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Home My WebLink About0114 VICTORIA STREET - Health 114 VICTORIA ST., CENTERVILLE A=148-074 a �7 � uu UPZ 25 R �fita NASTWII#911 TOWN OF BARNSTABLE LO=.-.A T ION SEWAGE # VIa r�LAGE K v) I LIP ASSESSOR'S MAP & LOT t t INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY C0 0 LEACHING FACILITY: (type) L (size) lOW NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist 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 �4`� F S F g M 3) �f b d Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessment,- ,M 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out 314forms on the vI/��computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name reb PO Box 1487 Company Address Marstons Mills MA 02648 eNm City/Town State Zip Code 508.428.1779 SI 12855 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 7� June 4, 2013 Job # 13-45 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. t5ins•3113 Title 5 Official In p c o Form.Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Tank was not in need of pumping at time of inspection, leaching system had 1" of standing water. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): 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 01 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ 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 w„ 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: 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 jround 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_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 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every 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. 1 have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water�iapply 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. CityrFown State Zip Code De:.o of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4 2013 every page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (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 ears usage d N/A Irrigation g ( y g (gp )) system. Detail: Sump pump? ❑ Yes ® No Last date of occupancy: CurrentlyOccupied. 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 s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Victoria Street Property Address Corrieri Owner Owner's Name information is Centerville MA 02632 June 4, 2013 required for every page. City/Town 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: Tank pumped July 2012 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspectic•n 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 Form: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 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Leaching system installed in 2009 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 8"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: 8.5' long x 5.2'wide - 1000 gal. Sludge depth: 2 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. Cityrrown 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 28" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Liquid level was at bottom of outlet invert and tees were 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 s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): a 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 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): No solids or high stains present. 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•3113 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 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 4 Infiltrators. ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Interior of infiltrators were video inspected and found 1" of standing water. 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w„ 114 Victoria Street Property Address Corded Owner Owner's Name information is required for Centerville MA 02632 June 4, 2013 every page. CityfTown 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 ^ ��\ Commonwealth of Massachusetts - - , ��^�� ~��:�~��~��N N��%��*��^�� 0°N�� | Title �� y� � ��*�� Inspection Form ��, xwn � ' ' -' _ _ -- - - ' -- '_-' -' '.~ ~' - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Victoria Street __ ---_ Property Address Auureus Corrieri o=nr, ----------------' -- ----' ' - -----' ——'----- '----------------- -------- ----- ownnrawamo information is required for Centerville _ _ MA_ _ 02632 June4 2013 every page, cuyrTown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including den 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 be|ow� [K hand-sketch in the area below El drawing attached separately | � 37 34 00000.....0.......... � | Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 114 Victoria Street Property Address Corried Owner Owner's Name information is Centerville MA 02632 June 4, 2013 required for _ every page. City/Town State Zip Code Dat-,of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 20+feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: pate ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers - (attach documentation) ® Accessed USGS database-explain: USGS topo map. You must describe how you established the high ground water elevation: Topo map shows property considerably higher than any ponds in area. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 114 Victoria Street Property Address Corrieri Owner Owner's Name information is required for Centerville MA 02632 Julie 4, 2013 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 i-- No. [[✓✓ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZLppgicatton for Ttgponr qppgtem Cott0tructtott permit Application for a Permit to Construct( ) Repair(.4 Upgrade( ) Abandon( ) ❑Complete System U<ndividual Components Location Address or Lot No. 11 q V``hp/-/a, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Ced ®rl'jer Installer's Name,Address and Tel o. Designer's Name,Address and Tel.No. gorypl � 0�6/"=,7�l_ � awl? e5��ace Type of Building: Dwelling No.of Bedrooms 3 Lot Size 146 O Z5—sq. ft. Garbage Grinder (�tv Other Type of Building `$A ear& No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.requi d) 330 gpd Design flow provided 3q® gpd Plan Date 17— Z © Number of sheets Revision Date Title 5 6/ le- iq g ,/l�° S• Size of.Septic Tank ��(,/�` /f9� Type of S.A.S. w Q Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in acco0ance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Comwliance has been issued by this Boa of Healt . Signe Date Application Approved by Date Application Disapproved by: KIY Date for the following reasons 9 Permit No. -'' Date Issued ..•+ lei'`�..c � �; f �� / t� � '� .. No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application forjf5po�aY '*pgtem Cottgtruction Permit Application for a Perm fto;ConstructO Repair((Upgrade(-) 'Abandon O ❑ Complete System LJ Individual Components n Location Address or Lot No. I f!