....--•- DATE.............. --==--••>/h....... .------••----------. Board of Health FORM 36508 HOBBS&.WARREN.INC..PUBLISHERS TO ' DATE TIME Q (J/� AM PM .01 Q OF FROWI�� AREA CODE NO. �j�Ca.. q 6l 7 U N EXT. E M E E s M � 0 E SIGNED PHONED❑/ BACK CALL[RETURNED SEE YOUOEl WILL AGAIN ALL WAS IN URGENT t' 7/ oF'IMHEr Town of Barnstable ti . BAAWNS,"BIZ : Department of Health, Safety, and Environmental Services ` Public Health Division �EDN'0�A P.O. Box 534, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health RECORD OF VERBAL COMMUNICATION caj� S'/-12- /'1 /L/ S 7 J > �-(( ►2cP /�ati,,,":e e iQ S��� il7.r�Gv4�, c..�.� � � r cv,-1 2 S—, zoo ! V-S '(J Ca"S din CA v P/✓�o ld t (�e �6 L�e.. (V).3af cn QL J J J Z���° V-elo�G'e verbcomm.doc Certified .Plot Plan in Barnstable NIA Address : 571. Strawberry Hill Road Prepared For : Patricia Perris Assessor's Map: 249 Lot: 014 Zoning District: Split RD-1 & RB Baxter. Nye Engineering 8c Surveying Overlays.. .WP, RPOD, SWEP Registered -Professional Community Panel,Number 250001 0564 J, Effective Date 07-16-14 Engineers and Land Surveyors F I.R.M. Map zone. X (un-shaded) 78 North Street, 3rd Floor Plan Reference: Plan Book 219 Page 111 & Plan Book 149 Page 13 Hyannis, MA 02fi01 Deed Refernce: Heed Book 29179 Page 154 Ph�te ;- (508) 771-7502 fax - {5Q8)-771-7622 Omer. Patricia M. Perris & Dorothy Ellen-Gross, Job Number. 2016-010 Scale. : 1" = 20' Date 04-07-2016 I N/F JILL CONNOLLY DEED BK 14925 PG 262 PARCEL 249-015 100.00 (PLAN) I a 95.84' CAL". 'r 8 '4615 E "' 3 f N as m WIRE FENCE O o. PARCEL 249 014 . � cc W 9 660f S.F. AC a8.3' 1 N RANDY S & 1cc i t ANN MARIE PEACOCK ,r N l DEED BK 15020 PG 227 z,,;.. �- a� : . - '-_ f J i PARCEL 249-021 Z EXISTINGo ccDWELLING - -O _. 1;� oNp g o DECK fcc 3 ` ALP SHED ' STONE his, 1 N/F EDWARD S JR & DRIVE MARIANNE 0 SUWVAN 23.2' - DEED BK 5417 PG 142 _ — `1 PARCEL 249=022 — — a S 89'46'15W 99.37',(CALL.) 100.00 (PLAN) clP I N/F EDWARD B JR & MARIANNE 0 SULLIVAN DEED BK 25524 PG 218 PARCEL 249-013 F: I. CERTIFY THAT TO THE. BEST OF MY KNOWLEDGE THE EXISTING STRUCTURES SHOWN HEREON IS LOCATED IN RELATION TO THE MONUMENTS SHOWN AND IS NOT LOCATED WITHIN A SPECIAL ��OF FLOOD HAZARD AREA. y BMANE � THIS PLAN IS NOT TO BE RECORDED NOR IS IT TO BE USED TO ESTABUSH PROPERTY LINES. ° _" M. ®; MALLON W No.48687 i REGISTERED PROFESSIONAL LAND SURVEYOR- BAXTER NYE ENGINEERING & SURVEYING DATE. t,�No sum t I N/1� JILL CONNOLLY i DEED BK 14925 PG PARCEL 249-01562 100.00' (PLAN)GO Jc�o 95.84' (CALC.) 99. 