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HomeMy WebLinkAbout0037 THOREAU DRIVE - Health 37 Thoreau Drive Centerville A= 191 231 x UPC 12534 N.O. visa" No.4: �—25 q10 Fee THE COMMONWEALTH OF MASSACHUSETfS Entered in computer: Yes PUBLIC 14EALTA DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for Mtzpool bpztem Construction Permit Application for a Permit to Construct( . )Repair Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location A ress or Lot No. �s Owner's N[a-me,,Addre s and Tel.No. �Xar-u,a- /VA V&YAX(/F4, �''(%/dear ��'� Assessor's Map/Parce/l Installer's Name Address,and Tel.No. � 775 Designer's N e,Address and Tel.No. /1 Da. &a-AUK Gva��t- �3 -rr�. � c``�`� . Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder 40) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow -3 367 gallons per day. Calculated daily flow _5 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature,of Repairs or Alterations(Answ r when applicable)f�l/ ,,ems/1 5 �lw 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 Certifi- cate of Compliance has been issued by this�OA�- of ealth. Signe Date Application Approved by Date � y`� ®� Application Disapproved for the following reasons Permit No. oQ C 0 6 Y f® Date Issued' ba o s— ----------------- — - �1 TOWN OF BARNSTABLE Y XATION '1 7 � K 1, /A 4---" 0/'- SEWAGE # 4°49LLAGE t%' c� `�' ASSESSOR'S MAP & LOT l91 3 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY , /(J is d LEACHING FACILITY: (type) c/ T`e 2 " �" (size) NO.OF BEDROOMS J BUILDER OR OWNER� ,� ® �1A .S PERMIT DATE: .2 e �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 I a #L -3� TOWN OF BARNSTABLE 'C4LOCATION ,37 l`►0� eCkU �ri.✓�' SEWAGE # t`VILLAGE C. e.4t ery, A�e ASSESSOR'S MAP & LOT/ /3JP.l INSTALLER'S NAME&PHONE NO.W'I-.L,a n C. --Ro b,17sdN SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS °�` � 0 BUBER GR OWNER PERMIT DATE: I LIANCE 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 AFurnished by J Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS v SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 37 Thoreau Drive .. . en ervi e Owner: Michas Thomas Date of ln3pecllow SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchdrarks.Locale all wells within too feet.Locate where public water supply enters the building. 6r 8 • t in (/�'✓ LJ! 0 No. - y Entered in computer: THE COMMONWEALTH OF>MASSACHUSETTS s5. Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for Zigpogar *pgtem Congtruction Permit k Application for a Permit to Construct( . )Repair( Upgrade( )Abandon( ) O Complete System El Individual Components Lo ation Add ss or Lot No. Owner's Na9 e,Address Md Tel.No. Asses1��Iap�cgl/ `1/ .S Installer's N e, ddress,and Te No. s- De gner's N� A�flress and Tel.No.41 / k/ t �G o�in�,70h �c p 7•��_A Type of Building: Dwelling No.of Bedrooms "Z Lot Size sq.ft. Garbage Grinder( A) a. Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 330 gallons per day. Calculated daily flow 3 25 © gallons, Plan-Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil S /J� l 0 Nature 2f Repairs or Alterations(An wey when applicable) anS o� f� 2 c!'� E7�' a 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 t.o place the system in operation until a Certifi- cate of Compliance has been issued by this Boar f alth. Signed Date " Application Approved by Date 2 l c5o`� OJ Application Disapproved for the following reasons Permit No. c=QDQc5 'Y)Q Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that thg OnLLsit&Sewage D'spos I Syste ,Constructed ( )Repaired( *Upgraded( ) Abandoned �O� �C- �n%/C'�- at 31 / has been constructed n accordance with the provisions of Ti e 5.and the for Disposal System Construction