� ��'�Qr��' 1 Owner's Name,Address,and Tel.No. ' Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.ot" Type of Building: Dwelling No.of Bedrooms i t Lot Size l 6 0 ZJ sq. ft. Garbage Grinder (/LOep n p Other Type of Building �PS� Lp�G(r No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �/? © gpd Design flow provided ,3ef gpd L k Plan Date C /Z 1106 Number of sheets Revision Date Title ✓ i /Cry //y ��iG�J',r sy Size of.Septic Tank /i0� �X/,$�`/�79 Type of S.A.S. rDescription of Soil Nature of Repairs or Alterations(Answer when applicable) f kt y I 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:of Healt.,. Signed?/ /4 Date Application Approved by �!_//t/`// / //��C /�i �/�t �1�/��1.1�f i( 7t�`�.�' Date Application Disapproved by: V ( / \. V f Date v t for the following reasons Permit No. O E/ / /(/ Date Issued I / ry / U THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On/-site�S[e age Di posal System Constructed ( ) Repaired ( k Upgraded ( ) Abandoned /( )bye/ j,ny©�r �Q< ' 5," �0/�� • at �/ y f/!C / 0/^Aq c.�/ (r & /�/fha� /end constructed'in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.C/�(/( � L�`/ dated Installer Designer #bedrooms `� Approved design flow / � gpd The issuance of this permitIs / tbeconstruuJd as a guarantee that the system will tfunctJ�i��t"as ignedi Date / / Inspector �'l/< � ti G� No. / �+[ �../ �C/ Feed~_ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION=BARNSTABLE, MASSACHUSETTS Tfgpoar �&p5tem Con5truction permit Permission is hereby granted to Construct Repair ( y) Upgrade ( ) on ( ) System located at 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 rbe co/m`pleted-within three years of the date of this permit. . Date / / / Approved by / / . .. -f•OM :down cape engineering ire ; FAX NO. :15083629880 Jan. 15 2009 12:51PM P1 Town of Barnstabic Regulatory Servkes M Thomins Y, tneileti•,T)axecdor Pubfi� Health Division r ° 'f.'homus McKean,Director 200.MOin,Strrct,Hyannis,MA (1,2601 Office: 508-862-4644 FaK: .508-790-6304 AubstaHe.r&6Desjp_ner(.'crtitflea Lion Form IDaatc: ©�—� ,Saw949e Permit# �®l 7 Assessor's]V a t': !_..... g�1..�rcel_ Designer. JJOwr✓E_ Address: Address: � Q��OX /V l / Y). no �Z`/s oo - ( 11 006 ...... 6nlwas � issued it permit to 1)s�tali a (date) (insaal.lcr) Lj septic system at 1 7 Victor",- cf�- —based ou a desip drawn by (address) c�1Q. dated (.A ) I certify' that the septic system referenced above was installed substantially according -to the design, Much may include minor approved changes such as lateral.relocation of tlzc di.,4xiNtion box and/or-septic tank, T certify that tho septic system referenced above was installed with tntjiin changcs (i.e. grca.ter than 10' lateral.relocation of the SAS or acty vertical re.loca.tiou of any eompononL of the septic syste►.xt)but in accordance'witb. State &T,(.ica.l Regulatloils, Plan revision or certi_1:i.ed as-built by designer to follow, fn DANIELA, (! OJAI A ti _testa S SignatuFe) CIVILNo.46.902 �t (Designer's Signat��,re) (fix Designner'!.Stasup*Here) LEASE AF..VTTRN 1'l? �saztvrAt;Trr. IIiEAli:D'8i ' >nTV�SiaBN. cfaTTT I:C:A'ro, c>�' �;'d➢:IVAI'LIA iQ:�VM,L 1®O]' BE USSITJf';lD UN'.a IT, RO'd'll 'IIHT.S . R [9f�11�_AS-D.T-H_,' ' CARD ARE I1I:C1AVHlt1VH,Ti BY THE 1TA1 NSTARI.,F,PUBLIC HFAi.,7['II DIVI TON. '1'I1[A:l`K YO R -- Ilcal.th/Septic/i?e.,iguor 'vr,IIcation Vbnn 3-26-41.Aac � is 4 ooa- a9� Town of Barnstable P# Department of Regulatory Services ' t Public Health Division Date EM �A �b �e 200 Main Street,Hyannis MA 02601 ' Date Scheduled Time . Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: LOCATION& GENERAL INFORMATION ' Location Address /1 t/% 6-J-9 r 6L . Owner's Name Co r-P,,e�n - - ce-h vll 1(f Address Assessor's Map/Parcel: f�8- 71. Engineer's Name (I e NEW CONSTRUCTION REPAIR Telephone# �-O& C /�- Land Use / Slopes(%) 0 Surface Stones � �Y Distances from: Open Water Body I>ICJ ft . Possible.Wet Area ( U� ft Drinking Water Well Drainage Way / ft Property Line G V ft Other ft t r-3 r. SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands?a pro 'mity to hc1w ., 1 r 6�Parent material(geologic) ��Z'/�'�S Depth to Bedrock _ - Depth to Groundwater: Standing Water in Hole: N Weeping Train Pit Race Estimated Seasonal High Groundwater AJ I— DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: In, Depth to soil mottles: Depth to weeping from side of obs.hole: ____�.�F�m In, Groundwater Adjustment ft• Index Well# Reading Date: Index Well level 9 ��„ Adl,factor.-,T� Adj.Oroundwater Level PERCOLATION TEST Dalez oi<T n e Observation Hole# Time at 9" ��! �✓�' Depth of Perc Time at G" Start Pre-soak Time @ _ Time(9"-G") - End Pre-soak, -� Rate Min./Inch Site Suitability Assessment: Site Passed _ Site,Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one (1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Sdil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones;Boulders. ^ Con istenc m ravel DEEP OBSERVATION HOLE LOG Hole# Depth from .Soil Horizon Soil Texture Soil Coior Soil Other Surface(in.) (USDA) (Munsell) Mottling , (Structure,Stones,Boulders. C nsis enc °lo Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consiste c 90 Gravel V DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency, l Flood Insurance Rate Man: Above 500 year flood boundary No Yes Within 500 year boundary No Yes Within t00 year flood boundary No Z Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring p7PV ' ist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring i s material? Cert— fication I certify that on 7/ date)I have passed the soil evaluator examination approved by the Department of EnviroAmenial Protection and that the above analysis was performed by me consistent with . the required train' ,expertise xp rience described in 310 CMR 15.017. Signature /Z Date V Q:\SEPTIC\PERCFORM.DOC I I A - ® o-a •a64e o 8' 1 p d m Al 11 a 1.3gnc �O mO aq a-,ai-so r 04, a` 1 .�°'� d ® , 1p 4 O 78-46 It Al 9 �\ O~ L \\aP O ^f 4bilYY'fj'I_'.til"�F. 1 �f ',qPa` $ aq�� ® ��0� d4�� y♦po %° IJ IIi�f a 'ro o L®d' 00 \m O moo ^ '3II4ir 1.� ;�` � ® +�" o ,. • aI Oo � � • �� (iw g �p41 NO 0 tp i► \�V' a V i¢ a � `� �p �by ' ® O Z-3 O P�Pvt (O V 1 141 _S6<£. 0 .O6 c� O •AP w07�017 e.Iy �� O •" �4V � `� ail r6 i .45 Ar- Kati P 96 ® i 44s7 A9,us co :144 oe ` js PA m 87 ed� REV. 8 . AV/S l9Y0 4�`�,° :. -••�� w \ IGINAI ISSUE: 1968 x�: I . Anne & Al Corrieri 114 Victoria Street Centerville, MA 02632 December 8, 2008 Cn Barnstable Health Department r 200 Main Street -e ; Hyannis, MA 02601 - �' r Re: Septic System at 114 Victoria Street, Centerville `n Dear Health Inspector: After speaking recently with Donna Miorandi, we understand that your department records indicate that our home on Victoria Street in Centerville is classified as a 2 bedroom home—thus can only accommodate a septic system for a 2 bedroom house when, in reality, we have a 3 bedroom home. I would like to make you aware of the following information/facts in the hopes to clarify the number of bedrooms and have you change your records to coincide with ours as well as other Barnstable town records. i 1. The original home owners of the property, Louis and Evelyn Maloof, built and purchased the home in December of 1983. They were continual year-round residents in the home until we purchased the house on July 6, 2000. 