9 `N 89048'1 S` E o Q I 100 Ow FEW a °pt L 1 Y 1 X995AC La r I c 1 1.500 GALLON 1 SEPTIC TANK 1 I 'B.F. 1 17. /EL. 94.65 R PARCEL 249--014 ,lcc 1 . �., AREA = 9,660t S.F. : ! t'x3 x32' LE,►c�NG TRENc�I i h I I I--u - MIV. EXISTING / ' iA 99.5 T N0 PATIO -EL. 9&2 #571DWM C4 Off/ I I Z D-80X 0?r 0 DOS7ING DUX do ® I PATIO TO BE J I . o 1 t i REldOVED I 'ANDY S & v 1 ` FFL SILL 1 I 121E PEACOCK 1 d-- 102.5 15020 PG 227 /ry�r I I 'L 249-021 x G .71 , 'f I cc 1 1 BENCHMARK G WATER GATE 2'x3'x32' LEA*MG TRENCH 1. APPROXIMATE SI:E sEPTIc°y o I,y EL_=sss5 1 1 iv EXISTING NOTE 3 ti L FW w w WG i 1 SEPnc(TO °,y / 99.6 O1 1 I °ti a� � ti I I i ° ) 8 R & MARTS' /ANNE O ! Gy I i SUW VAN BK 5417 PG 142 I �� ;CEL 249-022 I STONE x 99 24 I I / DNViE 1 p0 J WICMAW ca BOWD w. � �w ^ �v w►av�� � a L-7 o c - 0 co 11' - 7.25" } r 5 - 0.0 � =... 10 C� LO ' 14' - 11.25" o . :. d . Cu 15' • 0.00" \ W i �1 36, - 0.00" e90s f,., 571 strawterry hill , a 12' - 0.0" � f FEW ! ! `' m%v 8 inch fduhdauon tsn ira[ rt r r ! _ new 8 inch famdaGon An faotin k r € a 0 3 � h ,its ,., ,.�.,: v. .�l . existing f vundetion 571 strawberry hill rd 1/cinch=,#ooG 'j2/1/5 12' - 0.00" 12' - 0.00" a: 41 co tempered glass windo sy 7 1 YS . sc 4qqY t x J S l cu _ J yy 3 f 4 E: CIBC g ' _^Y•^. .! .... -•_ .k,, w.: 4 �i +r' .._ '%� r-';..'."' ., �..v i.� i'. �,.. '= k. t'.:....r.i �F ..:. � � An ' s DVV h f'1" 2 r kitche ,k Fri, � drain k ' 1' 6.00" 1' 6,00" 4 r_ti !rt s =..�.3.•w..,:»:.2.s:.4:�,..txk..w.w.:.�,.»-;'-�:+�5�.�..-...�,,.- � ,......- °,--�..� ....w.a,;:..,:.:.«w t ...,.xaa...;�:w.: �"�� �v 10' - 1 1.75" _ - CONSTRUCRON NOTES: T Y 1 TYPICAL SYSTEM PROFILE p ` tg a f� \ { r 1. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN , � 4 BAXTER NYE ITT M SCALE ACCORDANCE WITH TITLE V OF THE STATE SANITARY CODE DATED APRIL 21, 2006. AS AMENDED THROUGH THE DATE OF THIS PLAN, do ,,1` �p ANY LOCAL RULES do REGULATIONS APPUCABLE Q ENGINEERING �.1�F f DOSiNG DWELLINGf ` w r, Z ANY CHANGE 7D THIS PLAN MUST BE APPROVED IN WRITING BY r... 1� cr) •.