Permit No. Q S 9/O dated g 'D� f Installer d(/.F• / /n.Sc'I -S'/Z— Designer G-'D The issuance of this permits all not b construed as a guarantee that the sys em w I`fu c, as esigned. Date Inspector No. C7DOSL�h ---------------Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION . BARNSTABLE., MASSACHUSETTS Migpogaf *pgtem CowAruction Permit Permission is hereby ranted to onstruct( )Re air( 'Upgrade( )Abandon( ) System located a eifa- and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of`this a it. Date:_�_ I Approved bye f Notice: ThisForm Is To Be Used For,the Repair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, o g 6e V A 4 k0W v ,hereby certify that the engineered plan signed by me dated '91z( to r ,concerning the property located at 37 Thorekt) Dr SellerV;He meets all of the following criteria: • Two soil evaluations excavated for detailed examination(no hand augering)and two percolation tests shall be conducted. • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will be located no less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation(using GIS information) G 2 B) G.W. Elevation +adjustment for high G.W. DIFFERENCE BETWEEN A and B 2 u SIGNED :cZ�YM'C. �, G K� DATE: NOTICE LBaseduponhe above information, a repair permit will be issued for bedrooms o additional bedrooms are authorized in the future without engineered septic system gASepuc\percexemp.doc Town of Barnstable °OWE Regulatory.$ervices NAP ti� p. - Thomas F. Geiler, Director • BARNSTABM ► 9�A 6 9. � � Public Health Division lED N1°� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Designer: Eco-Tech Installer: Wm E Robinson Sr Septic Address: 43 Triangle Cir Address: PO Box 1089 Sandwich Centerville On `��—Gti Wm- E Robinson Sr Sept4gs issued a permit to install a (date) (installer) septic system at 37 Thoreau Drive, Centerville based on a design drawn by (address) Eco-Tech dated 8-21 -05 (designer) I certify that the septic system referenced above was installed substantially according to the de ign, which may include minor approved changes such as lateral relocation of the distri ution box and/or septic tank. 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. N OF Mgss9c DAVID D' vV G COUGHANOWR @4 (Installer's Signature) No. 1093 & a GISTS Nl TARV (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. f Q:Health/Septic/Designer Certification Form ,per COMMONWEALTH OF MASSACHUSETTS a--' EXECUTIVE OFFICE'OF ENVIRONMENTAL AFFAIRS . DEPARTMENT OF ENVIRONMENTAL PROTECTION d I d on TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 37 Thoreau Drive U Centerville - /7/ Owner's Name: Michael. Thomas c� ' Owner's Address: 66 Peter Road 2 tglymnuth , MA r 1 Date of Inspection: / i d L3 ca X Name of Inspector:(please print) W 1 1 i am E_ • Robinson Sr. co Company Name: William E. Robinson Septic Service Mailing Address: P O Box 1 089 CZs t-- Centerville, MA Telephone Number: (5081 775-8776 CERTIFICATION STATEMENT i certify that 1 have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 o[Title 5(310 CMR 15.000). The system: Passes Conditionally Passes eeds Further Evaluation by the Local Approving Authority Fails Inspector's Signature: ,�� Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health-% 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 seat to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time_This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 37 Thoreau Drive en ervi e Owner: Michael Thomas Date of Inspection: InspAiin3l ry: Check A,B,C,D or E I ALWAYS complete all of Section D A. und_ any information which indicates that any of the failure criteria described in 310 CMR 15.3R 15.304 exist.Any failure criteria not