2. The house is a 3 bedroom home and not a 2. I have attached a copy of the following for your consideration and documentation that our home is a 3 bedroom: • a copy of the real estate listing from 2000 indicating that the house was being sold as a 3 bedroom home. • a copy of the Title V inspection from 2000 which indicates that the house has 3 bedrooms. • a copy of Barnstable's Property Assessment.of our house which states that we are assessed (and have been assessed since we purchased the home) for a 3 bedroom house.. • a sketch of the floor plan of the entire home showing the 3 bedrooms Should you have any questions or need further documentation from us, please contact us at our home (508) 420-3744 Very truly yours, e A --, , n oj�� C Al ed N. Corrieri, Jr. Anne S. Corrieri Att. Acknowledgment On this /D day of , 2008, before me, the undersigned notary public personally appeared, Alfred N. Corrieri, Jr. and Anne S. Corrieri proved to me through satisfactory evidence of identification which was g2z'Vs � to be the persons whose names are signed on the attached document and acknowledged to me that they signed it voluntarily for its stated purpose. Notary Public My Commission Expires: 0-U-'-'U�'& 024/ r 1 1 C M GO I I ML# : 2002125p St:ACT Cat: SF LP: $229, 900 Addr: 114 VICTORIA ST Town:BARN Barnstable Zip: 02632- � - Vil1 :CEN Centerville County:BARNSTABLE ` Subd: Map# : 148 Par# : 074 ---------------------------------------------- -Bedrdoms `..`�.�T3-- Bsmt Baths : . 0 Waterfront:N Full Baths :2 Levl Baths :2 . 0 Waterview: N Half Baths : 0 Lev2 Baths : . 0 Mi/Bch:2+ MI Rooms : 7 Levi Baths : . 0 Poo1 :N Levels : 1 Basement: Y Dock:N # of Cars : 2 Fireplace: Y Yr Blt: 1983 Garage:Y Year Round:Y ACTUAL ---------------------------------------------- Room Levels and Dimensions Living: 1 15 . OX20 . 0 Mst. BR: 1 14 . OX15 . 0 Laundry:B X Sep Liv Qtrs :N Family: X Bedrm 2 : 1 11 . 0X12 . 0 X Dining: 1 14 . OX11 . 0 Bedrm 3 : 1 ll . OX12 . 0 X ___,K tchen : 1 13 . OX23.0 Bedrm 4 : X_- — X Foyer: l 5. OX 8 .0 ------------------------------------------------------------------------------ Foundation-Main Width: 42 Association:N Mbrshp Req:N Acres : . 37 Main Depth: 52 Ann Asc Fee: $/ Rd Frntg: 120 Irreg: Y Wing Width: Undgrnd Fuel:N UFFI :N Lot Depth: Wing Depth: Asbestos :N ' Lead Paint :N Cert/Treat:N ------------------- ----------------------------------------------- ------------- BCHDES-Ocean BCHOWN-Public SLVQTR-None STYLE -Ranch LIVSPC-1, 801to2, 200 GARAGE-Attached GARAGE-Door Opener POOL -None DOCK/M-No Dock HTCOOL-AC-Central HTCOOL-Natural Gas HTCOOL-Hot Water UTILS -Priv Sewer UTILS -Town Water UTILS -Gas UTILS -Telephone UTILS -Cable -TV HOTWTR-Natural Gas HOTWTR-Tank STREET-Public STREET-Paved EXTFEA-Deck EXTFEA-Insul Wndws EXTFEA-Screens EXTFEA-Storm Doors LVROOM-Fireplace LVROOM-W/W Carpet DNROOM-W/W Carpet KITCHN-Vinyl Floor KITCHN-Sliding Door KITCHN-Dining Area MBROOM-Pvt Mstr Bth MBROOM-Closet BASEMT-Full BASEMT-Bulkhead Acc BASEMT-Interior Acc FLOORS-Tile FLOORS-Vinyl FLOORS-W/W Carpet EQ/APP-Dishwasher EQ/APP-Range - Gas INFEAT-HU-Cable TV INFEAT-HU-Dryr Elec INFEAT-HU-Washer INFEAT-Linen Closet LOTDES-Level LOTDES-Interior FOUNDN-Concrete SIDING-Shingle SIDING-Clapboard ROOF -Pitched ROOF -Asphalt CONVEN-Shopping CONVEN-Golf Course CONVEN-Church DOCS -No Documents FLDPZN-Not in F1dP1 SHWINS-Appntmnt Req ------------------------------------------------------------------------------ Total- --Asmt : 137, 500 Ann Taxes : - -- - _ -$0/2000 Title Ref:3951 Land Asmt : 31, 000 Ann Bettrmt : 0 Plan: 182 Imprmts Asmt: 106, 500 Unpd Bettrm: 0 Zoning: RE To Be Assessed:N Spec Assessment: Mass Use: 101 SINGLE FAM ------------------------------------------------------------------------------ WONDERFUL CUSTOM BUILT RANCH WITH AIR COND. , 2 CAR, 6 FT. FIREPLACE, LG FOR MAL DINING RM. (CHANDELIER EXCLUDED) , FLORIDA RM WITH AWNINGS, NICELY LANDSCAPED NEEDS TO CLOSE ON JULY 6 OR7 AND STAY ONE WEEK IN THIS HOME CALL JUDY TO SHOW 7902303 X23 OR 7711347 Dir:NYE RD. TO RT. ON NOTTINGHAM TO LEFT ON BERNARD TO LEFT ON VICTORIA ------------------------------------------------------------------------------ Owner:MALOOF Contract Type :ER Orig LP: $229, 900 LO: TODAY REAL ESTATE (508) 790-2300 Ext : 23 List Date: 03/31/2000 LA:JUDITH SMALL (.508_)_ 771-1347 Ext : Exp Date SAC : 2 . 5 BAC:2 . 5 DDAC: O Othr Comm: O DOM: 14 ----- Information Deemed Accurate but not Guaranteed. ----- Copyright: 2000 by Cape Cod & Islands MLS, Inc.' 04/13/2000 14 : 02 Prepared by. Jacqueline Johnson on April 13,2000 -e-a- COMMONWEALTH OF MASACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET BOSTON MA 02108(617)292-3500 TRUDY COXE ARGEO PAUL CELLUCCI Secretary Governor DAVID B.STRUHS Commissioner _SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 114 VICTORIA_ ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF = Address of Owner: 114 VICTORIA ST.CENTERVILLE,MA 02632 Date of Inspection: ---4/20/00--- -- . Name of Inspector: JOHN GRACI I am a DEP approved system inspector pursuant to Secdon 15.340 of Title 5(310 CMR 15.000) Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02636 Telephone Number: 508-564-6813 FAX 508-564-7270 C RTIFI .eTtON STA tier iT 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 inspection.The inspection was maintenance of on-site sewage disposal systems.The system:.performed based on my training and experience in the proper function and X Pa — Conditionally Passes _ Needs Further Evaluatl5n yy the Local Approving Authority Fails Inspector's Signature: Date:4119100 The System Inspector shall subgfd a copy of this inspection report to.the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection.If thelsystem is a shared system or has a design flow of 10,000 gpd or ,the tor and the system shall submit the report to the appropriate regional office of the Department of Environmental Prrotection.ter The original should be sent to the caner system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS "The inspection is based on criteria defined in Title V code 310 CMR 15.303.My findings are of how m is performing at the time of inspection.My system the inspection does not imply any warranty or guarantee of the longevity of the septic system and any of its a syste components useful life." THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS FOR PROPER MAINTENANCE. revised 9!2i98 Pagel of 11 .. .... .... .... . ... . .... SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: .X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. 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. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If'not determined",explain why not-. Wa The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance ._ attached)indicating-that-the-tank was-installed-within twenty(20)years prior to the date of the inspection;or the septic tank, whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. D& Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or-uneven distribution box.The system will pass inspection if(with approval of the Board of Health). _broken pipe(s)are replaced _obstruction is removed _distribution box is levelled or replaced n1a The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if (with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed revised 9098 Page 2 of 11 _..