- SET AT LEAST OWMAlHOLE Flllltif SET OOVER TO 6' OEM FLASH GRADE 71iE ENGINEER. f1.EVAliON NFORMATION MUST NOT BE CHANGED SURVEYING .i `- & COVER 10 Wi24 6' OF FINISH Q I X RISER A WAR SHALL BE gA7ERMIIT WITHOUT WRITTEN PRIOR APPROVAL BY THE ENGINEER. sr RISERS & COVERS SWILL BE MLATE3U11GEir = r „s: ; -l cr) i:•Y FIN T) GRADE OWN TANK = 100.0 +� E71NSH GRADE ^, 99Jr* �' �` 4 - Registered9• �► 3. WHEN CONSTRUCTION IS COMPLETED PRIOR TO BACKFIRING, �c , � ��If�P"L S � , Professional Engineers NOTIFY THE BOARD OF HEALTH AGENT AND ENGINEER FOR 3;E �fx. . - " s : Fws11ED `,rtADE OVER ar and Land Surveyors �. LFi1tI1rG CtIAMRS = 99.7t INSPECTION. s 11 4' SCH. 40 PVC TOP EL�9.2 TOP Et 4. ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4' SCHED 40 �;= ", � 7$ North Street - 3rd Floor _•- (TYPICAL) 9 {min) Cover INSPECTION PORT TO PVC. UNLESS Ol1iERRWASE NOTED HERON. r f _ FiRsr 2 (TO f �. Hyannis, Massachusetts 02601 Op51NG SEWAR ;', 6' WL BE LEVEE.) 36 (max) Cover 3 BELOW GRADE � �� 4 - � ` - Y+*```1 ,� ' 77 ENV OUT 96.2 i 10" INIi , z _ t Y 2" PEASTONE OR 5. IF NEEDED EXCAVATE UNSUITABLE MATERIAL TO THE 'C - 3, . .• NV N- 972 � ENV OUT- 4 SCH. 40 PVC LOP p Sg7 3 HORIZON , FOR A HORI7_ DISTANCE OF 5 SURROUNDING THE �3 � G OTE MLE FILTER FABRIC - R " 97.5 2' Q� e D 1 E .__ __} END LEACHING FIELD. AND REPLACE WITH CLEAN SAND PER 310 CMR >_ Phone - 508) 77i 7502 , • 15.255 TO THE TOP ELEVATION OF THE SAS.. . . . . . . . . . . . . . . . . . . . . . . . . . . . -- 7622 wr N = 97.2 �' -. INv our = 97 0 ,.� �, Fax (508) 771- 14' ♦ :_ • PMC 6. M�ISULJ►TE ALL PIPES AGAINST FREEZING AS REQUIRED WHEN �': www.boxter-nye.com BAFFLE NVROWORCED 96.94 LESS THAN 3. OF COVER. - w_ • °°" 'E "''' !` '' Locus Map Scale: 1 -2000 } •' •- . 6' CRUSHED STONE 7. THE SEPTIC SYSTEM DESIGN DOES NOT INCLUDE GARBAGE BASE GRINDER DISPOSALS S T A �LgN OF I ,tX STAMP r tXtUt 5' L41N _ 1)4' EL 94.64 & CAUTION: THE CONTRACTOR SHALL CONTACT DIG SAFE (AT ©� STEPHEN yG TiON 80X 5' trI1Nfp STorrE 1-888-DIG-SAFE) AND UTILITY COMPANIES 70 LOCATE ALL g ALLYN (iAL1.!