evaluated are indicated below. Com B. System Conditio ally Passes: One or mores tern components as described in the"Conditional Pass"section need to be replaced or repaired.The system, on completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not d etermined(Y,N,ND)in the for the following statements.If"not determined"please explain. The septic tank i metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits subst intial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing tank is replace with a complying septic tank as approved by the Board of Health. •A metal septic tank w Il pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that)on is less than 20 years old is available. ND explain: Observsewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) e to a broken,settled or uneven distribution box.System will pass inspection if(with approval of Boealth): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The syst required pumping more than 4 times a year due.to broken or obsti ected pipe(s).The system will pass inspection i with approval of the Board of Health): broken pipe(s)are replaced obstruction is n=vcd ND explain: a Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) PropertyAddress: 37 Thoreau Drive Centerville Owner: Michael Thomas _ Date of Inspection: C. Further Evaluation is Required by the Board of Health: Conditi sexist which require further evaluation by the Board of Health in order to determine if the system is failing to prot t public health,safety or the environment. 1. System wi pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is n t functioning in a manner which will protect public health,safety and the environment: _ Cesspo I or privy is within 50 feet of a surface water _ Cesspo or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System wil fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is func oning in a manner that protects the public health,safety and environment: _ The stem has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface ter supply or tributary to a surface water supply. e system has a septic tank and SAS and the SAS is within a Zone i of a public water supply. he system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. Ilesystem has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well** Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and e presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other ilure criteria are triggered.A copy of the analysis must be attached to this form. 3. 01 her: 3 j Page 4 of I I . OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 37 Thoreau Drive Centerville Owner: Michael Thom Date of Inspection: / 6 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 V,day flow _✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number / of times pumped _ �//Any portion of the SAS,cesspool or privy is below high ground water elevation. i/ Any portion of cesspool or privy is within I00.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. t/ Any portion of a cesspool or privy is less than 100 feet but greater than 50 f et from a private Aatrr supply well with no acceptable water quality analysis.(This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free.from pollution from (fiat facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.) BLS (Yes1No)The system fails.1 have determined that one or more of the above failure criteria exist as J' 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 (he system must serve a facility with a design now of 10,000 gpd to 15,000 gpd• i You must dicate either"yes"or"no"to each of the following: (The foil ving criteria apply to large systems in addition to the criteria above) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If y u have answered"yes"to any question in Section E the system is considered a significant threat,or answered "y "in Section D above the large system has failed.The oKrncr or oprrator of airy large system considered a si nificant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 1.