------..--_----___._-_ a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 C. .FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions epst which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and 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 ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water - Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER.IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance n(a(appro)amation not valid). 3) OTHER n/a revised 9/2198 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid q d level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, --- - X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Q. X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, X 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.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. - ..-_..._....--- E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of-the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist- Yes No X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or mapped Zone II of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised-9/2/98 ___ Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner: LOU MALOOF Date of Inspection: 4120100 Check if the following have been done:You must indicate either'Yes*or"No'as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health. X = None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtainetl and examined:Note if they are not available with N/A. X _ The facility or dwelling was inspected for signs of sewage back-up. X _ The system does not receive non-sanitary or industrial waste flow. X _ The site was inspected for signs of breakout X _ All system components,excluding the Soil Absorption System,have been located on the site. X _ The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X _ Existing information,For example,Plan at B4O,H, X _ Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)1 5.302(3)(b)] X _ The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2/98 __ -- —----------_-_--- Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4120/00 FLOW CONDITIONS RESIDENTIAL- Design flow: 110 g.p.d./bedroom Number of b d_rooms(design) 3 J Number of bedrooms(actuao: Total DESIGN flow: 330 gpd Number of current residents:2 Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no): NO " — easonal use(yes or no): NO -- ------__ Water meter readings,if available(last two year's usage): Na gpd Sump Pump(yes or no): NO Last date of occupancy. Na GOMM R -IA nND 1 TRIA Type of establishment: Na _ Design flow: Na gpd(Based on 15.203) Basis of design flow-Na — — — ----- - — _ Grease trap present:(yes or no): NO Industrial Waste Holding Tank present:(yes or no): NO , Non-sanitary waste discharged to the Title 5 system:(yes or no):NO Water meter readings.if available: Na C-) Last date of occupancy:Na OTHER: (Describe) it! Na p r GENERAL INFORMATION - _._ ................ . PUMPING RECORDS and source of information: Na System pumped as part of inspection:(yes or no):NO If yes,volume pumped Na gallons Reason for pumping:Na TYPE OF SYSTEM X Septic tank/dishibution box/soil absorption system _ Single cesspool _ .Overflow cesspool — Privy _ Shared system(yes or no)(if yes.attach previous inspection records,if any) UA Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other:Na APPROXIMATE AGE of all components,date installed(if known)and source of information: 1983 Sewage odors detected when arriving at the site:(yes or no) NO revised 9/2/98 g ---.--P-a e 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 BUILDING SEWER.X (Locate on site plan) Depth below grade: 12" Material of construction: _ cast iron _ 40 Pvc X other(explain) Distance from private water supply well or suction line: n/a Diameter. n1a Comments: (condition of joints,venting,evidence of leakage,etc.) THE SYSTEM HAS TOWN WATER — — ---- - - SEPTIC TANK: X (locate on site plan) Depth below grade: 6" Material of construction: X concrete metal Fiberglass_ Polyethylene_ other explain: n/a---------If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 1000G L 9'H 6'W 5'3"H20" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: n/a - How dimensions were determined: MEASURED Comments: (recommendation for pumping,condition of inlet and.outlet tees or baffles,depth of liquid level in relation to outlet-invert,structural.integrity,evidence of leakage, etc.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.-RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. GREASE TRAP: _ ocate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_ Fiberglass _ Polyethylene_other Explain: n/a Dimensions:n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a Date of last pumping: n/a Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) n/a revised 92198 Page 7 of 11 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal:Fiberglass _Polyethylene _other Explain: n1a Dimensions: n/a Capacity: n/a gallons Design flow. n/a,. gallons/day_.___ Alarm present: NO Alarm level:N/A Alarm in working order.NO Date of previous pumping: n/a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) - n/a DISTRIBUTION BOX:X (locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) THE DISTRIBUTION BOX IS STRUCTURALLY SOUND. r PUMP CHAMBER: _ (locate on site plan) Pumps in working order.(Yes or No): NO Alarms in workingorder -- (Yes or No): NO - -- --- -- Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) n1a revised 912/98 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4120100 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: n/a Type: leaching pits,number.(1)1000 GAL 6'X 6' leaching chambers,number: (n/a)n/a leaching galleries,number. -(n/a)n/a leaching trenches,number,length: (n/a)n/a --— — leaching fields,number,dimensions: (n/a)Na overflow cesspool,number. (nfa)n/a Alternative system: n/a Name of Technology: n/a Comments: - (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) -THE LEACH PITS ARE STRUCTURALLY SOUND AND APPEARS TO BE_FUNCTIONING PROPERLY.THE PIT HAD 3'OF-WATER-IN-iT--AT—THE TIME— -- OF THE INSPECTION. CESSPOOLS: _ (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert; n/a Depth of solids layer. n/a Depth of scum layer. n/a Dimensions of cesspool: n/a Materials of construction: n/a indication of groundwater: n1a inflow(cesspool must be pumped as part of inspection)NO Comments: (note condition of soil,signs of hydraulic failure,level of.ponding,condition of vegetation,etc.) ...PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n1a Depth of solids: n/a Comments: - (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a revised 9/2/98 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4120/00 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) *'►ct ILL p A 1 Old C. 00 D a� 3� .4c se - AD r ay ,T �► i� B�'' a revised 912/98 Page 10 of 11 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE,MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 NRCS Report name: n/a Soil Type: n/a Typical depth to groundwater. n/a USGS Date website visited: n/a Observation Wells checked: NO Groundwater depth: Shallow_ Moderate_ Deep_ SITE EXAM _ Slope _ Surface water _ Check Cellar _ Shallow wells Estimated Depth to Groundwater 12 Feet+ Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record - Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records _ Checked local-excavators,installers --............._.....