(�I(XIE-(����T�,jwN( � EXISTING UTILITIES, -AT LEAST`72 HOURS BEFORE THE START OF ' a WN-so -c- %W EY ST15OD-H10 OR EMIR SNOREY 08-3.H-2O OR f971aN. No Groundwater Observed CONSTRUCTION. THE CONTRACTOR SHALL DETERMINE THE EXACT " No.3021 s TO BE NS?N1ED ON A LEVEL STABLE EMASE TO BE NSIALLFD ON ALE STSTABLE BASE LEACIM T>�M - LOCATION, BOTH HORIZONTALLY AND VERTICALLY, OF ALL EXISTING ��, .p (vt SEPTIC TJWC TO BE NSPECIED A CLEANED AINNALY UTILITIES BEFORE THE START OF ANY WORK. THE LOCATION OF �,� GISTE� PROPOSED TWO TREM0ES 32' LONG x Y MADE x 2' DEEP EXISTING UNDERGROUND U7iUTiES ARE SHOWN IN AN APPROXIMATE �`��>0 AL E�G� UQUD OEPiH N SEPTIC TANK DM OF OUiUFT LEE E>E1Dw FLOW lME MR " V WACNG BETWEEN EEE6 OF TREACLES MAY NOT BE LIMITED TO THOSE SHOWN HEREON AND WAY ONLY, 4 FIN 14 NICHES HAVE NOT BEEN MIDE�DENTLY VERIFIED BY THE OWNER OR ITS REPRESENTATIVE THE CONTRACTOR AGREES TO BE FULLY 5 FELT 19 NCEES RESPONSIBLE FOR ANY AND ALL DAMAGES WHICH MIGHT BE 6 FEET 24 VI OCCASIONED BY THE CONTRACTOR'S FAILURE TO LOCATE THE 7 FEET 29 NICHES UTIU71ES EXACTLY. IF ELEVATION INFORMATION DIFFERS FROM PLAN INFORMATION. THE CONTRACTOR SHALL NOTIFY THE ENGINEER CONSULTANT 6 FEET IMMEDIATELY FOR POSSIBLE REDESIGN. AT UTILITY CROSSINGS, 4' DIAL SCH. 40 PERFORATED PVC VERIFY IN FIE1-D TF� LOCATION / INVERTS OF ELECTRIC, GAS, 2" PEAST'ONE OR TELEPHONE do DATA/COMM AND RELOCATE IF CONFUCTING WITH INSPECTION PORT TO GEOTOMLE FILTER FABRIC PROPOSED INVERTS PER THE ENGINEERS DIRECTION. THE SEPTC SYSTEM NOTES: DESIGN SCNEDUIE FI FVpj�pN 3' BELOW GRADE < �, . - :< CONTRACTOR ONT R 0� SHALL PRESERVE ALL UNDERGROUND UTILITIES AS 1. A VARIANCE FOR REDUCTION OF SEPTIC SYSTEM COMPONENT TO EXISTING SEWER INVERT AT MAIN HOUSE 98.2 9. THE PROPOSED UTILITY CONNECTIONS SHOWN HEREON ARE CONSULTANT SCHEMATIC. FINAL LAYOUT SHALL BE AS DETERMINED BY THE FOUNDATION SETBACK (BUT IN NO CASE LESS THAN 50% REDUCTION IN SEWER INVERT INTO 1,500 GALLON SEPTIC TANK 97.8 EFFECTVE 3�" _ 1)!' APPROPRIATE UTMJTY COMPANY. THE REQUIRED SEPARATION DISTANCE). IS BONG REQUESTED IN SEWER INVERT OUT OF 1,500 GALLON SEPTIC TANK 97.5 ACCORDANCE WITH WRITTEN BOARD OF HEALTH POLICY 'COUNTER DEPTH DOUBLE WASHED STONE VARIANCE, APPROVASLE BY HEALTH INSPECTOR' DATED JANUARY 12. 2016. SEWER INVERT INTO DISTRIBUTION BOX 97.2 Q/�' c. 2. ALL EXISTING SEPTIC COMPONENTS ARE TO BE REMOVED FROM SITE. SSEWER INVW EWER INVERT INTO SAOF DISTRIEUTioN Box 96.