� .304.The system o%%wr should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 37 .Thoreau Drive Centerville Owner: Michael Thomas Date of Inspection: 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 V 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?. L., 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? zz — Was the site inspected for signs of break out? Were all system components,excluding the SAS,located on site? v____ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no% Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] 5 Page 6 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 37 Thoreau Drive Centerville Owner: Michael Thomas Date of Inspection:—27—l.S— 65 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):' Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms):. � Number of current residents:/ -_.? Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no):,L_& [if yes separate inspection required] Laundry system inspected(yes or no):,�,e) Seasonal use:(yes or no):L.. � Water meter readings,if available(last 2 years usage(gpd)): 200 3 — 67,000 Sump pump(yes or no): iG O — 60, 000 Last date of occupancy: 2�—/X—oS'� COMMERCIAL/IND STRIAL Type of establishment Desi/'r based 310 CMR 15.203): gpd Basisn flo (seats/persons/sgft,etc.): Grearese t(yes or no):_ Induste oiding tank present(yes or no):— Non- aste discharged to the Title 5 system(yes or no):_ Wateadings,if available: Last ccupancyOTHcribe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped asp of the inspection(yes or no): If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) - _Tight tank Attach a copy of the DEP approval —Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no):/t/p 6 .]'age 7 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORAYIATION (conlinucd) Property Address: 37 Thoreau Drive Centerville Owner: Michael Thomas Dote of Inspection: BUILDING/SEWElocate on site plan) Dcptls belowMaterials ofn:_cast iron _40 PVC_other(explaus): Distance Go 'aler supply well or suction 6c: Comments( n of jousts,venting,evidence of leakage, etc.): SEPTIC TANK: ✓(locate on site plan) Depth below grade: Material of construction: x".crete metal fiberglass_,olyetlsylene _otlscr(explain) If tank is metal list age:— Is age confsnned•by a Certificate of Compliance(yes or no):—(attach a copy of certificate) r , Dimensions: Sludge depth: s Distance front top of sludge to bottom of outlet Ice or baffle: 7-6 Scunt thickness: 5 i6 Distance from top of scum to top of outlet Ice or baffle: Distance [torn bottom of stunt to bottom of outlet Ice or baffle:/0 _ I osy were dimensions determined: 0 ��-- Comments(on pumping reeonsrnendations,inlet and outlet tee or baflle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): / � GREASE TRAP: ocate on site plan) Dcptls below grade: Material of cons tion:_(oncrete_metal fiberglass poi),cdl •Iene__otlser (explain): — Dimensions: Scum thicknes Distance Gott11 of scum to top of outlet Ice or baffle:_ Distance Go it bottom of scum to bottom of outlet Ice or baffle: Date of la s pumping: Conunen s(on pumping recommendations, inlet and outlet(cc or baflle condition, structural integrity, liquid levels as(elat d Io outlel invert,cvidcncc of leakage,etc.): 7 'age 8 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART SYSTEM INFORMATION(continued) Property Address: 37 Thoreau Drive Centerville Owner: Michael Thomas Date or Inspection: a 5 TIGIIT or 11OL ING TANK: (tuck must be pumped at time of inspection)(locate on site plan) Depth below gr de: Material of co struction: concrete_rectal fiberglass_pUlyelhylene other(cxplaut): Dimensions- Capacity: allons Design Fit; gallons/day Alarm pr sent(yes or no): Alarm I el: Alarm in working order(yes or no):— Date o last pumping: Comrr ents(condition of alann and float switches,etc.): DISTRIBUTION BOX:=(if present must be opencd)(locatc on site plan) Depth of liquid level above outlet invert: Conunents(note if box is level and distribution to outlets equal,an)-evidence of solids carryover,any evidence of leakage into or out of? f ox,etc.): PUMP/w -ing : (locate on site plan) Pumpsder(yes or no): Alamirder(yes or no):Conundition of pump chamber,condition of humps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 37 Thoreau Drive Centerville Owner: Michael Thomas Date of Inspection: K-`5%'o Sy SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: T)'Pe . leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: innovative/altemative system Type/name of technology: Continents(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): 16 CESSP/and (cesspool must be pumped as part of inspection)(locate on site plan) Numbefiguration: Depth iquid to inlet invert: Depth layer: Depth layer:Dimenesspool: Materistruction: Indicatoundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Mater' Is of construction: Dim nsions: De h of solids: C mments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 37 Thoreau Drive Centerville Owner: Michael Thomas .S� Date of Inspection: y SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or where public water supply enters the building. benchmarks.Locate all wells within 100 feet.Locate her pp, g P J 6 y ��I w 10 Pages I 1 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 37 Thoreau Drive Centerville Owner. Michael Thom Date of Inspection: SITE EXAM Slope Surface water Check cellar. Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-if checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You mu t describe how you established the high ground water elevation: Il F 4 ! nI n n Q a A-3 P /- * ,� * a a a q c 6__=_-_O�� 1 _==t_===a_ R.O. R.O. 32" 32' R.O._=______-__ 32" u x `� � (W283 I ) ( 283 I O) (W2831 O) 7 Z � 4 I Ova a v r m V.I.F (m V.I.F 4 L)0 �R- LOCATION TO { LOCATION TO C OIS i . EXISTING RIDGE EX15TING RIDGE 4 4 V II R.O. R.O. 32" 32" w ;I (A281) (A281) a ✓�'•7 � II y Z Li_ li/a� 29'-4 „ iti� p Z o� z `VCA ��� 1, T 6"c.h. - n D� o o 41; o ` u CD f U� A_4 u � 4 � uy ( O DN 4 u 73 - I R.O. R.O. 4 li c 1 32" 32" x ---------------------------------- �I (A281) (A281) o it ^ — LOCATION TO II - 0 LOCATION TO �` 4 O II O - EXISTING RIDGE - EXISTING RIDGE @'ACO O III ------------- _______'____ d h I 41 -- u R.O. R.O. R.O. u 32" 2" 32" (A281) A281) Ij C\ _ — ---------------------L--------------------L _4 3'-2" 1'-10' R.O. 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F N 0 � of h - J U N 76 -6 N � N ►— mU SHEET NO: A- 5 2 New Side Elevation 3/1 G - I -0 I CONT. RIDGE VENT o 0 (2) 2X 10 HEADER z Li FIXED TO 2X 12 RIDGE z c) f Z H %o� aka yd zUL) OLTop of Rid e — — — — — — — 12 a a G x aad 'man ----=------------ 2x8 RO L)� M ----=--- -- pF JOISTS 6 ------------ 2 ------ ----- @ / To of Dormer I V.1.F 1 2 1 O•C. OLTop of Plate z u II r--- AWNING WINDOW zz j I I I ca 0 New Walls �I New Shed Dormer ��! z5 U _ CEDAR SIDING TO � II I .. . Q MATCH EXISTING I I RUBBER EPDM MEMBRANE W/CONT. HORIZONTAL CV li I OZO ° FLASHING W/DRIP�2" t SYSTEM W/ICE E WATER SHEILD 0 OVERLAP @JOINTS = II I New Roo I ALL OVER IT -1 5# FELT 5/8" 1/2"CDX PLYWOODSHEATHING > II I ARCHITECTURAL