-... X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET revised 912/98 Page 11 of 11 Page 1 of 2 2008 Property Assessment Lookup Home: Departments:Assessors Division: Property Assessment Search Results New Search New Interactive Maps >> Owner: 2008 Assessed Values: CORRIERI,ALFRED N JR& 114 VICTORIA STREET Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $211,900 $211,900 148 /074/ Extra Features: $2,700 $2,700 Outbuildings: $0 $0 Mailing Address Land Value: $148,800 $148,800 CORRIERI,ALFRED N JR& CORRIERI,ANNE S Totals $363,400 $363,400 114 VICTORIA STREET- _ Residential Exemption Received=$105,082 CENTERVILLE,MA.02632 2008 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $50.99 Fire District Rates Town Barnstable FD-All Classes $2.04 $6.58 C.O.M.M.-All Classes $1.03 Commercial C.O.M.M.FD Tax(Residential) $374.30 Cotuit FD-All Classes $1.33 $5.80 Hyannis-Residential $1.53 Personal Proper Town Tax(Residential) $ 1,699.73 Hyannis-Commercial $2.35 $5.80 Hyannis-Personal $2.35 Other Rates W Barnstable-Residential $1.86 Community Prese W Barnstable-Commercial $1.86 W Barnstable-Personal $1.86 Total: $2,125.02 Construction Details Building Property Sketch & ASBUILT Cards Property Sketch Legend Building value $211,900 Interior Floors Carpet Style Ranch Interior Walls Drywall Model Residential Heat Fuel Gas Grade __ Average._. Heat Type Hot Water Stories 1 Story AC Type Central Exterior Walls Wood Shingle Bedrooms 3 Bedrooms Roof Structure Gable/Hip Bathrooms 2 Full file-HC-\T)OCTTMR,-1\nFFTC..F.-1\T.00AT.C...1\TPm,N\RS('QYTA7 btm 1 111nitArlo Page 2 of 2 Roof Cover Asph/F GIs/Cmp living area 1792 Replacement Cost $238088 Year Built 1983 i Depreciation 11 Total Rooms 6 Rooms Land CODE 1010 Lot Size(Acres) 0.37 Appraised Value $148,800 Assessed Value $ 148,800 -As--Built-Cards: I Y Uiew Interactive Maps >> Sales History: Owner: Sale Date Book/Page: Sale Price: CORRIERI,ALFRED N JR& Jul 6 2000 12:OOAM 13116/071 $224,500 MALOOF, LOUIS E&EVELYN F Dec 15 1983 12:OOAM 3951/182 $89;900 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL1 Fireplace 1 $2,700 $2,700 Property Sketch Legend BAS First Floor,Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport- - GRN Greenhouse -- UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished). SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) 5 Barnstable Assessing Search Results Page 1 of 2 Home: Departments:Assessors Division: Property Assessment Search Results New Search F New Interactive Maps Owner: 2008 Assessed Values: CORRIERI,ALFRED N JR& 114 VICTORIA STREET Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $211,900 $211,900 148 /074/ Extra Features: $2,700 $2,700 Outbuildings: $0 $0 Mailing Address Land Value: $ 148,800 $ 148,800 CORRIERI,ALFRED N JR& CORRIERI,ANNE S Totals $363,400 $363,400 114 VICTORIA STREET Residential Exemption Received=$105,082 CENTERVILLE, MA.02632 2008 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $50.99 Fire District Rates Barnstable FD-All Classes $2.04 C.O.M.M. -All Classes $1.03 C.O.M.M. FD Tax(Residential) $374.30 Cotuit FD-All Classes $1.33 Hyannis-Residential $1.53 Town Tax(Residential) $ 1,699.73 Hyannis-Commercial $2.35 Hyannis-Personal $2.35 W Barnstable-Residential $1.86 W Barnstable-Commercial $1.86 W Barnstable-Personal $1.86 Total: $2,125.02 Construction Details Proper1ftv Building �N ��yey14tch & AS® Building value $211,900 Interior Floors Carpet Style Ranch Interior Walls Drywall Model Residential Heat Fuel Gas Grade Average Heat Type Hot Water http://www.town.bamstable.ma.us/assessing/assess/displayparcelO8map.asp?map... 12/10/2008 i Barnstable Assessing Search Results Page 2 of 2 Stories 1 Story AC Type Central Exterior Walls Wood Shingle Bedrooms 3 Bedrooms Roof Structure Gable/Hip Bathrooms 2 Full Roof Cover Asph/F GIs/Cmp living area 1792 J 8 Replacement Cost $238088 Year Built 1983 ?_ 1113114,T Depreciation 11 Total Rooms 6 Rooms FOR 1 : b I Land ., 4 CODE 1010 Lot Size(Acres) 0.37 Appraised Value $ 148,800 Assessed Value $ 148,800 As Built Cards: 1 View_ Interactive M s Sales History: Owner: Sale Date Book/Page: Sale Price: CORRIERI,ALFRED N JR& Jul 6 2000 12:OOAM 13116/071 $224,500 MALOOF, LOUIS E&EVELYN F Dec 15 1983 12:OOAM 3951/182 $89,900 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL1 Fireplace 1 $2,700 $2,700 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area (Unfinished) BMT Basement Area (Unfinished) FTS Third Story Living Area UHS Half Story(Unfinished) (Finished) CAN Canopy FUS Second Story Living Area UST Utility Area(Unfinished) (Finished) FAT Attic Area (Finished) GAR Garage UTQ Three Quarters Story (Unfinished) FCP Carport GRIN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assess/displayparcelO8map.asp?map... 12/10/2008 MAY 3 200® TO�oF � COMMONWEALTH OF MASACHUSETTS o , EXECUTIVE OFFICE OF ENVIRONMENTAI AFFAIRS A DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET BOSTON MA 02108(617)292-3500 a -� TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Govemor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 kA Name of Owner LOU MALOOF �—�.S Address of Owner: 114 VICTORIA ST.CENTERVILLE,MA 02632 Date of Inspection: 4/20/00 Name of inspector: JOHN GRACI l am a DEP approved system inspector pursuant to Secdon 15.340 of Title 5(310 CMR 15.000) Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET,MA.02636 Telephone Number: '608-664-6813 FAX 608-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes _ Conditionally Passes _ Needs Further Evaluation y the Local Approving Authority Fails Inspector's Signature: Date:4/19/00 The System Inspector shall sub it a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection.If th 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 Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS "The inspection is based on criteria defined in Title V code 310 CMR 15.303.My findings are of how the system is performing at the time of inspection.My inspection does not imply any warranty or guarantee of the longevity of the septic system and any of its components useful life." THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING THE SYSTEM EVERY TWO YEARS FOR PROPER MAINTENANCE. revised 9/2/98 Page 1 of 111 SUBSUBSURFACE SEWAGIE a@SAL SYSTEM INSPECTION FORM 5SYSTE CER OFICATghtccontlinued� Na Proke *Ad!, ress: � STTG�bVIQL4A 02632 rIC 'UDat a e cfion: 4/1 4 0/00 SKIftARVWMWf1 SALCft*L4IV1B, C, or D: include ties to at least two permanent reference landmarks or benchmarks A. SY§)TE9&il MIANErWithin 100'(Locate where public water supply comes into house) X I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. 