$ r 3' '~ GENERAL W)TEV' SEW INMT A 96.64 WCHNG TRENCH PREPARED FOR TOP OF TRENCH 97.3 SCALE 1. TIC NfEW OF THIS PUN IS 10 DETAIL EXL W SIZE CONDITIONS AND DEM OF SEPTIC SYSTEM REPAIR BOTTOM OF SAS. 94.64 "Locl�171 SSA 'o Y HILL W . PATRICIA PERRIS NO GROUNDWATER OBSERVED TO ELEVATION 88.3 2. PER CURRENT ASSESSOR'S RECORDS: 571 STRAWBERRY HILL ROAD OMI�M PATRICIA POW CENTERVILLE, MA. 02632 DEED BOOK 29179 PAGE 154 RECORD PLAN BOOK 146 PAGE 13 LOT 5 PLAN BOOK 21S PAGE 111 1 ASSESSOR'S MAP 249 PARCEL 014 I 3. PRO►ECT 11901 MIRK AC SI#ONM ON THIS PLAN N/F JELL CONNOLLY LEACHING AREA REQUIREMENTS DEED BK 14925 PG 262 I 4. ZONaNG I�FORMNTIONk o PARCEL 249-015 P�i I ZONING DISTRICT' : SPIJi AD-1, idg 100.00 (PLAN) cqA r� I CURRE>rT MIN" ZOW3 REQUMMEMENTS: RESIDENTIAL: 3 BEDROOMS RD-1 , RB � 95.84' CALC. �• . ( ) �.\ I I MIN. LOT AREA = 87,L� sT- 43,560 SF .P L_1 x 110 PD BEDROOM � - ,. _ _ N 89'46'15'' E _ .. \ ;. � ,.- I Mrr. LOT FRo1ITAGE _ .�"�' Z0*. TOTAL DES."'' FLv�w'' m 330 GM �. _ 3: ` VA LOT NMI 125 GARBAGE GRINDER (NOT'INCLUDED) = N/A 0, � fRONf YMD ,� M. �. . c TP 2 � , ,�� �., � � i SIDE d< REAR YARD = Tit' 10' / \ N PERC RATE _ <5 MIN. INCH (CLASS 1) - - � � �\ � `o / / I OVERLY DISTRICTS: WIOi AW IMP LIAR = 0.74 GPD/S.F. / _ _ - • 10.0' 1 �,, ,',� "\\ N I 5. A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THS SHE THERE MAY Q MIN LEACHING AREA OF SAS, REQUIRED. � c� I e? r r cn ,' � BE W(�FITS BY OTFERS,.�JISEMENT, TAKMIGS, YORTCiA6ES, R16IIf OF MAYS 330 GPD/ 0.74 GPD/S.F. = 446 S.F. MIN. a_ 'e� I ETC NOT DEPICiF..D! F IUD 10 BE NECESSARY. A iME SEARCH �i.. a, 1 SKL BE PERFORMED EY OTHERS AND SUPPLED 10 avam NYE J x99.5 r \ I PROPOSED SYSTEM: 2 TRENCHES, MAX. WIDTH = 3', MAX. HEIGHT = 2', LENGTH = 32' x 1 / f -" \ I apNEERING StIRVEYNVG. _.1 m 1 ( 6. THE PROPERTY LIE N*Tl(t11A11ON SHOW IS BIASED ON CURRENT AVMA011 BOTTOM (32'x3') = 96 S.F. + SIDE (32'x2')x2 = 128 S.F = 224 S.F ` it 1 J ,r `' AC atEooRO MFORMA110N of PLANS AND DEEDS. TFE E�asTwG FEATURES LEACHING AREA: 224 S.F. x 2 = 44$ S.F. a Z 1 ; ' ❑ 5TIOMM IEREON HERE 01TUOED FROM AN ON THE CAROTID FEUD SIIIYEY Q i TOTAL EFFECTIVE 1 i 4 , PERFORMED BY BAM NYE 01G0EETIMIG E SIIIVEYNG ON JLLY 12, 2DI& SYSTEM DESIGN CAPACITY = 448 SF x 0.74 GPD/SF = 331 GPD o \ r' ; ; 3 W i 1 1,500 GALLON Y SEPTIC TANK \ ��� ��-- ..._ _ - 10 J � I 7. COIMIUNiTY PANEL NN1AEt7� ' 250001 0564 J. EFFECTIVE DATE JULY 16, 2014 W W W SEPTIC TANK SIZING: 330 GPD x 200% 660 GAL: USE 1,500 GALLON SEPflC TANK ADOIfiON ,' �� C i THE FLOOD NSIItANICE TOTE MAP DEFINES THIS ARIA AS ZONE x (LM�-swlDEn) m J PARCEL 249-014 1 1 I- LL' X 1 ( EL 94.65 PER MASS GIS OUVER AS OF 07118116. 