ASPHALT ROOF CDX RAFFlYLTERS @ ID SHEATHING 2X8 j DOUBLE HUNG TYVEKHOU5EWRAP II I RAFTERS @ 16"O.C. (SEE WINDOW 2X4 STUDWALL @ I G"O.C. 00 II I SHINGLES 30 YEAR MICE ( WATER FRAMING PLAN) 71/2 " cD TITL-WASH 3 1/2"FIBERGLASS I I II SHEILD 3 ft ABOVE DRIP EDGE 4-15# FIBERGLASS BATT INSUL. R-30 BATT INSUL.R-13(MIN)W/ i, 4 4 FELT 5/8"CDX PYLWOOD SHEATHING (MIN) 1/2"GYP BOARD ON IX3 r 1/2"BLUIfBOARD 4 SMOOTH 2X 10 RAFTERS @ I G"O.C. (2) 2X 10 STRAPPING @ 16"O.C. W/ E PLASTER SKIM COAT HEADER SMOOTH PIASTER SKIM COAT O LL: (SEE FRAMING PLAN FOR LOCATION) C O j _' > O II Oo i 00 v o EXISTING FLOOR 2X 10 JOISTS O 00 , / 4i 2nd Floor � a I I / F in o Z, NEW ROOF AND DORMER 75 +� / Of, I�- civ SHEET N0: 5ECTION THRU NEW 5HEDDOKMEK5� A- G _ 1 3/81I _ 1- - itO E U E- - zUU v �w (2) 2X 10 HEADER d p F a FIXED TO 2X 12 RIDGE 5� kTop of Rld e _ 12 zo w V.I.F. - -- --- - ----- - - - -- - 2X8 ROOF JOISTS y� 6il-To�—of Dormer C• l ' OZ kTop of Plate %� - — - — — — `• o L . ' z5 �____=__� • a� r— —n—IF--I New Walls �=' I I/ �I I° �Wol 0z • CEDAR SIDING TO j I) = r_, _;II F 0U MATCH EXISTING ,i III // II II �� I II W/CONT. HORIZONTAL II lL_ II�L PLASHING W/DRIP*2" New 5hed'=D6t1 =�— OVERLAP @ JOINTS = e'i New Dormer Roof DOUBLE HUNG L 1/2"CDX PLYWOOD5HEATHING > RUBBER EPDM MEMBRANE WINDOW- 4) LL TYVEKHOUSEWRAP ' SYSTEM W/ICE*WATER 5HEILD - TITLWASH E 2X4 STUDWALL @ I G"O.C. �I J ARCHITECTURAL ASPHALT ROOF SHINGLES 30 LQ 3 1/2"FIBERGLASS YEAR MICE*WATE R O 5HEILD 3 ft ABOVE DRIP ALL OVER IT 15# FELT 5/8" BATT IN5UL. R-13(MIN)W/ DOUBLE HUNG CDX PYLWOOD SHEATHING 2X8 - 1/2"BLUEBOARD�SMOOTH �` WINDOW EDGE�15#FELT 5/8"CDX PYLWOOD RAFTERS @ I G"O.C. (SEE O PLASTER SKIM COAT SHEATHING 2X6 RAFTERS @ 16"O.C. 2X8 TITL-WASH FRAMING PLAN) 71/2 " HEADER FIBERGLASS BATT IN5UL. R-30 / E�FRA EINRGSNBOR ATT INOSUL.IOR-30(MIN) (MIN) 1/2"GYP BOARD ON IX3 �� o '` N 1/2"GYP BOARD ON I X3 STRAPPING @ I G" STRAPPING @ I G"O.C. W/ _ > O.C. W/SMOOTH PLASTER SKIM COAT SMOOTH PLASTER SKIM COAT n z Sao ( O I w j 00 2nd_Floor EXISTING FLOOR 2X 10 JOISTS a F can o ___ �; i CD Fir NEW ROOF AND DORMER 5 o Q/0 N cm U SHEET NO: SECTION THRU NEW DORMER. A- 7 1 = 318 11 I 1 - IIO 60 PLAN REFERENCE CONTOURS 61 �� ' PLAN BOOK 272 PAGE 58 EXISTING - - - - - - - 50 ` 62 ASSESSOR'S MAP: 191, MINIMAL, GRADING PROPOSED Locus LOT: 231 m I'SO°° ft — BENCH MARK TP-1 TOP OF CONC BOUND ® ELEVATION - 62.09 BARNSTABLE GIS DATUM CL-M / I CENTERV/LLE. MA / LOCUS MAP 2 4-1 � NOT TO SCALE T -2 O O O / o C� O 0 60 VENT PIPE m o o /,j LEGEND 24 ft x 12.5 ft x 2 ft ' 1 Qj o - EXISTING / LEACHING GALLER JI I I �� I000 GALLON ' SEPTIC TANK \ O( WATER WATER l D-BOX O !2-P m ~ I L//�/E GATE o / o TES T PIT 6/ - LOT 86 J EXISTING O AREA /5000 sf +- �o p �� ' f 1 LEACH PIT r �R/�Elyq Y �J UTILITY POLE -� PLAN GAsi L/NE DRAIN 62 — O SCALE: l in = 20 ft 'S000 ft � —� TREE 63 _ GAS -NUMBER REFERS TO DIAMETER 63 GATE IN INCHES. LETTER DENOTES TYPE I 0-OAK M-MAPLE P-PINE FLOW PROFILE ALL PIPE ELEVATIONS SPECIFIED ARE INVERT ELEVATIONS VENT PIPE TOP OF FOUNDATION RAISE COVERS TO WITHIN 6 in OF FINAL GRADE EL - 64.04 +— ONE INSPECTION RISER FOR I[ LEACHING GALLERY 6225 /D- X MAX 2- LAYER SEWAGE DISPOSAL SYSTEM PLAN �3- DROP -TO SERVE EXISTING DWELLING FLOW LINE �(D VID MICHAEL & VALERIE THOMAS 10- - 14- 'a�,� PRECASTN3 3/4'-I v4' �� DAVID GN 48- GAs�a M"t, .sr `Ar°� +s y..: STONE p 37 THOREAU DRIVE CENTERVILLE. MA BAFFLE �RYWELL BOTTOM OF COUGHANOWR N 6 in 60.30+— SOIL ABSORPTION ECO-TECH ENVIRONMENTAL L - STONE 58.63 SYSTEM No. 1093 Ex�TMG EXISTM BASE LEACHING �Fc �° 43 TRIANGLE CIRCLE SANDWICH MA 0256 EXISTING 58'$° GALLERY �STE� 58.50 5.00 ft + ETA N �> 508 364-Q894 ewaTING (END VIEW) ss.5o IOOO GALLON — ETE-2162 I AUG 21. 