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. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. IlLa The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank, whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health: n1a Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health). _broken pipe(s)are replaced _obstruction is removed _distribution box is levelled or replaced nLa The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if (with approval of the Board of Health): _broken pipe(s)are replaced _obstruction is removed revised 9/2/98 Page 10 of 11 revised 9/2/98 Page 2 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) i Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4120/00 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. - X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. - X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. - X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, - X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Q. - X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. - X Any portion of a cesspool or privy is within a Zone I of a public well. - X Any portion of a cesspool or privy is within 50 feet of a private water supply well, - X 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.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No - X the system is within 400 feet of a surface drinking water supply - X the system is within 200 feet of a tributary to a surface drinking water supply - X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner: LOU MALOOF Date of Inspection: 4/20/00 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X - Pumping information was provided by the owner,occupant,or Board of Health. X - None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. _ X As built plans have been obtained and examined.Note if they are not available with N/A. X - The facility or dwelling was inspected for signs of sewage back-up. X _ The system does not receive non-sanitary or industrial waste flow. X - The site was inspected for signs of breakout. X - All system components,excluding the Soil Absorption System,have been located on the site. X - The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X - Existing information,For example,Plan at B4O,H, X - Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable)1 5.302(3)(b)] X - The facility owner(and occupants,if different from owner)were provided with Information on the proper maintenance of SubSurface Disposal Systems. revised 9/2/98 Page 5 of 11 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d./bedroom f Number of bedrooms(design): 3 Number of bedrooms(actual): Total DESIGN flow: 330 gpd Number of current residents:2 Garbage grinder(yes or no):NO Laundry(separate system)(yes or no): NO If yes,separate inspection required Laundry system inspected(yes or no): NO Seasonal use(yes or no): NO Water meter readings,if available(last two year's usage): n/a gpd Sump Pump(yes or no): NO Last date of occupancy: n/a COM MERC IAL/INDUSTRIAL Type of establishment: n/a Design flow: n/a gpd(Based on 15.203) Basis of design flow:n/a Grease trap present:(yes or no): NO Industrial Waste Holding Tank present:(yes or no): NO Non-sanitary waste discharged to the Title 5 system:(yes or no):NO Water meter readings.if available: n/a Last date of occupancy:n/a OTHER: (Describe) nla GENERAL INFORMATION PUMPING RECORDS and source of information: n/a System pumped as part of inspection:(yes or no):NO If yes,volume pumped nla gallons Reason for pumping:n/a TYPE OF SYSTEM X 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) _ I/A Technology etc.Attach copy of up to date operation and maintenance contract _ Tight Tank Copy of DEP Approval Other:n/a APPROXIMATE AGE of all components,date installed(if known)and source of Information: 1983 Sewage odors detected when arriving at the site:(yes or no): NO revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 BUILDING SEWER:X (Locate on site plan) Depth below grade: 12" Material of construction: _ cast iron _ 40 Pvc X other(explain) Distance from private water supply well or suction line: n/a Diameter: n/a Comments: (condition of joints,venting,evidence of leakage,etc.) THE SYSTEM HAS TOWN WATER. SEPTIC TANK: X (locate on site plan) Depth below grade: 6" Material of construction: X concrete_ metal_ Fiberglass_ Polyethylene_ other explain: n/a If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Age: n/a Dimensions: 1000G L 9'H 6'W 6'3"H20" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 32" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: n/a How dimensions were determined: MEASURED Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. GREASE TRAP: _ (locate on site plan) Depth below grade: n/a Material of construction: _concrete._ metal_ Fiberglass _ Polyethylene_other Explain: n/a Dimensions:Na Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle n/a Date of last pumping: n/a Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) n/a revised 9/2198 Page 7 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 TIGHT OR HOLDING TANK: _ (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: n/a Material of construction: _concrete_ metal_Fiberglass _Polyethylene _other Explain: n/a Dimensions: n/a Capacity: n/a gallons Design flow: n/a gallonsiday Alarm present: NO Alarm level:N/A Alarm in working order:NO Date of previous pumping: n/a Comments: (condition of inlet tee,condition of alarm and float switches,etc.) n/a DISTRIBUTION BOX:X (locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) THE DISTRIBUTION BOX IS STRUCTURALLY SOUND. PUMP CHAMBER: _ (locate on site plan) Pumps in working order:(Yes or No): NO Alarms in working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) n/a revised 9/2/98 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4120/00 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: n/a Type: leaching pits,number:(1)1000 GAL 6 X 6' leaching chambers,number: (n/a)n/a leaching galleries,number: (n/a)n/a leaching trenches,number,length: (n/a)n/a leaching fields,number,dimensions: (n/a)n/a overflow cesspool,number: (n/a)n/a Alternative system: n/a Name of Technology: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PITS ARE STRUCTURALLY SOUND AND APPEARS TO BE FUNCTIONING PROPERLY.THE PIT HAD X OF WATER IN IT AT THE TIME OF THE INSPECTION. CESSPOOLS: (locate on site plan) Number and configuration: n/a Depth-top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer. n/a Dimensions of cesspool: nla Materials of construction: n/a Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)NO Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Na PRIVY: (locate on site plan) Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a revised 9/2/98 Page 9 of 11 , v SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20100 SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) 7'A o � og D Ac 3e AD aq �y eic 3 q �o S° revised 9/2/98 Page 10 of 11 I , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 114 VICTORIA ST. CENTERVILLE, MA 02632 Name of Owner LOU MALOOF Date of Inspection: 4/20/00 NRCS Report name: n/a Soil Type: n/a Typical depth to groundwater: n/a USGS Date website visited: n/a Observation Wells checked: NO Groundwater depth: Shallow_ Moderate_ Deep_ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet+ Please indicate all the methods used to determine High Groundwater Elevation: _ Obtained from Design Plans on record Observed Site(Abutting property,observation hole,basement sump etc.) _ Determined from local conditions Checked with local Board of health Checked FEMA Maps Checked pumping records Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS-12+FEET revised 9/2/98 Page 11 of 11 LDCATIO SEWAGE PERMIT NO. VILLAGE Vi !