1 17. - AREA - 9,660t S.F. j }- W • 1 h� i I / ''� EXIS a, o / ' SITE DOES NOT APPEAR TO BE MITHN AN A.C-EC (AEA OF GUM ENIVI 0%8ffAL CWCERN). � (n E-- I I TING ; o I • SITE DOES NOT APPEAR 10 MITIl1 AN AREA of ESTIMATED IMHTAT of RARE MiLDIJFE As O t-- W 2 x3 x32 LEACHING TRENCH 1 �� %rINV. OUT DWELLING I /' N G✓ 1♦ I c{ PATIO fl 98.2 7t ! ; v� MAPPED ON MASS GIS (XW PER NHESP IMIMATEO W WARS OF RARE MM.D W FOR USE WIM a V7 U BOIL L+00e P-1�9 Dr►'iE:�/� �3 � T 1 � a � ' Z D-BOX EXISTING DECK do TIE MA WERMW PRO�EEC M ACT WMAiiONS (310 CUR 10� BARNSTABLE (o.0 f PATIO TO BE j SOIL EVALUATOR: B(apRp OF HEALTH AGENT o , t REMOVED j • 511E DOES Not APPEAR TO CENTIMES A coltMD VERNAL PE911L AS MAPPED ON MASS Gas a1ME1r o STEVE WILSON, P.E. DAViD STANTON a 1 ' ' ;` �' j ( PER NIiESP 'CERTFED VEIiNAI POOLS;' a o Z z FFL. SILL % I I ; 0 • SITE DOES NOT APPEAR TO BE MiTW A PRIORITY WA MT AS MAPPED ON MASS GIS OLM PER TEST PIT i TEST PIT 2 N/F RANDY S & _ i 1 Al I110N a /�EL 102 5 I NESP 'PRIORIIY HABIiJITS OF RMaE SPECIES' FOR SPECIES EMDER THE MASSACa#ISETTS z a " G.S.E. = 100.0t " G.S.E. = 99.8E ANN MARIE PEACOCK % / I I E1DrAKM SPECIES ACT, REGULATIONS (321 CUR 10). o - . . DEED BK 15020 PG 227 x9 .71 \ ;; Y �--- G - --__ G f � ® Q cc 0 Ap; LOAMY SAND Apo IOYR 4/4 , LOAMY SAND PARCEL 249 021 1 l I m SITE APPEARS 70 BE M"I MI A SPATE APPROVED ZONE I t;ttOIMDTMATER REDIARGE PROTECTION AREA. `°' � 8" 10 YR 3/3 6" 25.Z' z Uj BENCHMARK TRGAT 1 Z z o 1 O o EL=99.85 SITE APPEARS 10 BE WifFMi A ZONE OF COIYTRDIlTION TO A SALiwAIER E5iL1ARY (BVIRNLSTJIBLE B; 10YR 5/8 ; LOAMY SAND B; 1OYR 5/6 ; LOAAMY SAND 1 h' O W l WG I B.O.H. REG 360-45). 1 h' I 4o tp W 16 15 2'x3'x32' LEACHING TRENCH 1 `Q APPROXIMATE LAIN W W I 9. UTILITY INF01tMAT10N SHOMM 111RE0a: � " " 1 EXISTING Oh � ~` a C ; MED. SAND do FINE GRAVEL C ; IOYR 6/6 ; MED. SAND 1 SEPTIC(TO BE REMOVED) ti - - - - - - - _. - - -� BE CONiMCTOR %411. CONrACI` DIG SAFE (AT 1-M-DIG-SAFE) AND UMN COMPANIES TO LOCATE � Go 1 9 _ / I THE LOCATION O tlC IO N OF ALL D(IS10 NiDERG'ROUND NF LE T 72 HOURS PRIOR TO THE