2005 /q 1172 EwSTING SEPTIC TANK 20 ft o) 5 {+ 12.5 f1 ��VSf 21 2005 THIS PLAN IS TO BE CONSIDERED A DRAFT PLAN UNLESS IT b) 14 f+ BEARS THE STAMP AND SIGNATURE OF THE DESIGN ENGINEER ADJUSTED 37.0o ORIGINAL PLANS INTENDED FOR SUBMITTAL TO THE BOARD SEASONAL HIGH OF HEALTH WLL BE SIGNED IN BLUE AND STAMPED IN RED. GROUNDWATER DATE OF TEST: AUGUST 20, 2005 SOIL TEST - LOG SOIL EVALUATOR: DAVID D. COUGHANOWR. IRS CALCULATIONS, S ' WITNESS REQUIREMENT WAIVED - NO VARIANCES SOUGHT NO GROUNDWATER TEST PIT I PARENT MATERIAL: PROGLACIALDOUTWASH DESIGN FLOW: 2 BEDROOMS X 110 GPD - 220 GPD ELEVATION - 62.50 •- PERC AT 66 in : 2 MIN/INCH IN C SOILS SEPTIC TANK: 220 GPD X 2 DAYS - 440 GALLONS DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER USE EXISTING 1000 GALLON SEPTIC TANK IF IN SOUND STRUCTURAL (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED) 62.50 0-6 A SANDY LOAM 10 YR 2/2 NONE FRIABLE DISTRIBUTION BOX: USE 3 OUTLET D-BOX. 6-44 B LOAMY SAND 10 YR 5/6 NONE LOOSE SOIL ABSORBTION SYSTEM: A 24 ft x 12.5 ft x 2 ft LEACHING GALLERY CAN LEACH 58.83 44-150 C MEDIUM TO 10 YR 6/4 NONE LOOSE - COARSE SAN Abot - ( 24 x 12.5 ) 300 sf 50.00 Asdw _ ( 24 + 24 12.5 ; 12.5 ) x 2 - 146 sf Atot 446 sf Vt 0.74 x 446 330. 04 GPD NO GROUNDWATER ENCOUNTERED USE A 24 ft x 12.5 ft x 2 ft GALLERY. Vt - 330.04 GPD > 220 GPD REQUIRED TEST PIT 2 PARENT MATERIAL: PROGLACIAL OUTWASH _ ELEVATION - 62.10 +- PERC AT 64 in : 2 MIN/INCH IN C SOILS DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER (INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING 62.10 0-8 A SANDY LOAM 10 YR 2/2 NONE FRIABLE 8-42 B LOAMY SAND 10 YR 4/6 NONE LOOSE LEACHING GALLERY 500 GALLON DRYWELL 58.60 42-120 C MEDIUM TO 10 YR 6/4 NONE LOOSE DMNSIONS AND DETAIL COARSE SAN LWH-lO UVT 52.10 CONSTRUCTION DETAIL RYWELL UNIT INSTALL ONE INSPECTION D RISER TO WITHIN SIX STONE E 8'-6'x 4'-10'x 2'-9' FINAL RAVE ., INCHES OF L G 2 h EFF. DEPTH AND INDICATE LOCATION 24.0 f t ON AS-BUILT PLAN 0 i T � N O 1 E S oLn ` 0 33 '^ v ci opop 0�� in 0 0 00 c; - poo�oopppop OOpvO - o 0 0 pp pp op 000 I) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN � pppp�ppppp� �� 2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM. 3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS 3.5' 8.5 8.5' 3.5 I MR 15) NOT TO 142 in SEPTIC CODE (3 O C T TITLE 5 SE C OD ACHUSET S OF MASS 24.0 ft 4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES SCALE BEFORE EXCAVATING FOR SYSTEM. 5) EXISTING LEACH PIT TO BE PUMPED, COLLAPSED. AND FILLED. OR REMOVED 6) ALL STONE TO BE DOUBLE WASHED AND FREE' OF- IRON. FINES AND DUST IN PLACE 7) LINES EXITING D-BOX TO .RUN LEVEL FOR 2'-0" BEFORE PITCHING DOWN GROUNDWATER ADJUSTMENT SEWAGE DISPOSAL SYSTEM PLAN 8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALIrATION OF LOW FLOW FIXTURES EXISTING GROUNDWATER LEVEL -TO SERVE EXISTING DWELLING AND APPLIANCES. AND BIANNUAL PUMPING OF -THE SEPTIC TANK BASED ON TOWN OF BARBSTA.BLE 9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR,'LOADING. DO NOT GIS DEPARTMENT RECORDS. MICHAEL & VALERIE THOMAS PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. . INDICATED GW 35.00 37 THOREAU DRIVE CENTERVILLE. MA 10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. INDEX WELL SDW-252 ZONE II) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL READING DATE DJULY. 2005 EC0-TECH ENVIRONMENTAL STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH READING 46.7 SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING ADJUSTMENT 2.0 43' TRIANGLE CIRCLE SANDWICH MA 02563 12) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED ADJUSTED GW 37.00 FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. ETE-2162 AUG 20. 2005_ 2/2