��4 d &,t, I N S T A_LLER'S NAME i ADDR SS e UILDE R OR OWNER LP DATE PERMIT ISSUED DATE COMPLIANCE ISSUED t� THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH �® ............OF......... .�51'�--8--L'E Apphration for UiipngFal Vorkii Tonfitrurtiun Prrutit Application is hereby made for a Permit to Construct (>Q or Repair ( ) an Individual Sewage Disposal System at: Ii� G�blLt 45 ✓ , t_-6-T o do ddrss r r Lot 01.e------------------------------------------ .......... fA 00 --- Installer Address Type of Building Size Lot....01.PO.®....Sq. feet � Dwelling—No. of Bedrooms __...-..... -_--_--•--Expansion Attic ( ) Garbage Grinder ayp g _f-�' __ No. of persons............................ Showers (a) — Cafeteria ( )Other—T e of Building -*� __ ___.__._ Otherfixtures :................................................................................................................................................ W Design Flow...........a�___5�.......................gallons per person per day. Total daily flow..:......?: .......................gallons. WSeptic Tank—Liquid capacity/v�.4_gallons Length----6�-_!..... Width....I.`...._. Diameter................ Depth....¢`..... x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-------l_------------ Diameter.... ... Depth below inlet......6.......... Total leaching area.-`. /. . t.�•��g• Z Other Distribution box (X) Dosing tank ( ) aPercolation Test Results Z Performed by....4-A .. ,Date.&_' 7__-_a- ........ Test Pit No. 1-__._•_-_______.minutes per inch Depth of Test Pit.. `___. Depth to ground water.lt?o. .__ fT4 Test Pit No. 2................minutes per inch Depth of Test Pit..____......__...... Depth to ground water�f✓ Q+' -------------q -------- ..••.. :::_------------------------- 0 Description of soil.............-`5-�------� '--'------------✓' ��--------.yh20-f---� �O x W -------•-----------------------------------�r.-P. .--••--•- by, o�.........[.r� U Nature of Repairs or Alterations—Answer when applicable............................................................................................... --------•---------------------------------------•-----------............................................................------•••-'•'-•••---•••---'•'--•••-----••-......••-'••-'•-•-......•'-"-..... Agreement: The undersigned agrees,,to install-the aforedescribed In vid 1 Sewage Disp sal System in accordance with the provisions of iITLL 5 of the State S�rftary Co — The nd signed further ees not to place the system in operation until a Certificate of Compliance has bee sue by he rd of li It Signed..!.... S n Date Application Approved By............ A-----------_-------------- '-'--'-••••................... ............. ............ .....Date Application Disapproved for the following reasons:-----•-'-••• •••---•-•---•'-•'-•--'--•----•---------'•---"•--•--------------"'--•-•'•••"-•'---•..."'-----. ...........'-'•"'•'---'•'....----'•-----••-'•--....----""-----"-'-•---••----'-"-'-----------•---•'-----•--•-•-•--•--••••---•-----------•---•-•-••••'•••---•-----•--'-••••------•-•••-'•--..'-'-'--- --...--Date Permit No. ,3 -- �s•-�-- • Issued........... Date y • „�F FEB cfes THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................OF...... ��+2,j.►..... .... rpfiratiou for Uhipoii al Worko Tomitrurtion ramit ;.. Application is hereby made for a Permit to Construct (pQ or Repair ( ) an Individual Sewage'.Disposal System at: _ ................- ...---•_-•-• �--------------------•-•-•-•---.----- ----••......••-------- ..:°._........ . ->...................- ----•----•- - Location-Address 91 /� ddr !?- [! V : / Installer Address j U Type of Building Size Lot____-!',/.t© �...Sq. feet �-, Dwelling—No. of Bedroom _.. Expansion Attic ( ) Garbage Grinder,( ) a ---- aOther„, Type of Building _..gP(.............. No. of persons_________________________°__ Showers Cafeteria ( ) Otherfixtures: ' - '---------....................................................... Design Flow .... "_.��.........................gallons per person per day. Total daily flow gal WIons. WSeptic Tank—Liquid capacityf + gallons Length____ '�_j._._ Width.. Diameter ...Depth_._... ...... x Disposal Trench No ............... Width .... Total Length..................... Total leaching area_____ .sq. ft. 4.-. Depth below inlet....... #......rTotal''leachin �rea.i'— .s .- t:'55^J>4. � Seepage Pit No. ___l_.__.._:._ Diameter �!�� p g q.5,¢ ' Z Other Distribution box (}C) Dosing tank ( ) Percolation Test Results Performed by. 4r444 ---- �.•-- �f 4+Date.. �_ _ -??....... Test Pit No. 1----------------minutes per inch Depth of`Test Pit___ l1G�x....___ Depth to ground water.. fl: ._. , P= Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.� q.,-�!--- D17 .....................w ,rt ....._ t `f ------------- Description of Soil '.'G.`�"f� ...... � {`":------� � -= 't-------- --. U ---------------•----------......----------------- -----------•-•----------- UNature of Repairs or Alterations—Answer when applicable.....................:......................................................................... --------------------------------------------------------------------------------------------•-•....•-••---•- Agreement: 4sa The undersigned agrees to install the aforedescribed I dividual /ewage Dispm in accordance with the provisions of TITLE 5 of the State Sanitary Code— T undersig d furth a system in operation until a Certificate of Compliance has be issued b the board< g - Signed•-- J Application Approved By---•- (� � h .. -Date. \ ................U .�.e.-•-..f...-.._.' __. ✓ Date Application Disapproved for the following reasons----------=---------•------............................................................................. -------------------- Date Permit No........ --." `-- - Issued--........-••-•--•••••••-• . ................ i�__.._.._.._ :_.._-----_- Date f THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................::...........OF..................................................................................... .: Trdifiratr of Toutphattrr THIS IS TO CERTIF'Y;That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b �c.k. ------ U V/ .••-- ------. •---••-----••-•.......................... -•-•........................•--•........