START OF ARE S1`tOMM 132" 10 YR 5/6 138' (PERC O 48'� 1 9.2' \ 24 O �� IN AN APPRO)M AIE TRAY ONLY, MAY NOT BE�THW SI MM HO MI AND �BEEN Q Q 3 3 >- _ 1 I ti RESfAR(,'NEn BASED ON THE AVAI,ABIF URBY RECORDS NOTED IETIEONL TIE CONTRACTOR AGREES TO o WATER NO WATER OBSERVED -� - i I Oy OA, / I I BE FULLY RE WONSIS E' FOR ANY AND ALL 80WES MI" MIM BE OOPAS'101ED BY THE ® © z NO ` CONTRACTOR'S FMLW 10 LOCATE SAID WRAS7RUCRK AND URITES EXACTLY. F FIELD CONDITIONS 99.610.0' I Oy DIFFERS FROM PLAN MA•'ORMNTION, THE CON1RACiOR SHALL NOTIFY TIE D OM AWDIAiELY FOR SHEET TITLE 0);, POSSIBLE REDESIGN. ■ a N EDWARD B JR & MARIANNE 0 CRUSHED Oy P I �� I � Septic SUWVAN SOURCE WMIATION FROM PLANS HAS BEEN COMBMED IMiH 08SEINED EVDEN(E OF URITMPS TO DEED BK 5417 PG 142 ( STONE j DEVELOP A VIEW OF 1M'JSE UNDERGROUND I/TIlTE�. IIOAIEVEJa, LACIa1G EXCAVA110NL 11E EXACT PARCEL 249-022 X 99. 24 ( , 1 LOCATION OF UNDERGROUND FEATURES CANNOT BE AOCLIRVMY, COMPLETET.Y AND RELiABIY DEPIC" System Upgrade Plan 0 22.2' DRIVE _ _ _ sc.0 MIERE ADDITIONAL OR liIORE DETAILED INFORMATION IS R0100, THE CLEAT 6 AMM THAT f /J __ _ - - - - - - EXCAVATION MAY BE NECESSARY. ;ar23.2' / ) - - _ - - SHEET NO I CERTIFY THAT IN APRIL 1995, 1 HAVE PASSED THE SOIL EVALUATOR EXAMINATION BENCHMARK o J L - - EX9W SEPTIC SYsip1 MIF0RMN11ON OBTAINED FROM SEPTIC SYSTEM AS-8LNJ REPORT, FOR CL CL APPROVED BY THE DEPARTMENT OF ENVIRONMENTAL PROTECTION AND THAT THE ABOVE CONCRETE BOUND a - - - t�u - Q� ' EL=t00.32 y PERMIT OYITE 12-16--9�1 ON FIE AT BOARD OF HEALTH. o ANALYSIS WAS PERFORMED BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE 1 MR 15.017. S 89'46'15' W C2nO to9 • TOW WATER Sa3MM !1MWN ON THIS PLAN FROM FIRD LOCATED M IER GALE E DIG-SAFE AND EXPERIENCE DESCRIBED IN 310 C 99.3T (COLIC.) ,� ' MARIMMS 07/12/16. D A T E : 08/01/2016 o DATE EXISTING SHED 100.00' (PLAN) N/F EDWARD B JR & MARIANNE 0 ,GpQ ' • GAS SERVICE SI MM ON PLAN PER FED LOCATED METER & DIG-SAFE MARIIMK;S. 10 0 10 20 SIGNATURE TO BE RELOCA DEED BK 25524 PG 218 Q`� • ELECTRIC tx1E SHOMM �1w1 THS PLAN PER Flan tDrA>m MIE7ER E POIF MMOIrATIrG OVEiIEFAD SCALE IN FEET (SE-2622) PARCEL 249-013 SERVICE FROM MR iVIE 33 ON 07/12/16. SCALE : 1 10" 0 1 1 goo DRAWNIDESIGN BY: SW CHE' ED BY: UK r, o JOB NO: 2016-010 CADD FILE: 2016-01OSPAI i 0