-- y.. w ... -✓_ �G /l'A1 f" Install"e 'tc f 0t.,#Ti!YY at....................4 5r:?� �..................0 ------.......................--•----- has been installed in accordance witli the provisions of TIT I,!�,,; 5(O —The State Sanitary Code i csib-A k the application for Disposal Works Construction Permit N�o,sa_4_ "......................::..: dated_--..___._._.-. -----------------••.--••---•-••- THE. IX)�. 1�;,3' F THIS CER'PIFI:CA>TE-SHALL NOT.:BE-CONSTRU AS:.i4 GUARANTEE-THAT-THfSYSTEM CTION SATISFACTORY.1DATE. --------------- Inspector -----•-••-•---••••. ---------------------------•-•..............•. 4 Aeq THE COMMONWEALTHy'OF:-Ivl'ASS.ACHUSETTS BOARD OF HEALTH ......:..................................OF............................................................. No...... FEE.-................. Uiiipao tl Vork.5 TDons#r iutt amit Permission is hereby granted.......................le.0..e*:"f.r...._..._. ' 14 . to Construct (_ ) of Repair ( ) -an Individual Sewage Disposal System atNo...............k sr.:...._ . rh.{Adz s ........................................ _`1ell .........._ pl. ..... as shown on the application for.Disposal Works Construction Permit No.. ................ Dated.......................... ,-:_ :........ Board of Hea#h. DATE..................................................................=W---•-....... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS _ T<7t? GF FOUnJD. D� ST, /l4 - C� E '' i 4• 00 c3o x 5-7 0 AJ �o t /U¢, 06 , ic. c7 TE- G -T- EXTE->UD ALL APPLJGABLE - - - ---- e xrstin ground ,oro�r ;'e 9 /O - S C-- / �J/ -- -- V E )2 T SCALE- /O' iNOL E GOVE,QS To !nl/TN/l-J o,e�z s c A L E I --- _ O / P.-oPoscd 9rbund Profs /e E©UHL `r'L7 SEPTJC Cmrnrrr►urn �" PE►r foo-f'� 2 O� �Q - �2•• waSf�Bc� S-><'one -7 ��TF nlK-• JAlE- JILIrr 1AJ, o 0 D/sT BOX ° /000 GHL. SEPT/C Tf}ti✓K c,.�czs/-+cd S�'one ° ° ° ° °° ° a G ° O r- . a D�2 f-I0 E— DATE : t3 ' /7=83 TEST E3Y: GUl�1 G✓EC.GEe2` /�.IGr ->E .2C A'ATE < Z L �� f= ;ram 07Zo _ .. ��fa/4}'' Z:) 1 � \ Z5 �P%!` —7 /9A ,� 7- OS3A T& ST LE7 #� j " (�S� loots C�AL. 7-,19.VA:� � r� G r J � \ �- -_ _ :''- _'a s i� .� _ •fir'��.P G. 'o n , tv r n r I s�AJ z� 2 /Oct. OT Ajo rfZo i t✓ ► \ / cE�TiFY T/-lF ' tip E3C.) G F',20PO5E-D oA./ Tr-lE G2C7CinJL'> r9S SSE 47 AJ s l o w Ai n nJ -r-/-a E s o T 45 t GONF0,2M TO -rA4,t_ BU/` D/A/G V/GTLD,2 T BfaCk- )EQCJ//2E/`-IEAJTS OF- TNE- �26-: CED FoAe: ' S C ALE : A S S N G!nJ nJ 7 is: A U G :J 5 '-_- wo . I� Ali -- .� A? E fG ": Ar Uo] 1 i p HINT 0 4 Oo ex /S-t/ nq elevatJon BLDG S�TB /9C,L `�` Yfq /`-70C/ 7-f � 0 0 0 = p�oPc�sed e /e vatJon QEQU/,2E- T'S c0/-7 rs SJ de /o �9PPQ© vF_ D : __- _ 4 Corn-fo f-S 0 B oFt oc- NEA(_ TH ALL SYSTE SHALL SYSTEM PROFILE MARKED WITHCMAGNETICTTAPE OR BE NOTES NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. APPROXIMATE NGVD e Lane e P°nds ( 1. DATUM IS ace o� Three ACCESS COVERS TO WITHIN 6" OF FIN. GRADE PROVIDE INSPECTION PORT TO WITHIN 3" OF FINAL GRADE 2. MUNICIPAL WATER IS EXISTING \ TOP FOUND. EL. 61.1' �o 59.0' MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE RE RED OVER SYSTEM 59.0' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. 4. DESIGN LOADING FOR ALL PROPOSED PRECAST Rs�wJ� UNITS TO BE AASHO H-1Q Z r° 2'0 ' 4"OSCH40 PVC 4'SCH40 PVC 8.5 f 2" DOUBLE WASHED E'EASTONE 5. PIPE JOINTS TO BE MADE WATERTIGHT. D �o LPIPES LEVEL 1ST 2' I I o OR GEOTEXTILE FABRIC a *EXISTING *"EXISTING 1000 GAL 57.26' 1 p" SEPTIC TANK 14" 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE '~ EXISTING " TEE TEE WITH 310 CMR 15.000 (TITLE V.) �o Locus 7.1 f ° ° 000 o� °O°O°°°°°°° 0 56.76 0 2.8' AT SIDES 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND I t c GAS BAFFLE::: �°�°,°,°°°°°O° J ( J _ NOT TO BE USED FOR LOT LINE STAKING OR ANY ge 56.94' 56.77' go 2 0.8' AT ENDS o OTHER PURPOSE. 54.76' 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. DEPTH OF FLOW = 4' 9. COMPONENTS NOT TO BE BACKFILLED OR TEE SIZES: 6" CRUSHED STONE OR MECHANICAL 3/4" TO 1 1/2" DOUBLE WASHED STONE CONCEALED WITHOUT INSPECTION BY BOARD OF = 10„ COMPACTION. (15.221 [2]) HEALTH AND PERMISSION OBTAINED FROM BOARD INLET DEPTH N OF HEALTH. OUTLET DEPTH = 1 4" 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING DIGSAFE (1-888-344-7233) AND LOCUS MAP VERIFYING THE LOCATION OF ALL UNDERGROUND & ( 1 % SLOPE) ( 1 % SLOPE) 48.5' BOTTOM TH-1 OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF SCALE 1"=2000'f NO GROUNDWATER FOUND WORK. FOUNDATION-EXISTING SEPTIC TANK 16' D' BOX 2' LEACHING 11. ANY UNSUITABLE MATERIAL ENCOUNTERED ASSESSORS MAP 148 PARCEL 74 FACILITY SHALL BE REMOVED 5' BENEATH AND AROUND THE *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **THE INSTALLER SHALL CONFIRM MIN. PROPOSED LEACHING FACILITY. LOCUS IS WITHIN FEMA FLOOD ZONE "C" UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS SEPTIC TANK SIZE AT 1000 GALLONS 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AS SHOWN ON COMMUNITY PANEL #25001 0015 C PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM AND ITS SUITABILITY FOR RE-USE AND REMOVED OR PUMPED AND FILLED WITH CLEAN DATED AUGUST 19, 1985 SAND. LOCUS IS WITHIN GP OVERLAY DISTRICT AND LEGEND ESTUARINE WATERSHED PROTECTION DISTRICT DRAIN -- 99-- EXISTING CONTOUR g� \ EASE. X 99.1 EXIST. SPOT ELEV. �O �� bo 99 PROPOSED CONTOUR JAG SYSTEM DESIGN: 198.41 PROPOSED SPOT EL. Gp�� GARBAGE DISPOSER IS NOT ALLOWED TEST HOLE \ z� SLOPE OF GROUND DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD 41 USE A 330 GPD DESIGN FLOW Q� UTILITY POLE p� GAS FIRE HYDRANT O 60 �� ETFR \ � SEPTIC TANK: 330 GPD (2) = 660 NOTE: NOT a1 TOA30LS MAY APPEAR IN MINING w\ _ **RE-USE EXISTING 1000 GAL. SEPTIC TANK UTILITY CLUSTER ELEC. PAD LEACHING: TEST HOLE LOGS CATV, TEL RISERS \ P VED � SIDES: 2 (30 + 10) 2 (.74) = 118 GPD G� c, T Gv LTE�. RIVE a `� Q � BOTTOM 30 x 10 (.74) = 222 GPD ENGINEER: DAVID FLAHERTY, R.S., SE2755 \ DAVE STANTON, R.S. EXISTING 3 BR BENCHMARK TOTAL: 460 S.F. 340 GPD DWELLING COR. CON. BLKHD WITNESS: ELEV. = 59.9' DECEMBER 24, 2008 \ TOP FNDN. = 61.1' USE (4) STANDARD "3050" INFILTRATORS DATE: _ GARAGE WITH 0.8 STONE AT ENDS AND 2.8 AT SIDES PERC. RATE < 2 MIN/INCH CLASS I SOILS P# 12444 _ ' -� 0 TH-2 1 ` MA ELEV. ELEV. \ \ 4 DECK V APPROVED DATE BOARD OF HEALTH opt 59.5' o„ `\j� 59.5' s A A � TH-, LS LS t LP IT) c5` 10YR 3/1 10YR 3/1 �-' BIRD � 6" 8" 1 LOT 45 (� BATH TITLE 5 SITE PLAN B B ho' QD _� of LS LS 10YR 4/6 10YR 4/6 NS 114 VICTORIA ST. 26" 57.3' 25" 57.4' (CENTERVILLE) BARNSTABLE, MA ® PREPARED FOR �P C C BORTOLOTTI CONSTRJ PERC oh. ALFRED & ANNE CORRIERI MCS MCS SWIN DATE: DECEMBER 24, 2008 SE ' \ �LTNOFMgSS off 508-362-4541 I fax 508-362-9880 2.5Y 6/4 2.5Y 6/4 5% GRAVEL 5% GRAVEL ��SNOFMgs9 ems` q° downcape.com � s° �o DANIEL y�N DANIELA. yGs o A. dOWn cope engineering, Inc. z OJALA �, " OJALA CD IL N No.40980 civil engineers 132" 48.5' 120" 1 49.5' P No.465 Q o Fs \o ` land surveyors 411 NO GROUNDWATER ENCOUNTERED Scale: 1"= 20' l2_2 _ G� °IFS c�sTE��.� q u NJ 939 Main Street ( Rte 6A) YARMOUTHPORT MA 02675 o �c 20 �o �0 5o FEET DATE DANIEL A. OJALA, P.E., P.L.S. DCE #08-2�98 08-298 BORTOLOTTI_CORRIERI.DWG (DDF)